Coronary artery disease (CAD), also known as ischaemic heart disease, is caused by hardening and narrowing of the arteries. The National Heart Centre Singapore (NHCS) shares prevention tips and more.
Coronary artery disease (CAD), also known as ischaemic heart disease, is a silent killer.
"Very often, people with
coronary artery disease (CAD), also known as ischaemic heart disease, are not aware that they have it as it develops slowly and silently over decades. It can go virtually unnoticed until it produces a
heart attack," warns doctors from
National Heart Centre Singapore (NHCS), a member of the
SingHealth group.
Watch this video to learn more about coronary artery disease, also known as ischaemic heart disease!
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.
5 Ways to prevent coronary artery disease (CAD)
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:
Perform moderate intensity exercises at least 150 minutes a week. Moderate intensity exercises include brisk walking, jogging or swimming, are the best type of exercise for heart health. Walking is the safest form of exercise to start if you are uncertain of the level of intensity.
Get six to eight hours of sleep daily. Inadequate sleep of ≤ 4 hours or excess sleep ≥ 10 hours has been linked with increased risk of coronary artery disease.
Take two servings of fruits and three servings of vegetables daily. The My Healthy Plate is a good guide to follow.
Achieve and maintain a healthy BMI (Body Mass Index). The healthy range for Asians is from 18.5 to 22.9 kg/m2.
Stop smoking if you haven't. Smoking contributes to atherosclerosis and increases the risk of heart attack. Many stop-smoking aids can improve your chances of success in trying to quit smoking. Consult your doctor for help to successfully quit smoking.
For more ways to prevent and manage atherosclerosis (plaque buildup in arteries), click here to read the article.
Causes and risk factors 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.
Above diagram: A normal artery with nomal blood flow and an artery containing plaque build-up.
What puts you at risk of coronary artery disease (CAD)?
The risk factors that can contribute to coronary artery disease include:
Diabetes (Type 2 Diabetes Mellitus)
High blood pressure (Hypertension)
High cholesterol
Obesity
Sedentary lifestyle and a lack of physical activity
Smoking
Symptoms of coronary artery disease (CAD)
CAD varies in signs and 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:
Chest pain (angina)
Shortness of breath or breathlessness on exertion or when lying down
Pain in the neck, jaw, throat, upper abdomen or back
Severe chest discomfort lasting more than 10 to 20 minutes, which may be due to a heart attack.
Should you have severe chest discomfort, call an ambulance to bring you to the nearest hospital.
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Heart attack (Myocardial Infarction)
Diagnosis of coronary artery disease (CAD)
Diagnosis normally starts with a physical examination by a doctor, assessing your medical history and further investigative tests. Investigative tests generally include:
Functional Testing: Either a stress echocardiogram (dobutamine stress echocardiogram or exercise stress echocardiogram) or a nuclear stress test, to detect whether your heart responds abnormally to stress.
Coronary Angiography: A fine tube being threaded through your arm or leg artery to evaluate for blockages in your heart arteries. Coronary stents or balloons may be inserted into the heart arteries if there are significant blockages detected.
Other specific routine tests recommended may include:
Treatment of coronary artery disease
"You can prevent or slow down coronary artery disease by improving the health of your heart and blood vessels," advises doctors from NHCS.
Drugs and surgical techniques can open up narrowed coronary arteries. Making lifestyle choices to control the risk factors for coronary artery disease is the best long-term measure.
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).
1) Percutaneous coronary intervention
A common treatment for severe blockage of the coronary arteries, it is also known as
coronary or balloon angioplasty / percutaneous transluminal coronary angioplasty (PTCA) with coronary stent placement.
In PTCA, a small balloon or stent is used to help keep the part of the artery that is blocked open. The latest option within PTCA is the use of drug-eluting stents, which are stents covered with a drug, which supposedly has been shown to reduce the rate of re-narrowing of the arteries.
If percutaneous coronary intervention does not widen the artery or if complications occur, you may need coronary artery bypass surgery.
2) Coronary artery bypass surgery
Coronary artery bypass surgery is an open heart surgery where a route is created for blood to go around a blocked part of a coronary artery to supply your heart with enough blood to relieve chest pain.
Ref: H24 (ed)
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
