Coronary Artery Disease
Sutter Heart & Vascular Institute

What is coronary artery disease?

When the arteries that carry blood to the heart become blocked or weakened, they cannot deliver sufficient blood to the heart, resulting in coronary artery disease (CAD). Sutter Heart & Vascular Institute is a leading regional center for diagnosis and treatment of coronary artery disease, providing advanced diagnostic testing, treatment through medication, interventional catheterization, and cardiovascular surgery to more than 4,000 patients each year.

What are the warning signs and symptoms of coronary artery disease?

Angina (also referred to as chest pain) is a warning sign of coronary artery disease. Do not ignore this symptom, as it is often a sign of an impending heart attack. If you or someone you know is experiencing angina, immediately call 9-1-1 to get to an emergency room immediately.

It is important to understand that men and women experience angina differently. These differences are described below:

Men typically experience the following common warning signs of a heart attack:

• Severe to moderate chest pain
• Dizziness
• Shortness of breath
• Nausea
• Radiating pain in the arms and chest

Women may have symptoms that differ greatly from men. While chest pain is often a key warning sign of a heart attack, some women who have a heart attack do not experience chest pain. A woman's pain may be in the back, arm, neck, shoulder, and/or throat. Also, women will typically have more "non-pain" symptoms than men. These include vomiting, nausea, fatigue and shortness of breath.

It is also surprisingly common for people to experience no symptoms at all. This is especially true of diabetics and those over the age of 75. We recommend that these individuals visit their family physician and/or cardiologist on a regular basis to continually monitor their health.

How is coronary artery disease detected?

Usually doctors suspect that you may have cardiovascular disease based on your cardiovascular risk factors. During a physical exam, your doctor will evaluate many of these risks, which include diabetes, high blood pressure, high blood cholesterol, previous family history, history of smoking, etc.

We invite you to take our free online cardiovascular risk assessment at any time to evaluate your cardiovascular health. It only takes about ten minutes, and your results are generated immediately. Please print and bring these results to your next physician visit.

In addition to evaluating your risk factors, there are also noninvasive imaging techniques available to detect coronary artery disease at its earliest stage. Young or old, it is extremely important to be aware of coronary artery disease. It is a progressive disease that can lead to death or heart failure. There are many treatment options which can slow the progression or in some cases reverse the effects of the disease.

The non-invasive and catheterization technique available to detect coronary artery disease are listed below (catheterization technique is noted with an *):

• Electrocardiography (EKG)
• Treadmill
• Stress Testing
• Echocardiography (Ultrasound)
• Nuclear Studies
• Magnetic Resonance Imaging (MRI)
• Electron Beam Computed Tomography (EBCT) Scan
• Diagnostic Coronary Catheterization*

What are the treatment options for coronary artery disease?

The safest, simplest treatment for coronary artery disease is lifestyle change. Evaluate your modifiable cardiovascular risks - high blood pressure, high blood cholesterol, smoking, exercise, diet, weight, etc. - and work to reduce the damaging effects of each risk factor. If you smoke - stop smoking, if you do not exercise - develop an exercise regimen, if you have high blood pressure - devise a plan with your physician to reduce your blood pressure level - and so on.

As coronary artery disease progresses, medications, interventional catheterizations, or cardiovascular surgery may be required. Your doctor will work with you to devise a plan that is best suited for you.

Medications

There are thousands of medications available to treat coronary artery disease. The most common medications prescribed are blood pressure lowering medications, cholesterol lowering drugs, and anticoagulants (blood thinning) medications.

Procedures

To rid the arteries of atherosclerosis (plaque buildup), which prevents oxygen-rich blood from reaching the heart muscle, it is often necessary to treat plaque with invasive surgical techniques. Depending upon the degree of coronary artery disease, there are two methods to treat plaque build-up: 1) Catheter Interventions and 2) Surgery

Catheter Interventions are less invasive alternatives to surgery and thousands of them are done at Sutter each year. They generally require less hospitalization and recuperation time. The following are a list of interventional procedures offered at Sutter Heart & Vascular Institute:

• Balloon Angioplasty
• Coronary Stenting
• Drug-Eluting Stenting
• Intracoronary Ultrasound
• Atherectomy

If needed, your doctor may refer you to a cardiovascular surgeon for coronary artery bypass surgery (CABG). This is more invasive than any of the procedures listed above, but it is extremely safe and reliable. Sutter performs over 800 bypass surgeries every year, and its mortality and complication rates are among the best in the United States.