Coronary artery disease has two main subtypes: atherosclerotic coronary artery disease and nonatherosclerotic coronary artery disease.
Coronary artery disease happens when blood flow to your heart becomes restricted or blocked. This can cause serious complications, including a heart attack.
Coronary artery disease is the most common heart condition in the United States. According to the Centers for Disease Control and Prevention (CDC),
The disease has two main subtypes:
- Atherosclerotic coronary artery disease: This includes obstructive and nonobstructive coronary artery disease.
- Nonatherosclerotic coronary artery disease: This includes spontaneous coronary artery dissection (SCAD).
This article will take a closer look at the different types of coronary artery disease, the causes, the symptoms, and the treatment options.
Atherosclerotic coronary artery disease is the most common type of coronary artery disease. It’s caused by the gradual buildup of a fatty substance, known as plaque, in your coronary arteries. This buildup of plaque is called atherosclerosis.
The plaque is made up of cholesterol, fat, calcium, and other substances. Over time, it can harden and cause your arteries to become narrower. This can reduce blood flow to your heart.
Atherosclerotic coronary artery disease may be called obstructive coronary artery disease if more than 50% of the space within an artery is blocked. If less than 50% is blocked, it’s considered nonobstructive coronary artery disease.
Symptoms of atherosclerotic coronary artery disease include:
- chest pain or discomfort (angina)
- pain in your arms or shoulders
- heart palpitations
- shortness of breath
Risk factors for atherosclerotic coronary artery disease
Before age 55, atherosclerotic coronary artery disease is more
- high blood pressure (hypertension)
- high cholesterol
- early menopause
- polycystic ovary syndrome
- older age
- a family history of obstructive coronary artery disease
- long-term exposure to polluted air, including secondhand smoke
- certain lifestyle factors, such as:
You’ll notice that the language used to share stats and other data points in this article is pretty binary. Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.
Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.
Nonatherosclerotic coronary artery disease occurs when your coronary arteries don’t have significant blockages but may still have reduced blood flow. This happens when your arteries are compressed by surrounding heart muscle tissue or something other than a blockage.
Coronary artery spasms (vasospasms) are a frequent cause of artery compression. These are sudden contractions of the coronary arteries. Another cause is microvascular dysfunction — irregularities in the small blood vessels of the heart.
Some cases of nonatherosclerotic coronary artery disease are caused by congenital abnormalities.
Symptoms of nonatherosclerotic coronary artery disease are similar to those of atherosclerotic coronary artery disease.
This condition is often challenging to diagnose because symptoms can come and go. This can make it difficult to detect with tests.
Risk factors for nonatherosclerotic coronary artery disease
Nonatherosclerotic coronary artery disease doesn’t necessarily have risk factors on its own.
However, the following heart disease risk factors can contribute to microvascular issues, which can cause nonatherosclerotic coronary artery disease:
SCAD is a rare type of nonatherosclerotic coronary artery disease that occurs when there’s a tear in one or more layers of your coronary artery wall. This can prevent blood from reaching your heart. It’s a serious condition that needs emergency medical treatment.
The exact cause of SCAD isn’t always completely understood. But doctors believe it can be triggered by the weakening of the coronary artery walls.
Symptoms may begin more suddenly than in other types of coronary artery disease and can include:
- chest pain
- shortness of breath
- pain in your arm(s), shoulder, neck, or jaw
- cold sweat
Risk factors for spontaneous coronary artery dissection
This condition is most common in women 30–60 years of age. Other risk factors include:
Obstructive and nonobstructive coronary artery disease
Obstructive and nonobstructive coronary artery disease can be managed with lifestyle strategies and medications.
Lifestyle strategies may include:
- getting regular exercise
- following a balanced, heart-healthy diet
- quitting smoking if you smoke
- limiting or avoiding alcohol consumption
- managing stress in a healthy way
Your doctor may also prescribe medications to help manage conditions that can increase your risk of coronary artery disease. These medications may include:
- statins to keep your cholesterol levels in check
- ACE inhibitors, beta-blockers, or calcium channel blockers to help lower your blood pressure
- medications that help regulate your blood sugar
- nitrates such as nitroglycerin to help relax your blood vessels
Coronary artery tears due to SCAD often heal on their own, but surgery is sometimes necessary to restore blood flow to the heart.
Coronary artery disease is a condition that restricts blood flow to your heart. It can be categorized as either atherosclerotic or nonatherosclerotic coronary artery disease.
Obstructive coronary artery disease, the most common type, is caused by plaque buildup in your arteries. Nonobstructive coronary artery disease is caused by artery spasms and blood vessel irregularities. SCAD is caused by a tear in the layers of your coronary artery wall.
Treatment of coronary artery disease may involve lifestyle strategies, medications, heart rehabilitation, and, in more serious cases, surgery.