Coronary artery disease: Signs, treatment, and insurance support

What is coronary artery disease?

Coronary artery disease, also called coronary heart disease, occurs when the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked. This is usually caused by a buildup of fat, cholesterol, and other substances inside the arteries. When blood flow to the heart is reduced, your heart cannot get enough oxygen. 

CAD often develops slowly and can be present for years without symptoms. Gradual blockage can cause chest pain (angina) or shortness of breath, while a severe blockage can trigger a heart attack.

Is coronary heart disease the same as cardiovascular disease?

Cardiovascular disease is a broad term that covers all diseases of the heart and blood vessels.

Coronary heart disease is just one type of cardiovascular disease, and refers specifically to the narrowing or blockage of the coronary arteries that supply blood to the heart.

Causes of CAD

The main cause of coronary artery disease is atherosclerosis, a condition where plaques made up of cholesterol, fats, calcium, and other substances accumulate in the arteries. 

This build-up gradually narrows the arteries, limiting how much oxygen-rich blood can reach the heart. If a plaque breaks open, it can form a blood clot that may partially or completely block blood flow.

Coronary heart disease symptoms

Symptoms can be mild or severe, come and go, or be missed altogether. Some people don’t realise they have the condition until they have a heart attack. 

Common symptoms include:

• Chest pain or discomfort (angina), often described as pressure, tightness, squeezing, or heaviness in the chest
• Shortness of breath
• Pain or discomfort in the arms, shoulder, back, stomach, jaw, or neck
• Fatigue
• Cold sweats
• Dizziness
• Nausea
• Feeling faint or sick.

When to see a doctor

See a doctor if you experience recurring or worsening chest pain or other symptoms.

Get emergency help if you experience the following, as these may be signs of a heart attack:

• Sudden, severe chest pain
• Pain radiating to the arms, shoulders, neck, back, or jaw
• Shortness of breath, nausea, dizziness, or cold sweats.

Risk factors

Coronary artery disease develops due to a mix of factors. Some are outside your control, while others can be managed through lifestyle changes and medical care.

Risk factors you can’t control include:

• Increasing age
• Sex: Males have a higher risk of CAD at an early age, with risks in women rising after menopause
• Family history of early heart disease
• A history of pregnancy-related conditions, such as preeclampsia or gestational diabetes
• Having certain autoimmune diseases, such as lupus or rheumatoid arthritis.

Risk factors you can manage include:

• Smoking or tobacco use, or even breathing in secondhand smoke
• High blood pressure
• High LDL (“bad”) cholesterol 
• Low HDL (“good”) cholesterol
• Diabetes
• Being overweight or obese
• Lack of exercise
• Unhealthy diet
• Long-term stress
• Heavy alcohol use
• Too little sleep, too much sleep, or sleep disorders, such as sleep apnoea.

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Complications

CAD can lead to the following serious complications that may impact your quality of life or become life-threatening:

• Angina (chest pain) - caused by reduced blood flow to the heart muscle, and can also indicate worsening coronary heart disease
• Heart attack (myocardial infarction) - a medical emergency which occurs when a coronary artery becomes blocked, stopping blood flow to the heart 

• Heart failure - when the heart weakens or becomes stiff and can no longer pump blood efficiently
• Arrhythmias (irregular heart rhythms) - which can occur when the heart doesn’t get enough blood and oxygen.

Diagnosis

Your doctor may ask questions about your symptoms, lifestyle, and family history of heart disease. You may also undergo tests, which can include:

• Blood tests to check cholesterol, blood sugar, and markers of heart damage or inflammation
• Electrocardiogram to assess the heart’s electrical activity
• Echocardiogram to look at heart structure and blood flow
• Stress test to see how your heart works during physical activity
• Heart CT scan or CT coronary angiogram to detect blockages or narrowing in the arteries.

Coronary artery disease treatments

Coronary artery disease is managed with a combination of lifestyle changes, medicines and, in some cases, surgery. Treatments aim to ease symptoms, slow disease progression, and lower the risk of complications. 

Non-surgical management and treatment options include:

• Lifestyle changes, such as quitting smoking, eating a heart-healthy diet, being more physically active, maintaining a healthy weight, limiting alcohol consumption, and managing stress
• Medications to lower “bad” cholesterol, control blood pressure, reduce blood clot risk, and ease chest pain.

If your arteries are severely narrowed or blocked, you may need a procedure or surgery to restore blood flow to your heart:

• Coronary angioplasty and stents to reopen narrowed or clogged arteries
• Coronary artery bypass graft surgery to redirect blood flow around blocked arteries.

After a heart surgery or an event like a heart attack, cardiac rehabilitation may be recommended to help support your recovery and long-term heart health.

A cardiac rehab programme may include:

• Supervised or guided exercise
• Education about heart disease and medications
• Tips on recovery after heart surgery
• Advice on healthy eating, lifestyle changes, sleep, and stress management
• Mental wellbeing and emotional support.

Programmes can be delivered in hospitals, communities, or online. Your GP or hospital team can help you find free or paid programmes in your region. Some programmes also involve family or whānau, which can make recovery easier and better supported.

How your insurance can help 

Diagnostic tests, specialist consultations, and cardiac surgeries are free in the public health system, but waiting times can be long. For instance, Health New Zealand April 2025 figures show 2,561 cardiology patients waiting more than four months for their first specialist assessment, and 841 waiting over four months for treatment. 

Going private without insurance is costly. CT scans can cost $700-$2,000, while coronary artery bypass surgery can reach $50,000-$75,000. 

Even with insurance, a serious heart condition is stressful, potentially life-threatening, and can trigger various insurance payouts. Data below from New Zealand’s major insurers indicates how heart and cardiovascular conditions are commonly claimed.

Sources: AIA 2024 claims data; Chubb 2024 claims statistics; Fidelity Life claims data (July 2024 - June 2025); Partners Life claims stats (April 2024 - March 2025)

Here’s how each type of insurance can help support you through CAD-related medical events and expenses:

• Health insurance: Depending on your plan, health insurance can cover many of the medical bills for CAD, from specialist consultations and diagnostic tests to expensive surgeries, like bypass surgery. This means you can get timely private treatment with little or no out-of-pocket cost, allowing you to focus on getting better instead of worrying about hospital bills.
• Trauma (critical illness) insurance: Trauma cover pays out a lump sum if you suffer a condition covered by your policy, such as a heart attack or coronary artery surgery. You can use it to pay for treatment and rehabilitation costs, or to replace lost income while you recover.
• Life insurance: Life insurance offers peace of mind that if a heart attack or other CAD complication leads to death, your family will be left with a financial safety net. It pays a lump sum to your beneficiaries if you pass away (and often even if you’re diagnosed as terminally ill), which can cover funeral costs and debt payments, as well as provide ongoing support for your loved ones’ living expenses.
• Total and permanent disability (TPD) insurance: Disablement cover provides a one-off payout if a severe heart problem leaves you permanently disabled and unable to go back to work. You can use it to fund long-term medical care and living costs, home modifications, or other needs to help you readjust to life after a disabling cardiac event.
• Income protection or mortgage protection insurance: If CAD or heart surgery forces you to take time off work, these plans can replace part of your salary during your recovery. The monthly benefit helps you manage bills, living expenses, and mortgage or rent payments, so you can maintain your household’s financial stability while you concentrate on healing.

Insurers may apply exclusions or waiting periods for claims related to pre-existing conditions. If you already have a heart condition and are considering getting cover, talk to an adviser to understand which plan would best fit your situation. 

Even if your condition is permanently excluded, having insurance can still provide important protection. It may cover other serious conditions like cancer, protect your income, or provide support for your family if your health affects your ability to work or leads to long-term disability or death.

Protect your heart with Policywise

Coronary artery disease can lead to serious medical and financial challenges. Medical costs can be high, especially if private surgical expenses are included. There are also indirect costs, such as lost income from being unwell yourself or needing to care for someone else. Having the right insurance cover can lighten the load immeasurably. 

Policywise is a 100% free service which tells you which health, life, and disability insurance provider best fits your needs. We offer fast, comprehensive, and easy-to-understand comparisons of all leading providers, and a simple summary clearly recommending which insurer is best for your situation.

Not all insurance policies are the same. Policywise can help you sort out the duds, avoid the lemons, understand the fine print and exclusions, and get the right insurance for you and your family.

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Check out the reviews on our homepage for how other New Zealanders have found our service, because now is the time to get your personal insurance sorted. Give your family or someone you love the most outstanding financial support possible. Book a 5-minute callback with Policywise today; our service is fast and free.