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Living with Coronary Artery Disease

Contributor: Farouc Jaffer, MD, PhD
9 minute read
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Key takeaways for patients

To manage coronary artery disease (CAD):

  • Follow your treatment plan. Your cardiologist and primary care provider (PCP) develop a personalized plan tailored to your health and lifestyle.
  • Take your medications as prescribed: Statins for cholesterol, blood pressure medications, and others can help you keep CAD under control and prevent complications.
  • Know the emergency signs of heart attack: Learn the symptoms and call 9-1-1 immediately if you experience them.
  • Prepare for appointments: Use the "Questions to Ask" list for your next doctor's visit.

The most common type of heart disease in the United States is coronary artery disease (CAD), according to the Centers for Disease Control and Prevention (CDC). It affects 1 in 20 Americans aged 20 and older.

“Coronary artery disease is when plaque builds up on the walls of the arteries that supply blood to your heart, due to high cholesterol and high inflammation,” Farouc Jaffer, MD, PhD, explains. Dr. Jaffer is a Mass General Brigham interventional cardiologist who cares for patients at Massachusetts General Hospital.

Plaque is made up of cholesterol, fat, cells, and other substances. As the buildup of plaque narrows the arteries, blood flow to the heart can be reduced. This can lead to chest pain, known as angina, and even heart failure. If the arteries become fully blocked, you could be at risk for heart attack or sudden death.

Coronary artery disease can have serious effects on your health, and if you’ve been diagnosed with CAD, it’s easy to feel overwhelmed. Fortunately, if you follow the treatment plan from your care team and make healthy lifestyle changes, you can manage the condition and improve your health. Learn more about living with coronary artery disease.
 

Follow your coronary artery disease treatment plan.

Two avocado toasts with eggs

It’s important to follow the treatment plan established by your cardiologist and your health care team. They’ll take into account your family health history, symptoms, and diagnostic test results to determine the best treatment for you. Depending on how severe the CAD is, your treatment plan may include making lifestyle changes, medications, procedures, and managing any other chronic conditions.

Make healthier lifestyle choices to manage coronary artery disease.

Heart-healthy lifestyle habits are an important part of a coronary artery disease treatment plan. Your cardiologist or primary care provider (PCP) can help guide you and suggest changes to help with your particular situation. They may suggest you:

  • Quit smoking. Smoking increases the formation of plaque in blood vessels. Quitting smoking is important for your heart health, but it can be very difficult to do alone. If you need help, ask your PCP about Mass General Brigham smoking cessation programs. They can connect you with resources, like coaching, to help you succeed.
  • Get regular exercise. Exercise can help slow the progression of coronary artery disease and improve how your heart functions. Strength training or even walking can make a big difference in your health.
  • Eat a balanced diet. Use our heart-healthy grocery list tips to focus on foods that reduce cholesterol and inflammation in your body. Eat whole grains, fruits, vegetables and lean proteins. Avoid foods with high cholesterol. Your doctor may also recommend reducing your salt intake or drinking less fluid. Working together with a Mass General Brigham dietitian, you can develop a meal plan tailored to your health, lifestyle, and food preferences.
  • Limit the amount of alcohol you drink. If you need help to limit drinking, tell your PCP. They can connect you with resources to help.
  • Aim for a healthy weight. If you have overweight or obesity, your doctor may recommend you lose weight. Extra weight can put a strain on the heart. Weight loss medications may be an option if lifestyle changes alone aren’t helping.
  • Focus on getting 7 to 9 hours of sleep each night. Sleep and heart health are closely related. If you struggle to get this much sleep, or you snore heavily or stop breathing in your sleep, tell your PCP. They may recommend you see a sleep specialist to be tested for a sleep disorder, like sleep apnea. Sleep apnea is treatable, but left untreated, it can lead to serious heart and lung problems.

Take prescription medications to manage coronary artery disease.

Your care team may prescribe you a variety of medications to treat your coronary artery disease. These may include statins to lower cholesterol, and drugs to control high blood pressure (hypertension), diabetes, high triglycerides (a type of fat that circulates in the blood), and inflammation.

Talk to your health care care team about interventional or surgical procedure options.

Minimally-invasive or surgical procedures to treat coronary artery disease may include:

  • Angioplasty: A small balloon is used to widen narrowed arteries.
  • Stent placement: A small mesh tube is inserted into an artery to hold it open.
  • Coronary artery bypass graft: A surgeon uses a blood vessel from elsewhere in the body to reroute blood through the heart.

Manage other chronic health conditions.

Certain chronic conditions may contribute to coronary artery disease, like cancer, diabetes, or lung or kidney disease. Making sure these other conditions are managed can help improve your overall health. Mass General Brigham specializes in multidisciplinary, coordinated care of multiple conditions. PCPs collaborate closely with other specialists on your team to efficiently manage the chronic conditions affecting your health.

Cardiac rehabilitation for coronary artery disease

Depending on your symptoms, your care team may recommend a cardiac rehabilitation program. These programs are designed to help you recover from a heart attack, heart failure, or other heart problems that require medical care or surgery. A cardiac rehabilitation program provides you with a dedicated team that includes your existing care team, nutrition and exercise specialists, counsellors, and physical therapists. These specialists will help guide you through physical activity, provide education on living a healthy lifestyle, and offer tips on how to manage stress and improve your mental health.

We will review your medical history, symptoms, and test results together in great detail. We will ask you about your activity and life goals to design a personalized treatment plan for you.

Farouc Jaffer, MD, PhD
Interventional Cardiologist
Mass General Brigham

Living with complex coronary artery disease

“Complex coronary artery disease occurs when people have a more complicated form of the condition or have other conditions that make it more difficult to treat,” Dr. Jaffer says.

He explains, “In certain situations, treatment of complex coronary artery disease requires more specialized stenting or surgical procedures.” One example is a procedure called percutaneous coronary intervention, or PCI. In a PCI procedure, a thin tube called a catheter is inserted into the wrist or groin to place a stent in the heart. 

Dr. Jaffer specializes in treating a type of complex coronary artery disease called chronic total occlusion (CTO), where the arteries become completely blocked. Coronary artery bypass surgery used to be the only way to treat these blockages, but improvements in CTO stenting have made those procedures an effective option for treatment as well. 

Because complex coronary artery disease requires more advanced, specialized care, Dr. Jaffer and the experts at Mass General Brigham take a multidisciplinary approach. Interventional cardiologists and cardiac surgeons work closely together, in collaboration with your existing care team, to develop individualized treatment plans.

“We will review your medical history, symptoms, and test results together in great detail. We will ask you about your activity and life goals to design a personalized treatment plan for you,” confirms Dr. Jaffer.

Get support for dealing with coronary artery disease.

Mental health is another important element of living with coronary artery disease. Dealing with a medical condition like CAD can result in feelings of sadness, worry, stress, and anger. Uncontrolled stress or an emotional event can even cause broken heart syndrome, or Takotsubo cardiomyopathy, where people feel heart attack symptoms.

If you need help managing stress, or are experiencing anxiety or depression, talk to your metal health care provider, PCP, or cardiologist. If you don’t have a mental health care provider, your doctors can refer you to a counselor or other mental health professional. Medications for anxiety or depression may also help.

You don’t have to face your CAD diagnosis alone. Share your diagnosis with friends and family, keep them updated, and ask for help if you need it. Your care team may connect you to local patient support groups for patients with heart disease. It may be helpful to connect with other people going through a similar experience.

Know when to seek further help or emergency care for coronary artery disease.

The most common symptom of coronary artery disease is chest pain or discomfort (angina). Many other people don’t experience symptoms, and aren’t diagnosed with coronary artery disease until they have a heart attack, according to the CDC.

Trust your instincts and call 9-1-1 if you think you may be having a heart attack or medical emergency. Signs and symptoms may include:

  • Angina, tightness, or pressure
  • Pain or pressure in the neck, shoulder, arm, or back
  • Worsening shortness of breath
  • Weakness or dizziness
  • Nausea or abdominal pain and cramping (for women)
  • Sweating

 

What questions should I ask my doctor about coronary artery disease?

You may have lot of questions after you’ve been diagnosed with CAD. Bring a list of questions with you when you see your doctor, so that you don’t forget to ask anything that’s important to you.

Some questions you might consider asking about CAD:

  • What’s causing my CAD? How blocked are my arteries? How will the blockages be monitored over time?
  • What is my risk of having a heart attack, and what can I do to prevent one? When should I seek emergency medical attention?
  • What symptoms should I be keeping an eye on? When should I notify your office if I see change?
  • What medications might be right for me? When would a procedure or surgery be recommended?
  • Are there any over-the-counter medications that might interact with my prescription medications?
  • Do I have any activity restrictions I should be aware of, whether it’s a type of exercise, daily activities, or sex?
  • Are there any patients support groups or other resources I should be aware of?

Coronary artery disease requires careful management and adjusting your lifestyle. But by following your treatment plan and working closely with your providers, you can prevent it from getting worse and improve your health.

Learn about Mass General Brigham Heart and Vascular services

Heart & Vascular Care
Farouc Jaffer, MD, PhD

Contributor

Farouc Jaffer, MD, PhD
Interventional Cardiologist