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Coronary Artery Disease Singapore

Coronary artery disease occurs when the blood vessels become narrowed or blocked by fatty deposits called plaque, limiting blood flow to your heart muscle. This narrowing reduces the flow of oxygen-rich blood to your heart, which can cause chest pain and potentially lead to heart attacks. The condition develops gradually over many years and is one of the most common forms of heart disease. Understanding the symptoms and treatment options can help you manage this condition with guidance from a cardiologist in Singapore.

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Dr. Kua Jieli

MBBS (SG)|MRCP (UK)|MMed (Internal Med) (SG)|FAMS (Cardiology, SG)

Image Carrington coronary artery disease
Symptoms Causes Types Diagnosis Treatment Prevention When to See a Cardiologist FAQ
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Symptoms
Causes
Types
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Treatment
Prevention
When to See a Cardiologist
FAQ
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Symptoms of Coronary Artery Disease

Many people with coronary artery disease experience symptoms during physical activity or emotional stress, when the heart needs more oxygen than the narrowed arteries can provide.

  • Chest pain or discomfort (angina): This often feels like pressure, squeezing, or tightness in the centre of your chest. Pain often spreads to the shoulders, arms, neck, jaw, or back, lasting a few minutes.
  • Shortness of breath: Feeling breathless during daily activities or when lying flat due to reduced oxygen-rich blood supply to the heart.
  • Fatigue: Unusual tiredness or weakness, especially during activities you normally manage easily, can occur when your heart isn’t working as well as it should.
  • Heart palpitations: You might notice your heart beating irregularly, racing, or feeling like it’s skipping beats. Some people describe this as a fluttering sensation in their chest.
  • Nausea or light-headedness: These symptoms can occur alongside chest pain, particularly during episodes of angina or when your heart is under stress.
  • Sweating: Unexplained sweating, especially when it occurs with chest discomfort, may indicate that your heart is working harder than usual to pump blood.

Causes and Risk Factors of Coronary Artery Disease

Coronary artery disease develops when plaque builds up inside your coronary arteries, a process that typically happens over many years due to various factors.

  • High cholesterol levels

    When you have too much cholesterol in your blood, it can stick to artery walls and form plaque deposits. This process gradually narrows the arteries that supply blood to your heart muscle.

  • High blood pressure

    Consistently elevated blood pressure damages the inner lining of your arteries over time. This damage makes it easier for cholesterol and other substances to build up and form blockages.

  • Smoking

    Tobacco use damages blood vessel walls and reduces the amount of oxygen in your blood. It also makes your blood more likely to clot, which can block already narrowed arteries.

  • Diabetes

    High blood sugar levels can damage blood vessels throughout your body, including the coronary arteries. People with diabetes often develop coronary artery disease at a younger age.

  • Age and gender

    Men generally face higher risk from age 45 onwards, while women’s risk increases after menopause, typically around age 55. The risk continues to rise with age for both men and women.

  • Family history

    Having close relatives with coronary artery disease increases your risk.

  • Lack of physical activity

    A sedentary lifestyle contributes to many other risk factors, including high blood pressure, high cholesterol, and obesity. Regular physical activity helps keep your heart and blood vessels healthy.

  • Chronic stress

    Long-term stress can contribute to coronary artery disease by raising blood pressure and potentially leading to behaviours like overeating or smoking.

Types of Coronary Artery Disease

Coronary artery disease can be classified based on how symptoms occur and the severity of artery blockage.

Stable angina

This is the most common form, where chest pain occurs predictably during physical activity or stress and goes away with rest. The symptoms follow a consistent pattern and are usually manageable with medication.

Unstable angina

Chest pain occurs unpredictably, even during rest, and may be more severe or last longer than usual. This type requires immediate medical attention as it can indicate that a heart attack may occur soon.

Silent ischaemia

Some people have reduced blood flow to the heart without experiencing chest pain or other obvious symptoms. This condition is more common in people with diabetes and can only be detected through medical testing.

Diagnostic Methods

Several tests can help determine whether you have coronary artery disease and assess how severe the blockages might be.

Transthoracic Echocardiogram (TTE)

An ultrasound scan creating detailed images of your heart’s chambers and valves to identify areas affected by reduced blood flow.

Exercise Treadmill ECG

Monitoring your heart rhythm, rate, and blood pressure while exercising on a treadmill to assess how your heart responds under stress.

CT Coronary Angiogram

A non-invasive imaging test using contrast dye and CT scanning to identify the location and severity of artery blockages clearly.

Coronary Calcium Score

A scan assessing calcium deposits in your coronary arteries to evaluate your risk of significant heart disease.

Treatment Options for Coronary Artery Disease in Singapore

Non-Surgical Treatment

Several medications and lifestyle approaches can help manage coronary artery disease and reduce symptoms without requiring surgical procedures.

  • Lifestyle modifications and medications: Tailored guidance on lifestyle changes combined with appropriate medication to manage symptoms and prevent disease progression, coordinated by your cardiologist.
  • Beta-blockers: These medications slow your heart rate and reduce blood pressure, which decreases the amount of work your heart needs to do. This can help reduce chest pain and improve how well your heart functions.
Surgical Treatment

When medications and lifestyle changes aren’t sufficient to manage symptoms or when blockages are severe, surgical procedures may be recommended to restore blood flow to the heart.

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Prevention and Management

Managing coronary artery disease involves regular follow-ups with your cardiologist to control risk factors through tailored lifestyle modifications, medication management, and monitoring of your heart’s health. Maintaining healthy cholesterol and blood pressure levels, stopping smoking, following a heart-healthy diet low in saturated fats, and engaging in regular physical activity as advised by your doctor can significantly reduce your risk of heart attacks. People with diabetes should maintain good blood sugar control, and taking prescribed medications consistently helps manage symptoms and prevent complications.

When to See A Cardiologist in Singapore

You should consult a cardiologist in Singapore if you experience:

  • recurring chest pain
  • shortness of breath
  • unexplained fatigue
  • heart palpitations

 

Early evaluation by a cardiology specialist can prevent serious complications.

Frequently Asked Questions (FAQs)

Will I know if my coronary artery disease is getting worse?

Some people notice worsening symptoms like more frequent chest pain or shortness of breath with less activity, while others may not experience obvious changes. Regular check-ups with your doctor and monitoring tests help track how your condition is progressing.

Can coronary artery disease affect people under 50?

Yes, though it’s less common, coronary artery disease can develop in younger people, particularly those with strong family histories, diabetes, or multiple risk factors. Early symptoms are sometimes mistaken for other conditions, which can delay diagnosis.

What happens during a heart attack with coronary artery disease?

A heart attack occurs when a plaque ruptures and completely blocks blood flow to part of your heart muscle. This causes severe chest pain that doesn’t go away with rest, and the affected heart muscle begins to die without immediate treatment.

How often will I need follow-up appointments?

Most people need check-ups every 3-6 months initially, then less frequently as their condition stabilises. Your doctor will adjust this schedule based on your symptoms, test results, and how well you’re responding to treatment.

Can stress alone cause a heart attack?

While emotional stress can trigger a heart attack in someone who already has coronary artery disease, stress alone doesn’t typically cause heart attacks in people with healthy arteries. However, chronic stress may contribute to developing the condition over time.

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Dr. Kua Jieli

MBBS (SG)|MRCP (UK)|MMed (Internal Med) (SG)|FAMS (Cardiology, SG)

Dr. Kua is a senior consultant cardiologist specialised in interventional cardiology and is the medical director at Carrington Cardiology.

  • He is experienced in managing complex coronary artery disease and a variety of other cardiovascular diseases and conditions.
  • He also handles difficult coronary interventional procedures such as left main disease, chronic total occlusions, and calcified lesions.
  • He served as a Senior Consultant at National University Hospital Singapore and Ng Teng Fong General Hospital and was also the Director of the Cardiovascular Catheterisation Laboratory.

Prior to this, he served as an International Cardiology Fellow and Honorary Consultant at Hammersmith Hospital Imperial Healthcare Trust, where he gained valuable experience in various prestigious healthcare institutions.

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    Image location

    Mount Elizabeth Medical Centre
    3 Mount Elizabeth, #12-02 Medical Centre
    Singapore 228510

    Image email info@carringtoncardio.com.sg
    Image phone +65 6956 6588
    Image mobile +Array
    Image time

    Mon to Fri: 09:00am – 05:00pm
    Sat: 09:00am – 12:30pm
    Sun & Public Holidays: Closed