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Contact usCoronary Artery Disease (CAD) is the most common form of heart disease, caused by plaque buildup (atherosclerosis) in the arteries that supply blood to the heart. Over time, these narrowed arteries reduce blood flow, which can lead to chest pain (angina), shortness of breath, or a heart attack.
CAD develops from risk factors such as high blood pressure, high cholesterol, smoking, diabetes, obesity, lack of exercise, poor diet, and family history of heart disease.
Symptoms may include chest discomfort, pain in the arms, neck, or jaw, fatigue, or shortness of breath — though some people have no symptoms until a heart attack occurs.
Acute Myocardial Infarction (AMI), or heart attack, happens when blood flow to part of the heart is suddenly blocked, usually by a clot in a coronary artery. Without oxygen-rich blood, the heart muscle begins to die, making this a life-threatening emergency.
The most common cause is atherosclerosis — plaque buildup in the arteries — but heart attacks can also result from high blood pressure, smoking, diabetes, stress, or conditions like spontaneous coronary artery dissection (SCAD).
Symptoms vary but may include chest pressure or pain, pain in the arm, back, neck, or jaw, shortness of breath, sweating, nausea, dizziness, or fatigue. Women may experience less typical symptoms, such as indigestion, back pain, or unexplained fatigue.
Prompt treatment is critical — if you think you may be having a heart attack, call 911 immediately.
Chronic Total Occlusion (CTO) is a complete blockage of a coronary artery that has lasted for three months or more. This blockage is usually caused by long-term buildup of plaque (atherosclerosis) that hardens over time.
Because the artery is fully blocked, blood may be forced to flow through smaller vessels (collateral circulation) to supply the heart — but this is often not enough, leading to chest pain, fatigue, or shortness of breath. Some people may have no symptoms until a stress test or angiogram reveals the problem.
CTO is linked to risk factors such as smoking, high cholesterol, diabetes, high blood pressure, obesity, and family history of heart disease. Treatments may include medications, angioplasty with stenting, or bypass surgery, depending on severity.
According to the Centers for Disease Control, coronary heart disease contributes to over 375,000 deaths in the U.S. every year. About 20% of those deaths are people under the age of 65. If you’re facing coronary artery disease in Orange County, you need an advanced and experienced program and team for specialized cardiac diagnosis and care. You need Hoag.
From next-generation diagnostic testing to early-detection programs that catch cardiac conditions sooner and save lives, Hoag delivers caring, patient-centered care. Read on to learn more about the tests and exams we use to diagnose coronary artery disease at Hoag.
Preventive Diagnosis vs. Emergency Diagnosis
The way coronary artery disease is diagnosed and addressed depends greatly on whether a person is:
At Greater Risk for CAD and Experiencing Mild Symptoms: People can be at greater risk for CAD due to factors like being older, having high cholesterol, high blood pressure, diabetes or a family history of heart issues. Those with any of these risk factors should be periodically evaluated for CAD by a physician as a preventative measure. That’s especially true if those with risk factors experience symptoms that might indicate CAD in its early stages, like mild chest pain, discomfort in the arms or shoulders or mild shortness of breath.
Experiencing a CAD-related Medical Emergency: A coronary emergency related to coronary artery disease is often life-threatening, and usually involves severe chest pain or chest discomfort (angina), muscle or body weakness, light-headedness, nausea, cold sweats, pain or discomfort in the arms or shoulder and severe shortness of breath.
These more severe symptoms can indicate a person has myocardial ischemia, a severe blockage in the coronary arteries which can severely damage the heart muscle, including causing a potentially deadly heart attack (myocardial infarction) or stroke.
Don’t wait. Call 911 immediately if you’re experiencing symptoms like severe chest pain and shortness of breath indicating you could be having a heart attack or stroke. This is a life-threatening medical emergency that requires immediate care.
At Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, there are a variety of medical tests used to diagnose coronary artery disease, determine if you are experiencing a life-threatening emergency and help your health care provider decide which type of coronary artery disease you might have. These tests may include:
Blood Testing
During and after a heart attack, the body releases certain chemicals into the blood known as cardiac biomarkers or cardiac markers. By doing blood testing for elevated levels of these cardiac markers, physicians can determine whether a person has had a heart attack.
Electrocardiography
An electrocardiogram (ECG or EKG), which can reveal the strength and regularity of the electrical activity of the heart, which can sometimes show if you’ve experienced a heart attack. In addition to taking your vital signs and asking you questions about the symptoms you are experiencing, your family history of heart disease or heart attacks, your personal history of issues like chest pain, heart disease, heart attack, coronary artery disease and other issues, your health care provider will likely begin by administering an electrocardiogram (EKG) test.
Stress Testing
A stress test measures the activity and efficiency of the heart while you are doing physical exercise. During the test, your doctor will monitor your heart through various methods — often including ECG — while you exert yourself by walking on a treadmill or ride a stationary bike.
Imaging Tests
Cardiac imaging is also an important tool in the diagnosis of heart attacks, helping physicians locate the blocked coronary artery, evaluate the extent of damage to the affected heart muscle, determine the patient’s risk stratification and chart a short-term and long-term treatment course. Types of imaging used to diagnose and treat coronary artery disease include:
Cardiac MRI: Cardiac MRI is a special form of magnetic resonance imaging (MRI) used to evaluate the function and structure of the heart, valves, blood vessels and other structures.
Cardiac Nuclear Imaging Stress Test: A Cardiac Nuclear Imaging Stress Test is a diagnostic imaging test that utilizes a radioactive tracer that allows physicians see how well blood is flowing through the arteries to the heart muscle, both while a patient is resting and doing some form of exercise, like walking on a treadmill.
CT scan: CT scanning of the heart is an important tool in the diagnosis of coronary artery disease, allowing healthcare providers to capture detailed images of blockages in the heart due to calcium deposits and other issues.
Coronary CT angiography (CTA): Coronary angiogram (also known as coronary CT angiography) is an advanced form of computed tomography (CT) scan that utilizes a contrast dye that allows doctors to collect clearer images of the coronary arteries. Among other uses, coronary angiography allows physicians to visualize and examine the coronary arteries for blockages or other restrictions that might be hindering blood flow to the heart.
Echocardiogram: An echocardiogram is a test that utilizes high-frequency sound waves to create moving images of the heart. This can help your healthcare provider better understand how blood is moving through the heart. That can help health care providers diagnose issues like blockages in a coronary artery, valve disease, blood clots or other potential causes of coronary artery disease.
Electron-beam computed tomography (EBCT), which is a special kind of CT scan used to look for the buildup of calcium in the coronary arteries.
Cardiac catheterization: Cardiac catheterization is a test that allows physicians to visualize the coronary arteries. During cardiac catheterization, a thin, flexible tube called a catheter is fed into the body through a blood vessel, then guided to the heart. Contrast is introduced to determine the presence of narrowing or blockages caused by coronary artery disease.
At Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, experienced cardiologists can make a big difference in your care. It’s part of the reason why U.S. News & World Report has rated Hoag a high-performing hospital in both Heart Attack Care and Heart Bypass Surgery for 2023-2024.
If you need world-class coronary artery disease treatment in Newport Beach, Huntington Beach, Anaheim, Irvine, Mission Viejo or other communities across Orange County, the area’s most advanced cardiac treatment is just a short drive away, at Hoag.
To learn more, contact us through our online form.
Residents of Orange County with coronary artery disease have a powerful ally, right here in the neighborhood. At Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, our dedicated team of cardiovascular specialists stands ready to help patients diagnosed with heart conditions like coronary artery disease, heart attack, chronic total occlusion and more. As a high-volume center for cardiac treatment in Orange County, we’ve got the advanced tools, techniques and treatment options you need to come back strong.
Read on to learn more about how we treat coronary artery disease at Hoag.
There are a variety of treatments for coronary artery disease. Which treatment you might receive depends on several factors, including the type of coronary artery disease you have, the symptoms you are experiencing, your overall health, the degree and extent of blockage in your coronary arteries and other factors.
Options for non-surgical coronary artery disease treatment include:
Because lifestyle factors figure heavily in the development of coronary artery disease, it’s likely you’ll have to make modifications in your diet, exercise and life.
Lifestyle changes include:
Quitting smoking
Adopting a heart-healthy diet
Getting regular exercise
Maintaining a healthy weight
Managing stress
Medications to help control the symptoms of heart disease, high blood pressure, high cholesterol and other conditions that can contribute to coronary artery disease have advanced significantly in recent years, helping those with CAD live longer, healthier lives.
Medications to help treat coronary artery disease and the conditions that contribute to it may include:
Antihypertensives to help lower blood pressure such as:
ACE inhibitors
Angiotensin Receptor Blockers (ARBs)
Calcium channel blockers
Beta blockers
Cholesterol lowering medications to lower LDL cholesterol
Weight loss medications
Mental health medications to help patients reduce stress
Percutaneous Coronary Intervention (also known as PCI and CTO-PCI): Percutaneous Coronary Intervention is a minimally invasive procedure used to treat narrow or blocked arteries and restore blood flow to the heart. Here is a high-level overview of the procedure:
During the PCI procedure, an interventional cardiologist inserts a thin, flexible tube called a catheter through a blood vessel in the groin or wrist, then directs it through the body to the blocked coronary artery.
Next, a procedure called a balloon angioplasty, a tiny balloon at the tip of the catheter is then inflated, widening the artery and opening the blocked or narrowed artery.
Once the artery is open and blood flow is restored to the heart muscle, the interventional cardiologist then places a small mesh tube called a stent in the artery. This stent holds the artery open to prevent it from becoming blocked again in that place.
Other percutaneous coronary interventions include rotational or laser atherectomy. These advanced techniques involve the use of a revolving instrument or a laser to break up particularly tough blockages, or calcified plaque.
Need Orange County’s Experienced Cardiac Catheterization Team? Your Search Ends at Hoag.
Hoag is at the heart of innovation for advanced catheter-delivered treatments and patient-centered care for cardiac issues. Case in point: Hoag’s state of the art Allan & Sandy Fainbarg Electrophysiology Cath Lab Suite at Hoag Hospital Newport Beach. This 12,740 square-foot facility — the first of its kind in Orange County — is dedicated to being a comfortable, patient-centered hub for catheter-delivered cardiac diagnosis and care for a wide range of cardiac conditions, including coronary artery disease and atrial fibrillation.
Also known as CABG Surgery, Coronary Artery Bypass Surgery, a coronary artery bypass graft or just “bypass surgery,” Coronary Artery Bypass Surgery (CABG) is a form of open-heart surgery that uses “new” blood vessels taken from other parts of the body to route blood flow around a coronary artery blockage. During the procedure, cardiothoracic surgeons usually remove blood vessels from the leg, then surgically implant them in the heart, bypassing the narrowed or blocked coronary arteries entirely. CABG Surgery is helpful in cases in which patients have a complete blockage that can’t be cleared by other means.
Hoag is nationally rated for Heart Bypass Surgery. For 2023-2024, U.S. News & World Report named Hoag a High-Performing Hospital — their highest distinction — in Heart Bypass Surgery. Additionally, Hoag earned the highest distinction possible, a three-star rating out of three stars, from the Society of Thoracic Surgeons (STS) for isolated coronary artery bypass grafting (CABG).
After a heart attack or diagnosis with coronary artery disease, many patients can benefit from a cardiac rehabilitation program. Cardiac rehab is a physician-supervised exercise program designed to help patients recover from cardiac episodes or cardiac surgery.
Cardiac rehab programs help patients return to heart health through carefully controlled physical activity, along with counseling and guidance in areas that can aid in cardiac recovery, including: eating a heart-healthy diet, taking medications as directed, maintaining a healthy weight, quitting smoking, strategies for reducing stress and improving mental health and managing other risk factors.
Coronary Artery Disease takes the lives of over 375,000 people in the U.S. every year. But every day, the experienced cardiovascular specialists at Hoag are focused on raising the bar for patient care, delivering a team-based approach that allows them to work collaboratively toward diagnosis and treatment options that improve outcomes and lead to a fuller recovery.
From next-generation treatments for high-risk heart failure to diagnosing chest pain and advanced clinical trials, Hoag has the experience, expertise and advanced technology that Orange County residents need.
Contact us through our online form.

Cardiology
Nurse Practitioner, Cardiothoracic Surgery

Nurse Practitioner, Cardiothoracic Surgery

Nurse Practitioner, Coronary Artery Disease Program