Coronary Artery Disease

Your coronary arteries supply blood to your heart. If they get too narrow or even blocked with plaque (fat and cholesterol), your heart won’t get the right amount of blood (myocardial ischemia). This can cause chest pain (angina), shortness of breath (dyspnea) or other more serious heart conditions, like:

• Heart attack.
• Heart failure.
• Arrhythmia.
• Cardiogenic shock.

There are two main kinds of coronary artery disease:

• Stable ischemic heart disease is ongoing (chronic). You can live with it day to day but may have symptoms that get worse.
• Acute coronary syndrome (ACS) is a medical emergency when plaque opens up (fissures) and attracts a blood clot, which then blocks blood flow.

No matter what type of CAD you have or where you are on your journey, we’re here to help you make the most informed decision about your care, whether you:

• Are wondering what’s causing your chest pain.
• Have been diagnosed with CAD and want to learn about ways to manage your condition and prevent future blockages.
• Need treatment for severe symptoms and blockages.
• Want a second opinion about CAD treatments, particularly if you’re choosing between coronary artery bypass surgery and catheter-based surgery.
• Have been told your severe blockage or ischemic heart disease can’t be treated any further.

What to expect at your first visit

We recommend scheduling your first appointment in person. This gives you and your providers the chance to get to know each other. It’s important for you to feel comfortable with your providers and for them to understand what’s been going on from your point of view. That’s why they’ll ask you about:

• Any symptoms you’re having.
• When they started.
• If they’re getting worse.
• How they’re affecting your life.
• If anyone else in your family has had heart disease.

Then, they’ll take a closer look at you and your heart by doing a physical exam and checking your blood pressure.

Testing for coronary artery disease

During your first visit, your provider will likely order tests to help confirm your diagnosis and figure out how severe your blockage is. Tests may include:

• Blood tests.
• Cardiac catheterization.
• CT angiogram.
• Calcium heart scan.
• Echocardiogram (Echo).
• Electrocardiogram (EKG/ECG).
• Exercise stress test.

Meet Our Coronary Artery Disease Team

When you come to Cleveland Clinic, you’ll have an experienced team of providers from different specialties on your side. This lets us make sure you get the most comprehensive and personalized treatment. Your care team may include:

• Cardiologists.
• Interventional cardiologists.
• Electrophysiologists.
• Cardiothoracic surgeons.
• Cardiac rehab.
• Radiologists.
• Respiratory therapists.
• Pain management.
• Nurse practitioners.
• Physician assistants.
• Care coordinators.

Your treatment plan depends on your unique needs and how bad your CAD is. Your provider may recommend eating a well-balanced, nutritious diet, exercising more and stopping the use of tobacco and recreational drugs. Our dietitians and cardiac rehab specialists can help you make lifestyle changes to slow the progression of your CAD.

Our preventive cardiology team can also help you find ways to manage risk factors, like high blood pressure, diabetes, high cholesterol, angina, blood clots or obesity. They may prescribe medications to help your heart pump blood better and protect it from more damage.

Sometimes you may need surgery to treat your CAD symptoms and improve blood flow to your heart. Your care team will go over which of these options is the best for you and your unique diagnosis.

Percutaneous coronary intervention (PCI)

An interventional cardiologist will do this minimally invasive procedure, which uses a small balloon to open your blocked coronary artery and increase blood flow. Typically, your provider will place a small permanent tube (stent) to keep your artery open. Medicine is sent through the stent directly into your artery to keep it from getting narrow again.

Coronary artery bypass grafting (CABG)

Coronary artery bypass graft surgery creates a new way (bypass) for blood to reach your heart without going through the blocked artery. Your surgeon will take a blood vessel from somewhere else in your body — like your arm, leg or chest — and shape it to create the bypass and attach (graft) it onto your heart. We may need to do this with more than one blood vessel. That’s why you’ve heard of double, triple and quadruple bypass surgeries.

Bypass surgery can either be traditional open-heart surgery, minimally invasive or a hybrid, which combines the bypass surgery with other treatments you may need. The type of surgery your provider recommends will depend on your health and specific needs.

Traveling for Heart Care at Cleveland Clinic

Traveling for healthcare can sometimes feel stressful and overwhelming. Whether you’re traveling from another city, state or even another country, we want to make your journey as easy and convenient as possible. From knowing where to stay, eat and shop, how to get to and from the airport to just finding your way around any of our hospitals, we’re here for you.

If you’re traveling from outside the U.S., our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They can connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when you return home.

Taking the Next Step

Having coronary artery disease is life-changing. But you don’t have to make these changes alone. Cleveland Clinic is on your side. Whether you have to make big updates to your lifestyle or need surgery to treat your CAD, our highly skilled and compassionate cardiovascular team can help you achieve the best possible results.