ASYMPTOMATIC CORONARY ARTERY DISEASE

Coronary artery disease

The heart is a large muscle that needs oxygen to pump blood around the body. Oxygen is carried in the blood through the blood vessels. The blood vessels that deliver oxygen to the heart are called coronary arteries.

Sometimes problems can occur when a coronary artery becomes too narrow, stopping enough oxygen from reaching certain areas of the heart. When one or more coronary arteries become too narrow, this is called coronary artery disease.

Reduced blood flow to the heart can cause chest pain (angina pectoris, also referred to as angina). Usually this is not life threatening, but it can be a warning sign that you might be at risk of a heart attack. A heart attack happens when a coronary artery gets fully blocked. A heart attack is very rare, especially in young people. There are a number of things anyone can do to lower the risk of having a heart attack, such as adopting or maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.

Am I at higher risk of coronary artery disease?

Anyone, including people who have never had cancer treatment, may develop coronary artery disease. However, there are some cancer treatments that may increase the risk of having coronary artery disease later in life.

The following treatment can increase the risk of coronary artery disease:

  • Radiotherapy to an area involving the heart

You can find out if you have received radiotherapy to an area involving the heart by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you experience coronary artery disease, it does not always mean that this is caused by your cancer treatment. Coronary artery disease may have other causes, such as high blood pressure, being overweight, diabetes, high cholesterol (a fatty substance in the blood), smoking and older age. For more information on high blood pressure, overweight and obesity, diabetes and dyslipidemia please read: Hypertension, overweight and obesity, impaired glucose metabolism and diabetes, dyslipidemia . If coronary artery disease, angina pectoris or heart attack is common in your family, this may also increase your risk of having coronary artery disease.

What are the symptoms and signs of angina pectoris and a heart attack?

Narrowing of the coronary arteries is a slow process which usually does not cause any symptoms. However, when a blood vessel gets (almost) fully blocked, this can cause angina pectoris or a heart attack.

There are symptoms and signs that can tell you if you might have angina pectoris or a heart attack. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

These symptoms and signs may suggest that you are experiencing angina pectoris or a heart attack are:

Angina pectoris  Heart attack
  • Chest pain (during exercise)
  • Shortness of breath
  • Feeling very tired
  • Bad pain and/or pressure on the chest
  • Discomfort or pain in shoulders, neck and/or the left arm
  • Jaw, neck or upper back pain
  • Dizziness or feeling lightheaded
  • Sweating
  • Shortness of breath
  • Nausea or vomiting
  • Feeling very anxious
  • Coughing or wheezing 

Symptoms and signs of a heart attack can differ from person to person. Sometimes the symptoms and signs are sudden (usually in men), but they can also be milder and develop more gradually (usually in women or older people).

I am at higher risk of coronary artery disease. What tests should I have and when?

If you are at higher risk of coronary artery disease (even when you do not experience any symptoms or signs), it is advised to:

  • Have your blood pressure, blood glucose (sugar) and cholesterol in the blood measured at least every 5 years, starting no later than 40 years of age. Your general practitioner or follow-up care specialist may also ask about smoking, your weight and your level of physical activity. These are factors that can increase your risk of heart problems.

What happens if I have coronary artery disease?

If you have coronary artery disease, the treating doctor will discuss with you what can be done to reduce your symptoms (if you have any) and lower your risk of a heart attack. He or she may also refer you to a:

  • Cardiovascular specialist (physician specialised in the heart and blood vessels)

To lower your risk of a heart attack, adopting or maintaining a healthy lifestyle is extremely important. For more information on taking up a healthier lifestyle, please read: Health promotion.

Sometimes, the doctor may also prescribe medication, for instance to lower your blood pressure or cholesterol.

What else can I do?

It is important that you are aware of the possibility of developing coronary artery disease and that you may not experience any symptoms or signs.

Knowing that you may be at increased risk of coronary artery disease can be difficult. Talking to friends and family can be helpful. If they cannot provide the support you are looking for, you may find specialist counselling and/or contact with support groups, such as patient organisations, helpful. For more information on taking care of your mental health, please read: Mental health problems.

As stated above (What happens if I have coronary artery disease?), it is extremely important to live a healthy lifestyle to lower your risk of having coronary artery disease. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

If you have any further questions about this or the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about coronary artery disease online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • Together: Here you can find more information about cardiac late effects in general and about coronary artery disease

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the IGHG* guideline about “Coronary artery disease” [1].

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

*International Guideline Harmonization Group for Late Effects of Childhood Cancer

[1] Van Dalen, E.C. et al. (2021) Coronary artery disease surveillance among childhood, adolescent and young adult cancer survivors: A systematic review and recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Available at: https://www.ejcancer.com/article/S0959-8049(21)00396-8/fulltext