Coronary heart disease is a condition in which fatty deposits build up in the walls of the arteries to your heart, which causes them to narrow. This can reduce the supply of oxygen to your heart, which may cause angina (pain in your chest) and over time can lead to a heart attack.
Your heart is a pump that circulates blood to your lungs and the rest of your body. It supplies your body with oxygen and nutrients and takes away carbon dioxide and waste products. Your heart also needs a supply of blood and this is provided by blood vessels called coronary arteries.
Coronary heart disease happens when fat and cholesterol in your blood builds up in your artery walls and forms a plaque or atheroma. This is known as atherosclerosis. The plaque can prevent your heart muscle from getting the blood supply it needs.
Sometimes the plaque may rupture (break open) and a blood clot forms on the surface of the plaque. This can stop an area of your heart muscle receiving blood and oxygen, which can lead to a heart attack. Heart muscle damage can result in abnormal heart rhythms which can cause cardiac arrest where your heart stops beating altogether, which is fatal. In the UK, more people die from coronary heart disease than from any other cause.
Coronary heart disease develops slowly over many years. In some people, breathlessness when exercising is the only symptom. You may not know anything is wrong until you develop chest pains (angina) or have a heart attack.
Angina usually happens if the blood flow in the arteries that supply your heart is restricted.
Angina typically starts when you're exerting yourself physically or feeling upset. It can also be brought on by cold weather or after a meal. Symptoms include:
Angina usually lasts for a few minutes and disappears quickly after you rest.
A heart attack can cause severe pain in the centre of your chest, which may feel like very bad indigestion, or you can have mild pain and feel unwell. Symptoms can happen suddenly, but sometimes the pain can develop more slowly. Symptoms include:
It’s possible that you may not have any symptoms. This is called a silent myocardial infarction.
Call for emergency help immediately if you suspect you or a person you’re with is having a heart attack. If it’s to hand, take an aspirin to chew, or swallow it dissolved in water (provided you aren’t allergic to aspirin). This will help to prevent the clot that is blocking the coronary artery from growing.
An arrhythmia is an irregular heartbeat, which you may feel as a heart palpitation (a sensation of a skipping or thumping heart beat).
Over time, coronary heart disease may weaken your heart, and lead to heart failure. Heart failure means your heart isn't strong enough to pump blood around your body effectively and you get tired and out of breath easily. It can also cause swelling in your ankles and legs.
Coronary heart disease is caused by a build up of fatty deposits on your artery walls.
Coronary heart disease is more common in older people (men over 45 years and women over 55). It's also more common among people from South Asia. Other factors that increase your risk of developing coronary heart disease include:
Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. You may have one or more of the following tests.
Your treatment for coronary heart disease will depend on how serious it is. There are several treatments available.
Your doctor may advise you to make certain lifestyle changes to reduce your symptoms or prevent a heart attack, but this on its own won’t be enough. See Prevention.
Medicines aim to stop coronary heart disease getting worse or prevent future heart attacks. Examples include the following.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
A coronary angioplasty can widen your narrowed coronary artery. Your doctor will pass a collapsed balloon through your blood vessels until it reaches the arteries of your heart and then inflate it. He or she may insert a stent (flexible mesh tube) to help keep your artery open.
Your surgeon may recommend a coronary artery bypass graft (CABG). In this operation he or she will take a piece of a blood vessel from your leg or chest and use it to bypass the narrowed coronary arteries. This can improve the flow of blood to your heart.
You can usually prevent coronary heart disease by adopting a healthy lifestyle. This includes:
Produced by Rebecca Canvin, Bupa Health Information, June 2012.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
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