Coronary Artery Disease

Coronary artery disease — the narrowing of the heart's arteries by a gradual build-up of fatty deposits — is the most common form of heart disease and the leading cause of heart attacks. Yet it is also one of the most treatable conditions in modern medicine. Diagnosed early, it can be managed so effectively that most patients live full, active lives.

I am Dr Ozan Demir, a Consultant Interventional Cardiologist practising in London and Essex, with subspecialty expertise in  coronary intervention. I manage the complete pathway of coronary artery disease — from first symptoms and diagnosis through to angioplasty and stenting, which I perform personally at leading hospitals.

Your heart muscle is supplied with blood by the coronary arteries. Over time, cholesterol-rich deposits (plaque) can build up in the artery walls — a process called atherosclerosis. As arteries narrow, blood flow to the heart muscle becomes restricted, particularly during exertion when the heart needs more oxygen.

This can cause:

• Angina — chest tightness, pressure or heaviness on exertion, easing with rest. Some people feel breathlessness rather than pain
• Heart attack (myocardial infarction) — if a plaque ruptures and a clot suddenly blocks the artery completely

Coronary artery disease may develops silently over years, which is why it can first present as a heart attack in someone who felt entirely well. Identifying it early — before an emergency — is the entire purpose of proactive assessment.

Coronary artery disease may cause:

• Chest tightness, pressure, heaviness or aching — typically triggered by exertion, cold weather, stress or heavy meals, and settling with rest
• Pain or discomfort spreading to the arms, neck, jaw or back
• Breathlessness on exertion — sometimes the only symptom, particularly in women and people with diabetes
• Reduced exercise tolerance — struggling with hills or stairs that were previously manageable
• Fatigue

Importantly, coronary artery disease can also be completely silent. If you have significant risk factors, assessment is worthwhile even without symptoms.

Your first appointment lasts around 30 minutes and includes:

1. A detailed discussion of your symptoms and risk factors — including family history, lifestyle and previous test results
2. A physical examination and resting ECG performed in clinic
3. A personalised risk assessment — understanding your individual likelihood of coronary disease
4. A clear plan — which tests you need, and what the results will mean

Investigations are tailored to your symptoms and risk profile. I can arrange rapid access to:

• CT coronary angiogram — a highly accurate, non-invasive scan of the coronary arteries, and the first-line test recommended by NICE for suspected angina. It can detect disease at its earliest stages
• Coronary artery calcium score — a quick scan quantifying calcified plaque, useful for refining risk in people without symptoms
• Echocardiogram — assessing the heart's pumping function
• Stress testing — assessing how the heart performs under exertion
• Blood tests — including a full cholesterol profile and diabetes screening
• Invasive coronary angiography — the definitive assessment, performed by me personally via the wrist artery, with the option to treat significant narrowings during the same procedure

Most patients complete their assessment and key investigations within one to two weeks.

Treatment has three pillars, used alone or in combination:

1. Medication and risk factor control Statins and other cholesterol-lowering drugs, blood pressure treatment, antiplatelet therapy and diabetes management dramatically reduce the risk of heart attack — and can stabilise or even regress plaque. Many patients with coronary disease are managed with medication alone, very successfully.

2. Coronary angioplasty and stenting (PCI) Where narrowings significantly restrict blood flow, I perform angioplasty and stenting — a minimally invasive procedure in which the artery is reopened with a balloon and held open with a stent. It is usually done through a small puncture in the wrist, as a day case, under local anaesthetic. My subspecialty focus is complex coronary intervention, including heavily calcified arteries and multi-vessel disease — cases that require advanced techniques and equipment.

3. Coronary bypass surgery (CABG) For some patterns of disease, surgery offers the best long-term result. Where this is the case, I will explain why, and refer you directly to leading cardiac surgical colleagues — with your case discussed at a specialist heart team meeting.

Whatever your treatment, you remain under my care for follow-up and long-term risk management.

• Consultant Interventional Cardiologist with subspecialty expertise in complex coronary intervention — including calcified arteries, chronic total occlusions and multi-vessel disease
• PhD from King's College London and advanced interventional fellowship training at San Raffaele Hospital, Milan — one of Europe's leading centres for complex coronary intervention — with over 100 peer-reviewed publications
• End-to-end care — from first consultation through CT imaging to angioplasty and stenting, under one consultant, with no need for re-referral
• Rapid access — same-week appointments at Heart Health Welbeck London (Marylebone), Cromwell Hospital (Kensington), The Wellington Hospital (St John's Wood), Bupa Health Care Canary Wharf, The Essex Cardiothoracic Centre (Basildon)
• Consultations in English and Turkish
• Recognised by all major private medical insurers; self-paying patients welcome

Coronary artery disease is most treatable when caught early — before it becomes advanced. Contact my practice team to arrange a consultation at one of my London or Essex locations.

Contact Ms Amelia Garner (PA) on 020 3198 9826 or drozandemir.sec@outlook.com to arrange a consultation.