Coronary Artery Disease
Our dedicated team of experts offers sophisticated diagnostics, state-of-the-art treatments, and strong support for prevention and rehabilitation.
If you have coronary artery disease, you have built up blockages in the blood vessels of your heart, which may limit the amount of blood that can flow to your heart. You may have symptoms such as chest pain or shortness of breath.
If a portion of the buildup in the coronary arteries (“plaque”) ruptures, a blood clot forms that can block the artery entirely, starving the heart of oxygen. This leads to the emergency known as myocardial infarction, or heart attack. Even when a heart attack is not fatal, it can seriously damage heart muscle.
UT Southwestern’s heart team brings the latest scientific insights and most advanced therapies to the care of people with or at risk for coronary artery disease. Our team of experts works closely with you and your family to choose the most appropriate treatment to prolong and improve the quality of your life.
At UT Southwestern, our physicians, clinical teams, and biomedical scientists are continually pursuing and pioneering innovative treatments that not only extend and enhance the lives of our patients, but also advance the care of people with coronary artery disease throughout the world.
The UT Southwestern Preventive Cardiology team helps patients understand their risk for coronary artery disease through detailed assessments and tests, as well as an evaluation of hereditary risk factors and other conditions that could impact their heart health. Our team then works with patients to reduce risk through interventions such as lifestyle modifications and medications to lower blood pressure and reduce plaque within coronary arteries.
For patients who have more advanced disease requiring more aggressive treatment, our Interventional Cardiology team provides expertise in evaluating and clearing clogged arteries with catheter-based techniques such as:
- Coronary angiogram to visualize blood vessel blockages
- Angioplasty to open up clogged coronary arteries to restore blood flow
- Placement of a stent – a small, cage-like structure – to hold a cleared artery open
When severe coronary artery disease affects multiple blood vessels, open-heart bypass surgery known as coronary artery bypass graft, or CABG, may be the most appropriate treatment. UT Southwestern’s Department of Cardiovascular and Thoracic Surgery is one of the nation’s leading programs, with fellowship-trained surgeons performing more than 600 open-heart procedures each year.
Whatever your degree of coronary artery disease or risk for developing it, our multidisciplinary team of cardiologists and cardiothoracic surgeons will discuss options with you and tailor a treatment plan to your condition, goals, and lifestyle.
Coronary Artery Blockages
The heart’s intricate system of chambers, valves, and blood vessels recycles, replenishes, and recirculates about 2,000 gallons of blood per day. The heart obtains its own blood supply from two arteries that originate just above the aortic valve: the left main coronary artery and the right coronary artery. These arteries branch off into smaller arteries that supply the heart’s chambers and tissues with nutrient-rich blood.
As we age, fat can build up in the walls of our coronary arteries. Calcium, protein, and other materials moving through the blood vessels stick to the fat, forming a material called plaque. This buildup of plaque – a condition called atherosclerosis – occurs more rapidly in some people than others.
As the plaque layer thickens, blood flow to the heart can be reduced, damaging the heart muscle. If coronary artery disease goes undiagnosed and untreated for an extended period of time, the heart will weaken and pump blood less efficiently. This condition is known as heart failure. Should the flow of blood become completely blocked in one or more arteries, a heart attack can result, sometimes with deadly consequences.
Though treatment of heart attacks has improved dramatically in recent decades, coronary artery disease remains the leading cause of death for both men and women in the United States.
Understanding your risk factors for coronary artery disease can help you reverse, reduce, or even prevent its harmful effects.
Risk factors for coronary artery disease that cannot be controlled are: gender (males are at higher risk), age (older people, including postmenopausal women, are more likely to have heart disease), race and ethnicity (African-Americans, for example, have a higher incidence than Caucasians), and a family history of heart disease.
However, there are many more risk factors that can be addressed with medical care, preventive treatments, and healthy lifestyle choices. These include:
- High blood pressure
- High cholesterol
- Sedentary lifestyle
- Being overweight, especially with excess abdominal fat
- Diet high in saturated fat and cholesterol
Symptoms of coronary artery disease include angina (chest pain or pressure that gets worse with activity), shortness of breath, and irregular heartbeat (arrhythmias). In “silent” or asymptomatic heart disease, you may not notice any symptoms until the blockage is severe enough to cause a heart attack. That’s why it’s important to get regular medical checkups and talk with your doctor if you are experiencing symptoms of coronary artery disease.
Heart attack symptoms can include:
- Chest discomfort, pain, or sensation of pressure or squeezing
- Pain in the stomach, shoulders, arms, back, neck, or jaw
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or dizziness
- Sweating or sensations of anxiety
Heart attack symptoms vary from person to person. So if you suspect you may be having a heart attack, seek expert medical attention immediately.
Common tests for coronary artery disease each reveal specific, important information about the health of your heart. They include:
- Electrocardiogram (EKG) – a visual record of the heart’s rate and rhythm
- Echocardiography – a noninvasive diagnostic tool that bounces sound waves off the heart’s structures to evaluate the heart’s size and shape, tissues, pumping capacity, and other useful data
- Cardiac calcium scoring – an imaging test that measures how much calcium has accumulated in the coronary arteries, which is correlated with plaque formation
- Exercise stress test – a study that can show if your heart is not getting enough blood with exercise
- Cardiac catheterization – the insertion of a long, thin, flexible tube into an artery at the groin or wrist, which is then guided toward the heart and its arteries. A contrast agent is injected into the coronary arteries (the heart’s blood vessels) allowing the cardiologist to directly visualize any buildup in the walls of the arteries
There are three levels of treatment for coronary artery disease: medical intervention (lifestyle and drug therapy), interventional procedures, and surgical interventions.
For people with any degree of coronary artery disease, lifestyle modifications such as a healthy diet, regular exercise, and smoking cessation will help foster a longer, more vigorous life.
Patients with coronary artery disease that has been caught early and people with one or more elevated risk factors for developing it can often be treated effectively with lifestyle changes and medications.
Medications to prevent and treat coronary artery disease include:
- ACE inhibitors, such as beta blockers and/or calcium channel blockers to lower blood pressure
- Statins to lower cholesterol levels, which decreases the risk for heart attacks in people with high cholesterol, established coronary disease, and/or other risk factors
- Aspirin or other anticoagulants to reduce the risk of blood clots by thinning the blood
Interventional and surgical procedures
For patients with more severe coronary artery disease, interventional cardiologists and cardiac surgeons offer more aggressive therapies.
UT Southwestern’s interventional cardiologists have extensive experience in the latest approaches to percutaneous coronary intervention (PCI). A catheter is inserted into an artery at the groin or wrist to access and open blocked coronary arteries, increasing blood flow and reducing symptoms. A small, cage-like structure called a stent is often placed within a cleared artery to keep it open. Facilitating rapid recovery with minimal pain and complications, these minimally invasive procedures require only a brief hospital stay.
For patients with severe coronary artery disease that cannot be successfully managed with less invasive treatments, heart bypass surgery, known as CABG (coronary artery bypass grafting), may be recommended. In CABG, a healthy artery or vein is harvested from another part of the body and joined to the obstructed coronary artery, past the blockage, creating a detour route for oxygen-rich blood to reach the heart muscle.
In the more than 65 years since CABG was first performed, numerous advances in technologies and techniques have steadily improved patient outcomes.
People who have been treated for or are at risk for serious coronary artery disease can reduce their likelihood of future heart problems with the assistance of UT Southwestern’s collaborative cardiac rehabilitation team. Customized diet, exercise, and smoking cessation programs provide patients with the understanding, support, and motivation they need to make the lifestyle choices and changes that will pave the way to improved health.
Preventive and Rehabilitative Cardiologists
- James Atkins, M.D.
- Jarett Berry, M.D.
- Laura Collins, M.D.
- Sandeep Das, M.D., M.P.H.
- James de Lemos, M.D.
- Joseph Hill, M.D., Ph.D.
- Amit Khera, M.D.
- Katy Lonergan, M.D.
- Susan Matulevicius, M.D.
- Darren McGuire, M.D.
- Ian Neeland, M.D.
- Gail Peterson, M.D.
- Angela Price, M.D.
- Sharon Reimold, M.D.
- John Rutherford, M.D.
- Monika Sanghavi, M.D.
- Satyam Sarma, M.D.
- Melanie Sulistio, M.D.
- Berge Tasian, M.D.
- Duwayne Willett, M.D.
- Pietro Bajona, M.D.
- Neelan Doolabh, M.D.
- Lynn Huffman, M.D.
- Michael Jessen, M.D.
- Matthias Peltz, M.D.
- Michael Wait, M.D.
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