Coronary Artery Disease: Assessment and Intervention

What coronary artery disease is

Coronary artery disease develops when the vessels supplying blood to the heart muscle narrow, usually through plaque build-up over years. The symptoms that bring patients to assessment — chest tightness on exertion, breathlessness, or reduced exercise tolerance — are the same everywhere; what differs between countries is how quickly the work-up proceeds.

For international patients, the usual reason to come to China is scheduling: coronary angiography, and where indicated stenting, can often be arranged within days rather than weeks, at large-volume interventional cardiology units in Shanghai, Beijing, Guangzhou and Chengdu.

Non-invasive assessment first

A cardiologist will start with an ECG, an echocardiogram, and blood tests including cholesterol and cardiac markers. A stress test — treadmill or pharmacological — or a coronary CT angiogram helps decide whether an invasive angiogram is justified. This sequence is deliberate: it separates patients who need catheterisation from those better served by medication and lifestyle management.

Bring any previous ECGs, echocardiogram reports and stress tests. Serial comparison over time tells a cardiologist more than any single snapshot, and can avoid repeating tests unnecessarily.

When stenting or bypass is considered

Angiography maps the inside of the coronary arteries. If one or two vessels have significant narrowings, angioplasty with drug-eluting stent placement is the common approach — a one- to two-hour procedure, usually through the wrist, with one to three nights in hospital. If three vessels or the left main artery are involved, or the heart's pumping function is reduced, the multidisciplinary team may discuss bypass surgery (CABG) instead, which means open-heart surgery and a one- to two-week hospital stay.

Stenting does not cure the underlying disease. Regardless of where the procedure happens, long-term medication — antiplatelet agents, statins, blood-pressure control — continues for life, and this is exactly the plan your physician at home needs in writing.

Cardiac rehabilitation and follow-up

After intervention, Chinese centres typically schedule a review before you fly, including an echocardiogram and a medication check. Flying is generally acceptable within a week after uncomplicated stenting; after bypass surgery the usual guidance is to wait longer, and to confirm this with your surgeon.

Ask for three documents before departure: the angiogram images on disc, the procedural report including stent type and diameter, and a discharge medication list with generic drug names. These make the handover to your home cardiologist straightforward, and they are the documents your insurer will ask for.