I. Introduction

Coronary arteries supply blood flow to the muscle of the heart. Atherosclerosis results in vessel narrowing or even occlusion and myocardial ischemia. Risk factors for atherosclerosis include aging, hypertension, diabetes mellitus, smoking, high blood cholesterol, obesity, stress and lack of exercise.

II. Symptoms

The chest discomfort is effort-related, located at the retrosternal or precordial area, may radiate to the left shoulder or jaw and lasts for 3–5 minutes. It may be associated with cold sweating, too.

III. Management

Stop activities and take a rest. You can take nitroglycerin tablet (NTG) sublingually once every five minutes, with up to maximal 3 times. Seek medical help immediately.

IV. Examination and treatment

1. Electrocardiogram (EKG or ECG): could reveal ischemia in unstable angina pectoris or myocardial infarction.
2. Treadmill exercise EKG test: take a quick walk on a treadmill machine, with increase in heart rate and myocardium oxygen demand, this may reveal ischemia related EKG changes.
3. Holter EKG: record 24-hour of EKG, which may reveal ischemia or arrhythmia.
4. Nuclear medicine scan: after dipyridamole or exercise induced stress, use nuclear isotope perfusion scan to detect myocardial ischemia.
5. Cardiac catheterization: for confirming the diagnosis of coronary artery stenosis or occlusion, to proceed to percutaneous coronary intervention (PCI), balloon dilatation or stenting if needed.
6. Medicine: take medication regularly (aspirin, antihypertensive agent, cholesterol-lowering agent)

             Recommended cooking methods:

•  Soup can be stored in the refrigerator. Remove the oil on the upper layer to reduce the fatty content.

• Use steamed stewed, roasted, or water-boiled method for preparing food. Avoid frying or fried food and eating low-salt diet to prevent hypertension.
• Eat more fruits and vegetables to avoid constipation.
• Eat low-calorie diet and avoid snacks.

      3. Take medicine on time to control blood pressure below 130/80 mmHg. Maintaining fasting blood glucose below 80-130                mg/dl, after meal glucose below 140 mg/dl.

                     (Photographed by AI)                                 (Photographed by AI)

     4. Quit smoking is a powerful preventive measure for CAD.

     5. Avoid emotional stress and job strain.

     6. Have nitroglycerin tablets in the pocket at any time.

     7. Moderate exercise: avoid strenuous and competitive exercise; you can do walking, tai chi or jogging.

• Take your pulse rate before and after exercise.
• If you have any discomfort after exercise, take a rest immediately.
• Take physical exercise in warm weather; avoid doing it in the extremely cold or hot environment.
• Avoid doing the Valsalva maneuver; avoid lifting heavy loads.

VI. Reference

1. Ciuca-Pană, M. A., Boulmpou, A., Ileri, C., Manzi, G., Golino, M., Ostojic, M., Galimzhanov, A., Busnatu, S., Mega, S., & Perone, F. (2025). Chronic Heart Failure and Coronary Artery Disease: Pharmacological Treatment and Cardiac Rehabilitation. Medicina (Kaunas, Lithuania), 61(2), 211. https://doi.org/10.3390/medicina61020211 
2. Ono, R., & Falcão, L. M. (2026). Coronary Artery Disease in Heart Failure With Preserved Ejection Fraction. The American journal of cardiology, 258, 12–18. https://doi.org/10.1016/j.amjcard.2025.08.035
   
3. Li, F., Hong, D., Yang, M., Pang, Z., Xi, H., Zhang, Q., Li, C., Mo, L., & Peng, L. (2026). Premature coronary artery disease in women: sex-specific risk factors, pathogenetic mechanisms and clinical implications. Annals of medicine, 58(1), 2613563. https://doi.org/10.1080/07853890.2026.2613563