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Types of Heart Disease

Heart disease is a general term that describes many different diseases.

Coronary artery disease (CAD), the most common form of heart disease, is caused by a narrowing or clogging of the coronary arteries that supply the heart with oxygen and nutrients. CAD can cause angina (chest pain), myocardial infarction (heart attack), and cardiac sudden death (caused by severely abnormal and ineffective beating of the heart)

What Is Coronary Artery Disease?

The coronary arteries serve as the main blood supply for the heart muscle, which requires oxygen and other nutrients in order to function. Coronary artery disease (CAD) occurs when these arteries become narrowed or clogged. When the heart doesn't get enough oxygen, the muscle becomes injured, which usually causes chest pain called angina. If untreated, CAD can progress to the point where the coronary arteries are completely blocked, cutting off the heart's blood supply. This is what is commonly known as a heart attack, or in medical terminology, a myocardial infarction.

You may have encountered the term coronary heart disease (CHD), which occurs when CAD results in permanent damage to the heart muscle. CHD and CAD are often used interchangeably; here, we will use CAD as a blanket term for both conditions.

What Causes CAD?

CAD is caused by a narrowing of coronary arteries, called atherosclerosis. Blood flow becomes more and more restricted as the artery continues to narrow.

Most commonly, atherosclerosis results when cholesterol and fat circulating in the bloodstream build up on the artery walls. The triggering event is an injury to the artery's inner lining; the injury can be caused by high blood pressure, diabetes, or other causes. The body's immune system responds to the injury, causing inflammation. Immune cells called macrophages are activated and try to heal the injury. This process creates a plaque within the artery wall made up of low density lipoprotein (LDL cholesterol), other fats, and macrophages. 

Some plaques are hard; others have just a thin cap on top of a soft, fatty core. If the cap ruptures, the underlying core will be exposed to the blood, triggering the formation of a blood clot. If the blood clot is large enough, blood flow in the artery will be completely blocked. This is what causes a heart attack.

Signs and Symptoms

Symptoms of CAD can range widely, from no symptoms at all, to mild intermittent chest pain, to pronounced and steady pain. In some people, symptoms can be severe enough to hinder their normal daily activities. A person experiencing angina may feel heaviness, tightness, pain, burning, pressure, or squeezing, usually behind the breastbone but sometimes also in the arms, neck, or jaws. These sensations are usually localized to the left side of the body. Angina is often accompanied by shortness of breath, and sometime by nausea and sweating. These symptoms are usually brought on by exertion and relieved by rest. Nevertheless, some people (especially diabetics) have heart attacks without ever experiencing any of these symptoms.

According to the American Heart Association, the most common warning signs include:

  • Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back
  • Pain that spreads to the shoulders, neck or arms
  • Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath

Less common warning signs include...

  • Any chest pain unlike the pain described above
  • Stomach or abdominal pain
  • Nausea or dizziness (without chest pain)
  • Shortness of breath and difficulty breathing (without chest pain)
  • Unexplained anxiety, weakness, or fatigue
  • Palpitations, cold sweat, or paleness
Not all patients experiencing these symptoms have CAD. However, if you experience these symptoms, you should consult your doctor for further evaluation.


A stroke occurs when blood vessels supplying the brain become narrowed or clogged. Peripheral vascular disease is similar, but occurs in the arteries that supply the legs. The same problems that can lead to CAD can also cause these diseases.
Congestive heart failure results when the heart muscle becomes weakened and can no longer pump blood efficiently. Common symptoms include shortness of breath, exercise intolerance, and edema (swelling of the legs). Congestive heart failure can result from damage induced by heart attack or cardiomyopathy (disease of the heart muscle).


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