Coronary Artery Disease
What is Coronary Artery Disease (CHD)?
Coronary Artery Disease (CAD), also called Coronary Heart Disease (CHD) or ischaemic heart disease, refers to when the arteries supplying blood to the heart muscle become narrowed or blocked. This happens due to a build‑up of fatty deposits (called atheroma or plaque), cholesterol, calcium and inflammatory changes in the arterial walls. Over time, the reduced blood flow may cause chest pain (angina), breathlessness, or even a heart attack.
Symptoms of Coronary Artery Disease
Symptoms vary depending on how severe the disease is, how many arteries are involved, and how much collateral circulation (alternate blood supply) you have. Common symptoms include:
Angina: chest pain, discomfort, or tightness, often when exercising or under stress
Shortness of breath, especially on exertion or when lying flat
Fatigue or weakness, particularly with activity
Pain in arms, neck, jaw, shoulder or back, sometimes instead of chest pain
Feeling faint or nauseated — though in many cases the disease develops gradually and symptoms may be mild or intermittent
Some patients may have no symptoms until a significant narrowing or a sudden blockage occurs. That’s why risk assessments and screening are important.
What Causes Coronary Artery Disease? The Risk Factors…
The development of CHD is influenced by a combination of modifiable (you can change) and non‑modifiable risk factors.
Non‑modifiable risk factors
Age (risk increases as you get older)
Gender (men are at higher risk earlier; risk in women increases after menopause)
Family history of heart disease (especially early heart disease in close relatives)
Modifiable risk factors
High cholesterol (especially LDL or “bad” cholesterol) and lipid disorders
High blood pressure (hypertension) puts extra strain on arteries and the heart
Smoking – one of the strongest risk factors
Diabetes mellitus – high blood sugar damages blood vessels
Obesity or overweight, high body mass index (BMI)
Physical inactivity / sedentary lifestyle - exercise helps improve your overall health but particularly cardiovascular health
Poor diet – high saturated fat, trans fats, excessive salt, sugar; low fruit, vegetables, whole grains
Smoking / second‑hand smoke
Other factors: high levels of lipoprotein(a), inflammation, kidney dysfunction, sleep apnoea, chronic stress
Diagnosing Coronary Artery Disease at London Heart Group
At London Heart Group, we use a comprehensive diagnostic process to evaluate coronary artery disease, its severity, and how best to treat it. This helps us devise a personalised treatment plan.
Medical History & Physical Examination
Symptoms: chest pain (character, onset, triggers, relief), breathlessness, fatigue
Past medical history: diabetes, hypertension, lipid disorders, prior heart issues, family history
Lifestyle: diet, exercise, smoking, alcohol, stress
Baseline Blood Tests
Lipid profile (cholesterol, LDL, HDL, triglycerides)
Blood sugar / HbA1c (for diabetes)
Kidney function, electrolytes
Other markers if needed (e.g. inflammation, lipoprotein (a))
Non‑invasive cardiac tests
Electrocardiogram (ECG) — resting ECG to look for signs of prior damage
Echocardiogram — ultrasound to assess heart function, valves and chamber size
Stress testing (exercise ECG / treadmill, or pharmacologic stress tests) to check for exercise‑induced pain, and therefore limited blood flow through the coronary arteries
CT Coronary Angiography (CTCA) — imaging of coronary arteries with CT to detect narrowing or plaques (non‑invasive)
Invasive angiography
Coronary angiogram (cardiac catheterisation) is considered the gold‑standard for detecting and precisely defining blockages in coronary arteries. It can also facilitate treatment (e.g. stenting)
Risk assessment tools
Assess overall cardiovascular risk (e.g. using QRISK or other UK risk calculators)
Assessment of other potential or diagnosed conditions that can affect risk and treatment choices
Treatment and Management
The goal of treatment is to:
relieve symptoms like chest pain / angina and breathlessness
improve quality of life and functional ability
reduce the risk of heart attack, heart failure, or other complications
slow or stop disease progression
Treatment is generally in stages, combining lifestyle change, medical therapy, and in some cases invasive procedures.
Lifestyle Changes (First Line & Ongoing)
These are essential and often make a big difference:
Quit smoking and avoid second‑hand smoke
Healthy diet: more fruits, vegetables, whole grains, less saturated/trans fats, moderate salt and sugar
Regular physical activity: e.g. aim for at least 150 minutes of moderate aerobic activity per week plus strength work, as tolerated Heart Research UK+1
Maintain a healthy weight / body mass index
Control blood pressure, blood sugar, cholesterol through diet, weight, and medication if needed
Manage stress and mental health
Limit alcohol intake
Medications
Depending on your risk profile, symptoms, and degree of coronary artery disease, your cardiologist may prescribe one or more of the following:
Statins to lower LDL (“bad”) cholesterol and stabilise plaques
Antiplatelet / antithrombotic drugs (e.g. low‑dose aspirin, other agents) to reduce the risk of blood clots, which can trigger heart attacks
Blood pressure‑lowering medicines: ACE inhibitors, ARBs (angiotensin receptor blockers), beta blockers, calcium channel blockers as needed
Medications to relieve symptoms: nitrates (e.g. short‑acting for angina attacks), possibly long‑acting nitrates, beta blockers, calcium channel blockers for angina relief
Other lipid‑lowering agents: in certain patients, PCSK9 inhibitors or newer cholesterol‑lowering drugs may be considered when statins are not enough or not tolerated.
Choosing London Heart Group: How We Help You
At London Heart Group, we offer private, specialist cardiology care with the following advantages:
Shorter waiting times, flexible appointment options
Highly experienced cardiologists and cardiac surgeons
Access to advanced diagnostics (CTCA, cardiac MRI, angiography, imaging)
State‑of‑the‑art treatment options: PCI, CABG, hybrid approaches
Personalised treatment plans, based on your condition, risk profile, lifestyle and preferences
Clear communication: we ensure you understand your disease, treatment options, risks and expected outcomes
Ongoing follow‑up and holistic support, including rehabilitation, lifestyle coaching, psychological support
Are you worried you may be at risk of coronary artery disease?
If you're concerned about chest pain, heart disease, or your risk of coronary artery disease, our team of leading private cardiologists in London is here to help.
Call us today or book your consultation online with London Heart Group, based in the heart of London, to receive expert care and peace of mind.