Yes, coronary artery disease is the narrowing of the coronary arteries that supply blood to the heart muscle (myocardium). In 2018, coronary heart disease was the leading cause (42.1%) of deaths attributable to cardiovascular disease in the US, followed by stroke (17.0%), high blood pressure (11.0%), heart failure (9.6%), diseases of the arteries (2.9%) and other cardiovascular disease (17.4%).

"Traditional" risk factors are high blood pressure, high cholesterol, diabetes, smoking, sedentary lifestyle, lack of exercise, family history, ethnicity, and advanced age (over 45 in men and over 55 in women). There are also more recently identified risk factors (''non-traditional'') which include chronic renal failure, rheumatoid arthritis, systemic lupus erythematosus, non-alcoholic fatty liver disease (NAFLD) and other conditions.

Unfortunately, in many people, the first manifestation of coronary artery disease is a heart attack (sudden blockage of the coronary arteries). Heart attack symptoms appear suddenly and include chest pain or discomfort (angina), difficulty breathing (dyspnea), arm or shoulder pain or discomfort, sweating, weakness, dizziness, nausea. In other cases, symptoms appear gradually, in a more stable and chronic pattern and for that reason it is called “Stable Angina". In these cases, Chest/arm/shoulder pain or shortness of breath occur or worsen with physical activity (e.g climbing stairs or walking).

The main means of prevention are a healthy diet, exercise, complete avoidance of smoking and a visit to the doctor to examine if there are risk factors for cardiovascular diseases in order to decide whether therapeutic intervention is needed for high cholesterol, high blood pressure, diabetes, etc.

Interventional cardiology provides the option of percutaneous (through the skin) interventions on the heart which essentially means without a scalpel. With cardiac catheterization (through the skin) we examine the heart's arteries, identify blockages and, if necessary, place stents that allow an artery to remain open. In some occasions the blockages of the arteries are in places where it is not possible to place a stent, or the blockages are so extensive that the best option is to perform open heart surgery to bypass the blockages with grafts (''Coronary Artery Bypass Grafting - CABG''). That is done by a cardiac surgeon in the operating room under general anesthesia. Most interventional cardiology procedures do not need general anesthesia. In general, the treatment of severe coronary artery blockages can be performed either by stenting (performed by interventional cardiologists) or by open heart surgery (performed by cardiac surgeons). The interventional cardiologist should explain all options and help the patient choose the best solution to the problem. The best option can sometimes be stent placement, sometimes open-heart surgery and sometimes the combination of the two options at different time intervals.

A balloon is placed at the site of the blockage, through a catheter that reaches the heart. The interventional cardiologist then fills the balloon with fluid in order to expand the site of the blockage and allow better blood flow. The balloon is then removed and a stent is placed at the site of the blockage in order to keep the artery open. A stent is essentially a metal tube with a diameter of a few millimeters. This metal tube is placed percutaneously (through the skin) at the point of the narrowing and helps the artery remain open, after the balloon is removed.

There are two main scenarios in which someone may need stents. The first scenario is for the treatment of acute myocardial infarction, which happens as a result of sudden blockage of one of the coronary arteries that supply blood to the myocardium (the heart muscle). In this case, balloon angioplasty and stent placement is the most effective way to open the coronary artery and restore myocardial perfusion. This reduces the chances of heart failure and very often saves a patient's life. The second category of patients are those who have a more chronic narrowing of the coronary arteries and who continue to have symptoms of Stable Angina (eg chest pain or shortness of breath), despite having tried anti-anginal drugs. In these patients, angioplasty is indicated for symptom relief and it is very effective.

Placings stents to open blockages is very effective but does not stop the development of new blockages. The buildup of blockages can be significantly slowed down by completely avoiding smoking, maintaining excellent cholesterol levels, controlling blood pressure and blood glucose and, in general, with drug therapy to control the various risk factors for coronary artery disease. Lifestyle changes like exercise, healthy diet and avoiding stress are of outmost importance.

In addition to the treatment of coronary artery stenosis, interventional cardiology offers treatment options for percutaneous repair of some congenital heart diseases (eg treatment of atrial or interventricular communication), transcatheter (percutaneous) aortic valve replacement, percutaneous mitral valve repair and opening of peripheral arteries in the legs. These percutaneous procedures are performed in the catheterization laboratory, which is a sterile space with very advanced technology.