Coronary artery disease (CAD) is a silent killer.

"Many people with this disease (coronary artery 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," say doctors from National Heart Centre Singapore​ (NHCS), a member of the SingHealth​ group.

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What is coronary artery disease (CAD)?

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 a build-up of fatty deposits called plaque on their inner walls. 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 is reduced, which can cause chest pain (angina). A sudden, complete blockage can lead to a heart attack.

Read this article for ways to prevent and manage atherosclerosis (plaque buildup in arteries).

Causes and symptoms of coronary artery disease (CAD)

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 and over time, it can:

  • Narrow the arteries, reducing the amount of blood and oxygen reaching the heart.

  • Block the arteries completely which stops the flow of blood to the heart.

  • Cause blood clots to form which can block the arteries that supply blood to the heart.

Coronary Artery Disease

Above diagram: A normal artery with nomal blood flow and an artery containing plaque build-up.

CAD varies in signs and symptoms and in severity.

  • No symptoms

    • Referred to as silent ischaemia, you do not have any symptoms although the blood supply to your heart may be restricted.

  • Chest pain (angina)

    • Usually brought about by physical or emotional stress. It feels like a heavy weight on your chest.

  • Shortness of breath

    • Occurs when the heart fails due to damage to the heart muscle.

  • Heart attack (Myocardial Infarction)

    • Caused by a blood clot or rupture in a narrowed coronary artery. The part of the heart muscle fed by that artery dies. Pain from a heart attack is often described as crushing and may feel similar to angina, but lasts longer.

See next page for the treatment of coronary artery disease​ (CAD).

Ref: V10

Check out other articles on heart health:

Tips for a Healthy Heart

Sudden Chest Pains You Shouldn't Ignore

Heart Palpitations: When Are They Serious?

How a Viral Infection Can Affect the Heart

How to Survive a Heart Attack When Alone