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Coronary artery disease and heart attacks

  • Fatty deposits can form and harden in the arteries of your heart. This material, or plaque, narrows the arteries in a process called atherosclerosis which can restrict blood flow to your heart. The more plaque in your arteries, the greater your risk for a heart attack or heart symptoms.

    There are two types of plaque:

    • non-obstructive: Plaque that cracks can cause a clot to form within a coronary artery. The clot can stop blood flow to your heart, leading to heart attack or heart damage. This form of plaque is the most likely to cause a heart attack.
    • obstructive: Plaque can continue to build up slowly over time, reducing blood flow to your heart. When this happens, you may feel chest pains when you are physically active. Obstructive plaque does not always cause chest pain.

    There are several problems that could develop with your heart. The following are some common heart problems.

    Coronary artery disease (CAD)

    If the arteries to your heart become narrow, you probably have coronary artery disease (CAD). This narrowing is caused by atherosclerosis (fatty deposits inside your arteries), a spasm or a blood clot. This makes it difficult for the blood to get to the heart and give it oxygen to work. Coronary artery disease can cause angina or a heart attack


    Angina is chest pain or discomfort when your artery becomes narrowed.

    Angina is a discomfort or pain caused by temporary decrease in the amount of blood to an area of the heart. It occurs when the blood vessels are unable to deliver enough oxygen to meet the heart muscle's need for oxygen. This lack of oxygen is called ischemia.

    A heart attack may occur when a coronary artery is totally blocked. You may feel the same kind of discomfort as angina but it doesn't go away after 15 minutes or with nitroglycerin. Because a part of your heart muscle is not getting oxygen during a heart attack, that part of the muscle may be permanently damaged. This is called a myocardial (heart muscle) infarction (tissue death)

    The term "acute coronary syndrome" refers to unstable angina (chest pains) and to acute myocardial infarction (heart attack).


    Heart attack happens when an artery becomes blocked with plaque or a clot. When blood cannot flow to the heart, damage or death to the heart muscle may occur. This is a life-threatening situation.

    Both angina and heart attack may feel the same.

    With angina and a heart attack you may feel:

    • tightening, pressure, squeezing or aching in your chest or arms
    • a feeling of indigestion
    • a feeling of fullness
    • a sharp, burning or cramping pain
    • aching, weakness or numbness that begins in or spreads to your neck, jaw, throat, teeth, back, shoulder or arms
    • discomfort in your neck or upper back, particularly between your shoulder blades
    • trouble breathing
    • nausea (upset stomach) or vomiting (throwing up)
    • cold sweats
    • paleness
    • generalized weakness or severe fatigue (tiredness)
    • anxiety


    Quick treatment in a hospital emergency room, especially within the first hour after an attack, reduces heart muscle damage and increases the odds of survival.

    What to do if angina or heart attack occurs

    If you feel symptoms of angina, follow these steps unless your health care provider has given you other instructions:

    • Take one nitroglycerin tablet or use one nitroglycerin spray.
    • Sit for five minutes.
    • If the angina goes away, rest for a while, then continue your normal routine.
    • If the angina does not go away or gets worse, call 911 right away. Do not delay. Do not drive yourself to a hospital emergency room or urgent care.

    After calling 911, the American Heart Association recommends taking an aspirin as soon as the warning signs of a heart attack occur. Research shows that if you take aspirin as soon as you feel heart attack symptoms (and get medical help) your chances of survival can significantly improve.

    Do not take aspirin if you have an allergy to aspirin.

    Did you know?

    • One in four women dies from heart disease.
    • About six million American women have heart disease.
    • About three million American women have had a heart attack.
    • Two-thirds of American women who have had a heart attack don't make a full recovery.
    • Nearly two-thirds of American women who die suddenly of a heart attack had no symptoms.

    (Source: National Heart, Lung, and Blood Institute)

    Special information for women

    Heart disease is the No. 1 killer of women in the U.S. The most common heart attack symptom for women, as with men, is chest pain or discomfort. But there are differences in how women and men respond to a heart attack. Women are less likely than men to believe they are having a heart attack and more likely to delay in getting emergency treatment.

    Women's heart attack warning signs include:

    • chest pain or discomfort
    • pain or discomfort in other areas of the upper body, such as the arms, back, neck, jaw, stomach, midchest, shoulders, elbows or fingers
    • shortness of breath, lightheadedness, unusual fatigue (tiredness), breaking out in a cold sweat, nausea, loss of appetite and indigestion

    If you are not sure about what you are feeling or have questions about how you are feeling:

    • Stop whatever you are doing right away.
    • Call your clinic and ask to talk to a doctor or nurse.

    Do not try to deny, dismiss or make excuses for early warning signs. Call 911 right away if the signs get worse when you walk around or if the signs do not get better when you rest.

  • Heart disease and your risks

    You can help your heart and your health by managing your risk factors and living a healthy lifestyle. Risk factors are behaviors, habits or conditions that can put your heart at a high risk for problems.

    There are two types of risk factors: those you can control and those you cannot.

    Risk factors you can control

    expand to learn moreTobacco use

    expand to learn moreHigh blood pressure

    expand to learn moreHigh blood cholesterol

    expand to learn moreLack of exercise

    expand to learn moreWeight

    expand to learn moreDiabetes

    expand to learn moreAlcohol

    expand to learn moreStress

  • Risk factors you cannot control

    expand to learn moreAge

    expand to learn moreGender

    expand to learn moreFamily history

  • diagram of atherosclerosis

    Coronary artery disease occurs when blood flow is blocked by fatty deposits inside an artery.


    How to prevent heart disease:

    • don't use tobacco
    • maintain a healthful weight
    • exercise regularly
    • eat a healthy, well-balanced diet low in sodium and fat
    • monitor your blood pressure
    • manage your stress


    There are several risk factors you can control. The three major risk factors are tobacco use, high blood pressure and high blood cholesterol. People who have diabetes are at a greater risk for heart attacks and peripheral artery disease (PAD).