Coronary artery disease (CAD), also known as atherosclerosis, is the most common form of heart disease. According to the CDC, it claims the lives of an estimated 375,000 Americans each year.
Often described as “hardening of the arteries,” CAD develops slowly, sometimes over decades. It occurs when plaque continues to accumulate inside the arteries that supply blood to the heart, narrowing them and limiting blood flow.
Because this buildup happens gradually, the risk of CAD increases with age. A November 2025 report published in the American Heart Association’s Circulation journal found that adults age 75 and older account for up to 40% of hospitalizations for acute coronary syndrome (ACS). Often the result of CAD, ACS occurs when plaque suddenly ruptures, forming a clot that blocks blood flow and can trigger a heart attack.
Hidden Dangers
One of the most dangerous aspects of CAD is how quietly it can develop. The disease may be present for years—in rare cases, even in children—without causing noticeable symptoms. When symptoms do appear, such as chest pain or shortness of breath, they often don’t emerge until someone is in their 60s or later.
Even then, symptoms can be subtle or intermittent and may be mistaken for other conditions, including anxiety, allergies, emphysema, or even a collapsed lung. Unfortunately, for many people, the first sign of CAD is a sudden heart attack. This is why regular medical checkups are so important.
Who Is at Risk?
Several risk factors for CAD can be modified or managed. These include:
- High blood pressure
- Diabetes
- Smoking
- Physical inactivity
Family history also matters, particularly if a parent or sibling has had CAD. Men are generally at higher risk, although a woman’s risk increases after menopause due to hormonal changes.
How CAD Is Detected
Assessing your risk for CAD can be straightforward. A routine blood test can reveal diabetes, plaque-related proteins, and abnormal levels of low-density lipoprotein (LDL, the “bad” cholesterol) and high-density lipoprotein (HCL, the “good” cholesterol).
Noninvasive tests such as chest X-rays, electrocardiograms (EKGs), and cardiac positron emission tomography (PET) scans of the heart can also reveal CAD.
Another valuable tool is a coronary calcium score, a specialized CT scan that measures calcification in the arteries to estimate your risk of a heart attack over the next 10 years:
- Mild risk: 1–100
- Moderate risk: 100–300
- Severe risk: Above 300
A severe score—sometimes reaching several hundred—signals the need for prompt action, including major lifestyle changes, medications, additional tests, and possibly stenting or a bypass.
Next Steps
If a person’s case of CAD is found to be especially concerning, there are several prudent treatment options. These can range from taking medications to undergoing surgery. If you are concerned that you may be at risk for, or already have, CAD, ask your doctor to perform an EKG, bloodwork, and/or a calcium score test. Early detection can make a life-saving difference.
Dr. Gregory Pontone is the Acting Chief of the Cardiology Department at White Plains Hospital. He is a noninvasive cardiologist, and also serves as the Associate Medical Director of Ambulatory Quality & Physician Services. To make an appointment, call 914-849-4800.