Coronary Artery Disease

In a healthy heart, blood flows smoothly and easily through clear arteries and the heart gets all the oxygen it needs. But if you are diagnosed with coronary artery disease (CAD), the arteries that bring blood to your heart become hardened and narrowed by plaque buildup, reducing the amount of oxygenated blood delivered to your heart.

As the leading cause of heart attacks and death in the United States, it’s important to take a CAD diagnosis seriously. Our board-certified cardiovascular physicians can help ease your concerns and improve your outlook by providing a full range of state-of-the-art cardiac care. In our Cardiac Catheterization Laboratory, known as our Cath Lab, we perform a range of diagnostic and interventional cardiac procedures, including heart catheterization to assess and diagnose CAD, and treat with angioplasty and stent placement.

CAD: The Most Common Type of Heart Disease

If you have CAD, you’re not alone. It’s the most common type of heart disease in the United States. CAD occurs when cholesterol and other materials build up on the insides of your arteries. This buildup, known as atherosclerosis, starves your heart muscle of oxygen and may create pain, which is known as angina. If plaque breaks up, a blood clot can form and cut off blood supply to your heart, causing a heart attack. CAD can also lead to other heart conditions, such as arrhythmia or heart failure.

Although you may never experience symptoms from CAD, especially in the early stages, if you have any of these symptoms, talk to one of our specialists to determine if you have the disease.

• • Chest pain or discomfort, especially with activity or emotion
  • Heaviness or pressure on your chest, under your breast bone or in your neck, upper back, stomach or arms
  • Shortness of breath
  • Fatigue
  • A general feeling of weakness

Determining Your Diagnosis

We offer a full range of tests to diagnose CAD and other cardiac conditions. Our diagnostic tests, many of which are non-invasive, offer safe, painless ways to check your cardiac function and determine the extent to which plaque may be blocking your arteries. Our specialists use the latest tests and tools to diagnose CAD, including:

• • Electrocardiogram (ECG or EKG): A test that measures heart rate, monitors the heart’s electrical system and provides images of the heart’s structures, assessing heart and valve health and blood flow. 
  • Cardiac stress test (also known as a treadmill test or exercise EKG or ECG): A test that measures how your heart performs in response to exercise or stress. This test monitors blood flow and oxygen levels as your heart beats faster and works harder.
  • Pharmacological (medication-induced) stress echocardiogram: A stress test that uses medication to stimulate exercise for patients who are unable to exercise safely.
  • Metabolic stress testing: A test that measures the performance of the heart and lungs while under physical stress. Like an exercise stress test, it includes an analysis of your respiratory system.
  • Nuclear stress test: A test that assesses the blood flow to your heart by taking two sets of pictures of your heart: one set while you’re at rest and the second while your heart is being stressed by exercise, medication or a combination of both. Radioactive material is injected into your vein to highlight healthy and damaged tissue in the pictures. 
  • Coronary arteriogram (or angiogram): With this procedure, X-rays are taken to locate the narrowing, occlusions and other abnormalities of specific arteries.
  • Echocardiogram (Echo): An ultrasound test that uses sound waves and the echoes they produce to obtain highly detailed images of the walls and chambers of the heart.
  • Transesophageal echocardiogram (TEE): This test is like an echocardiogram but is for patients who have conditions such as serious lung disease, immobility or excess weight that may interfere with the creation of high-quality images with a standard echocardiogram. Instead of using an external ultrasound transducer, this test passes the transducer into the esophagus or stomach through a thin swallowing tube. 
  • Catheterization (Cath) and angiogram: This test, which is used both for CAD diagnosis and treatment, creates images that can be captured in an X-ray of artery blockages that may require repair. During the catheterization, a thin flexible tube called a catheter is inserted through a blood vessel in your groin (or sometimes in your arm) and guided toward the blocked vessel. Dye injected through the catheter allows images of your blood vessels to appear on a monitor for analysis.
  • Diagnostic peripheral arterial catheterization: This test is used to diagnose artery disease and blockage that occurs outside the heart, such as in the legs. 

Treatment Options Available to You

Once we have a full understanding of your condition, as well as your health history and your risk factors, we work with you to develop a treatment plan that best meets your needs. We provide a wide range of CAD treatments, including:

• • Catheterization and balloon angioplasty: A test in which an inflatable balloon-type tool is used to compress plaque against artery walls, allowing increased blood flow. Balloon angioplasty is performed during a catheterization. 
  • Angioplasty and coronary stent replacement: A stent is a tiny mesh tube that our doctors implant in an artery to prevent plaque from blocking the blood vessel. Stents may be implanted in arteries in your heart (coronary arteries), neck (carotid arteries) or liver. After clearing blockage in an artery, your doctor uses a catheter to place the stent in the newly opened artery. The stent helps hold the artery open and reduces the chance that plaque will block the artery again. 
  • Coronary artery bypass grafts (CABG): Also known as heart bypass surgery, this procedure isopen-heart surgery requiring general anesthesia. During bypass surgery the surgeon removes a piece of a healthy blood vessel from your leg, arm or chest wall to use as a graft to create a new path for blood flow around a blocked artery. One end of the healthy graft is sewn to the blood vessel just below the blocked artery. The other end of the graft is sewn above the blocked artery. Blood can then flow around the blocked area. After bypass surgery, blood moves more freely through the coronary arteries, lowering the risk of heart attack. 

Cardiac Rehab for a Smooth Recovery

We help our CAD patients get back on track with a comprehensive cardiac rehabilitation program. Our Cardiopulmonary Rehabilitation Program ensures exceptional care for all our patients. Our team guides you and your loved ones to achieve a good quality of life after surgery or other cardiac treatment. The program is held on the first floor of the Young wing in the Cardiopulmonary Rehabilitation Department.

Cardiac rehabilitation is a medically supervised program to help you recover by following an individualized plan that provides evaluation and instruction on physical activity, nutrition, stress management and other health-related areas as needed. Cardiac rehabilitation will help you achieve greater quality of life when recovering from CAD and other heart conditions such as:

• • Heart attack
  • Angina
  • Coronary artery angioplasty or stents
  • Open heart surgery such as coronary bypass or valve surgery
  • Heart failure
  • Heart transplantation

You will need to obtain a referral from your physician to enter our cardiopulmonary program; however, we encourage you to call us for more information (207) 795-8225 for assistance in accessing our services or to answer any questions you may have about our program.