Updated
What is coronary artery disease?
Coronary artery disease develops when plaque builds up in the arteries supplying the heart muscle. Plaque may narrow an artery, and a disrupted plaque can trigger a clot and a heart attack. The amount of narrowing and future risk are related, but they are not the same measurement.
Some people have no symptoms. Others develop chest pressure or breathlessness with exertion. New or changing symptoms deserve assessment.
Why different tests are used
A calcium score helps with selected prevention decisions. A coronary CTA looks at plaque and artery narrowing. A stress test assesses the response to exertion or medication-induced stress. Your symptoms, previous results and other conditions determine which test is useful.
A normal test cannot guarantee that a heart problem will never occur. Tell your clinician when symptoms change rather than relying only on an older result.
What treatment may include
Cholesterol-lowering treatment, blood pressure management, avoiding tobacco, appropriate activity and food choices all matter. Medicines may also help angina. Antiplatelet treatment depends on your history and bleeding risk; follow the plan from your clinician, particularly after a stent.
Stents or bypass surgery can be appropriate for certain symptoms and patterns of disease. They do not remove the need for ongoing prevention. In stable disease, the best next step is individualized.
Ask whether you qualify for cardiac rehabilitation. Bring up treatment cost, symptoms and practical barriers so the plan is workable.
When to seek care
Call 911 for new severe chest pressure or discomfort lasting more than a few minutes or recurring, especially with sweating, nausea, breathlessness or pain spreading to the arm, jaw or back. Heart attack symptoms can vary. Do not drive yourself or wait for an online response.
For familiar angina, follow your prescribed action plan. Increasing frequency, symptoms at less activity or symptoms at rest need prompt medical evaluation.
Questions for your next visit
- What does my diagnosis mean for my future risk?
- What is my plan for chest symptoms?
- What are my cholesterol, BP and activity goals?
References and further reading
- ACC: 2023 Guideline for Managing Chronic Coronary Disease
- ACC/AHA: 2026 Guideline on the Management of Dyslipidemia
- AHA: Exercise Stress Test (2025)
Use these sources with your own clinician's advice. Recommendations depend on your health history and can change as evidence develops.