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Coronary Artery Disease


Coronary arteries are the network of vessels inside the heart that transport blood. If too much cholesterol and plaque build up within them, these arteries can narrow and become blocked, which means the heart muscle won’t get enough blood to function properly. As a leading cause of death in the United States, coronary artery disease can lead to chest pain or heart attack.

At the forefront of cardiac medicine, WakeMed’s specialized cardiologists and cardiothoracic surgeons expertly evaluate and treat patients with coronary artery disease, providing them with options and a treatment plan to match their goals and lifestyle.

Patients come to WakeMed Heart Center from across the Triangle and eastern parts of North Carolina knowing they can trust us to provide the best care.

Causes of Coronary Artery Disease

Some people — especially those with a family history of heart disease — are genetically predisposed to coronary artery disease. Men are more likely to have it, as well as older people.

However, certain lifestyle factors such as smoking, a sedentary lifestyle and obesity can also be significant risk factors in developing coronary artery disease. High blood pressure and high cholesterol can also play a role.

Symptoms of Coronary Artery Disease

Some people will have no symptoms of coronary artery disease until the disease has caused a severe blockage. This can take years, and even decades.

Others may experience signs including:

  • Chest pain, or angina.
  • Fatigue
  • Irregular heartbeat
  • Pain
  • Shortness of breath

These symptoms should be evaluated by a doctor promptly. If you believe you’re having a heart attack, call 911 immediately.

Diagnosing Coronary Artery Disease

If we suspect coronary artery disease, our doctors will take a detailed health history and perform a thorough physical exam, including listening to the heart.

A variety of cardiovascular tests and studies can be used to evaluate and diagnose coronary heart disease. These can include:

  • Electrocardiogram (EKG or ECG): This noninvasive test records the heart’s electrical activity.
  • Echocardiogram: This type of cardiac imaging uses sound waves to create moving pictures of the heart and its blood vessels.
  • Treadmill stress test: This gest can help determine if the heart is getting enough blood during periods of exertion.
  • Cardiac catheterization: A minimally invasive test in which a long, thin tube (catheter) is placed in an artery in the groin, wrist or arm. Using a tiny camera and X-rays, it can evaluate how well the heart is functioning.
  • Blood tests: Certain blood tests can provide information on whether enzymes are leaking into the blood and if the heart muscle is damaged.

Treating Coronary Artery Disease

Early in coronary artery disease, lifestyle changes can make a significant impact. Changes we may recommend include:

  • Quitting smoking
  • Losing weight
  • Eating healthier
  • Exercising

Medications can also be useful in treating coronary artery disease. These may include cholesterol-lowering medications, as well as beta blockers, which slow the heart rate and the heart’s demand for oxygen. Calcium channel blockers can be used in addition to beta blockers.

If coronary artery disease is more severe, there are surgical procedures we can perform to help reduce blockages in the arteries, and restore a better blood flow. These include:

  • Percutaneous trans-luminal coronary angioplasty (PTCA): This opens up an artery so blood can flow normally again.
  • Coronary artery bypass grafting (CABG): During this open-heart surgery, a healthy artery or vein from the body is grafted on to the blocked coronary artery, giving a way to bypass the blocked portion.
  • Stent placement: During a heart catheterization, your heart doctor may open a blocked artery that is in your heart and place a stent to help the artery stay open.

We have been very successful at treating chronic total occlusion (CTO), which is a more complex form of coronary artery disease, and which can result in a heart attack if left untreated.

The WakeMed PCI/CTO Program is aimed at helping patients who have complete blockages of the coronary arteries. PCI/CTO is offered as a minimally invasive procedure using specialized devices to treat both narrowed and completely blocked arteries to restore normal blood flow. Learn more about our PCI/CTO program.

Make an Appointment

We welcome new patients. If you’d like to meet with one of WakeMed’s cardiology experts, please make an appointment by calling us at 919-350-9648.