• Heart Disease

A Guide to Coronary Artery Disease Self-Care

Medically reviewed and edited by Taryn Facella-Scheuer, ANP-C

Self-care became a marketing buzzword during the COVID-19 pandemic, but it’s so much more than that.

The World Health Organization (WHO) defines self-care as the ability to care for yourself, prevent disease, and manage illness and disability with or without the help of a healthcare worker.

Self-care includes, among other factors, the prevention of disease and the promotion of health.

In this article, we’ll explain what coronary artery disease is, including its symptoms and risk factors, and how you can use self-care strategies to keep your heart healthy.

What is Coronary Artery Disease (CAD)?

Coronary artery disease (CAD) — which is also known as coronary heart disease or ischemic heart disease — is a disorder characterized by decreased blood flow in the major arteries that supply oxygen-rich blood to the muscles of the heart.

These major blood vessels are called the coronary arteries. Generally, these arteries can become blocked due to the accumulation of fat, cholesterol, and other substances in the artery walls through a process known as atherosclerosis.

By preventing optimal blood flow to the heart, one of three major conditions can occur, depending on the severity of the blockage.

Coronary artery disease is a spectrum of the following diseases, ranging from least severe to most severe:

Stable angina

This type of chest pain is the result of a partial blockage of a coronary artery that does not damage the heart.

It causes chest pain only during exertion when the heart requires more oxygen than normal — like during physical exercise.

Unstable angina

This typically feels like chest pain that gets progressively worse. It involves a major blockage of a coronary artery that causes pain even when resting.

Although the blockage is more severe than it is in stable angina, it is not a complete blockage.

Heart damage doesn’t typically occur with this chest pain, but unstable angina cannot be safely distinguished from a heart attack — where heart damage has occurred — without an electrocardiogram (EKG) and special blood tests.

Myocardial infarction

Commonly known as a heart attack, a myocardial infarction involves the major or complete blockage of a coronary artery, which causes pain when resting.

During a heart attack, heart damage occurs but the degree of the damage depends on how blocked the artery is. As mentioned above, a heart attack can only be confirmed by an EKG and blood tests.

The type of pain that occurs with a heart attack might not feel like chest pain.

What are the Symptoms of Coronary Artery Disease?

CAD typically doesn’t have noticeable symptoms in the early stages of the disease.

A recent study found that while most participants under evaluation for coronary artery disease presented with chest pain, this symptom alone is not enough to diagnose patients with CAD.

Here are some of the symptoms you may experience:

• Chest pain: Generally, this pain occurs behind the breastbone and radiates to the left arm, neck, or jaw, and it feels as if there is pressure on the chest. In severe cases, pain is typically felt at rest, while in early disease stages or less severe CAD, chest pain flares up only during physical activity..

Usually, chest pain is accompanied by shortness of breath. If this chest pain is not relieved by rest (or nitroglycerin), urgently seek medical advice.

• Shortness of breath: This is generally accompanied by chest pain but it can appear on its own, too. Like the chest pain typical of CAD, this shortness of breath is also associated with physical activity.

• Cold sweats and nausea: This symptom is usually only present if CAD has led to a heart attack.

• Fatigue or weakness: A decreased ability to perform normal tasks without getting excessively tired may indicate that you have CAD.

What are the Risk Factors of Coronary Artery Disease?

Risk factors for CAD can be separated into risk factors that can be fixed or changed, and those that cannot be fixed or changed.

How Do I Know if I Have Coronary Artery Disease?

If you have any of the symptoms we outlined earlier, you may have coronary artery disease. However, symptoms and risk factors don’t definitively indicate that you have CAD.

A healthcare professional can diagnose CAD through various methods.

Coronary angiography

This involves taking multiple X-rays of the coronary arteries after a dye has been injected into them. The dye helps to highlight any blockages in the artery.

Electrocardiogram (EKG)

An EKG may be able to show the presence of a heart attack, current or previous. It picks up the presence of any abnormal heart rhythms associated with CAD.

This EKG can either be done while resting or while exercising.

Echocardiogram

This is an ultrasound of the heart and it’s used to see whether the heart shows signs of abnormality.

The echocardiograms of those who have had heart attacks previously may reveal evidence of heart failure or abnormal heart muscle movements.

Blood tests

Your doctor may do blood work to test for the presence of the following:

• Cardiac enzymes (for example, troponins, CK-MD, and myoglobin): These tests are used to confirm whether a heart attack has recently occurred.

• Cholesterol: High cholesterol is not enough to diagnose coronary artery disease, but it does increase the likelihood of developing heart issues.

• Diabetes: This type of test is not indicative either, but diabetes can increase the likelihood of developing CAD.

This test can be done either as a fasting glucose test (measuring the blood sugar level after an individual has fasted for at least eight hours), or a random glucose test (measuring the blood sugar level regardless of when the individual last ate).

When Should I See a Doctor for CAD?

Everyone who has multiple CAD risk factors should see a doctor. Modifiable risk factors should be addressed at these consults.

Individuals who experience any danger signs should also seek medical attention. Some of these signs include:

• Any kind of chest pain — especially if the pain occurs at rest

• Shortness of breath

• Swelling in the legs

• Excessive fatigue or weakness

What Can I Do to Prevent Coronary Artery Disease?

By making a few key changes to your lifestyle, you can greatly decrease your chances of developing CAD.

Remember to monitor your blood pressure and glucose levels as you change your diet and level of physical activity.

Follow a heart-healthy diet

Diet plays a key role in the development of coronary artery disease.

According to the American Heart Association (AHA) and American College of Cardiology (ACC), a plant-based Mediterranean diet is recommended for the prevention of CAD.

A Mediterranean diet is ideal, as it includes:

• Fruit and vegetables

• Nuts and whole grains

• Legumes

• Lean animal proteins, such as fish

• Very limited processed foods

Limit certain foods

Even if you’re following a diet that promotes heart health — like the Mediterranean diet we mentioned above — you should also avoid consuming certain foods for optimal health.

Cut back on unhealthy fats

Foods that contain saturated and trans fats, for example, should be consumed in moderation or avoided entirely.

Some examples of foods that contain trans fats include:

• Fast foods

• TV dinners

• Instant ramen noodles

• Deep fried foods

• Baked goods, such as cakes and cookies

Some examples of foods that contain saturated fats include:

• Dairy-based products like butter and cheese

• Oils like coconut or palm oil

• Meats like pork or beef that are high in fat

• Cured meats

• Processed meats, like sausages and cold cuts

A great way to cut back on trans and saturated fats is by replacing them with good fats.

Limit sodium intake

Cutting back on sodium is important to prevent CAD. Remember, sodium can be present in food that’s not obviously salty, too — such as fruits and vegetables.

Studies, most notably the DASH trial (Dietary Approaches to Stop Hypertension), have shown that a decreased intake of dietary sodium can have a positive effect on cardiovascular health and help reduce blood pressure.

A good start to this dietary change would be by not adding additional salt to meals.

Maintain a healthy body mass index (BMI)

Obesity, or being overweight, is a well-known contributor to the development of CAD. BMI is one of the measurements used to quantify weight.

Generally, a BMI of over 25 is considered a risk factor for the development of CAD, but there are several other factors that need to be taken into account, too.

For example, a BMI calculation has limitations, such as not being able to differentiate between lean body mass and excess fat.

Therefore, your BMI may be combined with an abdominal circumference measurement, as this is regarded as a better predictor of the development of poor cardiac outcomes in males and postmenopausal females.

A healthcare professional can help you to accurately calculate your BMI and assess related risk factors.

Quit harmful habits

Certain habits can increase stress and raise blood pressure without you even realizing it. By quitting these habits, you can lower blood pressure and prevent CAD.

Some bad habits to give up include:

• Smoking

• Excessive alcohol consumption

• Illicit drug use

• A sedentary lifestyle

• Snacking when you’re bored

Increase physical activity

Exercise is also a known contributor to cardiovascular health. Lack of exercise is a risk factor for the development of coronary artery disease.

The AHA currently recommends at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week.

Additionally, moderate to high-intensity muscle strengthening (e.g. resistance training), is recommended at least two days per week for adults.

For individuals just starting to exercise, 75-150 minutes of exercise a week may seem difficult. It’s recommended that you start training at levels that are sustainable in the long term and to gradually increase the time and duration as you feel more comfortable.

What Happens if I’m Diagnosed with CAD?

If you are diagnosed with CAD, your health care provider may start certain medications which include, but are not limited to, antihypertensives, aspirin, and/or a statin (cholesterol-lowering medication).

While medication is important, you should not forget the basics of managing CAD. Lifestyle management is crucial, whether or not you are taking medication.

Always consult with your healthcare provider regarding the most appropriate treatment plan for you.

Where Can I Learn More About Coronary Artery Disease (CAD) Prevention?

If you are concerned about your current health status or you think you’re at a higher risk of developing CAD, LifeMD can help.

We provide online access to doctors and valuable resources about heart health. Visit our portal and book your appointment to get started.

Taryn Facella-Scheuer, ANP-C

Taryn earned her Bachelor’s in Nursing from Rutgers University, her Master’s in Nursing from Fairleigh Dickinson University, and her Master’s in Adult Gerontology Critical Care from the University of Pennsylvania. She has provided care to a wide array of patients across various healthcare settings. Fitness is Taryn’s passion. She weight lifts and runs regularly, and she also enjoys cooking and traveling.

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