Blockages in the main arteries of the heart, a disease status called coronary artery disease, remains the leading cause of death in the United States. Certain areas of the heart may receive less blood flow because of these blockages, causing the heart to receive less oxygen, which can lead to a variety of symptoms.

Coronary artery disease: Symptoms

The most common symptoms associated with coronary artery disease include:

• Chest pain or discomfort
• Jaw pain
• Pain in the upper extremities
• Shortness of breath

For some people, particularly female, elderly and diabetic patients, the symptoms of coronary artery disease may not be typical. Symptoms may occur only with exertion and may get worse over time, or patients may experience sudden symptoms, which indicate they are having a heart attack.

Over the past few decades, less invasive techniques have become available to diagnose and treat coronary artery disease and have proven to be successful in relieving symptoms. In patients presenting with heart attacks, these techniques have also proven to be lifesaving.

Coronary artery disease: Diagnosis

• Diagnostic angiography helps measure the severity of blockage in the main arteries of the heart, called coronary arteries.
• Cardiac catheterization is generally performed in conjunction with diagnostic angiography. This test measures the blood pressure within the heart and how much oxygen is in the blood. It is also used to gather information about the pumping ability of the heart muscle.

Other diagnostic procedures may be necessary in conjunction with diagnostic angiography to help further determine the severity and importance of the blockages in the arteries of the heart. These diagnostic procedures include advanced imaging modalities such as coronary intravascular ultrasound, or IVUS, and optical coherence tomography, or OCT, as well physiologic assessments such as fractional flow reserved, or FFR.

Coronary artery disease: Treatment

Our UF Health interventional cardiologists offer patients a number of treatment options for coronary artery blockages. These procedures are generally performed after the diagnostic procedures have been completed and the best treatment plan has been selected. Often these blockages can be treated with less invasive techniques, such as stents. However, based on the severity and location of the blockages, patients may require coronary artery bypass surgery.

• Percutaneous transluminal coronary angioplasty involves using a special balloon inserted through a catheter to open a blockage in the heart artery.
• Coronary artery stents are a metallic scaffold that are expanded in the heart artery, keeping it open at the site of the blockage.

Other treatment modalities are available to assist with opening the arteries of the heart. Among these are procedures such as atherectomy for patients who have very calcified blockages that are more challenging to open with balloons. Laser ablation is used for some patients who have excessive tissue growth inside the stent. We also have access to technologies that may be useful for removing blood clots from arteries in patients who are having a heart attack.