Coronary Artery Disease & Angina
Coronary artery disease happens when fatty plaque narrows the arteries feeding the heart, often causing chest pain or pressure called angina, especially during exertion or stress.
What happens inside the heart
The heart muscle gets its own blood supply through the coronary arteries. Over the years, cholesterol, calcium and other material can build up inside their walls as plaque. A narrowed artery may still carry enough blood at rest, but when you walk fast, climb stairs or feel stressed, the heart needs more oxygen than the artery can deliver. That shortfall is felt as angina: a pressure, heaviness or tightness in the chest that usually eases with rest.
Stable angina follows a predictable pattern, coming on with a similar amount of effort. Unstable angina, meaning pain that is new, getting worse or coming at rest, can be a sign that a plaque is breaking open and needs urgent care.
Who is at higher risk
- Diabetes, high blood pressure and high cholesterol
- Smoking, bidi, gutkha or any tobacco use
- A family history of heart disease at a young age
- Little physical activity and extra weight around the waist
- Increasing age and long-term stress
Tests your doctor may advise
An ECG, blood tests (sugar, cholesterol, kidney function), an echocardiogram and a TMT (treadmill stress test) are common first steps. If these suggest a significant blockage, coronary angiography shows exactly where and how much the arteries are narrowed. During angiography, OCT, IVUS or FFR can help judge whether a borderline blockage needs treatment.
Treatment options
Most people start with lifestyle changes and medicines: a blood thinner, a cholesterol-lowering statin, and medicines that reduce the heart's workload. Some patients need angioplasty with a stent, and difficult blockages may need complex coronary intervention. Bypass surgery is another option for some. The choice depends on the number and location of blockages, your symptoms and your overall health.
When to go to the emergency
If chest pain lasts more than a few minutes, comes at rest, or comes with sweating, breathlessness or vomiting, treat it as a possible heart attack and call 108 at once. Read what to do on the emergency page.
Diagnosis and treatment are decided only after a proper examination by your doctor. This page is meant to help you understand the condition.
For understanding only — the right test or treatment is decided after examination.
