CORONARY ARTERY DISEASE (CAD): DIAGNOSIS, SYMPTOMS & TREATMENT

Protect your heart before symptoms strike. Coronary Artery Disease can develop silently, increasing the risk of heart attacks and complications. Early detection through advanced cardiac screening and lifestyle modifications can significantly reduce the risk of CAD and blood flow abnormalities. 

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WHAT IS CORONARY ARTERY DISEASE (CAD)?

Coronary Artery Disease, also known as Ischemic Heart Disease, develops when the arteries supplying oxygen-rich blood to the heart become narrowed or blocked by fatty deposits called plaque. Severe blockages can trigger chest pain, heart attack, stroke, or other serious heart complications, making early detection and management crucial.

SYMPTOMS OF CORONARY HEART DISEASE (CHD)

Not everyone with CHD experiences the same symptoms. Signs can vary based on age, gender, and the severity of arterial blockage. In some cases, symptoms may develop gradually over decades or appear suddenly. Some common symptoms of CAD include: 

  • Chest Pain or Discomfort (Angina)
  • Feeling Faint, Lightheaded, or Dizzy
  • Shortness of Breath
  • Heart Attack in Severe Cases

CAUSES OF CORONARY ARTERY DISEASE

Coronary disease develops when the coronary arteries become damaged or narrowed, causing a restricted blood flow. This condition can be caused by underlying medical conditions, lifestyle, or genetic factors, such as:

  • Smoking
  • Excessive Alcohol Consumption
  • Inactive Lifestyle
  • Foods Rich in Sugar and Unhealthy Fats
  • Underlying Medical Conditions, Including Hypertension, High Cholesterol, and Diabetes
  • Family History of Heart Disease 

TYPES OF CORONARY HEART DISEASE

  • Obstructive CAD

    Obstructive Coronary Artery Disease refers to a condition in which one or more coronary arteries become significantly narrowed due to the buildup of plaque. This narrowing hinders the normal blood flow and oxygen supply to the heart muscles, causing difficulty breathing, chest pain, and a heart attack in severe cases.

  • Non-Obstructive CAD

    In non-obstructive Coronary Artery Disease, plaque accumulates in the coronary arteries but doesn’t significantly block blood flow. Although the arteries are not severely narrowed, this condition can still cause chest discomfort, reduced blood supply during stress, and an increased risk of future heart events.

  • Spontaneous CAD (SCAD)

    Spontaneous Coronary Artery Disease is a rare but serious condition caused by a sudden tear in the walls of the coronary arteries, causing an increased risk of heart attack. SCAD is more commonly seen in younger adults and women and requires prompt medical attention.

  • Triple Vessel CAD

    The 3 Vessel CAD occurs when all major arteries supplying blood to the heart become blocked. This advanced form of Coronary Disease severely limits blood flow and is associated with a higher risk of heart failure and heart attacks.
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HOW TO DIAGNOSE CORONARY ARTERY DISEASE?

CAD often develops gradually over the years without any clear symptoms. Therefore, diagnosis can not rely on symptoms alone. If your cardiologist suspects CAD, cardiac investigations may be recommended to evaluate heart function, blood flow, and arterial health. Standard diagnostic tests include:

ECG

An ECG reveals the abnormal electrical activity of the heart caused by reduced blood supply to the heart muscle. In patients with suspected Coronary Disease, ECG findings may indicate previous heart attacks, ongoing ischaemia, or abnormal heart rhythms linked to impaired coronary circulation.

Heart Echo

An echocardiogram test uses ultrasound imaging to assess the heart structure. It identifies areas of the heart muscle with restricted blood flow caused by narrowed or blocked coronary arteries.

Exercise Stress Test (ETT)

The ETT evaluates how well the heart performs under physical exertion. For CAD assessment, this test helps detect exercise-induced chest pain, ECG changes, or reduced blood flow that may not be evident when the heart is at rest. 

Holter Monitoring

Ambulatory Holter Monitoring involves continuous ECG recording over 24 hours or longer. It helps detect heart rhythm abnormalities or silent ischaemic episodes that occur during daily activities and may be associated with compromised coronary blood flow.

Heart CT 

Cardiac CT is a non-invasive imaging test used to detect calcium deposits and plaque within the coronary arteries and assess the risk of future cardiac events. 

Cardiac MRI

Cardiac MRI provides high-resolution images of the heart using magnetic and radio waves. It helps assess heart muscle damage, reduced blood supply, scarring from previous heart attacks, and overall cardiac function with exceptional detail.

WHAT TO EXPECT IN YOUR INITIAL CAD ASSESSMENT?

Dr Francesco Lo Monaco conducts a comprehensive cardiac assessment by reviewing your medical history, current symptoms, and performing a physical examination. Your vitals and lifestyle factors, such as diet, physical activity, smoking, alcohol intake, and stress levels, are carefully evaluated. Based on this assessment, Dr Monaco identifies whether further diagnostic tests are required and develops a personalised plan accordingly.

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PREVENTION AND TREATMENT OF CAD

Dr Monaco, the preventive heart specialist in London, adopts a proactive, prevention-focused approach by identifying cardiovascular risk factors early, combining advanced cardiac screening with personalised lifestyle guidance. By addressing risk factors earlier, he helps patients reduce CAD complications and maintain long-term heart health.

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FAQs

CAD can be serious or even life-threatening if not diagnosed and managed early. Timely intervention can help reduce the risk of heart attack, stroke, and other cardiovascular complications significantly. 

Coronary heart disease cannot be fully reversed, but its progression can be slowed down with regular monitoring, lifestyle changes, and proper treatment.

Uncontrolled blood pressure, high cholesterol, smoking, obesity, inactive lifestyle, stress, and family history can significantly increase the risk of developing CAD. 

With early diagnosis, proper treatment, and risk-factor control, many people with CAD can live long and active lives.

Chest pain or tightness, shortness of breath, chronic fatigue, dizziness, and symptoms triggered by physical exertion or stress are some early warning signs of clogged arteries.

Coronary Artery Disease often progresses slowly without visible symptoms. In many cases, it can take years before symptoms appear and may become life-threatening without proper management.

Yes, a family history of coronary artery disease increases the risk of CAD, especially if close relatives were diagnosed at a young age.