​Coronary heart disease refers to the progressive narrowing of the heart arteries with aging. This is usually due to the varying accumulations of fibrotic tissue, fatty deposits, and calcium. Depending on the composition of these plaques, it may be at risk of rupture, exposing its contents and resulting in the sudden occlusion of the heart artery and causing a heart attack. Even when these sudden events do not occur, the progressive accumulation of these tissues will result in narrowing of the heart arteries and reduce blood flow to heart. This may cause symptoms of chest pain, difficulty breathing, or reduced effort tolerance. 

​Lifestyle measures and medications are fundamental to the treatment of coronary heart disease. These include a healthy diet, regular exercise, minimizing a stressful lifestyle, and taking appropriate medications with consultation with your doctor. Depending on the extent of disease, and associated medical conditions, these medications could include blood thinning and cholesterol lowering medications. Of note is that the target cholesterol level for established coronary heart disease is lower than that of the general population without heart disease hence do not be surprised that you are prescribed cholesterol lowering medications despite apparently normal cholesterol levels. Where the symptoms cannot be adequately controlled with medications alone, procedures to improve blood flow to heart may be performed. These include percutaneous coronary intervention, commonly called "balloon and stent", or a more invasive procedure like coronary artery bypass grafting may be offered. Where the patient presents with a sudden heart attack, percutaneous coronary intervention is commonly offered as it offers a quick way to relieve the blockage. Which treatment modality is best is a decision made after consultation between the patient and the doctor. 

​The National University Heart Centre offers a broad range of treatment for the patient with coronary heart disease. Depending on the patient's age, activity level, associated medical conditions, and personal preference, treatment is personalized to the specific patient. We also have the capability of in-depth evaluation and diagnosis of uncommon heart disease such as microvascular dysfunction and coronary artery spasm. These conditions require dedicated equipment and expertise in diagnosis, following which specific treatment can be offered to best alleviate the patient's symptoms and minimizing unnecessary medications. The availability of percutaneous coronary intervention procedures as well as coronary artery bypass grafting can provide for symptomatic relief and potentially improve longevity in the appropriate patient. Beyond improving blood flow to the heart through these procedures, we also have an established cardiac rehabilitation program to help ease the patient back to independent community living.