Asymptomatic coronary artery disease

About narrowed coronary arteries (without symptoms)

The heart is a muscle that needs oxygen to pump blood through the body. Blood flows through the blood vessels and delivers oxygen and nutrients to the muscles and organs. The heart itself receives oxygen through the coronary arteries.

When one or more coronary arteries are narrowed, insufficient oxygen reaches certain parts of the heart. Narrowed coronary arteries can cause angina pectoris (chest pain). This is usually not life-threatening, but can also indicate a heart attack. During a heart attack, the heart muscle is damaged because a coronary artery is partially or completely blocked. A heart attack in young people is very rare. You can do a number of things to reduce the risk of a heart attack, such as living a healthy lifestyle.

Do I have an increased risk of narrowed coronary arteries?

Everyone, including people who have never had cancer, can develop narrowed coronary arteries. However, some cancer treatments can increase the risk.

The following treatment can increase the risk of narrowed coronary arteries:

• Radiation to the chest where the heart is in the radiation field

You can see in your treatment summary whether you have received this radiation. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated.

What are symptoms and signs that indicate angina pectoris or a heart attack?

The narrowing of the coronary arteries happens slowly and usually does not cause symptoms. But when a coronary artery becomes (almost) completely blocked, you can develop angina pectoris (chest pain) or a heart attack. Certain symptoms and signs may indicate angina pectoris or a heart attack. Even if you do not have these symptoms and signs at the moment, it is important to recognize them in case you ever develop them.

The following symptoms and signs may indicate angina pectoris:

• Chest pain (during exertion)

• Shortness of breath

• Severe fatigue

The following symptoms and signs may indicate a heart attack:

• Severe pain and/or pressure on the chest

• Pain in the shoulders, neck, and/or left arm

• Pain in the jaw, neck, and upper back

• Dizziness or lightheadedness

• Sweating

• Shortness of breath

• Nausea or vomiting

• Feeling very anxious

• Coughing and wheezing

The symptoms and signs of a heart attack can vary from person to person. Sometimes they occur suddenly (especially in men), but they can also develop slowly and be milder (especially in women or older people). If you recognize any of these symptoms or signs, contact your general practitioner or LATER physician. In case of a heart attack, rapid diagnosis and treatment are important. When you visit the LATER clinic regularly, any heart problems may already be detected before you experience symptoms.

I have an increased risk of narrowed coronary arteries. What tests are necessary and when?

If you have an increased risk of narrowed coronary arteries, the recommendation is (even if you have no symptoms or signs) to:

• From age 40, have your blood pressure, blood sugar, and cholesterol measured at least every 5 years. Your general practitioner or LATER physician will probably ask whether you smoke, what your weight is, and how much you exercise. These are factors that can increase the risk of heart problems.

What happens if I have narrowed coronary arteries?

If you have narrowed coronary arteries, your doctor will explain how you can reduce the symptoms (if you have them) and the risk of a heart attack, for example with a healthy lifestyle. Your doctor may prescribe medication to lower your blood pressure or cholesterol. If necessary, your doctor will refer you to a:

• Cardiologist (physician specialized in heart and blood vessels)

They will discuss treatment options with you.

What else can I do?

Living with an increased risk of narrowed coronary arteries can be difficult. Talking with friends and family can help. Contact with people in a similar situation can also be helpful, for example through a patient association such as VOX, part of the Dutch Childhood Cancer Association.

Above all, take good care of yourself. With a healthy lifestyle, you can reduce the risk of narrowed coronary arteries. Also take care of your mental health. Small changes can already have a positive impact on your physical and mental wellbeing. Read more about choosing a healthy lifestyle and attention to your mental health.

It is important to know that you can develop narrowed coronary arteries without symptoms or signs. If you have questions or are concerned after reading this information, contact your general practitioner or LATER physician.

In the PanCare Plain Language Summaries you will find links to reliable information in English. You can search for information about narrowed coronary arteries online, but keep in mind that it is sometimes not up-to-date or accurate.

Where can I find more information?

This LATER website also contains information about:

• Healthy lifestyle

• Dyslipidemia

• Heart problems

• High blood pressure

• Mental health

• Overweight and obesity

• Disturbed sugar metabolism and diabetes

Disclaimer

This information is based on the plain language summary of the guideline below, created by the PanCare Plain Information Group, and has been adapted to the Dutch LATER guideline where necessary. If you experience symptoms and signs, do not rely solely on this information, but consult your general practitioner, LATER physician, or specialist.

```