Coronary artery disease

Coronary artery disease is a reduction of your heart's blood supply due to a fatty substance that can build up in your coronary arteries. 

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London Heart Practice

Coronary artery disease is a common condition and one we offer comprehensive care for, from fast diagnosis to the most effective treatment and management.

  • Appointment confirmed with a coronary artery disease specialist within 24 hours
  • Rapid access to the latest tests and treatment, if needed
  • No.1 in UK for private cardiovascular care, trusted by more coronary artery disease patients than any other provider
  • 99% of cardiac patients would recommend us to friends and family

What are the symptoms of coronary artery disease?

If your coronary arteries are constricted, they can't supply enough oxygen-rich blood to your heart. This is particularly true when your heart is beating harder than normal, such as during exercise. 

This decreased blood flow may not cause any symptoms at first. But as fatty plaque continues to build in your arteries, you may experience these coronary artery disease signs and symptoms:

  • Chest pain (angina)
  • Pain in other areas of the upper body, including your shoulder, arm, back, jaw or teeth
  • Shortness of breath
  • Chest tightness
  • Feeling faint, lightheaded or dizzy
  • Feeling sick (nausea)

Not everyone has the same symptoms and some people don't have symptoms at all. Women may experience different signs of coronary artery disease, such as neck or jaw pain, as well as shortness of breath, fatigue and nausea. 

Cardiac test

When to get medical help

A completely blocked coronary artery can cause a heart attack. If you think you may be having a heart attack due to symptoms such as chest pain, pain travelling to other parts of your body, shortness of breath and sweating, call emergency services immediately.

If you're worried about developing coronary heart disease due to risk factors such as smoking, high blood pressure or cholesterol, diabetes or a family history of heart disease, we can help. Our experts will check for signs of coronary artery disease, such as narrowed arteries, and help you understand and effectively manage your risk. 

The most effective coronary artery disease care for you

  • #1 in private cardiovascular care: More patients trust us with their cardiac care than any other provider. Our experience and resources help us deliver better outcomes for every individual, with 99% of people we have treated saying they would recommend us to friends and family. 
  • Quick access to coronary artery disease testing: If you have symptoms or worries, we'll confirm an appointment with a specialist within 24 hours. We can offer the full range of tests and state-of-the-art imaging on the same day, with results available within 48 hours for your peace of mind. 
  • Full treatment options: If needed, we provide comprehensive coronary artery disease treatments through our private network. Our experts will recommend the most effective options for you, from risk factor management to medication and procedures.  
  • Leading consultants and subspecialist teams: You'll be looked after by consultants who are experts in their field. They're supported by subspeciality multi-disciplinary teams (MDTs) who share their knowledge from a range of backgrounds to find the best solutions for you.  
  • Highest quality facilities and technology: We invest continuously to offer the best possible environments for your care, including five cardiac hospitals and 15 outpatient centres equipped with the latest diagnostic and treatment technologies.
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What is coronary artery disease and what causes it?

Coronary artery disease (CAD), also known as coronary heart disease or ischaemic heart disease, is caused by a narrowing or blocking of the blood vessels that carry blood and oxygen to your heart. This is due to a build-up of fatty substances (atheroma) inside your blood vessels over time, a process known as atherosclerosis. 

It can be brought on by high blood pressure, high cholesterol or diabetes, as well as lifestyle factors such as smoking and excessive alcohol consumption. It's a common condition, affecting around 2.3 million people in the UK.

It can have serious complications without diagnosis or treatment, including heart attack if there's a complete blockage of blood flow. If you have symptoms or concerns, rest assured we can provide swift diagnosis and effective treatment as needed, including tailored advice on reducing your risk. 

Types of coronary artery disease

The two main types of coronary artery disease are: 

  • Stable ischemic heart disease, where your coronary arteries gradually narrow over time. You may experience some symptoms but can live with your coronary artery disease condition on a daily basis. 
  • Acute coronary syndrome, where plaque build-up in your coronary artery suddenly breaks open and forms a blood clot which blocks blood flow completely, leading to a heart attack. This is an emergency and requires immediate medical attention. 

Coronary artery disease risk factors

Risk factors increase your chances of developing a condition. Some you can change or manage, such as physical activity and smoking, while others you can't, such as age and genetics. 

The main risk factors for coronary artery disease that you can influence include:

  • Smoking: People who smoke have a significantly higher risk of heart disease. Breathing in second-hand smoke also increases your risk.
  • High blood pressure: Uncontrolled high blood pressure can result in hardening and thickening of your arteries over time, narrowing the channel that blood flows through.  
  • High blood cholesterol levels: High levels of low-density lipoprotein (‘bad’) cholesterol can also cause the narrowing and blocking of your blood vessels. 
  • Diabetes: Type 2 diabetes, in particular, shares similar risk factors with coronary artery disease, such as obesity and high blood pressure, although both types of diabetes can cause inflammation in your blood vessels. 
  • Being overweight or obese: Being overweight typically worsens other risk factors associated with coronary artery disease, such as type 2 diabetes and high blood pressure.  
  • Eating an unhealthy diet: Your risk is higher if your diet is rich in saturated fats and trans fats (found in some meat and dairy products and baked goods), salt and sugar.
  • Physical inactivity: A lack of exercise is also associated with coronary artery disease as fatty deposits can build up in your arteries.  
  • High levels of stress: Research shows that unrelieved stress may damage your coronary arteries, as well as worsen other risk factors for the condition such as high blood pressure. It can also lead to unhealthy lifestyle choices, such as overeating or smoking. 

Risk factors that you can’t control include: 

  • Age: Getting older increases your risk of damaged and narrowed coronary arteries.
  • Family history: A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed it at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55, or if your mother or a sister developed it before age 65.
  • Sex: Men are generally at greater risk of coronary artery disease, although the risk for women increases after menopause.
  • Ethnicity: Some ethnicities are at higher risk than others. 

Risk factors often occur together and one may trigger another. For example, an unhealthy diet and lack of exercise can lead to obesity, which can in turn lead to type 2 diabetes and high blood pressure. 

When grouped, certain risk factors increase your likelihood of developing coronary artery disease. For example, metabolic syndrome – a group of conditions that includes high blood pressure, low HDL (‘good’ cholesterol), high insulin levels and excess body fat around the waist – increases risk. But sometimes coronary artery disease develops without any risk factors. 

If you're concerned about your risk, we offer comprehensive coronary artery disease testing to give you a clearer picture and an effective plan for managing it. 

Coronary artery disease diagnosis

If your consultant feels you may be at risk of coronary artery disease, they'll carry out a full assessment to learn about your medical and family history and your lifestyle. They'll also carry out a physical examination which will include:

  • Blood pressure check: High blood pressure is often related to coronary heart disease.
  • BMI: This stands for body mass index, and measures whether you are a healthy weight for your height. High BMI (being overweight or obese) is related to coronary artery disease.
  • Waist measurement: Men with a waist size over 37in and women with a waist size over 31.5in are at high risk of coronary artery disease. 

Depending on the results, you may be referred for further tests including:

  • Blood tests: To provide a range of information about your heart muscle by measuring the enzymes, cholesterol and proteins in your blood. You may have speciality cardiac blood tests as well as other blood tests that measure the health of your entire body and its potential impact on your heart. 
  • Electrocardiogram (ECG): Attaching sensors to your chest to measure the rate, rhythm and electrical activity of your heart. It's a painless test which usually only takes a few minutes to complete.
  • Echocardiogram: Using sound waves to create moving pictures of your beating heart to check for weaknesses that may be caused by coronary artery disease or other conditions. It takes between 15 and 30 minutes. 
  • Exercise ECG (also known as a cardiac stress test): To see how your heart responds to moderate exercise, for example, while walking on a treadmill. This test usually takes around half an hour with a consultant monitoring you. It also records your blood pressure.
  • Coronary angiogram (also known as cardiac catheterisation): A small, flexible tube is inserted into your artery, at the top of your leg or in your arm, and a fine wire is guided along the arteries of your heart. A dye is injected and a series of X-rays are taken so that your consultant can see whether your coronary arteries are narrowed or blocked.

If they are, your consultant may carry out a coronary angioplasty (see treatment section below). 

  • Imaging tests: These include MRI, CT scans and PET scans, which provide high-definition images of your heart and surrounding arteries to check for narrowing and blockages.

Your doctor will decide which tests are most appropriate for you. We carry out more tests every year than any other UK private provider, including over 25,000 ECGs, over 20,000 echocardiograms and thousands of imaging tests, ensuring you get accurate results without delay. 

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Get an accurate coronary artery diagnosis quickly

Our private diagnostics network is the most comprehensive in the UK, offering rapid access to the latest coronary artery disease scans and tests. If you're worried about symptoms or risk, you can have an appointment confirmed within 24 hours and undergo all the tests you need on the same day. Your results will be interpreted by experts and available within 48 hours.

Coronary artery disease treatment and prevention

If you receive a diagnosis, your consultant will recommend the best treatment for your coronary artery disease. Treatment can significantly relieve your symptoms as well as decrease your risk of a heart attack or a stroke. 

Your recommended treatment may include a combination of lifestyle changes, medications and, in some cases, a procedure or surgery. 

Lifestyle changes

Your doctor will recommend making some heart-healthy lifestyle changes to manage your condition or prevent you from developing it. These will include:

  • Eating a healthy diet and maintaining a healthy weight (losing weight if necessary)
  • Cutting down on alcohol
  • Giving up smoking
  • Trying to avoid or reduce stress
  • Taking regular exercise, starting slowly and gradually building your activity level 

Our coronary artery specialists can give you advice on the most impactful ways to manage your risk. 

Coronary artery disease medications

  • Nitrates: Most people with stable coronary artery disease are prescribed a medicine called glyceryl trinitrate (GTN), which comes in spray form or as tablets that dissolve under your tongue. GTN works by dilating your arteries, reducing pressure on the heart muscle.
  • Beta blockers: These are sometimes prescribed to prevent angina attacks caused by coronary artery disease. Beta blockers slow down the heart by reducing the amount of adrenaline your body produces. 
  • ACE (angiotensin-converting enzyme) inhibitors: These drugs reduce blood pressure by helping to relax your veins and arteries making it easier for your heart to pump blood around the body. 

Some people experience unpleasant side effects from ACE inhibitors, so they are prescribed Angiotensin II receptor blockers (ARBs) instead for the same purpose.

  • Statins, like atorvastatin: These are used to lower blood cholesterol, which helps prevent blockages in the blood vessels. 
  • Calcium channel blockers: These prevent calcium from entering your arteries and heart, helping the blood vessels to relax and reducing blood pressure.
  • Blood-thinning medications: These medicines, including low-dose aspirin, help to thin the blood and prevent heart attacks and strokes in people with coronary artery heart disease. 
  • Diuretics: These are medicines that make you pass more urine and help relieve the symptoms of coronary heart disease by flushing excess water and salts from your body.

Coronary artery disease procedures

If your condition is serious or if medication doesn't relieve symptoms, your doctor may recommend coronary artery disease surgery. 

There are two main types of medical procedure for coronary artery disease:

  • Coronary angioplasty and stenting: Following an angiogram, a tiny balloon is used to inflate a narrow artery which is then held open by a stent (a small wire tube). This procedure can be used to treat the symptoms of coronary heart disease as well as heart attacks in emergencies. 
  • Coronary artery bypass graft (CABG): In this surgical treatment for coronary artery disease, an artery from another part of your body (usually the chest, leg or arm) is attached above and below the blocked section of the coronary artery to divert the blood flow (this is known as a graft). 

The operation is carried out under general anaesthetic and takes between three and six hours. You may need more than one graft, depending on how severe your coronary artery disease is.

Find a consultant

Receive the best treatment for your coronary artery disease

If you receive a coronary artery disease diagnosis, our consultants and MDTs - including experts in cardiac imaging, interventional cardiology, cardiac surgery and more - will recommend the most effective treatment for you without delay. We treat more people than any other private provider and deliver better outcomes, including a 99.6% survival rate for CABGs in cases where surgery is needed. 

Coronary artery disease complications

The complications of coronary artery disease can be prevented with accurate diagnosis and appropriate treatment. Without them, the condition can lead to:

  • Chest pain (angina) and shortness of breath when your heart doesn't receive enough blood when it needs it most, for example, while exercising. 
  • Heart attack, when fatty build-up in your coronary arteries breaks open and causes a blood clot that blocks blood flow to your heart.
  • Heart failure, when narrowed coronary arteries restrict your heart's ability to pump blood.
  • Cardiac arrhythmia, when reduced blood flow to your heart alters its signalling and causes an irregular rhythm.

Patient stories

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Life-saving heart surgery

David's story
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Mr Aziz's blocked artery

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Find a coronary artery disease specialist

We're proud to work with leading cardiology experts who have years of experience in treating coronary artery disease and other heart conditions. You can use our consultant finder to view their expertise and experience and directly book an appointment. Alternatively, we can quickly connect you with the right specialist for your symptoms or diagnosis when you request an appointment. 

Our Coronary artery disease locations

The Harley Street Clinic

The Harley Street Clinic

35 Weymouth Street W1G 8BJ London
The Lister Hospital

The Lister Hospital

Chelsea Bridge Road, SW1W 8RH London
The Cardiac Clinic

The Cardiac Clinic

London Bridge Hospital SE1 2PR London
London Bridge Hospital

London Bridge Hospital

27 Tooley Street SE1 2PR London
The Wellington Hospital

The Wellington Hospital

8A Wellington Place NW8 9LE London
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Paying for your coronary artery disease testing or treatment

The cost of your diagnosis and medical treatment for coronary artery disease will depend on the specifics recommended by your consultant. We'll provide a breakdown so you know what to expect. 

We offer several ways to pay, including self-pay and private medical insurance. To make sure you receive the best available care, mention HCA UK and your preferred consultant, if you have one, to your insurer when discussing your options.  

How to book an appointment

Request a cardiac appointment

If coronary heart symptoms or worries are affecting your quality of life, we’re here to help. Our heart team is available to book an appointment with a cardiac specialist.

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.