Coronary Atherosclerosis

• Coronary artery disease: Coronary atherosclerosis can lead to coronary artery disease when the coronary arteries become significantly obstructed. 
• Heart attack: When atherosclerotic plaque breaks, it results in clot formation. The clot blocks the coronary artery and prevents oxygen and nutrients from reaching the heart. This causes irreversible damage and muscle death in certain areas of the heart, called a heart attack. 
• Heart failure: If the heart muscle is damaged, the heart becomes weak and stiff, thus losing its ability to effectively pump blood to other parts of the body which results in heart failure. 
  

• Eat a healthy diet: Eat foods that are high in fibre and wholegrains. Avoid foods with excessive salt, sugar or saturated fats 
  

• Regular exercise: Aerobic exercises such as jogging, brisk walking or cycling are the best types of exercises for heart health. One should ideally complete 150 minutes of moderate-intensity exercise each week. Please seek your doctor’s advice if you are unsure of the suitable level of intensity for yourself.  
• Achieving and maintaining a healthy body mass index (BMI): The healthy range for Asians is from 18.5 to 22.9 kg/m².
• Get sufficient sleep: One should aim to get six to eight hours of sleep daily. Inadequate sleep (≤4 hours) or excess sleep (≥10 hours) has been associated with increased risk of coronary artery disease. 
• Stop smoking: Smoking contributes to atherosclerosis and increases the risk of a heart attack. Many smoking cessation aids can improve your chances of success in trying to quit smoking. Speak to your doctor for help with quitting smoking.
  
• Reduce alcohol consumption: You should not take more than 2 glasses of wine or 1 can of beer a day. 
  

• High blood pressure (hypertension): High blood pressure can cause damage to the walls of blood vessels, allowing plaque to build up. 
• High cholesterol: Your total cholesterol levels should be kept as low as possible because any excess cholesterol may be deposited in the arteries. This build-up causes the arteries to harden and narrow, preventing or reducing blood flow to the heart.  
• Smoking: Nicotine, a chemical found in cigarettes, causes damage to blood vessels and also can cause constriction of vessels. 
  
• Diabetes mellitus: Diabetes results in damage of the inner layers of blood vessels, increasing the build-up of plaque.
• Obesity: Being overweight can increase one’s risk of coronary atherosclerosis. 
• Unhealthy diet: Eating foods high in saturated fats can increase the level of cholesterol in the body which causes the build-up of plaque that clog the arteries. 
• Lack of exercise: An inactive lifestyle is associated with increased risk of coronary atherosclerosis.

• Age: Those who are older have a higher risk of developing coronary atherosclerosis. 
• Genetics: Those with a family history of coronary atherosclerosis are more likely to suffer from this condition. 
  

• Listen to your heart with a stethoscope.
• Ask about your medical and family history.
• Ask about your lifestyle. 
• Check your symptoms. 
• Measure your blood pressure. 

• Blood tests: Blood tests can be conducted to identify risk factors of atherosclerosis such as high cholesterol and sugar levels. 
  
• Cardiac Catheterisation: A long thin tube (catheter) is inserted into the coronary arteries to determine the exact location and severity of any narrowed coronary arteries. 
• Cardiac Computed Tomography (CT) scan: A CT scan shows the location and severity of the plaque build-up in your arteries. 
• Cardiac Magnetic Resonance Imaging (CMR): The CMR can help detect damage in heart tissues or issues with blood flow. 
  
• Echocardiogram: An echocardiogram or heart ultrasound shows how well the heart is pumping. 
• Electrocardiogram (ECG): An ECG gives information on heart rhythm and electrical activity. 
• Exercise stress test: Patients will be asked to exercise while connected to an electrocardiogram (ECG) machine to detect changes in the ECG which might suggest blocked coronary arteries. In the event that patients are unable to exercise, medications can be given to induce the effects of exercise on the heart. 
  

How is coronary atherosclerosis treated?

• Exercise regularly 
  
• Adopt a healthy diet 
• Quit smoking (if you smoke)
• Manage stress 
• Achieve and maintain a healthy weight 
• Keep your cholesterol, blood sugar and blood pressure levels in check 

• Lower blood pressure
• Lower cholesterol levels 
• Reuce blood-clotting

2) Coronary artery bypass grafting