Coronary artery disease - Diagnosis and treatment - Mayo Clinic

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Mayo Clinic cardiologist Stephen Kopecky, M.D., answers the most frequently asked questions about coronary artery disease (CAD).
Hi, I’m Dr. Steve Kopecky, a cardiologist at Mayo Clinic. And I’m here to answer some of the important questions you may have about coronary artery disease.
Many small changes can lead to great benefit over time. Remember that nothing you do to improve your health is ever too little. And nothing you do to improve your health is ever too late.
Cholesterol is always involved in the initiation of the narrowing of the arteries to the heart. And every plaque or narrowing of your arteries contains cholesterol. It is essential to control the cholesterol in order to optimally lower your chance of a heart attack.
Yes. All the studies that have shown regression of arterial narrowing have done three things. First, take care of the obvious factors like high blood pressure, smoking and high cholesterol. Second, address diet and physical activity. And third, help patients manage stress.
No. Half of the time, the first symptom a person has of coronary artery disease is actually a heart attack. And half of these heart attacks are fatal. So overall, for one out of four people, the first symptom is what we term sudden cardiac death.
No. Studies have shown that even if your cholesterol is well control with medicines, if you do not eat a healthy diet, your heart attack, stroke, and death rate is not significantly reduced.
Yes. Since your heart beats one hundred thousand times a day, even mild elevations of blood pressure above 130 over 80 can cause significant health problems, including heart attacks, strokes and heart failure.
I tell people they have a new part-time job called Your Health. In part of this is knowing what medicines you’re on, what doses you’re taking and why you’re taking these medicines. Also very helpful, check your blood pressure regularly. Check your weight regularly at home. If any questions arise about your health, put them in your smartphone, so you’ll have them the next time you have your visit with your doctor. Never hesitate to ask your medical team any questions or concerns you have. Being informed makes all the difference. Thanks for your time and we wish you well.
To diagnose coronary artery disease, a healthcare professional examines you. You are usually asked questions about your medical history and any symptoms. If you have symptoms of coronary artery disease such as chest pain or shortness of breath, tests may be done to check your overall health.
Tests to help diagnose or watch coronary artery disease include:
Our caring team of Mayo Clinic experts can help you with your coronary artery disease-related health concerns Start Here
Treatment for coronary artery disease may include:
Many medicines are available to treat coronary artery disease, including:
Aspirin. Aspirin helps thin the blood and prevent blood clots. Daily low-dose aspirin therapy may be recommended for the primary prevention of heart attack or stroke in some people.
Daily use of aspirin can have serious side effects, including bleeding in the stomach and intestines. Don’t start taking a daily aspirin without talking to your healthcare team.

To place a coronary artery stent, a balloon on the tip of the catheter is inflated to widen the blocked artery (A). Then a metal mesh stent is placed (B). The stent helps hold the artery open so blood can flow through it (C).

Coronary artery bypass surgery creates a new path for blood to flow to the heart. A healthy blood vessel from another part of the body is used to redirect blood around a blocked area of an artery. Usually the blood vessel is taken from an artery in the chest, called the internal mammary artery. Sometimes it’s taken from a leg vein, called the saphenus vein.
Surgery may be done to fix a blocked artery and improve blood flow. Surgeries or procedures for coronary artery disease may include:
If you’ve had coronary artery bypass surgery, your healthcare professional may suggest cardiac rehabilitation. This is a program of education, counseling and exercise training that’s designed to help improve your health after heart surgery.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Omega-3 fatty acids are a type of unsaturated fatty acid. It’s thought that they can lower inflammation throughout the body. Inflammation has been linked to coronary artery disease. However, the reasons for and against omega-3 fatty acids for heart disease continue to be studied.
Sources of omega-3 fatty acids include:
Other supplements and food items may help lower blood pressure or cholesterol — two risk factors for coronary artery disease. Some that may work are:
Always talk to a healthcare professional before taking herbs, supplements or medicines bought without a prescription.
Making certain lifestyle changes can help keep the arteries healthy and can prevent or slow coronary artery disease. Try these heart-healthy tips:
Regular health checkups also are 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 keep your heart healthy. Also ask about recommended vaccines, such as a yearly flu vaccine.
The lifestyle habits used to treat coronary artery disease also can help prevent it. A healthy lifestyle can help keep the arteries strong and clear of blockages. To improve heart health, follow these tips:
If you have symptoms of coronary artery disease or any risk factors, make an appointment for a health checkup. You may be sent to a doctor trained in heart diseases, called a cardiologist.
Here’s some information to help you get ready for your appointment.
Questions to ask your healthcare professional at your first appointment include:
If you’re sent to a cardiologist for coronary artery disease, you may want to ask these questions:
Don’t hesitate to ask additional questions.
A healthcare professional who sees you for coronary artery disease may ask:
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.
Coronary artery disease care at Mayo Clinic
Connect with others like you for support and answers to your questions in the Heart & Blood Health support group on Mayo Clinic Connect, a patient community.
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