Patient Fact Sheet – Coronary Artery Disease

Written by Dr Elizabeth Shaw, Structural and Interventional Cardiologist at 
Northern Beaches Hospital, Sydney

 

What is coronary artery disease?

Coronary artery disease is a serious condition that occurs when there is a narrowing or blockage of the arteries that supply blood to your heart.  It is usually caused by a build-up of plaque (cholesterol and fatty deposits) in the wall of the arteries.  If a blockage stops the flow of blood completely or almost completely, you will suffer a heart attack which can be life threatening.  Coronary artery disease is the most common form of heart disease in Australia.

 

What are the symptoms?

When your heart does not get enough blood supply, you may get the classic symptoms of coronary artery disease which include:

• Chest pain / tightness / pressure / heaviness / burning (commonly mistaken for indigestion)
• Jaw or neck pain
• Arm pain / heaviness / tingling
• Shortness of breath
• Sweating
• Feeling nauseous or vomiting.

Women may not always experience the classic symptoms and are more likely to have other symptoms including:

• Fatigue / weakness
• Feeling anxious
• Dizzy or lightheaded
• Back pain
• Sense of feeling something is not right.

 

What are the risk factors for coronary artery disease?

Risk factors you can’t control include:

• Age
  • Your risk of coronary artery disease increases as you get older.
• Genetics and family history of coronary artery disease
  • Coronary artery disease can run in the family. Your risk of coronary artery disease increases if a close family member has it.
• Gender
  • Obstructive coronary artery disease is more common in men. 
  • Non-obstructive coronary artery disease, which is harder to be diagnosed, is more common in women.
  • Women who suffer from endometriosis, gestational diabetes or pre-eclampsia are at an increased risk of developing heart disease.

Risk factors that you can control include:

• Smoking
• Being overweight or obese
• Having an unhealthy diet
• Physical inactivity
• High cholesterol
• High blood pressure
• Uncontrolled diabetes mellitus
• Excessive alcohol intake
• Depression, social isolation, lack of social support
• Stress.

 

How is coronary artery disease diagnosed?

Diagnosing coronary artery disease requires the doctor to take a detailed history of your symptoms and risk factors and performing an examination. They may also perform other tests including:

• Electrocardiogram (ECG)
  • This records the electrical signals of your heart and is measured by putting stickers and leads on your chest.
• Echocardiogram
  • This uses ultrasound waves to create pictures of your heart as it pumps the blood around. The test can reveal if your heart valves are working properly and also see if your heart’s walls are moving properly.
• Stress test
  • This measures the electrical signals of your heart as you do physical activity such as running on a treadmill or riding a stationary bike. If you can’t run on a treadmill, you may be given a special medication that speeds up your heart instead. An echocardiogram can be performed before and immediately after this test to improve the accuracy of the test.
• CT coronary angiogram
  • This is when you have a CAT scan while a special dye is running through your heart arteries. This allows for any blockages to be seen. This test can also tell you how much calcium deposits you have in your heart arteries. The more calcium deposits you have, the higher your risk of having a heart attack.
• Coronary angiogram
  • This is when a special dye is injected directly into your heart arteries to see if there are any blockages. This is always done at a hospital. If there are blockages, it can usually be treated straightaway during the same procedure.

 

What is the treatment of coronary artery disease?

It is important to reduce or control your risk factors by changing your lifestyle and medications.

Coronary artery disease can be treated with medications sometimes.

If your condition doesn’t improve with medications, you may need to have:

• Treatment of the blocked artery with balloon angioplasty and stent insertion
  • Widening of the blocked artery with a small balloon to push the plaque build up to the sides and insert a stent (metal scaffold that stays in the artery) to help keep the artery open. This is performed with a small incision from your wrist or groin. You are usually awake for this procedure.
• Coronary artery bypass graft surgery
  • Open heart surgery to restore blood flow to the heart. You require a general anaesthetic for this procedure.

 

What should I do if I am worried about coronary artery disease?

You should see your GP for a heart health check.

If you are experiencing any of the symptoms mentioned here, it is important to arrange an urgent review by your doctor.

If you think you are having a heart attack, immediately call Triple Zero (000) or attend your nearest emergency department.