Coronary heart disease

What is coronary heart disease?

Coronary heart disease (CHD), also known as ischaemic heart disease or coronary artery disease, is when the coronary arteries that supply the heart with oxygen-rich blood become narrowed.

The narrowing is a result of the build-up of fatty deposits within the coronary arteries – a process called ‘atherosclerosis’. The arteries become narrow and rigid, and can become blocked. This restricts blood flow to the heart, and the supply of oxygen and nutrients, which has a direct effect on the heart’s function.

Coronary heart disease (CHD) is the most common type of cardiovascular disease, and it is the most common cause of heart attack. In the UK there are 188,000 hospital visits each year due to heart attacks: that’s one every three minutes (Source: British Heart Foundation, accessed Feb 2019).

When CHD is untreated, it can lead to stroke, heart attack or heart failure. It’s therefore important to watch out for the following symptoms and seek advice from a health professional to ensure you get the right treatment.

Coronary heart disease symptoms

The main symptom of coronary artery disease is angina, a condition which produces a feeling of pain, discomfort, tightness or pressure across the front of the chest.

Other symptoms include:

• shortness of breath
• heart palpitations
• rapid heartbeat
• nausea
• sweating
• dizziness

What causes coronary heart disease?

The following lifestyle factors can cause atherosclerosis to develop:

• smoking
• high cholesterol and/or high blood pressure
• obesity
• diabetes
• family history of CHD

Diagnosing coronary heart disease

If you or your GP suspects that you may be at risk of developing CHD, it is recommended that you undergo an initial risk assessment. This involves:

• an assessment of your lifestyle, medical history and family history
• a blood pressure test
• a blood test to evaluate cholesterol levels in your blood

We have a rapid access cardiac clinic for patients experiencing chest pain, or other cardiac symptoms requiring non-emergency assessment.

In order to confirm a diagnosis of CHD, you may be referred to a specialist for more tests. These may include:

• blood tests
• x-rays
• electrocardiogram (ECG)
• coronary angiogram
• magnetic resonance imaging (MRI) scans
• computerised tomography (CT) scans
• radionuclide tests

Coronary heart disease treatment

With the right treatment, the symptoms of coronary heart disease (CHD) can be managed and the heart function improved.

Treatment for coronary heart disease typically involves a combination of lifestyle changes and medication, although a procedure such as coronary angioplasty (stenting) may sometimes be required in severe cases, or when the first two approaches have not worked.

Lifestyle changes to treat coronary heart disease

The following changes can help to reduce the symptoms of CHD and reduce the build-up of fatty deposits in the arteries:

• eating more healthily
• quitting smoking (if you smoke)
• doing more exercise

Medication to treat coronary heart disease

A range of medications can be used to directly reduce blood pressure or widen the arteries.

Surgery to treat coronary heart disease

The following procedures may be carried out to widen or unblock the coronary arteries:

• coronary angioplasty (stenting)
• coronary artery bypass graft (CABG)