Coronary artery disease (CAD) is the most common type of heart disease.1 The disease itself forms via atherosclerosis, a condition defined by a build-up of plaque (or fatty deposits) within the arteries. This plaque build-up causes the arteries to narrow and harden, which may limit the supply of blood and oxygen to the heart and brain. This can lead to serious events such as heart attack and stroke.2
Although some people inherit a higher risk of vascular disease, making it diﬃcult to prevent, there are still ways to reduce your risk:3
– Talk to your healthcare professional about resources
available to help you quit smoking3
– Have a healthy diet and weight3,5
– Have a regular exercise regimen3,5
– Get enough sleep – 7-9 hours is the standard recommendation6,7
– Avoid excess stress8
– Moderate your alcohol consumption3
If you think you may already suffer from a vascular disease, you should see a doctor as soon as possible. Help may be necessary and treatments may be prescribed to ensure you remain as healthy as possible.
It is advised that you visit your doctor for a vascular health check if you fall into any of the risk categories (i.e. high cholesterol, high blood pressure, diabetes, older age) or have any symptoms related to vascular disease (i.e. chest pain, shortness of breath, leg pain).3
If you are over the age of 40, and feel you may be at increased risk of vascular disease, ask your doctor if you are doing all you can to protect your vascular health. You can find some helpful questions on this page!
CAD often has no symptoms. However, as plaque build-up in the arteries worsens, symptoms begin to develop and the build-up may result in chronic CAD with stable angina.4 In 2019, the European Society of Cardiology released new guidelines on the management of chronic coronary syndromes (CCS). These guidelines redefine chronic CAD with stable angina as CCS to emphasise that the disease can have stable periods but can also become unstable at any time due to a cardiovascular event caused by changes to plaque build-up.9
When the heart muscle needs more blood and oxygen than it is getting i.e. during physical activity or times of stress.
Uncomfortable pressure, fullness or squeezing pain in the centre of the chest, which may also be felt in the neck, shoulders, back and arm.
It is important to understand that although you may not be experiencing any further symptoms, the risk of complications such as heart attack and stroke may still remain even after preventative treatment. Understanding your diagnosis of CCS is key to managing your ongoing, remaining risk and helps ensure you are doing all you can to protect your vascular health.
Some patients with CCS are at higher risk than others, for example those with diabetes, high blood pressure or high cholesterol, those who have a history of stroke, and the elderly.9, 11
If the plaque build-up is severe, it may result in unstable angina or heart attack.
Unstable angina is caused by reduced blood flow to the heart muscle due to arteries being narrowed by plaque build-up or blood clots.12
Chest pain or discomfort which may occur while you are resting or sleeping and possibly get worse over time. If plaque build-up worsens and completely blocks blood flow to the heart, it may result in a heart attack, which could be fatal. If you experience this type of new, worsening or persistent chest pain, you must see a doctor as soon as possible.12
CAD can also be associated with an increased risk of stroke, should plaque build-up block blood flow to the brain,1 and an increased risk of PAD, should plaque build-up block blood flow to the limbs.13
There are a variety of ways in which CAD can be diagnosed.
Your doctor will usually collect information about your medical history, do a physical exam and conduct a blood test. They may also carry out one of the following tests:14
Electrocardiogram (ECG): records electrical signals travelling through the heart. Certain abnormalities may indicate inadequate blood ﬂow to your heart.
Echocardiogram: creates images of the heart using soundwaves to determine how well it’s working. An area of the heart that shows weak movement can signal damage caused by a lack of oxygen.
Stress test: measures the impact of physical activity on the heart by conducting an electrocardiogram whilst walking on a treadmill or doing a similar exercise.
Nuclear stress test: similar to a stress test, but also collects images of the heart via a tracer injected into the bloodstream. The images can show areas of the heart that receive less blood ﬂow.
Coronary angiogram: a special dye is injected into your coronary arteries. The dye outlines plaque build-up and blockages on x-ray images.
Heart scan: computerised tomography (CT) scans are used to ﬁnd calcium deposits in arteries, to determine how narrowed the arteries are. You can also have a cardiac magnetic resonance imaging (MRI) scan. This is a type of scan that uses strong magnetic ﬁelds and radio waves to produce detailed images of the heart.
Current treatments include lifestyle changes, prescription medication and, sometimes, surgery.
For cholesterol control
For blood clot prevention
For high blood pressure
For diabetes control
Insulin/ antiglycaemic drugs
Percutaneous coronary intervention, or PCI14
Coronary artery bypass surgery14
Patients with CAD are at increased risk of experiencing complications such as:
Should plaque build-up block blood ﬂow to the heart.1
Should plaque build-up block blood ﬂow to the brain.1
Should plaque build up and block blood ﬂow to the limbs.2
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