Coronary Artery Disease (CAD) is a chronic, progressive condition resulting from atherosclerotic narrowing or occlusion of the coronary arteries, leading to impaired myocardial perfusion. It is the leading cause of morbidity and mortality worldwide.

The disease process begins with endothelial dysfunction and lipid accumulation, progressing to plaque formation, arterial stenosis, and potential plaque rupture with thrombus formation. Reduced coronary blood flow results in myocardial ischemia, manifesting clinically as angina, dyspnea, or acute coronary syndromes.

Risk factors include diabetes mellitus, hypertension, dyslipidemia, smoking, obesity, sedentary lifestyle, and genetic predisposition. Diabetic patients frequently exhibit diffuse, multivessel disease and may present with atypical or silent ischemia.

Clinical presentation ranges from stable angina to unstable angina, myocardial infarction, heart failure, or sudden cardiac death. Diagnosis involves ECG, stress testing, echocardiography, CT coronary angiography, and invasive coronary angiography for definitive anatomical assessment.

Management is multifaceted and includes lifestyle modification, pharmacologic therapy (antiplatelets, statins, beta-blockers, ACE inhibitors), and revascularization through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Early identification and comprehensive risk factor control are essential to prevent disease progression and improve survival.