Cardiac conditions

Coronary Artery Disease

The coronary arteries are the blood vessels that supply the heart muscle with blood to allow the heart muscle to beat uninterrupted.

In some people the coronary arteries can narrow significantly with deposition of cholesterol plaque. This narrowing can limit the flow of blood to the heart muscle wall, particularly when the blood flow demanded by the heart muscle increases (such as stress or exercise). When this occurs chest discomfort may occur, this is termed angina.

Detection of coronary artery disease has for many years concentrated on detecting changes on heart tests indicating significant (>70%) narrowing of the coronary arteries. These abnormalities can be seen on tests such as exercise ECGs, stress echocardiograms or nuclear isotope scans.

Concerningly however, many research studies now indicate that the majority of heart attacks do not occur in patients who have significantly narrowed arteries and so all of these tests will fail to predict heart attacks in these patients.

The majority of heart attacks occur in patients where the volume of cholesterol plaque in the arteries is not significant enough to obstruct the artery, but is however vulnerable to the plaque developing an ulcer on its inside surface. This exposes the blood flowing down the coronary artery to the cholesterol in the vessel wall and a blood clot forms causing a blockage in the artery, a heart attack. When a blockage occurs this can trigger arrythmias, and in the most severe situations, a cardiac arrest.

Technology now allows us to both visualise early plaque (high fidelity CT angiography) and assess the risk of this plaque causing a future heart attack (CaRiHeart FAI, Artrya Salix ).

Early detection of coronary artery disease is essential as it remains the leading cause of premature death both in the United Kingdom and world-wide. If significant coronary disease is detected then treatment is initiated that markedly reduces an individual’s risk of a subsequent heart attack.

Common Risk Factors:

• Family history of coronary artery disease
• Raised blood pressure
• Diabetes
• Elevated cholesterol
• Sedentary lifestyle
• Smoking
• Excessive alcohol

If you have one or more of these get checked out.