Coronary artery disease

Audience: Patients and providers
Status: Clinical guide · patient + provider
Last updated: 2026-03-09

1. Clinical overview

Coronary artery disease is atherosclerotic narrowing of the coronary circulation that may present with angina, exertional dyspnea, or silent ischemia and requires risk reduction plus symptom-directed therapy.

2. Common causes and risk factors

Atherosclerotic plaque accumulation in coronary arteries.
Risk factors: dyslipidemia, diabetes, hypertension, smoking, CKD, family history.

3. Typical symptoms

Exertional chest pressure, dyspnea, reduced exercise tolerance; atypical presentations occur.

4. Diagnosis and evaluation

Confirm diagnosis with guideline-based history, exam, and indicated testing.
Screen for severity, complications, and high-risk comorbid conditions.
Identify social or access barriers that could affect treatment success.

5. Treatment (non-pharmacologic)

Cardiac rehab, smoking cessation, nutrition and activity targets.
Stress management and sleep optimization as adherence amplifiers.

6. Treatment (pharmacologic)

Antiplatelet therapy commonly uses aspirin or clopidogrel, and high-intensity statin therapy commonly uses atorvastatin or rosuvastatin.
Antianginal therapy often starts with metoprolol or carvedilol, with amlodipine, diltiazem, long-acting nitrates, or ranolazine added based on symptom profile and blood pressure.
ACE inhibitor or ARB therapy such as lisinopril or losartan is often used with CAD plus diabetes, CKD, hypertension, or post-MI remodeling risk.

7. Monitoring and follow-up

Symptoms, BP/lipids, medication tolerance, adherence, and ischemic risk changes.

8. Practical counseling points

Give patients a clear “what to do today / when to call / when to seek urgent care” plan.
Use teach-back to confirm understanding of treatment goals and medication instructions.
Simplify regimens when possible to improve adherence and outcomes.

9. Red flags and escalation

Escalate care urgently for severe or rapidly worsening symptoms.
Reassess diagnosis if expected response does not occur within the anticipated timeline.

10. Guideline references

Note: Educational guide only; not a substitute for individualized medical care.