25 Questions and Answers
Coronary artery disease (CAD) is the narrowing or blockage of the arteries that supply the heart, caused by the build-up of cholesterol and fat on their inner walls. This restricts the oxygen reaching the heart muscle. When the heart is deprived of oxygen, chest pain, shortness of breath, and fatigue appear. As the disease progresses, a heart attack may occur. CAD is one of the leading causes of death worldwide, but it can largely be prevented with early diagnosis and the right lifestyle changes.
The underlying cause is atherosclerosis — hardening of the arteries. Cholesterol, fat, and calcium form plaques on the vessel wall, narrowing or completely blocking blood flow. High cholesterol, smoking, hypertension, diabetes, obesity, and stress accelerate this process. Genetic predisposition also plays an important role.
Pressure or burning in the centre of the chest (angina pectoris), pain radiating to the arm, jaw, or back, shortness of breath, rapid fatigue, nausea, sweating, and dizziness are the most common symptoms. In some people, symptoms only appear with exertion. Rest pain may signal a heart attack.
Men over 40 and post-menopausal women are at higher risk. Smokers, those with high cholesterol or blood pressure, individuals with a family history of heart disease, diabetics, and obese people face elevated risk. A sedentary lifestyle, high-stress work, and poor dietary habits also increase risk.
Yes. Women may experience atypical symptoms such as back, neck, or upper abdominal pain, nausea, and extreme fatigue rather than classic chest pain. Many women mistake a heart attack for a stomach complaint, leading to delayed diagnosis. Cardiac screening is recommended for women with risk factors.
Diagnosis starts with a physical examination, ECG, and blood tests. This is followed by a stress test, echocardiography, or coronary CT angiography to assess the vessels. In uncertain cases, conventional angiography (coronary angiography) directly images the inside of the arteries.
A thin catheter is inserted via the groin or wrist and contrast dye is injected into the heart arteries for imaging. It is the gold-standard diagnostic method and a stent can be placed in the same session if a significant narrowing is found.
A stent is a thin metal tube placed inside a blocked artery to keep it open after balloon dilation. Drug-eluting stents reduce the risk of re-blockage. Lifelong antiplatelet medication is required after stenting.
Bypass surgery creates a new blood route around the blocked coronary artery using a vessel from the leg or chest. It is preferred for multi-vessel disease and when stenting is not feasible.
Yes. For mild narrowings, blood thinners, cholesterol-lowering drugs, blood pressure medications, and lifestyle changes can control the disease. These treatments do not cure it fully but slow its progression.
CAD is a long process — the artery narrows gradually over years. A heart attack is the sudden complete blockage of this artery by a clot, causing heart cells to die. Chest pain lasting over 20 minutes, cold sweat, and nausea require immediate emergency care.
A Mediterranean diet is recommended: olive oil, vegetables, fruit, fish, and whole grains. Red meat, saturated fat, processed food, and salt should be limited. Drinking 2 litres of water daily and increasing fibre intake supports vascular health.
At least 30 minutes of walking or moderate-intensity exercise on 5 days per week is recommended. Swimming, cycling, and yoga are heart-friendly. New patients must always obtain medical clearance first.
Smoking damages the vessel wall and increases clot risk. Alcohol raises blood pressure and triglyceride levels. Both habits accelerate the progression of coronary blockage.
Chronic stress raises adrenaline and cortisol, increasing heart rate and blood pressure. Over time it leads to vascular inflammation. Meditation, breathing exercises, and regular sleep are important for stress management.
LDL ("bad cholesterol") builds up on the vessel wall to form plaques; HDL ("good cholesterol") clears them. LDL should be kept below 100 mg/dL and total cholesterol below 200 mg/dL.
Individuals whose parents had heart disease before age 55 are at high risk. Regular cholesterol, ECG, and blood pressure checks should begin from age 35.
Atherosclerosis cannot be reversed, but its progression can be halted. Medication, diet, exercise, and quitting smoking can significantly reduce the risk of heart attack.
Not if the disease is well controlled. If chest pain or shortness of breath is present, medical clearance is required. Some medications used for sexual function may interact with heart medications.
Cold constricts blood vessels and raises blood pressure and cardiac workload. This is why heart attack rates rise in winter. Sudden exertion in the morning should be avoided especially on cold days.
Healthy nutrition, regular exercise, quitting smoking, weight control, stress management, and routine health check-ups can largely prevent CAD.
Blood sugar, cholesterol, blood pressure, ECG, and stress test should be checked annually. High-risk individuals may need CT angiography.
Yes. Sleeping less than 6 hours increases the risk of heart attack by approximately 20%. Quality sleep keeps blood pressure balanced and reduces vascular inflammation.
Medications must be taken regularly, exercise should be resumed gradually, stress must be reduced, and smoking must be stopped definitively.
If chest pain lasting more than 20 minutes, radiation to the left arm, shortness of breath, and cold sweating occur, call emergency services immediately.
