Severe Coronary Artery Disease

FAQs

• What makes coronary artery disease "severe"?

  The severity of CAD is generally determined by the degree of narrowing in the arteries and which specific arteries are affected. According to medical standards, CAD is considered severe when there is a 70% or greater blockage in a major coronary artery, or a 50% or greater blockage in the "left main" artery, which supplies a large portion of the heart's blood.

• What are the hallmark symptoms of severe CAD?

  Unlike mild CAD, which may be asymptomatic, severe CAD often causes noticeable issues due to significantly reduced blood flow, including: 

  • Chronic Angina: Frequent, predictable chest pain or pressure, especially during physical exertion or stress.

  • Worsening Shortness of Breath: Difficulty breathing even during light activities or while lying flat.

  • Extreme Fatigue: Feeling unusually tired with minimal effort, as the heart struggles to pump efficiently.

  • Ischemia: Evidence that the heart muscle is not receiving enough oxygen, often seen on a stress test or ECG.

• Can severe coronary artery disease be reversed?

  Generally, no, the physical plaque buildup cannot be fully reversed or "dissolved" away. However, aggressive treatment with medications (like high-dose statins) and lifestyle changes can stabilise plaque, making it less likely to rupture and cause a heart attack. In some cases, these interventions can slightly shrink the plaque volume, but they will not make it disappear entirely.

• What are the common treatment options for severe blockages?

  When blockages are severe or symptoms cannot be managed with medication alone, more invasive procedures are often required: 

  • Angioplasty and Stenting (PCI): A minimally invasive procedure where a balloon is used to open the artery and a mesh tube (stent) is placed to keep it open.

  • Coronary Artery Bypass Grafting (CABG): A major surgery where a healthy blood vessel from another part of the body is used to create a "detour" around the blocked artery.

• What are the risks of leaving severe CAD untreated?

  Leaving severe blockages untreated significantly increases the risk of life-threatening complications: 

  • Heart Attack: A sudden, complete blockage that can permanently damage the heart muscle.

  • Heart Failure: The heart becomes too weak or stiff to pump blood effectively, leading to fluid buildup in the lungs and legs.

  • Arrhythmias: Irregular heartbeats caused by damage to the heart's electrical signalling.

  • Sudden Cardiac Arrest: A sudden loss of heart function that can be fatal if not treated immediately.