Coronary Artery Disease

Coronary artery disease usually develops over many years, and you may not have any symptoms before a serious event such as a heart attack. As the arteries narrow, you may notice some symptoms such as: 

• chest pain (angina) – this typically happens after exercise or stress 

• shortness of breath

• fatigue

• dizziness

• pain in the arms, neck, jaw, or back

• nausea

• heart palpitations

Coronary artery disease is caused by atherosclerosis – the formation of fat deposits within the coronary arteries. These deposits are called atheromas or plaques and are made of cholesterol, fat, calcium, and other substances. They’re thought to arise when the wall of the artery is disturbed, which can lead to cholesterol entering the wall of the artery and becoming trapped.

The buildup of these deposits narrows the arteries, reducing and blocking blood flow. They can also detach, causing a blood clot that can result in a heart attack or a stroke.

It's well understood that certain risk factors increase the likelihood of developing coronary artery disease.  

Risk factors for coronary artery disease: 

• smoking

• type 1 and type 2 diabetes 

• high blood pressure 

• abnormal cholesterol

• genetic conditions, such as familial hypercholesterolaemia

• obesity

• excess alcohol consumption

• lack of exercise

• poor diet

• psychosocial factors such as stress

• inflammation 

• elevated lipoprotein(a) – this is usually genetic and is also known as a “sticky” cholesterol

Regular health check-ups and discussions with our team can help assess and manage these risks.

Coronary artery disease affects both men and women. It's more common with age, with people over 50 and post menopause usually more at risk. However, younger people can be affected if there's a genetic tendency or significant risk factors involved.

Early detection, management of risk factors, and lifestyle modifications are crucial in preventing or managing coronary artery disease. Our expert cardiologists can help with this by offering the most advanced diagnostics in our dedicated Heart Health centre. 

At your initial consultation, your cardiologist will talk to you about your medical history and any symptoms you have. They’ll carry out further testing to help assess your risk and to offer specialised advice on any treatments and changes that can help you live a heart-healthy lifestyle. 

Diagnostics for coronary artery disease include: 

• blood tests to measure cholesterol levels, triglycerides, and other lipid levels in the blood

• electrocardiogram (ECG) to measure the heart's electrical activity and detect abnormal heart rhythms, signs of a previous heart attack, or ischemic changes (indicating reduced blood flow to the heart)

• stress test to determine how well your heart and blood vessels are working 

• echocardiogram – an ultrasound to look at the structure and function of the heart and surrounding blood vessels 

• coronary angiography – a scan that takes pictures of your heart while it’s beating 

• cardiac MRI – a type of scan that uses a strong magnetic field and radio waves to create images of the body

Prevention of coronary artery disease is a major goal of healthcare. At Welbeck Heart Health, we usually think of this in terms of preventing coronary artery disease and its consequences from happening in the first place (primary prevention) or by preventing it from progressing if it has already happened (secondary prevention).

Primary prevention

The goal of primary prevention is to identify people who are otherwise well but may be at risk of coronary artery disease and help reduce their risk. At Welbeck, we can help estimate your risk of having a cardiovascular event over the next 10 years with a clinical review and risk scoring tools. 

The risk score is calculated using: 

• blood tests, which can provide information on diabetes, cholesterol values, and any underlying medical conditions

• blood pressure

• height

• weight

For some people, especially where the risk is borderline or could be underestimated, additional tests may include: 

• advanced cholesterol markers

• CT imaging of the heart

If your risk is found to be high, treatment usually involves addressing any medical conditions and supporting lifestyle and behavioural changes. 

Lifestyle and behaviour changes that can help include: 

• eating a healthy diet 

• regular exercise 

• weight management 

• stopping smoking 

• reducing alcohol intake 

• ensuring healthy sleep habits 

If, after that, the risk still remains high, then medications such as statin therapy may be considered to lower overall risk, even if cholesterol levels are not high.

Secondary prevention

If you’ve already had a heart attack, stenting, bypass surgery, or a stroke, then the goal is usually to avoid progression of the disease and further complications. This is known as secondary prevention.

Our coronary artery disease prevention specialists can advise you on methods for secondary prevention that are tailored to you. These may include: 

• lowering LDL cholesterol levels through lifestyle changes or medications such as statins

• aspirin to reduce the risk of blood clots 

• blood pressure treatments, including beta blockers

• cholesterol-lowering injections such as Inclisiran

• high-strength fish oils

• anti-inflammatory treatments

• blood-thinning medicines

Complications from coronary artery disease can be life-threatening, so it's important to manage your heart health.  

Complications of coronary artery disease include: 

• heart attack – where a blood clot blocks a coronary artery  

• heart failure – where the heart can no longer pump enough blood to meet the body's needs 

• irregular heartbeat (arrhythmia) 

• stroke – where the blood supply to the brain is affected 

• peripheral artery disease – where the disease spreads to other arteries, for example, in the arms and legs, causing pain

• aneurysm – where arteries bulge and may rupture, causing severe internal bleeding

• kidney disease 

Living with coronary artery disease may also cause anxiety due to uncertainty about the future and progression of the disease.

At Welbeck, our cardiologists are experts at managing coronary artery disease and reducing the risk of disease progression. 

Treatment options are the same as those used in secondary prevention: 

• lowering LDL cholesterol levels through lifestyle changes or medications such as statins

• aspirin to reduce the risk of blood clots 

• blood pressure treatments, including beta blockers

• cholesterol-lowering injections such as Inclisiran

• high-strength fish oils

• anti-inflammatory treatments

• blood-thinning medicines

Where these methods have not been successful in treating coronary artery disease, surgical procedures may be recommended.

Surgical treatment options include: 

• percutaneous coronary intervention (PCI) – surgery that uses a combination of balloons (angioplasty) and wire mesh stents to widen arteries 

• coronary artery bypass graft (CABG) – commonly referred to as heart bypass surgery, where healthy blood vessels are used to make a new path for blood flow to the heart 

At Welbeck, we ensure you have a trusted partner in caring for your cardiovascular well-being. You’ll receive a continuity of care that fosters a deeper understanding of your unique health needs and allows for timely adjustments to any treatment or management plan.

At Welbeck, our cardiologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.