It’s estimated that almost 600,000 Australian adults are affected by coronary heart disease (CHD) at some point in their lives. Coronary heart disease is also the leading cause of death in Australia. Effective treatment can improve the symptoms of coronary heart disease and lower your risk of further heart problems.

At Healthscope, our experienced heart specialists provide world-class care for people living with coronary heart disease. Our state-of-the-art technologies and advanced procedures support accurate, timely diagnosis and coronary heart disease treatment – tailored for you.

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If you are experiencing any cardiac symptoms: chest pain, palpitations, shortness of breath. dizziness or fainting or signs of heart failure (swollen ankles, unable to lie flat or waking short of breath) you should contact your GP or present to an emergency department for assessment.

If you require urgent attention dial 000 (Triple Zero) and ask for an Ambulance.

What is coronary heart disease?

As the most important of your muscles, your heart needs a constant supply of oxygen to keep pumping blood around your body. The coronary arteries supply this oxygen-rich blood to the heart.

Coronary heart disease (or coronary artery disease) happens when one or more of the coronary arteries becomes narrowed or blocked by plaque. This prevents blood from flowing freely to the heart muscle, depriving it of oxygen.

This can lead to angina (chest pain). Sometimes, an artery wall can tear and plaque can leak into the blood. This can cause a blood clot that completely blocks a blood vessel. When blood flow to the heart stops or is severely restricted, it can permanently damage the heart muscle. This is what happens during a heart attack.

Coronary heart disease symptoms

Coronary heart disease is a chronic condition that develops over time. Many people don’t have any symptoms in the early stages, and only find out they have coronary heart disease when they get chest pain or have a heart attack.

Symptoms of a heart attack include:

  •  chest pain (angina)
  •  pain in the neck, jaw or arm
  •  shortness of breath or trouble breathing
  •  feeling dizzy, faint or lightheaded
  •  feeling cold and sweaty
  •  nausea or vomiting
  •  unusual tiredness
  •  heart palpitations (racing, pounding or irregular heart beat).

A heart attack is a life-threatening emergency. If you suspect you or someone around you is having a heart attack, call 000 (triple zero) immediately.

Over time, coronary heart disease can also weaken the heart muscle and lead to heart failure – a serious condition in which the heart cannot pump blood properly.

What causes coronary heart disease?

There is no single cause of coronary heart disease, but it is related to a process known as atherosclerosis. In atherosclerosis, plaque (which is made up of cholesterol, fat and other substances) builds up inside your arteries. This can lead to stiffness and narrowing of the affected arteries, making it harder for blood to flow through them. If plaque breaks off, a blood clot can form, which may prevent any blood from flowing.

Coronary heart disease risk factors

Certain factors can raise your risk of developing coronary heart disease. Some of these cannot be changed, such as getting older, being male, and having a family history of the condition.

There are other coronary heart disease risk factors you can do something about (known as ‘modifiable risk factors’). These include:

  • smoking
  • high cholesterol
  • high blood pressure
  • diabetes
  • not getting enough physical activity
  • being above a healthy weight
  • drinking more than the recommended amount of alcohol
  • depression, social isolation and a lack of social support.

Referral for management of coronary heart disease

If you have symptoms of coronary heart disease, your GP might refer you to a cardiologist (heart specialist) for further investigations and treatment.

To start your coronary heart disease treatment with us, ask your GP for a referral to one of our experienced cardiologists.

Your doctor can address the referral to a specific cardiologist, or simply to ‘Dear Doctor’.

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Coronary heart disease prevention

To help lower your risk of developing coronary heart disease, work on reducing or eliminating any modifiable risk factors. Your doctor or practice nurse can do a Heart Health Check to help you identify your risk factors. Your doctor can also give you advice and treatment to help you manage or treat them.

Coronary heart disease testing and diagnosis

To diagnose coronary heart disease, your doctor or heart specialist will ask about your symptoms and family history. They might also arrange for you to have some tests.

Blood tests

Blood tests can show signs of a heart attack and measure the levels of substances that can affect your heart and blood vessels (such as blood sugar, cholesterol and fats).

Physical examination

Your doctor will probably check your blood pressure and heart rate and listen to your heart with a stethoscope.

Electrocardiogram (ECG)

This test measures the heart’s electrical activity. Your doctor might use an ECG to check for signs of a heart attack or reduced blood flow to the heart.

Echocardiogram (heart ultrasound)

This test uses sound waves to get a picture of your heart. It allows doctors to see the heart’s valves and chambers and check how well your heart is pumping.

Exercise tests

Also known as ‘stress tests’, exercise tests check how your heart responds to physical activity. They involve monitoring your heart while you ride an exercise bike or walk on a treadmill.


This involves taking images of the heart arteries by passing a thin tube (called a catheter) through an arm or leg artery to the heart. A small amount of contrast dye is injected and an x-ray camera outside the body takes the images.

CT of Coronary Arteries (CTCA)

In this test, a CT scan takes images of the heart to see if any of the coronary arteries are significantly narrowed.

Fractional flow reserve (FFR)

This technique involves using a catheter to measure pressure differences across a narrowed section of coronary artery to see if it is interfering with delivery of oxygen to the heart muscle.

Instantaneous wave-free ratio (IFR)

This test examines whether a blockage is limiting blood flow in the coronary arteries, thereby reducing oxygen delivery to the heart.

Coronary heart disease treatment

Coronary heart disease is a lifelong condition that needs ongoing management. Treatment revolves around managing the symptoms, reducing risk factors, and helping to prevent a heart attack or stroke.

Depending on your symptoms and the condition of your arteries, your heart specialist might recommend surgery or conservative treatment.

Medical (non-invasive) treatment for coronary heart disease

Lifestyle changes – working on your heart health can help to reduce coronary heart disease symptoms. The Heart Foundation recommends making five lifestyle changes to manage CHD:

1.       Eat a heart-healthy diet and maintain a healthy weight

2.       Spend more time being physically active

3.       Be smoke free

4.       Control your cholesterol levels

5.       Control your blood pressure 

You can get support to quit smoking, reach a healthy weight, eat well and get active. Your doctor can refer you to professionals and programs to help with this.

Medications – your doctor might prescribe medicines to help with coronary heart disease management. These include medications to:

  •  lower your blood pressure, cholesterol or blood fat levels
  •  slow your heart rate
  •  improve blood flow to your heart
  •  reduce your risk of developing blood clots
  •  reduce damage if you have a heart attack.

Cardiac rehabilitation – these programs involve education and exercise sessions to help you get stronger, fitter and make heart-healthy changes. Led by healthcare professionals, you’ll get advice and exercises tailored to your needs. Cardiac rehabilitation can improve your wellbeing and quality of life. 

Invasive treatment for coronary heart disease

Your doctor might recommend a procedure to improve blood flow to your heart. This includes:

Coronary angioplasty and stenting – this procedure is used to reopen blocked or significantly narrowed coronary arteries. It involves passing a thin tube through an artery in the arm or leg to the heart. Then a tiny balloon is inflated, and an expandable metal scaffold (stent) placed into the affected artery to restore blood flow. This procedure is often performed with sedation under local anaesthetic.

Coronary artery bypass grafting (CABG) – in this procedure, another artery or vein is used to ‘bypass’ a blocked one and restore blood flow to your heart muscle. This procedure may be performed through small incisions or as traditional open surgery.


Recovery time can vary significantly depending on which procedure you have, along with factors like your age, general health, and lifestyle. If you have a procedure that doesn’t require a general anaesthetic, you can often go home the same day. If you have open surgery, recovery could take several months.

You might benefit from rehabilitation to help you get stronger and return to activities like work, driving and sport. Other health professionals, such as physiotherapists, dietitians and exercise physiologists, might work with you to create habits that promote heart health.

Your heart specialist can talk to you about how long it is likely to take to recover from your procedure.

References heart disease

Reviwed by A/Prof. Eoin Jude O’Dwyer, Cardiologist and A/Prof. Vijay Solanki, Cardiologist at Northern Beaches Hospital.



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