Coronary Artery Disease

• What is it?
• How is it diagnosed?
• What is the treatment?

What is it?

In some people, the coronary arteries become narrowed, usually by a process called atherosclerosis in which cholesterol and other substances are deposited in the arterial wall. With progressive narrowing, the blood supply to the heart muscle gradually decreases, and eventually becomes insufficient to supply the needs of the heart muscles. This usually results in chest pain or angina pectoris during exertion or stress, but may also manifest as breathlessness, irregular heart rhythm or fatigue. When a blood vessel suddenly obstructs completely, a full-blown heart attack occurs.

Coronary artery disease (CAD) is one of the most common diseases and is a major killer in Singapore.

How is it Diagnosed?

• Your doctor will diagnose CAD based on
• Your medical and family histories
• Your risk factors
• Results of a physical exam and tests
• No single test can diagnose CAD. Your doctor will advise you to do one or more of the following tests to confirm it.
• Stress Testing
  •  You are made to exercise to make your heart work hard and beat faster
  •  If you cannot exercise, medicine is given to speed up your heart rate
  •  There will be a need for more blood and oxygen as the heart works harder. If the arteries are narrowed by plaque, there would not be sufficient supply of oxygen-rich blood to the heart.
  •  Heart tests will then be performed to see how the increased heart activity affects your heart rate/blood pressure, whether you develop shortness of breath or chest pain, or if there are abnormal changes in your heart rhythm or electrical activity.
  •  If you cannot exercise for as long as you should be able to at your age, it may be a sign that you have CAD.
• Electrocardiogram (ECG)
  •  An ECG detects and records the strength and timing of electrical activity of your heart.
  •  Certain electrical patterns detected by an ECG can help suggest whether CAD is likely.
• Echocardiography (ECHO)
  •  An Echo uses sound waves to create moving picture of your heart.
  •  It can identify areas of poor blood flow to the heart and areas of the heart muscles that are not contracting normally.
• Chest X-ray
  •  Pictures of your heart, lungs and blood vessels taken can reveal signs of heart failure or other causes of symptoms that are not due to CAD.
• Blood tests
  •  Abnormal levels of cholesterol, sugar, proteins and certain fats in your blood can show if you have risk factors.
• Coronary Angiography 
  •  Angiography may have to be performed if other test and factors show that you are likely to have CAD.

What is the treatment?

There are various treatments for coronary artery disease (CAD).

• Lifestyle changes
  •  follow a healthy eating plan to prevent or reduce high blood pressure or high blood cholesterol
  •  Increase your exercise regime.
  •  If you are overweight or obese, you should try to lose weight and maintain a healthy weight- If you smoke, you should quit smoking
  •  Reduce stress and learn to cope with it
• Medicines
  •  if life style changes are not enough, medication will be needed to treat CAD
  •  medicines can decrease the workload on your heart, decrease your chance of a heart attack, lower your cholesterol and blood pressure, prevent blood clots etc.
• Medical Procedures
  •  Coronary Angioplasty
  •  Coronary Artery Bypass Surgery
• Cardiac Rehabilitation

 Back to Top