Coronary artery disease: What are the causes, and how is it treated?

Written by: Dr Emmanuel Ako
Published: | Updated: 20/11/2023
Edited by: Aoife Maguire

Leading cardiologist Dr Emmanuel Ako explains the causes of coronary artery disease  (CAD) and its treatment methods in this informative article.

Illustration of coronary arteries that have a build up of fatty material, causing coronary artery disease

What is coronary artery disease?

Coronary artery disease, also known as coronary heart disease, is when your coronary arteries (arteries supplying blood to the heart) narrow due to a gradual build-up of fatty material within their walls. This affects the blood supply over time, and while the supply may be sufficient at rest, it can become more restricted when the heart works harder, such as during exercise.

 

When the heart cannot get the blood it needs from these arteries, the patient experiences angina, which feels like a dull, heavy or tight pain in the chest, which can also spread to the left arm, neck, jaw, or back. This typically only lasts about a few minutes. A sudden blockage, however, may result in heart attack.

 

 

What are the causes of coronary artery disease?

There are many factors that increase the chance of developing CAD. Some are modifiable, but some are factors that we have no control over, such as genetics, gender (women typically develop the disease later than men), and age. However, changes to the following factors can be helpful at any age:
 


While some of these factors are existing conditions, they can be improved by lifestyle changes.

 

 

What is the treatment of coronary heart disease?

Firstly, the important thing is to change the modifiable factors mentioned above. Every patient will be given advice with respect to healthy living. Adopt the policy of ‘you are what you eat’, and make sure to follow a healthy diet, especially if advised to lose weight. Alcohol and caffeine consumption should be reduced.
 

Regular exercise is encouraged, but with realistic expectations, 20-30 minutes a day, 5 times a week, is what the patient should be aiming for.
 

Smoking is one of the most important modifiable risk factors, and smokers are advised to stop. Help and support aids will be provided, as quitting is not an easy task.
 

Certain medications can also be prescribed, to improve the symptoms of angina, and to prevent platelets (small components in the blood stream) from becoming ‘sticky’, leading to blood clots. Other drugs may also slow the rate that fatty deposits build up in the arteries.

 

 

What is the interventional treatment for coronary artery disease?

If patients still experience significant angina despite medical therapy, then interventional procedures may be helpful, such as PCI – percutaneous coronary intervention, formerly known as angioplasty or stenting. PCI is a day case procedure, so no overnight stay in hospital is needed. A fine wire is passed through the skin under local anaesthetic via an artery in the wrist or groin, and then fed across the narrowed section of coronary artery. A tiny balloon is then inflated inside the artery, opening it up and allowing a small wire mesh, called a stent, to be inserted. This keeps the artery open and coronary blood flow can be restored.


In some cases, when coronary artery disease becomes more widespread or is more severe, coronary bypass surgery may be appropriate. In this procedure, healthy blood vessel segments from other parts of the body are used to bypass the narrowed sections of the arteries.


In order to help the prevention of CAD, it is best that the patient attends routine health screenings, and tries to be as healthy as they possibly can. It is better to take action to prevent coronary heart disease by maintaining your own health, rather than treat the symptoms later on.

 

 

 

If you would like to book an appointment with Dr Ako, don't hesitate to do so by visiting his Top Doctors profile today. 

By Dr Emmanuel Ako
Cardiology

Dr Emmanuel Ako is a highly-trained consultant cardiologist based in London. He is an expert in all areas of cardiology and internal medicine with particular expertise in treating chest pains, acute and chronic coronary syndrome, valvular heart disease, hypertension, arrhythmia and cardiac complications in haemoglobinopathies, such as thalassaemia and sickle cell disease.

Dr Ako graduated with a degree in medicine from University College London in 2005 and was awarded several awards from the Vandervell Foundation and National Institute for Health Research (NIHR). He completed an intercalated BSc in physiology and then went on to complete postgraduate medical training at St Georges, the London Chest and the Heart Hospital in London. After obtaining his MRCP, he achieved a dual accreditation in general internal medicine and cardiology in North East Thames and subsequently trained in interventional cardiology at the Heart Hospital and Barts Heart Centre.

Dr Ako is actively involved in clinical education and research. He has won several awards for his commitment and dedication including the American College of Cardiology Young Investigator Award in Chicago for research into haemoglobinopathy and the RSM Presidents Medal in London. Furthermore, Dr Ako has published multiple articles, presented at many conferences both in the UK and abroad and is a regular speaker in public engagement workshops internationally.

He is currently working as the principal investigator on several cardiology studies and has high-level expertise in simulation-based training in cardiology. He has been involved in developing a hugely successful simulation-based training programme with Imperial College London, which has recently been introduced across the UK aimed at cardiologists and anaesthetists.

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