Coronary Artery Disease

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Overview of Coronary Artery Disease

What is it?

Coronary Artery Disease (CAD) is the accumulation of a substance called plaque in the coronary arteries. The coronary arteries are important as they supply blood to your heart.

When the waxy-like substance plaque builds up, your arteries narrow in size and reduce blood flow to your heart muscle.

CAD can also go by these well-known terms such as Ischaemic Heart Disease, Coronary Heart Disease as well as Heart Disease.

It is important to recognise the signs and symptoms of CAD as well as manage your heart health, as blood clots could attach to the plaque on your narrow arteries, leading to a heart attack or angina; a condition where your heart receives less blood flow than needed and you can experience symptoms such as chest pain, sweating and dizziness.

People can live for years without ever having symptoms of CAD, which is why at Her Heart we advocate that you see your GP for a Heart Check.

Types of Coronary Artery Disease

CAD can be classified into different types, depending on your plaque levels and artery structure:

Non-obstructive CAD: this is where the arteries have less than 50% build-up of plaque, not leading to an obstruction of blood flow.

Obstructive CAD: when your plaque levels increase to greater than 50% in your arteries is considered when blood flow is obstructed in your arteries.

Coronary Microvascular Disease: this occurs when your coronary arteries are small (hence the term micro), therefore impeding blood flow. This condition may not necessarily be influenced by the level of plaque in your arteries.

Causes

It is important to understand the causes of CAD, as the more risk factors you have, the more likely you are to develop CAD.

There are several causes of CAD with some specific female causes:

  • High cholesterol levels in your blood
  • High blood pressure, also known as Hypertension
  • Diabetes
  • Smoking
  • Isolation and depression
  • Lack of physical activity
  • Excess body weight
  • Menopause
  • Polycystic Ovarian Syndrome (PCOS)

Statistics

  • CAD was the leading cause of death for Australians, accounting for around 11.6% of all deaths in 2017.
  • CAD is the second leading cause of death for Australian women, taking nearly 3x more women than breast cancer.
  • Worldwide, it is estimated that CAD is responsible for at least one-third of deaths amongst women.

Symptoms

Signs and Symptoms

As discussed earlier, you may have no signs or symptoms of CAD for a number of years.

However, the signs and symptoms of CAD be similar to those of a heart attack, all of which require urgent medical attention:

  • Chest pain
  • Arm, jaw or shoulder pain
  • Shortness of breath
  • Sweating
  • Rapid heartbeat/feelings of a fluttery chest
  • Extreme fatigue
  • Nausea
  • Dizziness

Treatment for Coronary Artery Disease

CAD cannot be cured, however in consultation with your cardiologist there are many changes and treatments you can embark upon in order to live a healthy and fulfilling life whilst managing your symptoms and reducing the risk of complications.

Here are some of the potential treatment options for CAD:

Stenting:

if the blood flow in your coronary artery is blocked or you continue to suffer chest pain even when taking medications, you may need a stent (a tiny tube made of mesh) placed inside your coronary artery to help it open and restore blood flow.

See coronary artery bypass surgery in their respective sections.

Bypass surgery:

depending on your CAD condition, your doctor may recommend bypass surgery if you have more than one blockage in your coronary arteries or if other treatments have not yet worked.

See Coronary Artery Bypass Graft Surgery.

Medications:

Your cardiologist or GP may recommend some medications for you to take to manage your CAD, more specific information on your medications can be found through NPS Medicinewise.

Here are some of the potential medications you may take:

Statins:

these medications help you manage high cholesterol. some of the trade names include Crestor and Lipitor.

Antiplatelets:

these medications are useful in preventing heart attacks as well as complications post an event. Some names of these medications include Aspirin and Ticagrelor (Brilinta).

Blood pressure medications:

these medications classes include ACE-inhibitors (such as Coversyl), aiming to reduce blood pressure.

Beta-blockers:

beta-blockers such as Noten and Minax are designed to relax your heart rate, however they can also have blood-pressure lowering effects.

Short-acting nitrates: often used if you have chest discomfort, these medications work on relaxing your coronary arteries to allow blood flow. These medications can be available as tablets under the tongue or in a spray; often these are known as GTN.

Lifestyle changes:

some of the basic and easy everyday changes you could make to improve your lifestyle include regular exercise, eating a healthy diet as well as quitting smoking. See our section on Taking Control of Heart Health.

Follow-up treatment: it is recommended that you continue having regular appointments with your doctors to discuss how you’re feeling and managing your CAD.

Another great idea could be to attend a cardiac rehabilitation program to help you learn how to manage your CAD, make the appropriate lifestyle changes as well as meet other people with CAD. Click here to find out more information about cardiac rehabilitation.

Prevention and Support

Follow the links below to find out more about how you can help prevent and support loved ones who have experienced Coronary Artery Disease

Prevention

Prevention

There are many heart-healthy choices you can make every day to help prevent CAD problems and make you feel better. Simple changes can make a big difference.
Find Out More
Supporters

Supporters

Reaching out to a support group could be a beneficial way to meet other people who has Coronary Artery Disease, as well as provide support for carers of individuals affected.
Find Out More
Carers

Carers

Caring for someone who has had a Coronary Artery Disease can be very stressful. If you are struggling to care for a loved one, discuss how you feel with someone.
Find Out More

FAQs

What you need to know

How does it affect women?

CAD is responsible for ⅓ of the deaths of women worldwide and is one of the leading causes of death for Australian women. Furthermore, CAD will take more women’s lives than breast cancer.

In terms of symptoms, women do have some differences in comparison to men (such as shortness of breath, fatigue and back pain) so it is important to know the difference between women and men.

Furthermore, these symptoms have more impact and burden on women with CAD than men, as well as impacting their everyday function and living.

What are the long-term implications?

Long-term implications for CAD depend on the severity of your CAD. As mentioned earlier, you may need more invasive treatments such as stenting or bypass surgery or managing your condition with medications.

Your doctor will be able to discuss with you what the long-term implications are for your recovery, your life and your loved ones.

The good news is that with lifestyle changes and medication therapy many women with CAD can lead functional and healthy lives.

What can I do about it?

If you are diagnosed with CAD, we recommend speaking with your doctor and treating team to learn more about daily management.

Research suggests that attending a Secondary Prevention Program for managing Heart Diseases can decrease the chance of being admitted to hospital, reduce your complications as well increase survival rates. One suggestion is cardiac rehabilitation, as these programs will teach you more about your disease, help you recover, empower you to make lifestyle changes to improve heart health as well as reduce your risk of further problems.

Click here to find your nearest cardiac rehabilitation program.

Your doctor may have recommended that you take some new medications if you have CAD. This could be an overwhelming time for you, especially as learn all about your new medications as well as any considerations for taking them.

Apart from having a discussion with your doctor and pharmacist, NPS Medicinewise has some great information on medication management, medication disposal as well as risk factors.

They also have some great information about medications for your heart, which can be found here.

It’s not too late to start looking after your heart health, even after an event of CAD.

Here are some great and easy everyday strategies you can do to look after your heart health:

  • Don’t smoke, as quitting smoking can reduce your risk by 50% in one year. Quitline would be a great way to start your quitting smoking journey.
  • Stay active, 30 minutes per day of exercise, such as walking, can reduce your risk by 30% and delivers many positive health benefits. More information about exercise as well as a sample walking session can be found here.
  • Get some sleep, aim for 7-8 hours sleep and aim to try and unplug from your technology (e.g. iPad) one hour before bedtime. The Sleep Health Foundation has many great women’s focused sleep pages for all stages of your life such as your menstrual cycle, pregnancy, new mothers and menopause.
  • Eat healthy: ensure you watch portion sizes, eat healthy and nourishing foods such as: high fibre foods (including oats and legumes), two pieces of fruit and seven serves of vegetables, reduced salt, three serves of fish per week, reducing saturated fats (such as chicken with skin on, baked goods, fried foods) whilst choosing more lean proteins such as tofu and trimmed meats. The Baker Heart and Diabetes Institute has created some handy factsheets to help you choose correct portions, supermarket shopping, healthy snacks and eating out.
  • Relax: try and take some time out for yourself, keep connected with friends and family, perhaps try activities such as meditation to help manage your stress levels. Beyond Blue has a great page full of practical stress relieving tips, and it could be worth to try some meditations from apps such as Smiling Mind, Headspace and Calm.

Are there support groups?

Yes! There are support groups and associations you can contact to connect with other women who have survived coronary artery disease: