Coronary artery disease - NYSORA

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Coronary artery disease

Learning objectives

  • Describe the general pathology of coronary artery disease
  • Describe the risk factors for coronary artery disease
  • Manage patients with coronary artery disease

Definition & mechanisms

  • Coronary artery disease or ischemic heart disease is characterized by obstruction of oxygen supply to the cardiac muscle
  • Results in a range of complications, including myocardial infarction, dysrhythmias, heart failure, deteriorating ventricular function, and sudden death
  • May also coexist with other cardiac pathologies, including valvular lesions and cardiomyopathies
  • Atheromatous disease remains the most common cause
  • Ischemia results when myocardial oxygen demand increases beyond supply or when there is a rupture of a plaque which can precipitate thrombosis and result in complete occlusion of an artery

Risk factors

UnmodifiableAdvancing age
Male gender
Family history of premature coronary artery disease
Premature menopause
Ethnicity (e.g. higher in those from the Indian subcontinent)
Modifiable Smoking
Diabetes mellitus
Sedentary lifestyle
High cholesterol (specifically a high ratio of low- to high-density lipoprotein)


coronary artery disease management, resting 12-lead ECG, ventricular function, stress testing, coronary angiography, revascularization, cardiology, beta-blockers, statins, ace-inhibitors, ST-segment monitoring, pulmonary artery catheter, transesophageal echocardiography, neuraxial, preload, afterload, analgesia, volatile anesthetics, cardioprotective, normothermia, sinus rhythm, contractility, antithrombotic, anticoagulant, NSAID, cyclo-oxygenase-2 inhibitors

Suggested reading

  • Pollard BJ, Kitchen, G. Handbook of Clinical Anaesthesia. Fourth Edition. CRC Press. 2018. 978-1-4987-6289-2.

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