Understanding Coronary Artery Disease (CAD)
Approximately 20.5 million U.S. adults have CAD1
CAD is a common type of heart disease that happens when the arteries that supply blood to the heart become narrowed or blocked. It is typically caused by a condition called atherosclerosis, which is the buildup of cholesterol, fat, and plaque on the inside of the heart arteries2. This buildup restricts blood flow to the heart and reduces the heart’s ability to function properly.
CAD: What can put you at risk
Several factors can increase your risk of developing CAD, including3:
- High blood pressure
- High cholesterol
- Smoking
- Diabetes
- Obesity
- Family history of heart disease
- Sedentary lifestyle
- Unhealthy diet
The signs and symptoms of CAD
There are several symptoms of CAD – you may experience some or all of the following:
- Chest pain (angina) – Have you experienced a heaviness, tightness, pressure, aching, burning, numbness, fullness, squeezing, or a dull ache during or after physical exertion? The pain may radiate to the shoulder, arm, neck, back, or jaw4.
- Shortness of breath – Do you have trouble catching your breath when doing regular activities or laying down4?
- Fatigue – Do you constantly feel tired or weak4?
- Pain, numbness, or weakness in arms or legs – Are you having unusual feelings in your limbs5?
- Nausea or indigestion – Do you feel sick to your stomach or feel like you have heartburn5?
- Swelling (edema) – This is swelling in the legs, ankles, feet, stomach and neck6.
- Coughing – A persistent, unexplained cough could be a sign that fluid is building up in your lungs7.
- Reduced or low ejection fraction (EF) – EF is the measurement of blood your heart pumps with each beat. An EF below 50% is considered Low EF; normal EF is 50-70%8.
Women & CAD: It’s not selfish to put your health first – it’s critical
Women suffering from CAD may experience different or additional symptoms than men. And because these symptoms are different, women often dismiss their CAD symptoms simply as signs of stress, common illnesses, being out of shape, or getting older. It’s a big reason why heart disease is the #1 killer of women. Here’s what to look for:
- Sleep problems – Do you have trouble falling asleep and/or staying asleep9?
- Pain in the jaw, throat, or neck – This can be a sign of reduced blood flow to the heart9.
- Nausea, vomiting, and abdominal pain – Indigestion can be an often-overlooked symptom of CAD9.
- Shortness of breath – Do you have trouble catching your breath when doing regular activities or laying down9?
- Swelling (edema) – In the legs, ankles, feet, stomach and neck6.
- Coughing – A persistent, unexplained cough could be a sign that fluid is building up in your lungs7.
- Fatigue – Do you constantly feel tired or weak4?
- Reduced or low ejection fraction (EF) – EF is the measurement of blood your heart pumps with each beat. An EF below 50% is considered Low EF; normal EF is 50-70%10.
- Angina (chest pain) - Have you experienced a heaviness, tightness, pressure, aching, burning, numbness, fullness, squeezing or a dull ache? The pain may radiate to the shoulder, arm, neck, back or jaw4.
If you have one or more of the symptoms, you should speak with your primary care physician or cardiologist.
How is CAD diagnosed?
When diagnosing heart failure or CAD, your physician will take into consideration your medical history, physical examination, family history of heart conditions, and diagnostic test results. Testing could include an electrocardiogram (ECG or EKG), stress test, coronary angiography, cardiac CT scan, or an echocardiogram.
A range of treatment options
If you are diagnosed with CAD, your physician may recommend a variety of treatment options depending on the severity of your condition. The goal is to reduce your risk of complications, improve your overall heart health, and relieve your CAD-related symptoms, which may include chest pain, fatigue, and shortness of breath. Treatment may include:
Lifestyle changes
Adjustments to your daily life can greatly improve your heart health: eating healthier with a focus on heart-healthy foods, exercising regularly and quitting smoking.11
Medications
There are a range of medication types that can improve your heart health, including statins, blood thinners, beta-blockers, ACE inhibitors.11
Surgery
Your doctor may recommend a surgical procedure to help restore blood flow to the heart.11
Interventional procedures
Your doctor may suggest a minimally invasive percutaneous coronary intervention (PCI) stenting to restore heart blood flow. For high-risk patients, Impella CP® with SmartAssist® might be used during the procedure12,13
What is Protected PCI with Impella CP?
Protected PCI, or protected stenting, with Impella CP is a widely accepted procedure in which Impella CP, is used to temporarily assist the pumping function of the heart while the interventional cardiologist performs the stenting procedure.
Studies have shown that possible benefits of this minimally invasive procedure are:
Reduction in symptoms and class of heart failure12,13
Improved left ventricular ejection fraction12
Reduction in the number of days in the hospital14
Reduction in readmissions due to fewer repeat procedures12
Enabled a more complete revascularization12,13
Could Impella be right for you?
How you can prevent CAD
Simple lifestyle changes can have a big impact on your risk of developing CAD. Here are some heart-health recommendations:
- Eat Well - Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins such as chicken and fish. Limit foods that are high in saturated fats, such as red meat, and ultra-processed foods, like fast food15.
- Exercise Regularly - Every little bit counts. Exercise with a friend or join an adult sports league to keep it fun15.
- Skip the Bad Stuff - Don’t smoke and limit alcohol, as these substances can cause increased stress on the heart15.
- Manage Stress - Meditation, daily exercise, and simply being around people you love can help reduce stress16.
- See Your Doctor - Work with your physician to control conditions that could contribute to CAD, such as high blood pressure, high cholesterol, and diabetes17.
- Watch Your Weight - Maintain a healthy weight to reduce stress on your heart. See the chart below for guidance18.
What is considered a healthy weight for your height? Here’s a guide.
While not always the case, individuals who maintain a healthy height-to-weight ratio can be less likely to be diagnosed with heart failure or CAD. Working towards and maintaining a healthy ratio could help reduce your chances of these heart conditions.19
References
Centers for Disease Control and Prevention. Cardiovascular disease indicator definitions. CDC. https://www.cdc.gov/cdi/indicator-definitions/cardiovascular-disease.html#:~:text=Approximately%2020.5%20million%20adults%20aged%20%E2%89%A520%20years%20have%20CHD
Mayo Clinic. Coronary artery disease symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613#:~:text=A%20buildup%20of%20fats%2C%20cholesterol%20and%20other%20substances%20in%20and%20on%20the%20artery%20walls%2C%20a%20condition%20called%20atherosclerosis%2C%20usually%20causes%20coronary%20artery%20disease.
National Center for Biotechnology Information. (2017). There are many risk factors for coronary artery disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC5686931/#:~:text=There%20are%20many,history%3B%20and%20race.
Mayo Clinic. Coronary artery disease symptoms and causes. https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613#:~:text=Chest%20pain%2C%20called,feel%20unusually%20tired
Mount Sinai Health System. What is coronary artery disease? Mount Sinai. https://www.mountsinai.org/care/heart/services/coronary-disease/what-is#:~:text=Signs%20and%20Symptoms,Indigestion%2C%20nausea%2C%20vomiting
University of Michigan Health. Coronary artery disease (CAD). University of Michigan. https://medicine.umich.edu/dept/cardiac-surgery/patient-information/adult-cardiac-surgery/adult-conditions-treatments/coronary-artery-disease-cad#:~:text=Heart%20failure%20also%20can%20cause%20swelling%20in%20your%20feet%2C%20ankles%2C%20legs%20and%20abdomen
Cleveland Clinic. Persistent cough: It may be a sign of heart failure. Cleveland Clinic. https://health.clevelandclinic.org/persistent-cough-it-may-be-a-sign-of-heart-failure#:~:text=In%20heart%20failure%2C%20your%20heart%20muscle%20has%20dysfunction%20that%20might%20be%20due%20to%20weak%20contraction%20or%20stiffness.%20This%20can%20allow%20fluid%20to%20back%20up%20in%20your%20lungs%2C%20creating%20a%20condition%20called%20pulmonary%20edema.%20Your%20body%20coughs%20persistently%20in%20an%20effort%20to%20eliminate%20the%20excess%20fluid.
American Heart Association. Ejection fraction: Heart failure measurement. https://www.heart.org/en/health-topics/heart-failure/diagnosing-heart-failure/ejection-fraction-heart-failure-measurement#:~:text=An%20EF%20from%2041%20to%2049%20percent%20might%20be%20considered%20too%20low
National Heart, Lung, and Blood Institute. Coronary heart disease in women. https://www.nhlbi.nih.gov/health/coronary-heart-disease/women#:~:text=Mental%20stress%20is,lack%20of%20energy
University of Rochester Medical Center. Heart failure with reduced ejection fraction. University of Rochester Medical Center. Retrieved January 28, 2025, from https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=56&contentid=DM14#:~:text=EFs%20between%2050%25%20and%2070%25%20are%20considered%20normal%20for%20the%20left%20ventricle.%20An%20EF%20under%20or%20equal%20to%2040%25%20means%20the%20muscle
Centers for Disease Control and Prevention. Coronary artery disease (CAD): Symptoms and causes. CDC. https://www.cdc.gov/heart-disease/about/coronary-artery-disease.html#cdc_disease_basics_treatment-treatment-and-recovery
Wollmuth, J., et al. (2022). Cardiac interventions for heart disease. Journal of the Society for Cardiovascular Angiography and Interventions, 1(5), 100350–100350. https://doi.org/10.1016/j.jscai.2022.100350
O’Neill, E., et al. (2022). Cardiovascular health and interventions. American Heart Journal, 248, 139–149. https://doi.org/10.1016/j.ahj.2022.02.006
Lansky, A. J., Spertus, J. A., & Weber, J. (2022). Cardiovascular outcomes following transcatheter aortic valve replacement: A review of current evidence. The American Journal of Cardiology, 169, 1-9. https://doi.org/10.1016/j.amjcard.2022.08.032
Cleveland Clinic. Coronary artery disease: Symptoms and causes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease#:~:text=Lifestyle%20changes%20play,Limit%20alcohol.
National Center for Biotechnology Information. (2020). Behavioral interventions such as mindfulness-based stress reduction.[PMC article]. https://pmc.ncbi.nlm.nih.gov/articles/PMC10843306/#:~:text=Behavioral%20interventions%20such%20as%20mindfulness%2Dbased%20stress%20reduction
Aurora Health Care. Coronary artery disease prevention. https://www.aurorahealthcare.org/services/heart-vascular/conditions/coronary-artery-disease/prevention#:~:text=Monitor%20your%20heart,of%20developing%20CAD.
Aurora Health Care. Coronary artery disease prevention. https://www.aurorahealthcare.org/services/heart-vascular/conditions/coronary-artery-disease/prevention#:~:text=Maintain%20a%20healthy,a%20healthy%20weight.
National Heart, Lung, and Blood Institute. Body mass index tables. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_tbl.htm
IMP-6269