Ischaemic heart disease (coronary artery disease)

Disease of the coronary arteries (also called “ischaemic heart disease”) occurs due to formation of coronary plaques and obstruction to blood flow. This can cause chest pain (often when exercising), breathlessness and a decrease in exercise capacity.\

More stable symptoms of ischaemic heart disease include chest pain and breathlessness that occur with exercise and are relieved fairly quickly by resting. More concerning chest pain is severe, often occurring at rest or at night, lasting a long time and sometimes with other symptoms such as breathlessness, sweating, palpitations or collapse. Importantly, a sudden increase in frequency of chest pain is also a concerning sign for which urgent medical attention should be sought.

A heart attack (acute myocardial infarction) can occur when one of these coronary plaques “ruptures”, causing a blood clot to form and suddenly obstruct blood flow to the area that artery supplies. This causes muscle damage and can be life threatening if not treated early.

If you have a history of known ischaemic heart disease, it’s important you know what to do if you experience chest pain:

If you are having symptoms such as chest pain or severe breathlessness, call 000 for an ambulance.

To learn more about heart attack and a chest pain action plan, see:
www.heartfoundation.org.au/conditions/heart-attack

For information in languages other than English:
www.heartfoundation.org.au/heart-health-education/info-lote

There are a number of risk factors which can contribute to the development of coronary disease. These include smoking, high blood pressure, high cholesterol, diabetes, family history of heart attacks at a young age, obesity. For women, additional risk factors include pre-eclampsia, gestational diabetes and premature menopause.

It is well recognised that women more frequently experience the less typical symptoms of a heart attack or angina compared with men. Rather than classic, “crushing” pain in the middle of the chest, they may develop breathlessness, nausea or pain in the arms or jaw. This can sometimes lead to delays in women seeking medical advice or attending hospital for assessment. If you are experiencing such symptoms, you should also call 000 for an ambulance.

Progressive narrowing of a coronary artery
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You may need further investigation if you have been evaluated for chest pain and discharged from an emergency department. Further tests may include stress testing, a CT coronary angiogram or an invasive coronary angiogram. If you have already undergone any of these tests, you may also require further detailed explanation of the result.

If you have been found to have ischaemic heart (coronary artery) disease, regular medications and pro-active management of your risk factors can help to reduce the risk of further heart issues in future.
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