Chronic Coronary Syndrome (CCS)

CCS is a long-term condition in which narrowing or dysfunction of the coronary arteries reduces blood flow to the heart. This can cause a temporary imbalance between the heart’s oxygen demand and supply, especially during exercise or emotional stress. As a result, patients may experience chest pain, shortness of breath, or sometimes no symptoms at all. Although CCS can remain stable for a long time, it is a progressive disease and may suddenly worsen, potentially leading to acute coronary syndrome (ACS), such as a heart attack.

• Obstructive coronary artery disease (Stable angina)
• Non-obstructive coronary artery disease

The most characteristic symptom of CCS is chest pain that occurs during physical exertion.

• Symptoms such as chest discomfort or dyspnea may occur during exercise or stress.
• Symptoms typically improve with rest.
• Administration of sublingual nitroglycerin usually leads to rapid relief.

Vasospasm

• In patients with nonobstructive coronary artery disease (CAD), variant angina often presents with symptoms that occur in the early morning, in cold weather, or after alcohol consumption.

Cause of CCS is progressive atherosclerotic narrowing of the coronary arteries leading to fixed obstructions and impaired blood flow during increased demand.

• Comorbidity: Hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease
• Lifestyle Factors: Smoking, Obesity

Healthy Behaviors

Regular physical activity, balanced diet, weight management, smoking cessation, mental health

Control of risk factors

Blood pressure, blood glucose, and cholesterol management

Medication adherence

Adherence to prescribed medications (e.g., statins, antihypertensives)