Coronary Artery Disease (CAD)

Your heart works nonstop to keep blood and oxygen moving through your body, beating over 100,000 times each day. But your health can change quickly when something slows that flow, such as a blockage in your arteries. Coronary artery disease, or CAD, is one of the most common and serious heart conditions worldwide. 

At Banner Health, we use advanced technology and experienced heart specialists to identify blockages early, often before symptoms appear. Our goal is to keep your heart healthy and your life moving forward.

What is coronary artery disease?

Coronary artery disease (CAD) happens when the blood vessels that supply oxygen and nutrients to your heart (coronary arteries) become narrow or blocked. This usually happens because of plaque buildup, a mix of cholesterol, fat and other substances that stick to the artery walls. 

Over time, this buildup limits blood flow to your heart muscle. That means your heart doesn’t get the oxygen it needs, especially during stress or activity. Reduced blood flow can lead to chest pain (angina), shortness of breath or even a heart attack.

Other names for CAD include coronary heart disease and ischemic heart disease. 

Common symptoms of CAD

CAD can develop gradually over many years, often going unnoticed until a serious event happens. However, your body may provide clues along the way. 

You might experience:

• Chest pain or pressure, especially during activity or stress
• Shortness of breath
• Fatigue, even with mild effort
• Pain in your arms, neck, jaw or back
• Nausea or dizziness

For some people, especially women, older adults and those with diabetes, symptoms can be subtle or feel different. You might feel unusually tired, lightheaded or notice discomfort in your upper body rather than a sharp chest pain. 

If you ever feel sudden, intense chest pressure or pain that spreads to your arm or jaw, call 911 right away. These could be signs of a heart attack. 

What causes CAD?

Several factors can raise your risk of developing CAD. Some you can control; others you can’t. 

Things you can’t change:

• Age
• Family history of heart disease
• Biological sex: Men over age 45; post-menopausal women

Things you can change:

• High cholesterol and high blood pressure
• Smoking
• Uncontrolled diabetes
• Obesity and inactivity
• Unhealthy diet
• Chronic stress

Knowing your risk factors is the first step toward protecting your heart. Even small changes, like walking for 30 minutes a day or choosing heart-healthy foods, can have a big impact. 

Types of coronary artery disease

There are a few different types of CAD. Each affects blood flow to your heart in a slightly different way:

• Obstructive coronary artery disease: Plaque builds slowly in your arteries, which can cause chest pain during activity or stress. It’s the most common type of CAD.
• Nonobstructive coronary artery disease: In this type of CAD, there is no plaque buildup. Instead, the narrowing of the coronary artery is caused by other conditions, such as irregular constrictions (coronary vasospasm), damage to the artery lining (endothelial dysfunction) and problems in the smaller artery branches (microvascular dysfunction).
• Spontaneous coronary artery dissection (SCAD): This is a rare but serious form of CAD that happens when the wall of a coronary artery suddenly tears, creating a blockage. SCAD often affects younger, healthier people, especially women who lack typical risk factors like high cholesterol or smoking.

How CAD is diagnosed at Banner Health

Several tests are used to diagnose coronary artery disease. Your health care provider will suggest tests based on your symptoms, risk factors and overall health. 

Standard diagnostic tests

Most people need one or more tests to diagnose CAD. These might include:

• Electrocardiogram (ECG or EKG): This test records your heart’s electrical activity and helps find signs of strain or prior heart damage.
• Echocardiogram: This test uses sound waves to view the heart’s structures.
• Exercise stress test: You’ll walk on a treadmill or receive medicine that makes your heart work harder while your provider monitors your heart’s response. This helps identify areas of poor blood flow. 
• Coronary calcium scan: A CT scan looks for calcium or plaque buildup.
• Nuclear stress test: A small amount of radioactive material is injected into the bloodstream to see how well blood flows through the heart at rest and during exercise.
• Coronary CT angiography (CTA): This imaging test uses CT technology and contrast dye to see how blood flows through the coronary arteries. 
• Cardiac catheterization (angiography): This test involves guiding a thin tube into the arteries through a small hole to see blockages in the heart arteries. Dye is used to help the arteries show up more clearly on X-ray images and video.

Advanced imaging: FFR-CT with HeartFlow analysis

Some health care systems now offer fractional flow reserve computed tomography (FFR-CT). This advanced, noninvasive technology goes beyond a regular CT scan. It uses computer modeling to show how blood flows through your coronary arteries, helping specialists see which blockages are most serious. 

This technology is designed for people at risk for CAD or who have already had a cardiac CT scan showing one or more blockages. At Banner Health, we use advanced CT technology including FFR-CT to help identify blockages without invasive procedures like catheterization.

Choosing the right test

No two patients are the same. Your provider or cardiologist will consider your symptoms, risk factors, medical history and previous imaging to decide which tests are safest and most informative.

What to expect before, during and after testing

Before your test

You might need to avoid eating or drinking for a few hours before your test and stop consuming caffeine or certain medications. Remove any metal jewelry before a CT scan and inform your care team about allergies or kidney problems.

During your test

Most tests are quick and painless:

• ECGs take just a few minutes.
• Stress tests usually last 30 to 60 minutes.
• CT scans are brief and you may feel a warm sensation from the contrast dye.
• Cardiac catheterization takes longer and is done in a hospital lab with local anesthesia and mild sedation.

After your test

Some results are available right away, while others (like CT or FFR-CT analysis) need more time for review. Your provider will review your results and discuss next steps.

Every test has small risks, such as contrast dye allergies or mild radiation exposure, but your team will take precautions to keep you safe.

Treatment options for CAD

Treatment for coronary artery disease might involve lifestyle changes, medication and heart procedures. 

Lifestyle and medication management

• Heart-healthy diet: Eat fruits, vegetables, whole grains, lean protein and healthy fats.
• Regular exercise: Aim for at least 150 minutes of moderate activity each week.
• Medication: To control blood pressure, cholesterol or blood sugar or to prevent blood clots.
• Smoking cessation: Quitting smoking or vaping improves circulation and reduces your risk of a heart attack almost immediately.
• Stress management: Activities like yoga, deep breathing or talking with a licensed therapist can help lower stress levels.

Interventional and surgical treatments

Some people need a procedure or surgery to manage CAD, including: 

• Coronary angioplasty or stent placement: A small balloon opens the artery and a tiny mesh tube (stent) keeps it open.
• Coronary artery bypass grafting (CABG): A surgeon creates a new route for blood to flow around the blockage. 

Learn more about heart surgery and procedures.

Ongoing care

Heart care doesn’t stop after a procedure. Cardiac rehabilitation, follow-up imaging and regular checkups help you stay healthy long-term. 

Why choose Banner Health

At Banner Health, our heart and vascular care teams combine compassion, expertise and advanced technology to provide you with the best possible care. From cutting-edge diagnostic tools like FFR-CT to less invasive procedures and cardiac rehab, we support your heart at every stage.

Take the next step toward protecting your heart health. Schedule an appointment today.