Coronary artery disease (CAD), also known as ischaemic heart disease, occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and narrow due to build-up of fatty deposits called plaque on their inner walls. The hardening of the artery walls is known as arteriosclerosis, while the build-up of plaque is known as atherosclerosis.
As the plaque increases in size, the insides of the coronary arteries get narrower and less blood can flow through them. Eventually, blood flow to the heart muscle is reduced and can cause chest pain (angina). A sudden, complete blockage can lead to a heart attack.
Many people with this disease are not aware they have it, as it develops slowly and silently over decades. It can go virtually unnoticed until it produces a heart attack.
Coronary artery disease varies in signs, symptoms and in severity. You may have no symptoms, otherwise referred to as silent ischaemia, where you do not have any symptoms although blood supply to your heart may be restricted.
You may also experience the following symptoms when you have coronary artery disease:
Should you have severe chest discomfort, call an ambulance to bring you to the nearest hospital.
You can prevent or slow down coronary artery disease by improving the health of your heart and blood vessels. Here are some heart healthy activities:
For more information on heart health activities and nutrition guide, visit our 'Guide for Patients with Coronary Atherosclerosis' here.
Coronary artery disease is caused by atherosclerosis or hardening of the arteries due to old age. In atherosclerosis, plaque build-up in the arteries is made up of fat, cholesterol, calcium, and other substances from the blood.
Plaque build-up in the arteries often begins in childhood. Over time, plaque build-up in the coronary arteries can:
The risk factors that can contribute to coronary artery disease include:
Diagnosis normally starts with a physical examination by a doctor, assessing your medical history and further investigative tests. Investigative tests generally include:
Other specific routine tests recommended may include:
It is recommended to first slow down coronary artery disease by improving the health of your heart and blood vessels, through lifestyle changes. Making lifestyle choices to control the risk factors for coronary artery disease is the best long-term measure.
Drugs and surgical techniques can open up narrowed coronary arteries. Optimal medical therapy such as aspirin (blood thinners), beta blockers (cardiac protective) and statins (cholesterol lowering medications) is given to all patients with coronary artery disease.
While many people are able to manage this disease with lifestyle changes and medications, others with severe coronary artery disease may need coronary angioplasty or surgery. There are various procedures to improve coronary blood flow (revascularisation):
Coronary artery disease (CAD) is a serious medical condition.
If you suspect you may have CAD, you may make an appointment with a cardiologist for further investigations and treatment.
To make an appointment at the National Heart Centre Singapore (NHCS), please visit here:
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