Coronary artery disease (CAD) is the most common type of heart disease, caused by plaque buildup in heart arteries that reduces blood flow, often leading to heart attacks. Symptoms include stable and unstable angina, and diagnosis typically involves tests like ECG and angiography. Prevention strategies focus on lifestyle changes such as exercise, diet, and medication to manage risk factors like obesity and hypertension.

1. CORONARY ARTERY
DISEASE (CAD)
By- Dr. Armaan Singh

2. Coronary artery disease (CAD) also known
as atherosclerotic heart disease, atherosclerotic
cardiovascular disease, coronary heart disease,
or ischemic heart disease (IHD),is the most common type
of heart disease and cause of heart attacks. The disease is
caused by plaque building up along the inner walls of
the arteries of the heart, which narrows the lumen of arteries
and reduces blood flow to the heart.
While the symptoms and signs of coronary artery disease are
noted in the advanced state of disease, most individuals with
coronary artery disease show no evidence of disease for
decades as the disease progresses before the first onset of
symptoms, often a "sudden" heart attack, finally arises.
Symptoms of stable ischaemic heart disease
include angina(characteristic chest pain on exertion) and
decreased exercise tolerance.

3. Signs and symptoms
• Angina (chest pain) that occurs regularly with activity, after
heavy meals, or at other predictable times is termed stable
angina and is associated with high gradenarrowings of
the heart arteries. The symptoms of angina are often treated
with betablocker therapy such as metoprolol or atenolol.
Nitrate preparations such asnitroglycerin, which come in short-
acting and long-acting forms, are also effective in relieving
symptoms but are not known to reduce the chances of future
heart attacks. Many other more effective treatments, especially
of the underlying atheromatous disease, have been
developed.
• Angina that changes in intensity, character or frequency is
termed unstable. Unstable angina may precede myocardial
infarction. In adults who go to the emergency with an unclear
cause of pain, about 30% have pain due to coronary artery
disease.

4. INVESTIGATIONS:-
• Baseline electrocardiography (ECG)
• Exercise ECG – Stress test, Exercise radioisotope test
(nuclear stress test.
• Myocardial scintigraphy), Echocardiography (including
stress echocardiography)
• Coronary angiography.
• Intravascular ultrasound.
• Magnetic resonance imaging (MRI)The diagnosis of
coronary disease underlying particular symptoms
depends largely on the nature of the symptoms.
• The first investigation is
an electrocardiogram (ECG/EKG), both for "stable" angina
and acute coronary syndrome. An X-ray of the
chest and blood tests may be performed.

5. PREVENTION INVOLVES:
• EXERCISE.
• DECREASING OBESITY.
• TREATING HYPERTENSION.
• A HEALTHY DIET.
• DECREASING CHOLESTEROL LEVELS.
AND STOPPING SMOKING.
• MEDICATIONS AND EXERCISE ARE ROUGHLY
EQUALLY EFFECTIVE.

6. PREVENTION INVOLVES:
• EXERCISE.
• DECREASING OBESITY.
• TREATING HYPERTENSION.
• A HEALTHY DIET.
• DECREASING CHOLESTEROL LEVELS.
AND STOPPING SMOKING.
• MEDICATIONS AND EXERCISE ARE ROUGHLY
EQUALLY EFFECTIVE.