Coronary artery disease
Coronary artery disease
Classification and external resources
ICD-10
I20.-I25.
ICD-9
410-414, 429.2
eMedicine
radio/192
MeSH
D003324
Coronary artery disease (CAD)(or athero-
sclerotic heart disease) is the end result of
the accumulation of atheromatous plaques
within the walls of the coronary arteries[1]
that supply the myocardium (the muscle of
the heart) with oxygen and nutrients. It is
sometimes also called coronary heart dis-
ease (CHD), but although CAD is the most
common cause of CHD, it is not the only
cause.
CAD is the leading cause of death world-
wide.[2] While the symptoms and signs of
coronary artery disease are noted in the ad-
vanced state of disease, most individuals with
coronary artery disease show no evidence of
disease for decades as the disease progresses
before the first onset of symptoms, often a
"sudden" heart attack, finally arises. After
decades of progression, some of these ather-
omatous plaques may rupture and (along
with the activation of the blood clotting sys-
tem) start limiting blood flow to the heart
muscle. The disease is the most common
cause of sudden death[3], and is also the most
common reason for death of men and women
over 20 years of age[4]. According to present
trends in the United States, half of healthy
40-year-old males will develop CAD in the fu-
ture, and one in three healthy 40-year-old
women.[5] According to the Guinness Book of
Records, Northern Ireland is the country with
the most occurrences of CAD. By contrast,
the Maasai of Africa have almost no heart
disease.
As the degree of coronary artery disease
progresses, there may be near-complete ob-
struction of the lumen of the coronary artery,
severely restricting the flow of oxygen-carry-
ing blood to the myocardium. Individuals
with this degree of coronary artery disease
typically have suffered from one or more
myocardial infarctions (heart attacks), and
may have signs and symptoms of chronic
coronary ischemia, including symptoms of
angina at rest and flash pulmonary edema.
A distinction