Coronary Artery Disease
What is It?
Coronary artery disease is a condition in which the coronary arteries, which supply blood and oxygen to the heart muscle, become narrowed by fatty deposits called plaques. This disease process is called atherosclerosis. Mild coronary artery disease may develop over decades without any symptoms. More severe disease can cause chest pain (angina) and shortness of breath. If a plaque suddenly ruptures, a blood clot can form and block blood flow, causing a heart attack. Over time, severe coronary artery disease can weaken the heart muscle and lead to heart failure or arrhythmias.
What are the symptoms?
Early coronary artery disease often has no symptoms. As it progresses, patients may experience chest pain or tightness (angina), particularly on exertion or with stress. Other symptoms include shortness of breath, fatigue, pain radiating to the arm, neck, jaw or back, and palpitations. A heart attack may present with sudden, severe chest pain, sweating, nausea and lightheadedness.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of coronary artery disease. Risk factors include:
- Modifiable risk factors: High blood pressure, high cholesterol, smoking, diabetes, obesity and physical inactivity.
- Dietary factors: Diets high in saturated and trans fats contribute to plaque buildup.
- Non-modifiable factors: Advancing age, male sex, and family history of early coronary disease.
- Other contributors: Chronic stress, poor sleep and inflammatory conditions.
How is it investigated?
Initial investigations include an ECG, blood tests (including cholesterol and cardiac biomarkers), and a baseline clinical assessment. Further investigations may include an exercise stress test, stress echocardiogram, CT coronary angiogram (CTCA) with calcium score, cardiac MRI, or invasive coronary angiogram. Your One Heart Centre cardiologist will discuss which test is most appropriate for you.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing coronary artery disease and will provide a personalised treatment plan for your coronary artery disease. Treatment options include:
- Risk factor modification: Lifestyle changes including a heart-healthy diet, regular exercise, smoking cessation, and weight management.
- Medical therapy: Medications including aspirin, statins, beta-blockers, ACE inhibitors, and nitrates to relieve angina.
- Percutaneous coronary intervention (PCI): Angioplasty and stent insertion to open blocked arteries.
- Coronary artery bypass graft (CABG) surgery: For patients with severe or complex disease.