2 Indications and current treatments
2.1 Coronary artery disease is narrowing (stenosis) of the coronary arteries caused by deposition of atherosclerotic plaque. This reduces blood flow to the heart muscle and is usually progressive. Symptoms of coronary artery disease typically include angina – chest pain that is exacerbated by exertion. A critical reduction of the blood supply to the heart may result in myocardial infarction or death.
2.2 The symptoms and health risks associated with a stenosed artery may be treated medically, by modifying risk factors (for example, smoking, hyperlipidaemia, obesity and hyperglycaemia) and by drug treatment (for example, with beta-adrenergic blockers, nitrates, calcium-channel blockers, antiplatelet agents and statins).
2.3 If medical management fails or is inappropriate, the usual options are surgical coronary artery bypass grafting or percutaneous transluminal coronary angioplasty (usually with insertion of a bare-metal or drug-eluting stent). Stents are inserted with a view to maintaining the patency of coronary arteries after balloon dilatation.