Multivessel coronary artery disease is any form of coronary artery disease (CAD) that affects several major arteries.

CAD is the most common type of heart disease in the United States, and in industrialized countries, it is the most common cause of mortality.

Multivessel coronary artery disease is a stage of this disease involving two or more major arteries. The condition can cause serious health complications. It occurs when too much plaque builds up within the arteries, making it harder for blood to circulate to supply oxygen and nutrients to the heart muscle.

This article provides information about multivessel coronary artery disease, its symptoms, causes, treatment, and diagnosis. It also discusses the outlook for people with this condition.

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Scientists define multivessel coronary artery disease as any significant narrowing of at least 70% of two or more major coronary arteries, with the latter being greater than 2.5 millimeters (mm) in diameter.

The condition, known as atherosclerosis, develops when plaque builds up, causing a thickening, inflammation, or hardening of the arteries. Plaque is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin.

The coronary arteries supply the heart with blood, and multivessel coronary artery disease may lead to serious complications, such as heart attacks and heart failure.

Learn more about coronary artery disease here.

The symptoms of multivessel coronary artery disease depend on several factors, including the severity of the disease and other health problems.

For example, people with a more stable form of multivessel coronary artery disease might only develop symptoms during exercise.

Angina, or chest pain, is the most common symptom of CAD. Other symptoms may include breathlessness.

Importantly, this chest pain can have several additional characteristics:

  • it can worsen due to physical or emotional stress
  • rest or nitroglycerin can make it less intense
  • the pain might radiate to the neck and the left arm
  • it can arise below the sternum (center of the chest), alongside a feeling of discomfort or pressure
  • a person may experience lightheadedness, nausea, or sweating

Older individuals with multivessel coronary artery disease might also experience discomfort in the upper abdomen and vomiting. This is especially common in older women and older people with diabetes.

Multivessel coronary artery disease arises when plaque builds up in the coronary arteries. This can arise for several reasons, and there are many risk factors associated with multivessel coronary artery disease.

People at an increased risk of developing multivessel coronary artery disease include those:

Not every person from these groups will develop multivessel coronary artery disease.

There are several different treatment options for multivessel coronary artery disease.


CAD can make it harder for blood to reach various organs in the body, including the heart. Sometimes, doctors will consider stenting or surgery to allow more blood to reach those organs. The medical community refers to this as revascularization.

Although revascularization surgery can sometimes be useful and may reduce mortality for many individuals, it is inappropriate for certain people. Importantly, revascularization surgery is most effective alongside lifestyle changes and other medical treatments.

Lifestyle changes and medical treatment

A 2021 review suggests that people should make significant lifestyle modifications and receive medical therapy to treat multivessel coronary artery disease.

Lifestyle changes can include:

Medical therapy can include:

A healthcare professional will assess the severity of the disease and recommend the best course of treatment for a person.

Healthcare professionals use various methods to diagnose multivessel coronary artery disease.

A doctor will examine a person’s symptoms and may use an electrocardiogram (ECG) to monitor the activity of the heart and circulatory system.

They may also use an echocardiogram, which uses ultrasound waves to create a picture of the heart. Doctors can use this image to examine how the vessels of the heart are functioning.

Other imaging techniques include coronary angiography, which uses X-rays to create images of a person’s blood vessels.

Another type of test used to diagnose heart problems is a stress test, or exercise test. This involves doctors monitoring a person’s heart rate, blood pressure, and heartbeat while they exercise on a treadmill. The results can show if a person’s artery is blocked.

It is important to leave this diagnostic work to professionals. If anyone experiences CAD symptoms, they should immediately seek a doctor’s advice. This is especially important if they are at greater risk of the condition.

The outlook for people with multivessel coronary artery disease varies depending on certain factors, such as disease severity or the presence of other health issues and heart function.

Some evidence suggests that the outlook for people with this condition is worse in females than males.

The coronary arteries supply the heart with oxygenated blood, which it needs to function. Because multivessel coronary artery disease may prevent enough blood from reaching the heart, this could lead to conditions such as an acute heart attack, which can have a mortality rate of 5–30%.

Multivessel coronary artery disease is a serious condition that involves two or more large coronary arteries narrowing due to plaque buildup.

Given the importance of these arteries, people with multivessel coronary artery disease have an increased risk of heart attack and heart failure.

Scientists have developed some treatment options to improve the outlook for people with this condition. Making significant lifestyle changes, such as exercising more, losing weight, and stopping smoking, can all help to improve outcomes in people with this condition.

However, people should make these changes alongside medication treatment and surgery, if appropriate.