Peripheral Artery

Coronary Artery Disease (CAD) happens when the main blood vessels that bring oxygen and nutrients to your heart get damaged or blocked. This usually starts when fatty stuff, called plaque, builds up inside the arteries. Over time, this buildup makes the arteries narrower, so less blood can flow through. That means your heart doesn’t get as much oxygen as it needs.

When blood flow slows down, you might feel chest pain (called angina), have trouble breathing, or notice other warning signs. If one of these arteries gets completely blocked, it can cause a heart attack.

The truth is that CAD tends to grow over several decades, and you may not notice until you have a major blockage or heart attack. That’s why CAD is sometimes called a ‘silent killer.’ The World Health Organisation says coronary artery disease is the leading cause of death around the world, killing an estimated 17.9 million people a year.¹

• Family history of heart disease
• Diabetes
• High blood pressure
• Unhealthy lifestyle
• Obesity
• High blood cholesterol or triglyceride levels
• Tobacco use
• Stress
• Physical inactivity

There are three known important symptoms that are particularly vital to be aware of:

1. Chest Pain (Angina)

The most common symptom of CAD is angina. It typically feels like:

• Pressure, tightness, or squeezing in the chest.

• Pain is primarily in the center or left side of the chest

• Radiation to your shoulders, once your arms, neck, jaw, or back

• Pain that is caused by motion or emotional stress.

• Usually, your symptoms will go away with rest.

Types of Angina:

• Angina that doesn’t follow a predictable pattern or that doesn’t respond to rest or medication.

• Occurs unpredictably, especially at rest, and may announce an impending heart attack (unstable angina).

• Coronary artery spasm variant angina – Often occurs at rest (not caused by atherosclerosis), increases the likelihood of future spasm.

2. Shortness of Breath (Dyspnea)

You may have respiratory distress, and not because of the lungs. You may suffer from difficulty breathing or an uncomfortable feeling, and you may even have such trouble catching your breath that it’s hard to say something, and you want to cry.

• Difficulty breathing during physical activity

• Breathlessness that becomes worse when lying flat.

• Your inability to sleep without pillows that help you breathe.

• Taking a sudden breath of breathlessness that awakens you from sleep

Often, this symptom signals that CAD is affecting your heart’s pumping ability, even hinting at heart failure.

3. Unusual Fatigue and Associated Symptoms

Advanced CAD can cause:

• Unexplained weakness or excessive fatigue during normal activities

• Nausea or indigestion-like symptoms (particularly common in women)

• Lightheadedness or dizziness

• Cold sweats

• Sleep disturbances

Important Note: Since the symptoms in women, older adults, and people with diabetes are atypical or less obvious, even if they don’t have symptoms. Women tend to complain of more fatigue, shortness of breath, and back or jaw pain, rather than chest discomfort.

Call emergency services immediately if you experience:

• Chest pain lasting more than a few minutes
• Chest discomfort with shortness of breath, sweating, and dizziness
• Nausea along with chest discomfort
• Pain extending to your arm, jaw, neck, or back

Modern medicine offers several effective ways to diagnose coronary artery disease: 

Non-Invasive Tests

• Electrocardiogram(ECG) – the non-invasive, painless method by which electrical activity of the heart, as well as the rate and regularity of the heartbeat, is measured.

• Echocardiogram – uses ultrasonic sound waves and traces an outline or picture of the heart’s movement.

• Chest X-ray – uses x-rays to trace pictures of the heart, lungs, respiratory tract, blood vessels, and the chest bones.

• Exercise stress test – measures heart rate when the heart is working under stress and is expected to pump more blood. It analyses how well the heart responds while a person is running on a treadmill.

• Cardiac CT scan – helps detect calcium deposits in the arteries, measuring the calcium build-up and plaque formation leading to blockages.

Invasive Diagnostic Methods

• Coronary angiogram – A minimally invasive but reliable method that utilises x-rays to view the heart’s blood vessels, measuring the blood flow through coronary arteries and detecting blockages.

• Cardiac catherization - Analyses the interiors of the arteries to detect blockages by introducing a thin, flexible tube called a catheter through an artery in the arm, groin, or neck to reach the heart's blood vessels.

Lifestyle modification:
Incorporating these simple lifestyle changes can help promote healthier arteries and treat coronary artery disease.

• Quit smoking

• Regular exercising

• Maintaining a healthy body weight

• Reducing stress levels

• Controlling risk factors like blood sugar, blood cholesterol and blood pressure.

• Eating healthy, low-fat foods

• Invasive procedural or surgical approach

Invasive Procedural or Surgical Approach:

When lifestyle changes and medications aren't enough:

Angioplasty and Stenting

During this procedure, a thin tube (catheter) with a balloon is inserted into the narrowed artery. The balloon is inflated to compress the plaque against the artery wall. A mesh tube (stent) is often placed to keep the artery open.

Modern Stent Technology: Advanced stents like Evermine50 offer:

• Ultra-thin struts (50μm) promote faster healing

• Variable strut width design for optimal radial strength

• A hybrid cell design allows side-branch access

• Drug-eluting capability with biodegradable polymers

Coronary Artery Bypass Surgery (CABG)

This major operation creates detours around blocked arteries using blood vessels taken from other parts of your body. CABG is typically reserved for severe CAD involving multiple arteries or when other treatments haven't worked.

Emerging Technologies

Bioresorbable Vascular Scaffolds (BVS) like MeRes100 represent the future of coronary interventions:

• Temporarily support the vessel, then gradually dissolve

• Minimise long-term complications associated with permanent implants

• Restore natural vessel function after resorption

• Feature advanced design with minimal strut thickness (100μm)

Prevention: The Best Approach to CAD

The most effective way to fight coronary artery disease is to prevent it:

• Get regular check-ups to monitor blood pressure, cholesterol, and blood sugar

• Know your family history and discuss it with your doctor

• Adopt heart-healthy habits early in life

• Recognise and manage stress effectively

• Consider preventive medications if you're at high risk

Coronary artery disease remains a leading cause of death worldwide, but it's largely preventable through lifestyle changes and proper medical care. Understanding the risk factors and recognising symptoms can help you seek timely treatment.

Don't ignore warning signs like chest discomfort, unusual fatigue, or shortness of breath. Early diagnosis and treatment can prevent complications and help you maintain a healthy, active life.

Remember that it's never too late to improve your heart health. Even small changes can make a big difference in preventing or managing coronary artery disease.