Angioplasty Versus Bypass Surgery for Coronary Artery Disease

What Is Coronary Artery Disease?

Coronary artery disease (CAD) is a disease caused by “hardening” (termed atherosclerosis) of the coronary arteries on the surface of the heart (Figure 1). CAD is the leading cause of death for both men and women in the United States.

The inside walls of arteries are normally smooth and flexible, allowing blood to flow through them easily. Fatty deposits, or plaques, may build up inside the arterial wall. These plaques narrow the artery and can reduce or even completely stop the flow of blood.

What Are the Symptoms of Coronary Artery Disease?

When blood flow is reduced in the coronary arteries, patients may develop angina. Angina is a discomfort in the chest, arms, or lower jaw that occurs when insufficient blood flows to the heart muscle. Angina typically develops during physical exertion or emotional stress, when the heart muscle needs more oxygen and is working harder. Angina usually lasts several minutes, and goes away with rest.

Patients with coronary atherosclerosis are at risk for suffering a heart attack. A heart attack can occur when a coronary artery becomes blocked, usually by a blood clot. The region of the heart muscle fed by the blocked artery loses its ability to function and eventually turns into scar tissue. Unlike anginal pain, the pain from a heart attack usually lasts more than 20 minutes and does not go away with rest.

How Is Coronary Artery Disease Diagnosed?

Your physician will obtain a medical history and perform a complete physical examination. An electrocardiogram (ECG) may show evidence …