Coronary Artery Atherosclerosis

What is Coronary artery atherosclerosis?

Coronary artery disease (CAD) is a disease that affects the arteries that supply the heart with blood. It is also known as coronary heart disease, arteriosclerosis, and hardening of the arteries. It is mostly caused by atherosclerosis, which is an accumulation of plaque inside the artery walls that causes thinning and reduces the efficiency of blood flow.

There are many risks associated with CAD. Some can be controlled with lifestyle and dietary changes, while others require medical intervention. CAD may develop over a long period before symptoms occur. 

Arteriosclerosis and atherosclerosis are sometimes used interchangeably to describe the same condition, but they are not the same. Arteriosclerosis occurs when the blood vessels that carry nutrients and oxygen from the heart to the rest of the body become thick and stiff, sometimes restricting blood flow to the organs and tissues. Healthy arteries are elastic and flexible but, over time, the walls in the arteries can harden. 

Atherosclerosis is a specific type of arteriosclerosis. Atherosclerosis is defined as the accumulation of cholesterol, fats, and other substances in and on the artery walls. This buildup is called plaque. This plaque can cause arteries to narrow, thereby blocking blood flow. The plaque can also rupture, causing a blood clot. Although atherosclerosis is frequently considered a heart problem, it can affect arteries anywhere in the body. Atherosclerosis can be treated. A healthy lifestyle can be used to help prevent atherosclerosis.2

Causes, symptoms, and diagnosis

What causes Coronary artery atherosclerosis?

Coronary artery disease is caused by a mixture of genetic and lifestyle factors called risk factors. The following are considered unmanageable risk factors:

  • Age
    • The risk of heart disease increases with getting older
  • Sex:
    • Men/Those assigned male at birth: males over the age of 55 are at higher risk of heart disease
    • Women/Those assigned female at birth: After menopause, the risk of heart disease increases
  • Heredity
    • The risk of heart disease is increased if close family members develop heart disease before age 55 or, in the case of female relatives, before menopause
  • Ethnicity
    • First Nations people and people of Asian or African descent are at higher risk of developing heart disease than other groups

The risk factors that are modifiable/manageable are:1

  • Smoking
  • Excess body weight, especially around your waist
  • Diabetes
  • High blood pressure (hypertension)
  • Abnormal blood cholesterol levels
  • Lack of regular exercise
  • Excessive stress levels
  • Depression

Symptoms of Coronary artery atherosclerosis

CAD generally has no symptoms for a few years during its early stages and can develop over time. The disease develops until the symptoms of angina or heart attack happen. These symptoms can be experienced during activity or while resting:

  • Chest pain, or a feeling of heaviness in the chest
  • Pain in the arm, neck, or jaw
  • Shortness of breath
  • Sweating
  • Nausea
  • Heart palpitations (a racing or irregular heartbeat)
  • Loss of consciousness

For women, the signs of heart attacks can be far more profound. Early signs in women can include:

  • Fatigue
    • A significant decrease in energy level that lasts more than a few days. At 70%, unusual fatigue is the single most common long-term symptom for women
  • Sleep difficulties
    • A pain or an ache that won’t let you sleep causes waking up in the night more than usual
  • Shortness of breath
    • Becoming winded doing the most basic activities, but mostly during exercise
  • Indigestion
    • Feeling uncomfortably full soon after eating, sometimes with burning or pain in the upper abdomen
  • Chest discomfort
    • It may be mild discomfort that resembles indigestion
  • Anxiety
    • Feeling nervous or apprehensive for no obvious reason

Symptoms women commonly experience when a heart attack happens include:

  • Chest pain
    • While men having a heart attack often report a stabbing or crushing pain in their chest, many women say they felt pressure, aching or thighing in their chest or back.
  • Fatigue
    • More than feeling tired, this overwhelming tiredness makes it hard to do anything.
  • Breathing difficulties
    • It’s unexpectedly a struggle to take a full breath.
  • Radiating pain
    • Pain spreads across the arm, jaw, and shoulder or radiates across the back.1

How is it diagnosed?

To find out if you have atherosclerosis, your doctor will ask you questions about your family history and lifestyle, and may send you to do some tests. If possible, learn if you have a family history of atherosclerosis or heart disease so your doctor can get a clearer picture. The tests can consist of:

  • Blood tests
    • To check your cholesterol levels and overall health
  • Carotid ultrasound
    • A test that takes images of the insides of the two largest arteries in your neck (called the carotid arteries)
  • CT scan/coronary calcium scoring
    • A scan of the heart to see how much plaque has accumulated in the arteries of your heart
  • Coronary angiogram
    • A special x-ray using dye to see your heart’s blood flow
  • ECG
    • A test that documents the electrical activity of your heart
  • Exercise ECG
    • A test that documents the electrical activity of your heart while you are exercising.3

Risk factors of coronary artery disease

Exactly why and how arteries become clogged is obscure.

It can happen to anyone, even though the following things can increase your risk:

  • Increasing age
  • Smoking
  • An unhealthy, high-fat diet
  • Lack of exercise
  • Being overweight or obese
  • Regularly drinking excessive amounts of alcohol
  • Other conditions -including high cholesterol, high blood pressure, and diabetes
  • A family history of atherosclerosis and CVD
  • Being of African-Caribbean, African or south Asian descent

You cannot do anything about some of these causes, but by making changes in things like an unhealthy diet and a lack of exercise, you can help decrease your risk of atherosclerosis and CVD.4


The complications of atherosclerosis depend on which arteries are blocked or narrowed. Such as:

  • Coronary artery disease
    • When atherosclerosis narrows the arteries close to your heart, you may develop coronary artery disease, which can cause a heart attack, heart failure, or chest pain (angina)
  • Carotid artery disease
    • When the arteries that deliver blood to your brain narrow due to atherosclerosis, you may develop carotid artery disease. This can lead to a stroke or a TIA (transient ischemic attack)
  • Peripheral artery disease
    • When atherosclerosis narrows the arteries in your legs or arms, you may develop blood flow problems in your legs and arms called peripheral artery disease. This can make you less sensitive to cold and heat, increasing your risk of burns or frostbite. Rarely, a lack of blood flow to the legs or arms can cause tissue death - known as Gangrene
  • Aneurysms
    • This is a serious complication that can happen anywhere in the body. Most people with aneurysms have no symptoms. Pain and aching in the area of an aneurysm may happen and is a medical emergency. If an aneurysm bursts, it can cause life-threatening bleeding inside the body
  • Chronic kidney disease
    • Atherosclerosis can cause the arteries in the kidneys to narrow, which prevents enough oxygen-rich blood from reaching the kidneys. The kidneys need enough blood flow to help filter waste products and remove excess fluids2

Treatment and Prevention

How is Coronary artery disease treated?

Treatment for CAD mostly includes lifestyle changes and medications, sometimes in combination with cardiac procedures or surgery. The best cure combination will be determined based on your individual circumstances.


Many medicines help coronary artery disease. Your doctor will probably prescribe a combination of medications that will:

  • Lower the workload of your heart
  • Help relax the blood vessels
  • Lower cholesterol
  • Help prevent blood clots from forming
  • Decrease the long-term risk of having a heart attack

However, you may have to take these medications for the rest of your life.

You may have to undertake a Cardiac Procedure. This is an angiogram which is vital to show the blockages and determine whether medications are enough for treatment or whether an angioplasty (using a balloon to open the obstruction) and stent (a wire netting tube to keep the artery open) are required. Sometimes, coronary artery bypass surgery is essential to attach new veins or arteries to go around the blockages.1

How can we prevent Coronary artery disease?

Making beneficial adjustments to your lifestyle is one of the best approaches to both improving and preventing the symptoms of atherosclerosis. The things that you can do to decrease your risk of developing atherosclerosis are:

  • Eating healthier foods
  • Keeping active
  • Keeping to a healthy weight 
  • Limiting alcohol consumption
  • Stopping smoking and using other tobacco products
  • Taking medications prescribed by your doctor3

When should I see a doctor?

If you think you have atherosclerosis, speak to a doctor. In addition, pay attention to early symptoms caused by a lack of blood flow, such as leg pain or numbness, or chest pain (angina).

Early diagnosis and treatment can stop atherosclerosis from worsening and prevent a heart attack, stroke, or other medical emergencies.2


Atherosclerosis is a serious condition where arteries become clogged with fatty materials called plaques.

These plaques cause the arteries to harden and narrow, restricting the blood flow and oxygen supply to crucial organs, and growing the risk of blood clots that could potentially obstruct the blood flow to the brain or heart.

Atherosclerosis is not likely to have any symptoms at first and many people may be oblivious they have it, but it can ultimately cause life-threatening problems, such as heart attacks and strokes if it gets worse.

Nevertheless, the condition is largely preventable as a healthy lifestyle, and treatment can help reduce the risk of serious problems happening.4


  1. Coronary artery disease(Atherosclerosis) [Internet]. University of Ottawa Heart Institute. [cited 2023 Jan 29]. Available from: 
  2. Arteriosclerosis / atherosclerosis - Symptoms and causes [Internet]. Mayo Clinic. [cited 2023 Jan 29]. Available from: 
  1. Atherosclerosis [Internet]. British Heart Foundation. [cited 2023 Jan 29]. Available from: 
  2. Atherosclerosis(Arteriosclerosis) [Internet]. 2017 [cited 2023 Jan 29]. Available from: 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Anna Mizerska

Masters in Global Health and Biomedical Engineer
Anna is a highly analytical and insightful professional with progressive experience in providing quality services in fast-paced and high-pressure environments. Over the years she has built up extensive knowledge, expertise and transferable skills that translate into writing reliable medical content and articles.

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