Coronary Artery Disease

What Is It?
Coronary heart 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. 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 and seriously damage your heart muscle.

Our Goal for Your Care
Our goal is to identify coronary artery disease at the earliest possible stage. We engage you in an active prevention and treatment program to manage your coronary artery disease and prevent a heart attack from occurring. If your disease is advanced, we perform heart bypass surgery using minimally invasive and open surgical techniques. We routinely treat people who have multiple and complex blocked arteries. Our involvement in clinical trials means you gain access to the most advanced therapies for coronary artery disease before they become widely available.

Lifestyle Changes

Our cardiac prevention and cardiac rehabilitation program gives you a personalized plan for recovery after surgery and long-term management of your heart health. Your program includes exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.

Medications

Cholesterol-lowering medications (statins), blood pressure medications (often beta blockers), 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.

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 stress test is an ECG that’s performed while you walk on a treadmill or ride a bike, or when a chemical is used to stimulate your heart. It is used to monitor changes in your heart’s function when it’s under stress that 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 overall function.

Stress Echocardiogram

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

3-D Transesophogeal Echocardiogram

An ultrasound probe passed through your esophagus is used to capture sound waves that create highly detailed, close-up 3-D 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 and overall heart function. 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 3-D 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.

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 cardiac prevention and rehabilitation program.

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.