Coronary Artery Disease
Coronary artery disease (CAD) is a common but serious condition that affects the blood vessels supplying oxygen and nutrients to the heart.
Over time, these vessels can become narrowed or blocked, reducing blood flow and potentially leading to chest pain, heart attack, abnormal heart rhythms, and other complications. Understanding CAD and its symptoms is key to protecting your heart health.
What is coronary disease? - When to see a cardiologist - Symptoms - Causes - Treatments - Complications
What is Coronary Artery Disease?
Coronary artery disease (also called “ischaemic heart disease”) occurs when the coronary arteries, which supply blood to the heart muscle, become narrowed due to the build-up of fatty deposits, or plaque, on the artery walls. This process, known as atherosclerosis, reduces blood flow and increases the risk of blockages.
The condition typically develops over decades and may go unnoticed until symptoms such as chest pain (angina) or a heart attack arise. CAD is the leading cause of death worldwide, but with early diagnosis and effective treatment, its progression can be managed and its complications prevented.
When to See a Cardiologist
Consulting a cardiologist is an important first step in diagnosing coronary disease. Many people with coronary disease have no symptoms. The first they may know of their diagnosis is when they experience a complication such as a heart attack, heart rhythm disturbance, or even sudden cardiac death.
For this reason, patients at risk for coronary disease through conditions such as diabetes, thyroid disease, hypertension, sleep apnoea, or a strong family history of coronary disease, should be regularly evaluated to catch the disease early and prevent complications.
Most people with coronary disease, however, do experience some or all of the following symptoms:
Persistent chest pain or discomfort, particularly during physical activity or stress.
Shortness of breath with minimal exertion or at rest.
Fatigue or dizziness, especially if accompanied by other symptoms.
Prompt evaluation can lead to early intervention, significantly reducing the risk of complications including heart attack and death.
Symptoms
The symptoms of CAD vary depending on the severity of the condition. Common signs include:
Angina:
A feeling of pressure, heaviness, or tightness in the chest, often triggered by physical exertion or emotional stress.
Shortness of breath:
A common symptom when the heart struggles to pump enough oxygen-rich blood.
Fatigue:
General weakness or tiredness, even with routine activities.
Heart attack:
In some cases, the first sign of CAD is a heart attack, which can cause severe chest pain, sweating, nausea, or lightheadedness.
Symptoms may be less noticeable in women or people with diabetes, so regular check-ups are important for patients at risk of the condition.
Causes
Coronary artery disease develops due to a combination of genetic, lifestyle, and medical factors. Key risk factors include:
High blood pressure:
Damages artery walls, making them prone to plaque buildup.
High cholesterol:
Particularly low-density lipoprotein (LDL) cholesterol, which contributes to plaque formation.
Smoking:
Damages blood vessels and reduces oxygen levels in the blood.
Diabetes:
Increases inflammation and accelerates artery narrowing.
Obesity:
Adds strain on the heart and increases risk factors like diabetes and high blood pressure.
Family history:
A genetic predisposition to CAD can heighten risk.
Age and gender:
CAD risk increases with age, and men are generally at higher risk until women reach menopause, after which the risk equalizes.
Treatments
Treatment for CAD aims to reduce symptoms, improve quality of life, and prevent complications like heart attacks. Depending on the severity, options include:
Lifestyle changes:
Adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
Engaging in regular exercise, such as walking or swimming.
Quitting smoking and managing stress.
Medications:
Statins: To lower cholesterol and stabilize plaques.
Beta-blockers and calcium channel blockers: To reduce blood pressure and heart workload.
Aspirin or other antiplatelet drugs: To prevent blood clots.
Nitrates: To relieve angina symptoms.
Medical procedures:
Angioplasty and stenting: A minimally invasive procedure to open narrowed arteries and insert a stent to keep them open.
Coronary artery bypass grafting (CABG): A surgical procedure to create new pathways for blood flow around blocked arteries.
Complications
Untreated or poorly managed CAD can lead to serious complications, including:
Heart attack:
Complete blockage of a coronary artery can damage or destroy part of the heart muscle.
Heart failure:
Prolonged reduced blood flow can weaken the heart, making it unable to pump blood efficiently.
Arrhythmias:
Irregular heart rhythms can occur due to scarring of heart muscle due to poor blood supply, or due to heart failure. The majority of deaths due to coronary disease are caused by arrhythmias.
Stroke:
CAD increases the risk of blood clots that can travel to the brain, causing a stroke.
Death:
Despite advances in treatment, coronary artery disease remains the leading cause of death worldwide and in the UK.
Early diagnosis and treatment significantly reduce the risk of these outcomes.