Coronary artery disease, also called arteriosclerosis or hardening of the arteries, is caused by a buildup of cholesterol and fat inside the walls of the arteries that bring oxygen-rich blood to the heart muscle. Coronary artery disease is caused by many factors, some that you can control and some that you cannot control.

Risk factors that can be controlled:

• smoking
• diabetes 
• high blood pressure 
• high cholesterol 
• weight (obesity) 
• sedentary lifestyle
  

Risk factors that cannot be controlled include:

• male gender
• female gender (post-menopausal) 
• family history of coronary disease 
• age
  

Coronary artery disease, or CAD, develops over many years. Most everyone develops some degree of CAD over their lifetime. It becomes problematic when blockages develop that compromise the flow of blood to the heart muscle, limiting the ability of the heart to pump effectively and get blood to the rest of the body. When an artery becomes 100 percent obstructed, a heart attack can occur.

Symptoms of CAD vary from patient to patient. Some people experience pain in their chest, neck or arms that may or may not be severe. The pain often occurs with exertion, but can occur at rest. Pain can last a few minutes or longer and may be relieved by nitroglycerin. Some people experience only fatigue and shortness of breath while others experience a heart attack as their first symptom of coronary artery disease.

It is important to be evaluated by a cardiologist if you have any symptoms that seem cardiac in nature. In situations where medical management or non-surgical interventions, such as angioplasty, are not applicable, patients will be referred to a surgeon for coronary artery bypass surgery.
If surgery is necessary, the good news is that technology and techniques have been developed that allow some patients to have their heart bypass surgery performed in a minimally invasive manner in a procedure called off-pump coronary artery bypass, also known as off-pump surgery, or beating heart surgery.

Beating heart surgery is a term used to describe coronary artery bypass grafting surgery in which the heart is allowed to continue beating normally while the bypasses are being performed by the surgeon and the surgical team. In most heart surgeries, including coronary artery bypass surgery, the heart is supported with the heart-lung machine. The vast majority of heart operations performed in the United States require that the heart is stopped. In recent years, technology and techniques have been developed that allow some patients to have coronary artery bypass surgery performed without the need for heart-lung machine support. Not all patients are candidates for off-pump/beating heart coronary artery bypass surgery. The potential benefits of performing the surgery in this fashion are a quicker recovery with a shorter hospital stay, avoidance of the potential physiological effects of being on the heart-lung machine, lesser blood requirements and complications in general.
 
Remember, if you have any signs or symptoms of coronary artier disease, or are concerned about your risk of developing coronary artery disease, please speak to your doctor.