# Coronary Artery Disease --- **Coronary artery disease** or **CAD** is a [[heart]] disease characterized by reduced blood flow to the [[cardiac muscle|heart muscle]]. This happens primarily when [[atherosclerosis|atherosclerotic plaques]] develop in the [[coronary circulation|coronary arteries]], which feed the heart itself blood. This blood of blood flow causes [[angina|chest pain]], discomfort, reduced cardiac output and can potentially even starve the muscles leading to [[tissue perfusion|ischemia]]. ## Risk Factors Risk factors for CAD include: - family history - age - sex - hyperlipidemia - [[smoking]] - this is huge...smokers are 4x more likely to develop heart disease than nonsmokers - [[hypertension]] - [[diabetes mellitus]] - [[metabolic syndrome]] - obesity - lack of [[exercise]] - [[chronic stress]] ## Complications Coronary artery disease is a big cause of [[myocardial infarction]]. ## Remodeling **Remodeling** is a phenomenon of the [[coronary circulation|coronary arteries]] where they change their size and shape in response to coronary plaques. **Positive remodeling**, or formation of [[collateralization]] is pretty handy because increases the size of the vessel to compensate for the decreased blood flow through them. **Negative remodeling** is not so handy as it shrinks the vessels that have a plaque. We see this sometimes when patients undergo [[percutaneous coronary intervention|PCI]] for some reason. [[ACE inhibitors]] (apparently) can prevent this sort of thing. ## Treatment Treatment for coronary artery disease consists of lifestyle changes and medications and potential surgery. - lifestyle changes - weight loss - exercise - smoking cessation - medical - The most commonly proscribed for are [[statins]] and [[nitrates]], but I'm thinking you also see [[ACE inhibitors]] used to prevent negative remodeling. - surgery - One potential option for people with CAD is a [[coronary artery bypass graft]], where surgeons can use a blood vessel from a different part of the body and attach it to the heart to restore blood flow. ___