Coronary artery disease (CAD) occurs when plaque builds up in the coronary arteries, reducing blood flow to the heart. It is the most common type of heart disease and leading cause of death in the US. CAD develops over many decades as risk factors like smoking, high cholesterol and blood pressure, and diabetes damage artery walls. It can cause chest pain, shortness of breath, heart attack, or heart failure if left untreated. Diagnosis involves tests like ECGs, stress tests and angiograms. Treatment focuses on lifestyle changes, medications, and procedures like stents or bypass surgery to improve blood flow.