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Waitematā DHB Cardiology Services

Public Service, Cardiology

Coronary Artery Disease

The heart is a muscle that pumps the blood to the body. The walls of the heart are nourished by three tubes (arteries) that arise from the aorta. These arteries travel on the surface of the heart. When viewed by imaging they appear to sit on top of the heart, just like a crown, and hence the name "coronaries".

Coronary artery disease refers to narrowing of the arteries that supply blood to the heart muscle. The heart, like all other organs in the body, needs a constant supply of oxygen and energy.  Narrowed arteries are unable to keep up with the demand needed to supply the heart muscle with blood. This can cause damage to the heart muscle if prolonged. 
 
The most common cause of this disease is "atherosclerosis" which results in narrowing and hardening of the arteries.
 
The most common symptom of this problem is chest pain that occurs when you exert yourself (angina). Typical angina chest pain is a heavy sensation in your chest associated with shortness of breath.  It sometimes radiates to your arms and can make you feel like being sick, dizzy or sweaty. Not everybody experiences the same sensation and any one of those symptoms can represent angina.  If your GP thinks you may have angina they will refer you for an assessment to plan treatment.
 
Heart Attack (Myocardial Infarction)
If an attack of angina lasts for more than 20 minutes then you may be having a heart attack.  This is when a piece of the heart muscle has been deprived of oxygen for so long that it can die, resulting in permanent damage to your heart and in some cases death.  There are treatments available in hospital that can prevent heart attacks and save lives, so if you have chest pain or symptoms of angina that last for more than 20 minutes you should call an ambulance and go to hospital as soon as possible.

Am I likely to have cardiovascular disease?
There are several risk factors that are scientifically proven to be associated with this disease. However, even if you don’t have any of the following, it could still happen to you.
 
You are more likely to have cardiovascular disease if you have any of the following:
  • are or have been a smoker
  • diabetes
  • high blood pressure
  • high cholesterol
  • a family history of the disease
  • are older (your risk increases as you get older).
 
Treatment consists of medications to protect the heart and its blood vessels.  These include:
  • aspirin which makes the blood less sticky and prone to clots
  • medication to lower your cholesterol (even if it isn’t very high this is still helpful)
  • medication to make your heart go slower 
  • medications to open the blood vessels
You will also be given a nitro lingual spray to carry with you with instructions of what to do if you have angina.

You will be given advice on diet changes and exercise that can protect the heart (lifestyle changes).

It is important that you stop smoking as continuous smoking increases the risk of death and heart attacks.

If you have had a heart attack you will be offered cardiac rehabilitation classes which will help you with recovery after a heart attack.

Depending on test results, you may have procedures offered to treat the narrowed blood vessels with either stenting or surgery.

The Cardiology Department and your GP often share follow-up for this condition. 

This page was last updated at 3:20PM on April 12, 2021.