Coronary Artery Disease (CAD)


What is coronary artery disease?

Coronary artery disease (CAD), also known as coronary heart disease (CHD) or ischaemic heart disease, occurs when your body’s major blood vessels that supply the heart struggle to send enough blood, oxygen, and nutrients to the heart muscle.


What are the causes of coronary artery disease?

CAD is commonly caused by inflammation of the arteries, which is the result of arterial plaque build-up. Plaque contains deposits of cholesterol and other substances in the artery. When the arteries narrow over time due to plaque build-up, the blood flow can be partially or totally blocked. This process is called atherosclerosis.


What are the symptoms of coronary artery disease?

  • Chest pain or pressure: Pain in the chest (also called angina) as well as pressure or the sensation of tightness, occasionally may extend to the neck, arm or back.
  • Weakness
  • Dizziness
  • Shortness of breath and fatigue
  • Heart attack: Classic signs of a heart attack include chest pain, shoulder or arm pain, shortness of breath and sweating

Symptoms may not manifest in the early stages as it may take anywhere from years to decades for plaque build-up.


What are the risk factors of coronary artery disease?

  • Unhealthy diet: Diet rich in saturated fat, trans fat, sugar, and salt
  • Family history: Having a close relative who developed heart disease at an early age, or family history of heart disease
  • Diabetes
  • Gender: Men are at greater risk of developing CAD, while the risk for women increases after menopause
  • Overweight or obesity
  • Older age
  • Hypertension
  • High cholesterol

How is coronary artery disease diagnosed?

Other than a physical examination, your cardiologist may require you to take one or more of the following tests:

  • Electrocardiograph tests (EKG)
  • Exercise stress tests/ treadmill tests (TMT)
  • Pharmacological stress test
  • Echocardiogram
  • Blood tests (to measure cholesterol, triglycerides, C-reactive protein, glucose, HbA1c, etc.)
  • Cardiac catheterisation
  • Coronary calcium scan
  • Nuclear imaging
  • Computed tomography angiogram

What are the treatment options for coronary artery disease?

  • Medications: Heart-related medicines e.g., medicines to lower cholesterol levels and blood pressure, medicines to manage angina, and anticoagulants and antiplatelet to reduce blood clots
  • Non-surgical treatments: e.g., balloon angioplasty and stenting
  • Surgical interventions:e.g., coronary artery bypass graft surgery (CABG)

What are the prevention tips for coronary artery disease?

Consider making the following lifestyle changes:

  • Stop smoking or avoid getting into the habit of smoking
  • Make dietary changes to manage health issues such as cholesterol and blood pressure
  • Maintain a healthy weight
  • Reduce and manage stress
  • Limit the consumption of alcohol
  • Exercise and increase your physical activity level

References

  1. Coronary artery disease (CAD). Available at https://www.cdc.gov/heartdisease/coronary_ad.htm [Accessed on 29 April 2022]
  2. Coronary artery disease. Available at https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613?p=1 [Accessed on 29 April 2022]
  3. Coronary artery disease. Available at https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease [Accessed on 29 April 2022]
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