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Ongoing Concerns
After being diagnosed with coronary artery disease (CAD), you will probably be most concerned about managing your symptoms and reducing the chance of heart attack, stroke, or other complications.
Symptoms of coronary artery disease often begin when less blood flows to the heart muscle. Sometimes collateral circulation develops to provide another source of oxygen-rich blood to the deprived heart muscle. Collateral circulation is tiny branches of the artery that form to "bypass" the area of narrowing and help to restore blood flow.
These blood vessels are often adequate unless the heart requires increased oxygen, such as during exercise or in stressful situations. During these times, you may have angina. Many people have stable angina, which is predictable and diminishes after they take nitroglycerin and get some rest. Although stable angina can be disturbing, it does not necessarily indicate heart muscle damage and can occur for years without harm.
In some cases, CAD can cause life-threatening conditions. Newly formed plaques tend to be more unstable and are more likely to break open (rupture). If a plaque ruptures, a blood clot may form and suddenly block the blood flow to your heart muscle, causing a heart attack or unstable angina.
Some people with CAD may have no symptoms, and the disease is only discovered during an electrocardiogram or stress test. Unfortunately, sometimes a heart attack is the first sign of coronary artery disease. According to the large, 50-year Framingham Heart Study, over 50% of men and 63% of women who died suddenly of coronary artery disease (mostly from heart attack) had no previous symptoms of this disease. 3
Making healthy lifestyle changes and taking aspirin and other medicines, if needed to control your blood pressure and lower your cholesterol, are important measures you can take to reduce your chances of heart attack and stroke.
If coronary artery disease progresses, you may develop additional problems. Over time, reduced blood flow may weaken your heart muscle so that it is not able to pump effectively. This may cause heart failure and abnormal heartbeats (arrhythmia). Atrial fibrillation is one of the most common arrhythmias associated with CAD. You are at increased risk of stroke if you have atrial fibrillation. For more information, see the topics Atrial Fibrillation and Stroke.
Atherosclerosis can affect other arteries of your cardiovascular system and cause other complications throughout your body. See an illustration of the cardiovascular system 
. Arteries that are commonly affected include those that supply blood to your heart, brain (cerebrovascular disease), and limbs ( peripheral arterial disease). For more information, see the topic Peripheral Arterial Disease of the Legs.
If your CAD is severe or your symptoms cannot be controlled with medicines, you may need to consider the following surgery or procedures:
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| Last updated: | May 29, 2007 |
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| Author: | Robin Parks, MS |
| Reviewed By: | Caroline S. Rhoads, MD - Internal Medicine, Ruth Schneider, MPH, RD - Diet and Nutrition |
| Editors: | Kathleen M. Ariss, MS, Pat Truman |
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