Coronary and ischaemic heart disease

Medically written by
Dr David Chandrakumar
BMed, MD, FRACP
Cardiologist
Consultant Cardiologist
Last reviewed: May 2026

What is coronary artery disease?

Coronary artery disease happens when the coronary arteries, which supply blood to the heart muscle, become narrowed or blocked. This is usually caused by a gradual build-up of fatty, cholesterol-rich material called plaque.

When the narrowing becomes severe enough, less oxygen-rich blood can reach the heart. This can lead to chest pain, shortness of breath or, in some cases, a heart attack. At this point, we would say that coronary artery disease has progressed to its endpoint – ischaemic heart disease.

Coronary artery disease is also known as coronary heart disease. It’s a long-term condition, but treatment can help reduce symptoms, support heart function and lower the risk of future heart problems.

Coronary artery disease symptoms

Symptoms can vary from person to person. Some people notice changes during activity, while others may not have clear symptoms until the condition becomes more advanced.

Common symptoms may include:

• Chest pain, pressure or tightness
• Shortness of breath
• Tiredness during physical activity
• Pain or discomfort that spreads to the arm, shoulder, neck, jaw or back
• Dizziness or light-headedness
• Nausea or sweating during times of chest discomfort

Chest pain linked to coronary artery disease is sometimes called angina. It may develop during stress or exertion, then ease with rest.

Some people, including those with diabetes, may have less typical symptoms. Diabetes can affect nerve supply to the heart, so chest pain may feel milder or be harder to recognise.

You should seek urgent medical help if your chest pain is: 

• Severe
• Lasts more than a few minutes
• Happens when at rest
• Is linked to breathlessness, sweating, nausea or feeling faint

What causes coronary artery disease?

Coronary artery disease is usually caused by atherosclerosis. This refers to the buildup of fatty, cholesterol-rich ‘plaque’ inside the artery walls over time. Plaque can make the arteries narrower and less flexible, reducing blood flow to the heart.

Several factors can increase your risk, including:

• High blood pressure
• High cholesterol
• Smoking
• Diabetes
• Excess body weight
• Physical inactivity
• Family history of heart disease
• A diet low in fruits and vegetables and high in fats

Age and male sex can also increase risk, especially when combined with other cardiovascular risk factors. Your doctor can help you understand your personal risk and the steps that may help protect your heart.

Diagnosing coronary artery disease

Your doctor will begin by asking about your symptoms, medical history and risk factors. They may also check your blood pressure, heart rate and general health.

Tests may include:

• Blood tests to check cholesterol, blood sugar and other markers linked to heart health
• An electrocardiogram (ECG) to record the electrical activity of your heart
• An echocardiogram to check your overall heart function and how well the valves are working
• An exercise stress test or sestamibi scan to check for evidence of severe coronary artery disease during physical activity
• A CT coronary angiogram to create detailed images of the coronary arteries

The right tests will depend on your symptoms, risk level and overall health. In some cases, your specialist will recommend proceeding to a direct coronary angiogram to confirm if you need a stent or bypass surgery to treat ischaemic heart disease. Your specialist will explain what each test involves and what your results mean.

Coronary artery disease treatment

Treatment depends on how narrowed the arteries are, your symptoms and your risk of future heart problems. Your care plan may include lifestyle changes, medicines or a procedure to improve blood flow.

Lifestyle changes may include stopping smoking, eating a heart-healthy diet, increasing physical activity and managing weight. 

Medicines may be used to lower cholesterol, manage blood pressure, control diabetes and reduce chest pain. 

If an artery is significantly narrowed, treatment may involve angioplasty with a stent. This involves inserting a small balloon and a tiny tube called a stent to open a narrowed artery. In some cases, patients will need coronary artery bypass surgery.

Your specialist will talk you through the most suitable options, so you can make informed decisions about your care.

Access expert care with Complete Health Australia

Coronary artery disease can feel unsettling, especially if symptoms come and go or you’ve been told you have risk factors such as high blood pressure, high cholesterol or diabetes.

At Complete Health Australia, we’ll help you make sense of your symptoms, arrange the right investigations and understand what your results mean. Your care will be shaped around your heart health, lifestyle and treatment needs, with clear guidance at each stage.

Book an appointment