Heart
Coronary Artery Disease
A common heart condition where the major blood vessels supplying the heart become narrowed by plaque.
Coronary artery disease occurs when plaque narrows the coronary arteries, reducing blood flow to the heart — leading to angina, heart attack, or heart failure. It is the leading cause of cardiac infarction worldwide.
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Coronary artery disease develops over time as cholesterol plaque accumulates, restricting vital blood flow to the heart muscle.
Types
- Obstructive CAD — significant narrowing (>50–70%) causing exertional angina
- Nonobstructive CAD — plaque present without flow-limiting stenosis; includes microvascular dysfunction and vasospastic angina
Symptoms
- Exertional chest tightness or pressure (angina)
- Breathlessness
- Reduced exercise tolerance
- Palpitations
- Atypical presentations in women, diabetics, and older adults: fatigue, nausea, jaw or back pain
Risk Factors
- Hypertension, high cholesterol, diabetes, smoking
- Obesity and physical inactivity
- Family history of heart disease
- Chronic inflammatory conditions including autoimmune diseases and sleep apnoea
Diagnosis
- Resting ECG and lipid/glucose blood tests
- Stress echocardiography and myocardial perfusion imaging
- Coronary artery calcium scoring
- CT coronary angiography
- Invasive coronary angiography with fractional flow reserve measurement
Treatment Options
- Statins and cardioprotective medications
- Antihypertensive and antiplatelet agents
- Glycaemic control
- Percutaneous coronary intervention (PCI) with stent placement
- Coronary artery bypass grafting (CABG) for complex disease
- Cardiac rehabilitation programmes
Concerned About Coronary Artery Disease?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.