Coronary artery disease is a leading cause of death in Australia, associated with several other cardiac conditions including heart attack and angina. The impact of coronary artery disease may be mitigated through lifestyle changes, medication, or specialist interventions such as coronary angioplasty.
Also known as coronary heart disease, coronary artery disease involves a blockage or narrowing of the coronary arteries that carry blood to your heart muscle. Like every other muscle in your body, the heart muscle requires an adequate supply of oxygen-rich blood to remain healthy and functional.
The narrowed arteries found in coronary artery disease develop due to an accumulation of plaque, which consists of cholesterol, inflammatory cells, calcium, and other waste substances. This results in the artery walls losing their elasticity while also narrowing the space inside, a process known as atherosclerosis.
Coronary artery disease is a contributing factor to other heart problems such as angina, heart attack, heart failure, and arrhythmia.
Many different factors can increase your risk of coronary artery disease, including lifestyle factors, genetic and other non-modifiable factors, and co-existing medical conditions.
Lifestyle factors for coronary artery disease are those with the greatest potential to manage and reduce your risk of developing atherosclerosis. They include:
Other medical conditions may contribute directly to an increased risk for coronary artery disease through driving plaque build-up and atherosclerosis of the blood vessels. Managing these conditions well improves your symptoms from the condition itself plus has the added benefit of reducing your coronary artery disease risk.
Some demographics or genetic factors may increase your risk of coronary artery disease. Though these factors cannot be removed or reduced, you can still address your coronary artery disease risk in other ways, such as focusing on modifiable risk factors, reviewing with your cardiologist regularly, or undertaking preventative interventions if necessary.
Non-modifiable risk factors include:
It is possible to have early disease without any coronary artery disease symptoms, or even advanced disease, as the condition progresses slowly and even extensive disease can be asymptomatic. This is why understanding your risk factors and seeing a doctor for a cardiac risk assessment are important, particularly if you are aged 45 or older, or 35 and older and living with diabetes.
The most common symptom of coronary artery disease is chest pain, known as angina.
For some, coronary artery disease only becomes apparent at the time of a heart attack. Symptoms of a heart attack include angina, light-headedness, nausea, arm or shoulder pain, and shortness of breath. This is an emergency and requires immediate medical attention by calling Triple Zero (000).
Coronary artery disease is often diagnosed only after a heart attack or episode of angina. However, it can be detected early through routine heart health screening or cardiac risk assessment, and managed before coronary artery disease symptoms develop.
In diagnosing coronary artery disease, your family history, lifestyle, and other known risk factors will guide your doctor’s tests. These may include:
Coronary artery disease treatment requires a personalised plan, taking into consideration your risk factors, test results, and the current state of your coronary arteries. Often, the most effective approach is a combination of treatment strategies.
If you are a smoker, quitting cigarettes is the single most significant step you can take to reduce your overall cardiovascular disease risk, not just for coronary artery disease. You may also slow or stop the progression of atherosclerosis through a balanced diet lower in saturated fats and salt, regular physical activity, reducing alcohol intake, and taking steps to keep your body weight within a healthy range.
Alongside healthy lifestyle changes, medications may be needed to help manage co-existing medical conditions that are contributing to your coronary artery disease and heart attack risk. These may be medications to treat hypertension, high cholesterol, or diabetes. Certain drugs can also be prescribed to reduce blood clotting risk or alleviate angina symptoms.
Percutaneous coronary intervention (PCI) is a procedure performed by an interventional cardiologist to widen a narrowed coronary artery and restore proper blood flow with the use of a stent.
Coronary artery bypass graft (CABG) surgery creates an alternative route for blood flow to the heart by grafting a small section of a blood vessel taken from elsewhere around the blockage. CABG surgery is performed by a cardiothoracic surgeon.
At Harbourside Cardiology, our team is dedicated to providing holistic, patient-centred care that aligns with the most recent clinical guidelines and research. We are with you every step of your health journey, providing continuity of care of all heart conditions from initial assessment through to treatment and recovery.
