Coronary Heart Disease: What It Is, Symptoms, Tests and Care

Coronary heart disease is one of the most common heart conditions in the world. It can build up silently over many years, and some people only find out when they have chest pain or a heart attack. This article explains what the NHS and the US CDC say about it.

What is coronary heart disease?

The NHS says coronary heart disease (CHD) is also called ischaemic heart disease or coronary artery disease. It occurs when fatty substances build up in the coronary arteries and block or interrupt the heart's blood supply. The CDC says it is the most common type of heart disease in the United States and that it can lead to a heart attack.

Causes

The NHS explains that fatty deposits, called atheroma, gradually narrow the artery walls. This process is called atherosclerosis. Lifestyle factors, such as smoking and regularly drinking large amounts of alcohol, can contribute. High cholesterol, high blood pressure and diabetes increase the risk.

The CDC names high blood pressure, high cholesterol and smoking as the three key risk factors for heart disease, and says 47% of people in the United States have at least one of them. Other risk factors include diabetes, overweight and obesity, an unhealthy diet, inactivity and too much alcohol.

Symptoms

Because the arteries narrow slowly, symptoms often appear only once the narrowing is significant. The NHS says symptoms may include:

• Chest pain (angina)
• Breathlessness
• Pain in the neck, shoulders, jaw or arms
• Faintness
• Nausea

Some people have no symptoms before they are diagnosed. The CDC says heart disease can be silent until a heart attack, heart failure or an irregular heartbeat occurs, which is one reason regular check-ups matter.

How is it diagnosed?

The NHS says a doctor may assess your risk by asking about your medical history, family history and lifestyle, and by taking a blood test. To confirm CHD, further tests can include an electrocardiogram (ECG), echocardiogram, chest X-ray and coronary angiogram.

Treatment and care

The NHS says CHD cannot be cured, but treatment can manage symptoms and reduce the risk of complications such as heart attacks. Options include lifestyle changes such as regular exercise and stopping smoking, medicines, angioplasty (using balloons and stents to open narrowed arteries) and surgery. Your doctor decides which are suitable for you. Treatment is usually long term, so it helps to ask your care team to explain each part of your plan, what it is for and what to watch for. The NHS says these steps also reduce the chance of complications such as heart attacks.

Prevention

The NHS lists these steps, which also lower the risk of stroke and dementia:

• Eat a healthy, balanced diet
• Be physically active
• Stop smoking
• Keep blood cholesterol and blood sugar levels under control

The CDC adds that adults should get cholesterol tested at least every 4 to 6 years, and that blood pressure should be measured at least once a year for adults with no risk factors. It also advises taking prescribed medicines as directed and not stopping them without talking to your doctor, nurse or pharmacist.

When to see a doctor

See a doctor if you have chest pain, unexplained breathlessness, or other symptoms that could be related to your heart, or if you have several risk factors and have never been checked. Do not wait for a crisis, because CHD can be silent.

Call emergency services at once for chest pain that is tight or squeezing, pain spreading to the arms, neck or jaw, severe breathlessness, or chest pain with sweating or nausea. The NHS advises not to drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).