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Stable vs. Unstable Coronary Artery Disease 

The human body is an amazing machine. When out of balance, the body sends signals to alert us that something is awry. Overwhelmed with stress? The body might respond with a headache or muscle tension. Fighting off an infection? The body might elevate its temperature or become easily fatigued. 

Chest discomfort is a common sign that the heart is not getting what it needs. More specifically, chest pain is the body’s way of screaming, “My heart is not getting enough oxygen-rich blood.” Chest pain signals that something is not quite right in the body.

Unfortunately, chest pain is a late symptom of coronary artery disease, or CAD. The type of chest discomfort experienced with CAD can offer important clues as to the severity of the problem at hand. In addition, the various characteristics of chest discomfort can help determine whether someone is experiencing stable versus unstable coronary artery disease. Understanding the difference between stable and unstable CAD can guide diagnostic and treatment decisions. 

What is angina? 

Coronary artery disease occurs when the arteries that supply blood to the heart become hardened and narrowed. Restricted coronary arteries make it difficult for oxygen-rich blood to reach the heart. 

One of the primary symptoms of CAD is chest pain, or angina. Muscles need oxygen, and the heart is no exception. Angina occurs as a result of reduced blood flow to the heart. 

Angina is estimated to impact over 10 million people in the United States. And while not all patients with coronary artery disease experience angina, studies show that those with angina have higher rates of future cardiovascular events. 

Angina can present differently for everyone, but it’s most commonly described as pressure, heaviness, squeezing, tightness, or pain in the chest. Some explain that angina feels as though weights are sitting on the chest. In addition, angina may be confused for indigestion. While discomfort is generally located in the chest, it can radiate to the neck, jaw, arms, back, and abdomen. 

The timing, frequency, and intensity of angina help guide healthcare providers to determine if an individual has stable versus unstable coronary artery disease. 

What is stable coronary artery disease? 

Stable coronary artery disease is CAD that occurs with no symptoms or with angina that presents in a predictable pattern. Because stable CAD is often asymptomatic, many individuals learn of their condition following a diagnostic procedure, such as a CT scan or an angiogram. 

Some people with stable CAD experience chest pain when exerting themselves, such as when walking up stairs or when experiencing a stressful event. However, the chest pain typically dissipates quickly after rest. Angina that comes on with exertion and stops with rest is often one of the first manifestations or warning signs of coronary artery disease. 

Stable angina is less worrisome than unstable angina. However, without significant lifestyle changes, stable coronary artery disease can quickly become unstable. 

Unstable coronary artery disease 

Stable coronary artery disease becomes unstable when individuals experience chest pain without exertion or while at rest. For example, someone with unstable CAD may experience chest pain while reading the newspaper or watching television. 

Moreover, individuals with unstable CAD often experience an increased frequency of angina. Instead of experiencing chest pain once in a while during exertion, those with unstable CAD regularly have chest pain. Unstable CAD is less predictable and more frequent than stable CAD. 

Stopping the progression of CAD 

Chest discomfort of any kind is a warning signal from your body that something needs to change. The best way to prevent stable CAD from becoming unstable is by adopting healthy lifestyle habits, such as: 

  • Eliminate all processed food, sugar, GMOs, and seeds oils. 
  • Increase your consumption of organic, whole foods such as vegetables, wild-caught fish, grass-finished beef, pasture-raised eggs and poultry, nuts, and seeds. 
  • Drink high-quality water.
  • Get adequate sunshine and sleep.
  • Exercise more, preferably outdoors.
  • Spend time in nature.
  • Lower your stress levels. 
  • Surround yourself with a positive community.
  • Reduce exposure to toxins and EMF.

Next steps

Chest discomfort should never be dismissed as normal. Learning to listen to the signals that your body is sending is vital to a long life. 

If you have ever been told that you have coronary artery disease or if you experience chest discomfort, immediately schedule an appointment with a Natural Heart Doctor practitioner. Please don’t wait until symptoms progress and it’s too late. Achieving your 100 Year Heart is possible, but you must start today. 

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Join cardiologist Dr. Jack Wolfson for a complete review of high blood pressure medications. You’ll learn:

Dr. Wolfson will also answer your questions about blood pressure medications. Register now.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a 20-minute phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $750.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.

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