Coronary Artery Disease
What is coronary artery disease?
Coronary artery disease (CAD) is a condition that develops when the arteries that supply blood to your heart become narrowed, blocked, or damaged and cannot supply enough oxygenated blood and nutrients to the heart. The disease can cause chest pain, shortness of breath or a heart attack (myocardial infarction) if there is a complete blockage.
What are the symptoms of coronary artery disease?
This is the most common symptom of CAD. It can feel like pressure or tightness in your chest as if someone were standing on you. It’s also described as a burning or squeezing sensation. These symptoms can sometimes be mistaken for indigestion or heartburn. The pain usually occurs on the middle or left side of the chest. It is often triggered by physical or emotional stress and may go away within a few minutes of the stress stopping. Some people describe the pain as brief or sharp. You can also feel pain in your arms, top of the abdomen, neck or back, which is more common among women than men.
Shortness of breath
You may also feel exhausted after being active. This can happen with or without chest pain.
Severe chest pain or radiating pain
Severe, crushing chest pain or pain radiating up the arm into the neck and chest could be symptoms of a heart attack. It may be accompanied by shortness of breath and sweating. Call 000 (triple zero) immediately if you think you may be having a heart attack.
Other symptoms of coronary artery disease
- Back pain
- Jaw pain
- Upper abdominal pain
Some of these symptoms may be more common among women than men. Never ignore any of the symptoms, especially if pain is severe. Call 000 (triple zero) if you’re concerned.
What causes coronary artery disease?
Coronary artery disease is believed to begin with damage to the inner lining of an artery. Once the wall is damaged, fatty deposits of cholesterol, known as cholesterol plaque or atherosclerosis gather at the injury site. If the surface of the plaque breaks, blood cells stick together as a mechanism to repair the artery. However, this clump of blood cells can also slow the blood flow or block the artery and cause a heart attack. The build-up of cholesterol can develop over decades, which means you might not notice a problem until you have a significant blockage.
There are a number of risk factors that can contribute to the development of coronary artery disease. Some of which can be managed, and some of which cannot. The more risk factors you have, the higher your risk. Also, one risk factor can trigger another. For example, being sedentary and eating an unhealthy diet may increase your cholesterol, lead to high blood pressure and increase your risk of type 2 diabetes.
Risk factors you can manage
Smoking: People who smoke have a significantly increased risk of heart disease
High cholesterol: High cholesterol can increase the risk of plaque in the arteries, as well as a thickening and hardening of the arteries, known as atherosclerosis. Work with your GP to reach your target cholesterol
High blood pressure: If high blood pressure isn’t controlled, it can lead to a hardening and thickening of the arteries. Work with your GP to set a personalised target blood pressure
Being overweight: Having a BMI of over 25 can typically increase the risk of heart disease
Sedentary lifestyle: Not being active is associated with heart disease. Aim for a minimum of 30 minutes of exercise daily to reduce your risk. Even light exercise like slow-paced walking can make a significant difference
Diabetes: Type 2 diabetes significantly increases your risk of developing heart disease. Your doctor may advise you to aim for lower blood pressure and cholesterol targets. Making the recommended lifestyle changes can positively impact the severity of both coronary artery disease and type 2 diabetes
High stress: High stress may damage your arteries as well as increase other risk factors. Finding a way to manage your stress levels can help reduce your risk
Sleep apnoea: This disorder causes you to stop and start breathing during sleep. This can increase blood pressure and strain the cardiovascular system, possibly leading to coronary artery disease. Your GP can help you manage sleep apnoea
Unhealthy diet: High amounts of saturated fat, trans fat, salt and sugar increase the risk of coronary artery disease. It’s important to eat a balanced diet and watch your calories!!
Excessive alcohol consumption: This is known to increase the risk of heart disease.
Risk factors you can't control
Age: The risk of CAD increases with age, with men slightly more at risk from 45 and women from 55.
Family history of premature heart disease: If you have a first-degree relative classified with heart disease before the age of 60, this increases your risk.
Gender: There is a small increased risk of heart disease in males.
Autoimmune diseases: People with conditions such as rheumatoid arthritis, lupus and other inflammatory conditions have an increased risk of atherosclerosis (hardening of the arteries)
Preeclampsia: This pregnancy condition causes high blood pressure and can lead to a higher risk of heart disease later in life.
How is coronary artery disease diagnosed?
If you are aged between 40 and 75 (or 35 and 75 for Aboriginal or Torres Strait Islander people), you can see your doctor for a heart health check to determine your cardiovascular risk.
There are several tests available to diagnose CAD. To understand how your heart is functioning, your doctor might refer you for one or more of the following tests at Advara HeartCare:
Electrocardiogram: This monitors electrical signals that travel through your heart
Coronary Artery Calcium Score: This measures the calcium build up inside your arteries.
Exercise Stress Echocardiogram: This measures the stress on your heart with exertion.
How is coronary artery disease treated?
There are several treatment options for patients with CAD. Your doctor will design a management plan based on your risk factors and the symptoms and severity of disease.
Lifestyle modifications such as stopping smoking, reducing alcohol consumption, exercising regularly and eating a healthy diet may be recommended. In addition, medication may be prescribed to treat high cholesterol, high blood pressure or diabetes.
If these non-invasive techniques don’t work, your doctor may advise a procedure that increases the blood flow to your heart. Your doctor will discuss these options with you if required.
This information is of a general nature. If you are concerned about your heart health, discuss this with your local doctor.