Coronary Artery Disease: Causes, Symptoms, and Treatment Options

What is coronary artery disease and how is it treated?

Coronary artery disease (CAD) occurs when plaque builds up inside the coronary arteries, narrowing them and reducing blood flow to the heart muscle. Symptoms range from chest pain and breathlessness to silent ischaemia. Treatment includes lifestyle changes, medications, and procedures such as angioplasty or bypass surgery, depending on severity.

S.L. Raheja Hospital in Mumbai, located at Mahim West, provides structured cardiac care for patients with CAD — from initial diagnosis through to interventional and surgical management under its Cardiac Science programme.

What causes coronary artery disease?

CAD develops when atherosclerosis — the accumulation of cholesterol-rich plaque — narrows the coronary arteries. Over time, plaque can harden, rupture, and trigger a blood clot that blocks the artery entirely.

Established risk factors include:

• High LDL cholesterol — promotes plaque formation in arterial walls
• Hypertension — damages the inner lining of arteries, accelerating plaque build-up
• Type 2 diabetes — raises cardiovascular risk through multiple pathways
• Smoking — damages endothelial cells and reduces HDL cholesterol
• Obesity and physical inactivity — contribute to metabolic risk factors
• Family history of heart disease — genetic predisposition increases risk
• Chronic stress — associated with elevated blood pressure and inflammatory markers
• Age and sex — risk rises with age; men are generally affected earlier than women

What are the symptoms of coronary artery disease?

Symptoms vary depending on the degree of arterial narrowing. Some patients experience no symptoms until a heart attack occurs — this is called silent ischaemia. When symptoms do appear, they typically include:

• Angina (chest pain or pressure) — often triggered by exertion or stress, relieved by rest
• Shortness of breath — particularly during physical activity
• Fatigue — unusual tiredness, especially in women
• Heart palpitations — irregular or rapid heartbeat
• Dizziness or light-headedness
• Pain radiating to the arm, jaw, neck, or back
• Nausea — more common in women during a cardiac event

What are the stages of coronary artery disease?

CAD progresses through recognisable stages. Understanding the stage helps determine the most appropriate treatment pathway.

How is coronary artery disease diagnosed?

Diagnosis combines clinical assessment with imaging and functional tests. A cardiologist will review symptoms, risk factors, and family history before ordering investigations.

Common diagnostic tools include:

• Electrocardiogram (ECG) — detects electrical abnormalities and signs of prior heart attack
• Stress test (TMT) — assesses heart function under controlled physical exertion
• Echocardiogram — ultrasound imaging of heart structure and wall motion
• CT coronary angiography — non-invasive imaging of coronary arteries
• Invasive coronary angiography — the gold standard for visualising blockages; a catheter is guided to the coronary arteries and contrast dye injected. Learn more about angiography at S.L. Raheja Hospital.
• Blood tests — lipid profile, blood glucose, cardiac biomarkers (troponin)

What is the best treatment for coronary artery disease?

Treatment is tailored to the severity of blockage, the number of vessels affected, and the patient's overall health. The three main approaches are:

1. Lifestyle modification and medications — first-line for mild-to-moderate CAD. Includes statins, antiplatelet agents (aspirin), beta-blockers, ACE inhibitors, and nitrates alongside dietary changes, exercise, and smoking cessation.
2. Percutaneous coronary intervention (angioplasty with stenting) — a catheter-based procedure that opens narrowed arteries using a balloon and places a stent to keep the vessel open. Suitable for single or limited vessel disease. Read about angioplasty at S.L. Raheja Hospital.
3. Coronary artery bypass grafting (CABG) — surgical creation of new routes for blood flow around blocked arteries using grafts from the chest wall or leg. Preferred for multi-vessel disease or left main artery involvement. See details on CABG at S.L. Raheja Hospital.

How can coronary artery disease be prevented or slowed?

CAD prevention centres on controlling modifiable risk factors. Even patients already diagnosed can slow disease progression significantly through consistent lifestyle and medical management.

Evidence-based steps to protect heart health:

• Maintain a diet rich in vegetables, whole grains, legumes, nuts, and oily fish; limit saturated fat, refined sugar, and excess salt
• Engage in at least 150 minutes of moderate-intensity aerobic activity per week
• Quit smoking — risk begins to fall within weeks of cessation
• Keep blood pressure below 130/80 mmHg through diet, exercise, and medication if needed
• Manage LDL cholesterol with statins if prescribed by your doctor
• Control blood glucose if diabetic — HbA1c targets should be discussed with your physician
• Maintain a healthy body weight
• Limit alcohol intake
• Manage chronic stress through structured relaxation, adequate sleep, and psychological support where needed

When should you see a cardiologist for coronary artery disease?

Do not wait for a cardiac event before seeking evaluation. Consult a cardiologist promptly if you experience any of the following:

• Chest pain, tightness, or pressure lasting more than a few minutes — especially during or after exertion
• Unexplained shortness of breath that has persisted for more than 2 weeks
• Palpitations or irregular heartbeat occurring frequently
• Dizziness or fainting episodes without a clear cause
• Fatigue disproportionate to your level of activity
• A family history of heart attack before age 55 in a first-degree male relative, or before age 65 in a female relative
• Newly diagnosed diabetes, hypertension, or high cholesterol — all warrant a baseline cardiac assessment

If you experience sudden severe chest pain, pain spreading to the arm or jaw, cold sweats, or loss of consciousness, call emergency services immediately — do not drive yourself to hospital.

How does S.L. Raheja Hospital in Mumbai support patients with coronary artery disease?

S.L. Raheja Hospital in Mumbai — a Fortis Associate located at Mahim West — provides a structured pathway for patients with coronary artery disease, from non-invasive diagnostic workup through to interventional cardiology and cardiac surgery. The cardiac team manages the full spectrum of CAD presentations, including stable angina, acute coronary syndromes, and complex multi-vessel disease.

Patients have access to:

• Diagnostic services including ECG, echocardiography, stress testing, and coronary angiography
• Interventional procedures including angioplasty with stenting
• Cardiac surgery including coronary artery bypass grafting
• Valve assessment and management — relevant where CAD coexists with valvular disease
• Coordinated care with nephrology and endocrinology for patients with diabetes or chronic kidney disease

For appointments or to discuss your cardiac symptoms, use the booking form on this page or email info@rahejahospital.com.