Coronary Artery Disease (CAD) is a condition where the coronary arteries become narrowed or blocked due to the buildup of fatty deposits called plaque. Coronary arteries supply blood to the heart muscle. Hence, blockage can lead to reduced blood flow to the heart, resulting in chest pain (angina), heart attacks, and other serious complications. Understanding CAD, its causes, symptoms, and treatment options is crucial for managing the condition effectively. CAD is also known as coronary heart disease, or ischaemic heart disease.
Coronary Artery Disease Statistics In Singapore
According to the Ministry of Health and the Singapore Heart Foundation, about 23 people die from cardiovascular disease (heart disease and stroke) every day in Singapore. Cardiovascular disease accounted for 30.9% of all deaths in 2023. This means that almost 1 out of 3 deaths in Singapore is due to heart diseases or stroke. Specifically for Coronary Artery Disease, the percentage of deaths attributable to it in Singapore in 2023 is 19.7%. More men than women die from Coronary Artery Disease.
Causes Of Coronary Artery Disease & Risk Factors
Coronary Artery Disease is primarily caused by atherosclerosis, a condition where fatty deposits (plaque) build up in the coronary arteries. Several risk factors contribute to the development of CAD, including:
- Smoking: Smoking damages the blood vessels and accelerates the buildup of plaque.
- High Blood Pressure: Hypertension can damage the artery walls and promote plaque formation.
- High Cholesterol: Elevated levels of cholesterol, particularly low-density lipoprotein (LDL) cholesterol, contribute to plaque buildup.
- Diabetes: High blood sugar levels can damage the blood vessels and increase the risk of CAD.
- Obesity: Excess weight is associated with increased cholesterol levels, high blood pressure, and diabetes.
- Sedentary Lifestyle: Lack of physical activity contributes to the development of CAD.
- Family History: A family history of heart disease increases the risk of CAD.
- Age: The risk of CAD increases with age, particularly after 45 for men and 55 for women.
- Unhealthy Diet: Diets high in saturated fats, trans fats, and cholesterol can lead to plaque buildup in the arteries.
Symptoms Of Coronary Artery Disease
The symptoms of Coronary Artery Disease can vary from person to person. Symptoms may not appear, or be noticed initially. With continued narrowing of the coronary arteries, symptoms can become more severe. Common symptoms include:
- Chest pain (angina). This is sensation of squeezing, pressure, heaviness, tightness or pain in the chest. Usually, this is felt in the middle or left side of the chest.
- Shortness of breath. You may feel like you can’t catch your breath.
- Fatigue. If the heart can’t pump enough blood to meet your body’s needs, you may feel unusually tired.
If a blocked coronary artery causes a heart attack, heart attack symptoms may be noticed, including:
- Chest pain (feels like pressure, tightness, squeezing or aching of the chest).
- Pain that spreads to the shoulder, arm, back, neck, or jaw.
- Cold sweat.
- Shortness of breath.
- Lightheadedness / dizziness.
- Fatigue.
- Heartburn.
- Nausea.
Screening & Prevention
Early detection and prevention of Coronary Artery Disease are essential for managing the condition effectively. Screening for CAD involves several methods:
- Electrocardiogram (ECG): Measures the electrical activity of the heart and can detect abnormalities.
- Stress Test: Assesses how the heart performs under physical stress, typically on a treadmill or stationary bike.
- Echocardiogram: Uses sound waves to create images of the heart and assess its function.
- CT Calcium Score – A CT calcium score uses a CT scanner to measure the amount of calcium in the coronary arteries, providing a score that indicates the risk of coronary artery disease.
- CT Coronary Angiography (CTCA) – CT coronary angiography uses a X-ray CT scanner to obtain detailed images of the coronary arteries, identifying any blockages.
- Blood Tests: Check for risk factors such as high cholesterol and diabetes.
- Coronary Angiography: Involves injecting a contrast dye into the coronary arteries and taking X-rays to see the blood flow and detect blockages.
Preventive measures include:
- Quit Smoking: Smoking cessation significantly reduces the risk of CAD.
- Healthy Diet: A balanced diet low in saturated fats, trans fats, cholesterol, and sodium helps manage CAD.
- Regular Exercise: Engaging in moderate exercise, such as walking, can improve cardiovascular health.
- Manage Chronic Conditions: Controlling diabetes, high blood pressure, and high cholesterol is crucial for preventing CAD.
- Maintain A Healthy Weight: Achieving and maintaining a healthy weight reduces the risk of CAD.
Coronary Artery Disease Treatments
Treatment for Coronary Artery Disease aims to reduce symptoms, improve quality of life, and prevent complications. The following treatment options are commonly used:
Lifestyle Changes:
- Quit Smoking: Reducing or eliminating smoking can significantly improve heart health.
- Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can help manage CAD.
- Exercise: Regular physical activity, such as walking, can improve cardiovascular health and reduce symptoms.
Medications:
- Antiplatelet Agents: Medications like aspirin help prevent blood clots and improve blood flow.
- Cholesterol-Lowering Drugs: Statins can help lower cholesterol levels and reduce the risk of complications.
- Blood Pressure Medications: Controlling high blood pressure is crucial for managing CAD.
- Beta-Blockers: Medications that reduce the heart’s workload and improve symptoms.
- Nitrates: Medications that relax and widen blood vessels, improving blood flow to the heart.
- Calcium Channel Blockers: Medications that relax the heart’s blood vessels and reduce heart rate.
Procedures:
- Angioplasty And Stenting: A minimally invasive procedure where a small balloon is inflated inside the artery to widen it, followed by placing a stent to keep it open.
- Coronary Artery Bypass Grafting (CABG): In severe cases, a surgeon may create a bypass around the blocked artery using a graft from another part of your body or a synthetic tube.
Cost Of Screening And Treatment
The cost of screening and treatment for Coronary Artery Disease in Singapore varies depending on the type of tests and procedures required. Here is a general breakdown:
- Electrocardiogram (ECG): Approximately S$100 – S$200.
- Stress Test: Approximately S$300 – S$500.
- Echocardiogram: Approximately S$500 – S$1,000.
- CT Calcium Score: Approximately S$300 – S$400.
- CT Coronary Angiography: Approximately S$1,000 – S$1,200.
- Blood Tests: Costs vary depending on the type and number of tests.
- Medications: Costs vary depending on the type and duration of the medication.
- Angioplasty And Stenting: Approximately S$40,000 – S$60,000.
- Coronary Artery Bypass Grafting (CABG): Approximately S$30,000 – S$50,000.
It’s important to check with specific healthcare providers for detailed cost information and to see if any insurance coverage or payment plans are available.
Survival Rate Statistics For Singapore
Survival rates for Coronary Artery Disease in Singapore are influenced by various factors, including the severity of the disease, the presence of other health conditions, and the effectiveness of treatment. Early detection and treatment significantly improve survival rates. Studies have shown that individuals who receive timely treatment for CAD have a higher survival rate compared to those who do not seek medical care.
By understanding Coronary Artery Disease, its causes, symptoms, and treatment options, you can take proactive steps to manage the condition and improve your overall health. Always consult with your healthcare provider to determine the best course of action for your specific situation.
Frequently Asked Questions (FAQs)
1. Why Is Coronary Artery Disease A Silent Killer?
Coronary Artery Disease (CAD) is a condition where the coronary arteries, which supply blood to the heart muscle, become narrowed or blocked due to the buildup of fatty deposits called plaque. This limits how much blood can reach your heart muscle. If the plaque triggers a blood clot, it may stop the flow of blood to the heart, resulting in a heart attack. CAD is often without symptoms until the heart attack – this is why it is considered a “silent killer” diasease.
2. How Is CAD Diagnosed?
CAD is diagnosed through methods such as electrocardiogram (ECG), stress test, echocardiogram, cardiac CT scan, blood tests, and coronary angiography.
3. How Can I Prevent CAD?
Preventive measures include quitting smoking, maintaining a healthy diet, engaging in regular exercise, managing chronic conditions such as diabetes, high blood pressure, and high cholesterol, and maintaining a healthy weight.
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