Coronary Artery Disease

What is coronary artery disease?

Coronary artery disease (CAD) is a prevalent cardiovascular condition characterised by the narrowing or blockage of the coronary arteries which supply oxygen-rich blood to the heart muscle. CAD is a leading cause of heart attacks, chest pain and other serious complications.

CAD occurs when the coronary arteries become narrowed or blocked due to the buildup of plaque—a combination of cholesterol, fat, calcium and other substances—on the artery walls. This narrowing restricts blood flow to the heart depriving it of the oxygen and nutrients it needs to function properly. Over time CAD can lead to chest pain, shortness of breath, heart attacks and other cardiovascular events.

Although CAD’s mortality rates have steadily declined since 2011 it remains prevalent and accounted for over 10% of all Australian deaths in 2020.

Coronary Artery Disease | Cardiology Specialists Melbourne | Professor Dion Stub | Specialist for Heart Conditions

Causes

CAD develops from a combination of factors primarily centred around the buildup of plaque within the coronary arteries.

Age

Atherosclerosis

Diabetes or insulin resistance

High blood pressure (hypertension)

High cholesterol levels

Sedentary lifestyle

Smoking or tobacco use

Symptoms

Chest pain and discomfort
Squeezing or burning sensation
Nausea
Light-headedness
Shortness of breath
Weakness

Aortic Stenosis | Cardiology Specialists Melbourne | Professor Dion Stub | Specialist for Heart Conditions

Risks of Coronary Artery Disease

CAD leads to the accumulation of plaque within the arteries, increasing the risk of blood clot formation. These clots can trigger heart attacks or heart failure. Clots may also travel to the lungs or brain causing pulmonary embolism or stroke.

Due to the often-asymptomatic nature of CAD until significant plaque build-up occurs, many Australians are unaware of the condition until experiencing a heart attack. This emphasises the importance of regular check-ups—especially for people at risk—to detect and manage the disease early.

Diagnosis

Diagnosing CAD typically involves a combination of clinical evaluation, imaging and cardiac assessments to accurately assess the extent and severity of coronary artery blockages.

Medical history and physical examination

Blood tests

Electrocardiogram (ECG or EKG)

Stress testing

Stress testing, such as exercise stress testing or pharmacologic stress testing, may be performed to evaluate the heart’s response to physical exertion and detect signs of ischemia or reduced blood flow to the heart muscle. Stress testing may be combined with imaging techniques such as nuclear myocardial perfusion imaging or stress echocardiography to assess myocardial function and detect areas of ischemia or scar tissue.