Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle become narrowed or blocked by the gradual build-up of fatty deposits known as atherosclerotic plaque.

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This process can reduce blood flow to the heart and may lead to symptoms such as chest pain (angina), breathlessness or reduced exercise tolerance. In some cases, coronary artery disease may develop silently and only become apparent during investigation.

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A cardiology assessment can help determine whether symptoms may be related to coronary artery disease and whether further investigation is required.

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Symptoms of coronary artery disease

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Symptoms can vary depending on the degree of narrowing in the coronary arteries.

Possible symptoms include:

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• chest tightness or pressure
• chest discomfort during exertion
• breathlessness on exertion
• reduced exercise capacity
• discomfort spreading to the arm, neck or jaw

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Some individuals may have few or no symptoms, particularly in the early stages of disease.

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Causes of coronary artery disease

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Coronary artery disease develops gradually over many years as fatty deposits build up within the coronary arteries.

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Risk factors that contribute to this process include:

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• high blood pressure
• high cholesterol
• smoking
• diabetes
• family history of heart disease
• increasing age
• excess weight and physical inactivity

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Managing these risk factors plays an important role in reducing the likelihood of cardiovascular events.

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How coronary artery disease is investigated

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If coronary artery disease is suspected, a cardiology assessment may include:

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• electrocardiogram (ECG)
• echocardiography
• coronary artery calcium scoring
• CT coronary angiography
• cardiac MRI in selected cases

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These investigations help determine whether there is significant narrowing in the coronary arteries and guide appropriate treatment.

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Treatment for coronary artery disease

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Treatment focuses on improving symptoms and reducing the risk of future cardiovascular events.

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Management may include:

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• lifestyle modification including diet, exercise and smoking cessation
• medications to reduce cholesterol and blood pressure
• medications to improve blood flow to the heart
• treatment of contributing conditions such as diabetes

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In some cases, procedures such as coronary stenting may be recommended if significant narrowing is identified.

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When to seek medical advice

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You should consider cardiology assessment if you experience:

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• chest discomfort during exertion
• chest tightness or pressure
• unexplained breathlessness
• reduced exercise tolerance
• a strong family history of coronary artery disease

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Early assessment can help identify cardiovascular risk and guide appropriate investigation and treatment.

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Consultation

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Private cardiology consultations with Dr Thomas Heseltine are available at Spire Murrayfield Hospital Wirral.

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Appointments include a detailed clinical assessment and advice regarding appropriate investigations, which may include coronary calcium scoring, CT coronary angiography or other cardiac tests if required.