Coronary artery disease develops when the major blood vessels that supply your heart become damaged or diseased. Cholesterol-containing deposits (plaques) in your coronary arteries and inflammation are usually to blame for coronary artery disease.
The coronary arteries supply blood, oxygen and nutrients to your heart. A buildup of plaque can narrow these arteries, decreasing blood flow to your heart. Eventually, the reduced blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.
Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But you can take steps to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.
If your coronary arteries narrow, they can't supply enough oxygen-rich blood to your heart — especially when it's beating hard, such as during exercise. At first, the decreased blood flow may not cause any symptoms. As plaque continues to build up in your coronary arteries, however, you may develop the following coronary artery disease signs and symptoms:

Women are somewhat more likely than men are to have less typical signs and symptoms of a heart attack, such as neck or jaw pain. And they may have other symptoms such as shortness of breath, fatigue and nausea.
Sometimes a heart attack occurs without any apparent signs or symptoms.
When to see a doctor
If you think you're having a heart attack, immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last option.
If you have risk factors for coronary artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, obesity a strong family history of heart disease — talk to your doctor. Your doctor may want to test you for coronary artery disease, especially if you have signs or symptoms of narrowed arteries.
Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including:

Once the inner wall of an artery is damaged, fatty deposits (plaque) made of cholesterol and other cellular waste products tend to collect at the site of injury. This process is called atherosclerosis. If the plaque surface breaks or ruptures, blood cells called platelets clump together at the site to try to repair the artery. This clump can block the artery, leading to a heart attack.
Risk factors
Risk factors for coronary artery disease include:

Risk factors often occur together and one may trigger another. For instance, obesity can lead to type 2 diabetes and high blood pressure. When grouped together, certain risk factors make you even more likely to develop coronary artery disease. For example, metabolic syndrome — a cluster of conditions that includes high blood pressure; high triglycerides; low HDL, or "good," cholesterol; high insulin levels and excess body fat around the waist — increases the risk of coronary artery disease.
Sometimes coronary artery disease develops without any classic risk factors. Researchers are studying other possible risk factors, including:

Coronary artery disease can lead to:

The same lifestyle habits used to help treat coronary artery disease can also help prevent it. A healthy lifestyle can help keep your arteries strong and clear of plaque. To improve your heart health, follow these tips:

The doctor will ask questions about your medical history, do a physical exam and order routine blood tests. He or she may suggest one or more diagnostic tests as well, including:

A CT coronary angiogram, in which you receive a contrast dye that is given by IV during a CT scan, can produce detailed images of your heart arteries.

Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.
Lifestyle changes
Making a commitment to the following healthy lifestyle changes can go a long way toward promoting healthier arteries:

Various drugs can be used to treat coronary artery disease, including:

If you've had a heart attack, aspirin can help prevent future attacks. But aspirin can be dangerous if you have a bleeding disorder or you're already taking another blood thinner, so ask your doctor before taking it.

Procedures to restore and improve blood flow
Sometimes more aggressive treatment is needed. Here are some options:
Angioplasty and stent placement (percutaneous coronary revascularization)
Your doctor inserts a long, thin tube (catheter) into the narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls.
A stent is often left in the artery to help keep the artery open. Most stents slowly release medication to help keep the arteries open.
Coronary artery bypass surgery
A surgeon creates a graft to bypass blocked coronary arteries using a vessel from another part of your body. This allows blood to flow around the blocked or narrowed coronary artery. Because this requires open-heart surgery, it's most often reserved for people who have multiple narrowed coronary arteries.
Lifestyle and home remedies
Lifestyle changes can help you prevent or slow the progression of coronary artery disease.

Regular medical checkups are also important. Some of the main risk factors for coronary artery disease — high cholesterol, high blood pressure and diabetes — have no symptoms in the early stages. Early detection and treatment can help you maintain better heart health.
Alternative medicine
Omega-3 fatty acids are a type of unsaturated fatty acid that's thought to reduce inflammation throughout the body, a contributing factor to coronary artery disease. However, some studies haven't found a benefit. More research is needed.

Other supplements may help reduce your blood pressure or cholesterol level, two contributing factors to coronary artery disease. These include:

Always talk to your doctor before adding a new over-the-counter medication or supplement to your treatment plan. Some drugs and supplements can interfere with other medications and cause side effects or make them less effective.
Preparing for your appointment
If you know you have symptoms of or risk factors for coronary artery disease, you're likely to see your primary care doctor. Eventually, you may be referred to a heart specialist (cardiologist).
Here's some information to help you get ready for your appointment and to know what to expect from your doctor.
What you can do

Questions to ask your doctor at your initial appointment include:

Questions to ask if you are referred to a cardiologist include:

Don't hesitate to ask additional questions about your condition.
What to expect from your doctor
A doctor or cardiologist who sees you for heart-related signs and symptoms may ask:

What you can do in the meantime
It's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and getting more exercise. These habits protect against coronary artery disease and its complications, including heart attack and stroke.

Our Experts