What is coronary artery disease and how is it diagnosed?
Coronary artery disease (CAD) occurs when the arteries supplying blood to the heart muscle narrow or harden due to plaque build-up, reducing blood flow. Diagnosis relies on a combination of clinical assessment, blood tests, and imaging studies. Early detection significantly improves management outcomes.
Deccan Hardikar Hospital in Pune offers comprehensive cardiology services — from initial risk assessment and non-invasive cardiac tests to interventional procedures — at its Shivajinagar campus, serving patients across Western Maharashtra.
Note: CAD is the most common form of heart disease. Recognising symptoms early and seeking timely evaluation can prevent serious cardiac events such as a heart attack.
What are the early warning signs of coronary artery disease?
CAD often develops silently over years. When symptoms do appear, they typically signal that blood flow to the heart is significantly restricted. The following warning signs warrant prompt medical attention:
- Chest pain or pressure (angina) — a squeezing, tightening, or burning sensation in the chest, often triggered by physical exertion or emotional stress and relieved by rest.
- Shortness of breath — difficulty breathing during activities that were previously manageable, or even at rest in advanced cases.
- Fatigue — unusual tiredness, particularly during physical activity, as the heart works harder to compensate for reduced blood flow.
- Palpitations — a sensation of rapid, fluttering, or irregular heartbeat.
- Dizziness or light-headedness — especially when associated with chest discomfort.
- Pain radiating to the arm, jaw, neck, or back — referred pain patterns that may accompany angina or a cardiac event.
- Nausea or cold sweats — more common during acute episodes and in women.
Warning: Sudden, severe chest pain lasting more than 15–20 minutes, especially with sweating, nausea, or pain radiating to the left arm, may indicate a heart attack. Call emergency services immediately — do not drive yourself to hospital.
Who is at highest risk of developing coronary artery disease?
CAD develops through a combination of modifiable and non-modifiable risk factors. Understanding your personal risk profile is the first step toward prevention.
| Category | Risk Factors |
|---|---|
| Non-modifiable | Age (men over 45, women over 55), male sex, family history of early heart disease, genetic predisposition |
| Modifiable — Lifestyle | Smoking, physical inactivity, unhealthy diet high in saturated fats, obesity, excessive alcohol consumption |
| Modifiable — Medical | High blood pressure (hypertension), high LDL cholesterol, diabetes mellitus, chronic kidney disease, sleep apnoea |
| Psychosocial | Chronic stress, depression, social isolation |
Individuals with multiple risk factors — for example, a diabetic smoker with hypertension — carry a substantially higher cumulative risk and should undergo regular cardiac screening.
What tests diagnose coronary artery disease?
No single test confirms CAD. A cardiologist typically combines clinical history, physical examination, and one or more of the following investigations to build an accurate picture:
- Resting ECG (Electrocardiogram) — records the heart's electrical activity; may reveal ischaemic changes, arrhythmias, or evidence of a prior heart attack.
- Stress Test (Treadmill Test / TMT) — monitors the heart's response to controlled physical exertion; identifies exercise-induced ischaemia.
- Echocardiogram — ultrasound imaging of the heart's structure and function, assessing wall motion and ejection fraction.
- Blood Tests — lipid profile, fasting glucose, HbA1c, cardiac biomarkers (troponin, CK-MB) to assess risk factors and rule out acute events.
- CT Coronary Angiography (CTCA) — non-invasive imaging that visualises coronary artery anatomy and detects plaque or stenosis.
- Coronary Angiography (Cardiac Catheterisation) — the gold-standard invasive test; a contrast dye is injected to visualise blockages directly and guide intervention decisions.
- Nuclear Stress Test / Myocardial Perfusion Imaging — assesses blood flow to the heart muscle under stress and at rest.
The choice of test depends on symptom severity, clinical risk score, and the patient's overall health status. A cardiologist at Deccan Hardikar Hospital will recommend the most appropriate diagnostic pathway after an initial consultation. Learn more about our cardiology services in Pune.
What are the stages of coronary artery disease?
CAD progresses through recognisable stages, and the clinical approach differs at each point:
- Stage 1 — Endothelial Dysfunction: The inner lining of coronary arteries becomes damaged, often without symptoms. Risk factor control at this stage can halt progression.
- Stage 2 — Plaque Formation (Atherosclerosis): Fatty deposits accumulate within arterial walls. Blood flow may still be adequate at rest; symptoms appear only during exertion.
- Stage 3 — Stable Angina: Narrowing is significant enough to cause predictable chest pain or discomfort during physical activity or stress, relieved by rest or medication.
- Stage 4 — Unstable Angina / Acute Coronary Syndrome: Plaque ruptures or a clot partially blocks an artery. Symptoms occur at rest and are unpredictable — a medical emergency.
- Stage 5 — Myocardial Infarction (Heart Attack): Complete blockage of a coronary artery causes irreversible damage to heart muscle. Requires immediate intervention.
Note: CAD can be managed effectively at every stage. Earlier intervention — whether through lifestyle changes, medication, or procedures — preserves more heart function and quality of life.
How is coronary artery disease treated without surgery?
Many patients with CAD are managed successfully through a combination of lifestyle modification and medication, without requiring surgical intervention. Treatment is tailored to the stage of disease, symptom burden, and individual risk profile.
Lifestyle modifications:
- Adopting a heart-healthy diet low in saturated fats, trans fats, and sodium
- Regular moderate-intensity aerobic exercise (as advised by the treating cardiologist)
- Smoking cessation
- Weight management and reduction of abdominal obesity
- Stress reduction through structured techniques
Medications commonly used in CAD management:
- Statins — to lower LDL cholesterol and stabilise plaque
- Antiplatelets (e.g. aspirin, clopidogrel) — to reduce clot formation
- Beta-blockers — to reduce heart rate and myocardial oxygen demand
- ACE inhibitors or ARBs — to manage blood pressure and protect cardiac function
- Nitrates — to relieve angina symptoms
When blockages are severe or symptoms are not controlled medically, interventional options such as percutaneous coronary intervention (angioplasty and stenting) or bypass surgery are considered. The cardiology team at Deccan Hardikar Hospital evaluates each patient individually to determine the most appropriate treatment pathway.
When should you see a cardiologist for chest pain or heart symptoms?
Seek a cardiology consultation promptly if you experience any of the following:
- Chest discomfort, pressure, or tightness lasting more than 5 minutes, even if it resolves with rest
- Shortness of breath during activities you previously managed without difficulty
- Unexplained fatigue persisting for more than 2 weeks
- Palpitations or irregular heartbeat occurring more than occasionally
- Dizziness or fainting episodes without a clear cause
- A new diagnosis of high blood pressure, high cholesterol, or diabetes — all of which require cardiac risk assessment
- A family history of heart attack or sudden cardiac death before age 55 in a first-degree relative
Do not wait if symptoms are sudden, severe, or accompanied by sweating, nausea, or pain radiating to the arm or jaw. These require emergency evaluation.
Deccan Hardikar Hospital in Pune, located at 1160/61, University Road, Shivajinagar, provides cardiology consultations and emergency cardiac care. Use the booking form on this page to schedule an appointment with our cardiology team, or visit us directly for urgent concerns. You may also consult Dr. Praveen Pawal, Senior Interventional Cardiologist, for specialist evaluation.
How does Deccan Hardikar Hospital support patients with coronary artery disease?
Deccan Hardikar Hospital in Pune brings together cardiology, cardiac surgery, and allied specialities under one roof, enabling coordinated care for patients with CAD — from initial diagnosis through to intervention and rehabilitation. The hospital holds NABH Pre-Accreditation from the National Accreditation Board for Hospitals and Healthcare Providers, and recognition from the Quality Council of India, reflecting its commitment to clinical standards and patient safety.
The hospital's patient-centric approach emphasises transparent cost communication, so patients and families can make informed decisions without financial uncertainty. Facilities are designed to provide a comfortable, supportive environment throughout the care journey.
Beyond cardiology, the hospital's multidisciplinary structure means that comorbidities commonly associated with CAD — such as diabetes, kidney disease, and vascular conditions — can be managed by the relevant specialists within the same institution. Explore our urology and general surgery services for related care needs.
Book a cardiology consultation at Deccan Hardikar Hospital, Pune
Use the booking form on this page to schedule your appointment, or visit us at 1160/61, University Road, Shivajinagar, Pune 411005.