Coronary Artery Disease

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Duke cardiologists identify coronary artery disease at its earliest stage and recommend lifestyle changes as well as medical and surgical treatments to prevent serious complications such as heart attacks. We offer individualized treatment plans to people with complex coronary artery disease, including those with chronic total occlusion, who may be turned away by other centers. Our goal is to optimize blood flow to your heart and help you live as active and healthy a lifestyle as possible.

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Expert Prevention and Treatment of Coronary Artery Disease

What Is Coronary Artery Disease?
Coronary artery disease develops when the arteries that supply blood, oxygen, and nutrients to your heart become narrowed or blocked by the buildup or rupture of plaque or cholesterol. Over time, the disruption of blood flow may cause chest pain, also known as angina, shortness of breath, and general fatigue. As it progresses, coronary artery disease may lead to a heart attack, stroke, and even sudden death.

Our Goal for Your Care
We aim to identify coronary artery disease at the earliest-possible stage and address risk factors to prevent complications. We recommend prevention and treatment strategies to manage your coronary artery disease. For more advanced disease, we perform heart bypass surgery using minimally invasive and/or open surgical techniques. We routinely treat people who have multiple and complex blocked arteries. Our involvement in clinical trials means you may be able to access advanced therapies for coronary artery disease before they become widely available.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments

Lifestyle Changes

Our heart disease prevention and cardiac rehabilitation programs give you a personalized plan for recovery after surgery and long-term management of your heart health. Programs include exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.

Medications

Cholesterol-lowering medications (statins), blood pressure medications, aspirin, and additional medications that decrease blood clotting and improve blood flow are used to prevent and treat coronary artery disease and associated symptoms, such as chest pain.

Angioplasty with Stenting

Also known as percutaneous coronary intervention (PCI), this procedure restores blood flow to the heart. A flexible catheter with a balloon at its tip is threaded through a blood vessel in your groin or wrist to reach the blockage in your heart. The balloon is opened and a metal mesh tube, or stent, is used to open the artery and restore blood flow. Duke cardiologists also use advanced techniques to tunnel through an artery that is nearly or completely blocked, a condition called chronic total occlusion, to restore blood flow.

Heart Bypass

During heart bypass, also known as coronary artery bypass grafting (CABG), a surgeon uses a piece of vein or artery taken from somewhere else in your body to reroute blood flow around a blocked coronary artery. Heart bypass surgery is performed through a mid-chest incision or through smaller incisions. In both approaches, a heart-lung bypass machine may be used as support during the procedure.

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Tests

We offer a range of tests to evaluate and identify coronary artery disease. Depending on your individual condition and circumstances, your care team may recommend one or more of the following:

Electrocardiogram (ECG)

Small electrodes are placed on your skin to record your heart’s electrical impulses. The tracings may help identify risk for or prior heart muscle damage.

Stress Test

A simple stress test involves an ECG that’s performed while you walk on a treadmill or ride a stationary bike, or when a chemical is used to stimulate your heart. The test assesses symptoms, vital signs, and heart changes brought on by stress, which may indicate coronary artery disease.

Echocardiogram

An ultrasound probe is moved over the surface of your chest to capture moving images of your heart. This allows us to determine your heart’s chamber dimensions, shape, valve structures, and function.

Stress Echocardiogram

A stress echocardiogram is performed while you walk on a treadmill or ride a stationary bike, or when a chemical is used to stimulate the heart. The test monitors changes in your heart’s function while it’s under stress that may indicate coronary artery disease.

3D Transesophogeal Echocardiogram

An ultrasound probe passed through your esophagus is used to capture sound waves that create highly detailed, close-up, 3D images of your heart’s chamber dimensions, shape, valve structures, and overall function.

Cardiac Catheterization

Flexible tubes called catheters are guided through a blood vessel to your heart to look for blockages. Contrast dye is injected and X-rays are taken to capture images of your heart, coronary arteries, and other blood vessels.

CT Coronary Angiography

A contrast agent is injected into your arm, and a CT scan produces highly detailed 3D images of your coronary arteries to help identify anatomy and blockages.

Cardiac MRI

Radio waves, magnets, and a computer create still and moving images of your heart, heart muscle, blood vessels, and surrounding structures.

Related Conditions and Treatments

Why Choose Duke

Clinical Trials Access
As a Duke patient, you may be eligible to participate in clinical trials or therapies related to your particular needs and conditions that are not available at other health care facilities.

Personalized Risk-Factor Management Program
We offer one-on-one exercise and nutrition counseling, high blood pressure management, and more through our heart disease prevention and cardiac rehabilitation programs.

Hybrid Surgery
When appropriate, interventional cardiologists and surgeons work together in our hybrid operating room to perform combined procedures. This may shorten procedure and recovery time.

Best Heart Hospital in North Carolina

When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

This page was medically reviewed on 02/07/2023 by

Christopher B. Granger, MD | Cardiologist