Definition

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease.

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Coronary Artery Disease Facts">Coronary artery disease is …The correct answer is all of the above. Coronary artery disease (CAD) and coronary heart disease describe the same condition: the buildup of plaque in the arteries that carry blood and oxygen to the heart. These are called the coronary arteries. Over time, they can become narrow, slowing or stopping blood flow to the heart.What causes plaque to build up in the arteries?The correct answer is all of the above. Any of these factors cause damage to the inside walls of the coronary arteries. Cholesterol and other chemicals in the blood then build up on these injured areas as plaque. This process is called atherosclerosis.You can have CAD and not have any symptoms.The correct answer is true. Plaque buildup occurs slowly over time, so you can have the disease and not have any symptoms. This is especially true in the early stages of heart disease. Sometimes, a heart attack is the first sign of CAD.What are the noticeable symptoms of CAD?The correct answer is all of the above. Angina (chest heaviness, pressure, or pain) is the most common symptom. It often occurs during activity or stress and goes away with rest or when you take an angina medicine (most often nitroglycerin under your tongue). You also may feel shortness of breath, fatigue, or weakness.Angina is another name for a heart attack.The correct answer is false. Angina is a sign that your heart isn’t getting enough oxygen. A heart attack occurs when heart muscle cells die due to a blocked artery. Having angina means you are at risk for a heart attack. If you have angina, and your chest pain doesn’t go away minutes after rest or medicine, call 9-1-1.Which heart problems can be caused by CAD?The correct answer is all of the above. Reduced blood flow can damage the heart in different ways. Heart failure occurs when the weakened heart muscle can’t pump enough blood to the rest of the body.
CAD can damage the heart’s electrical system, causing arrhythmias. A blocked artery can cause a heart attack.
If you have heart disease, you are at higher risk for depression.The correct answer is true. It’s unclear why, but there is a link between depression and heart disease, angina, and heart attack. Being depressed may make it harder to follow your treatment plan, and treating depression can help you better manage heart disease. If you think you may be depressed, talk with your doctor.How may CAD be treated?The correct answer is all of the above. Your treatment depends on your symptoms and how much artery blockage you have. For some people, lifestyle changes alone can treat CAD. Others may need medicine, angioplasty, or surgery. Talk with your doctor about the best treatment for you.Which lifestyle change WON’T help treat CAD?The correct answer is following a gluten-free diet. Most people don’t need to follow a gluten-free diet, and avoiding gluten certainly won’t help treat CAD. Follow a plant-based diet low in sodium, cholesterol, and trans and saturated fats. Talk with your doctor about other changes that can help your heart.Plaque buildup can begin in childhood.The correct answer is true. It may seem hard to believe, but plaque starts building up on artery walls in our childhood and teen years. That’s why it’s never too early to eat a healthy diet, get regular exercise, and manage stress. And if you never start smoking in the first place, you never have to quit!

Alternative Names

Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD

Causes, incidence, and risk factors

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.

Coronary heart disease is caused by the buildup of plaque in the arteries to your heart. This may also be called hardening of the arteries.

  • Fatty material and other substances form a plaque build-up on the walls of your coronary arteries. The coronary arteries bring blood and oxygen to your heart.
  • This buildup causes the arteries to get narrow.
  • As a result, blood flow to the heart can slow down or stop.

A risk factor for heart disease is something that increases your chance of getting it. You cannot change some risk factors for heart disease, but others you can change. See: Heart disease – risk factors

Symptoms

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms. This is especially true in the early stages of heart disease.

Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

  • It may feel heavy or like someone is squeezing your heart. You may feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.
  • The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
  • Other symptoms include shortness of breath and fatigue with activity (exertion).

Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as:

  • Fatigue
  • Shortness of breath
  • General weakness

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Signs and tests

Your doctor or nurse will examine you. Your doctor will often order more than one test before making a diagnosis.

Tests may include:

  • Coronary angiography — an invasive test that evaluates the heart arteries under x-ray
  • Echocardiogram stress test
  • Electrocardiogram (ECG)
  • Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries — the more calcium, the higher your chance for CHD
  • Exercise stress test
  • Heart CT scan
  • Nuclear stress test 

Treatment

You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor’s directions closely to help prevent coronary artery disease from getting worse.

Goals for treating these conditions in people who have coronary artery disease:

  • Blood pressure less than or equal to 140/90 (even lower for patients with diabetes, kidney disease, or heart failure)
  • HbA1c levels if you have diabetes at a level recommended by your doctor
  • LDL cholesterol level less than or equal to 100 mg/dL (even lower for some patients)

Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat heart disease, blood pressure, diabetes, or high cholesterol. Follow your doctor’s directions closely to help prevent coronary artery disease from getting worse.

Never stop taking your medicines without talking to your doctor first. Stopping heart medicines suddenly can make your angina worse or cause a heart attack.

Your doctor may refer you to a cardiac rehabilitation program to help improve your heart’s fitness.

Procedures and surgeries used to treat CHD include:

  • Angioplasty and stent placement, called percutaneous coronary interventions (PCIs)
  • Coronary artery bypass surgery
  • Minimally invasive heart surgery  

Expectations (prognosis)

Everyone recovers differently. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications exactly as the doctor prescribes. Others may need medical procedures such as angioplasty or surgery.

Although everyone is different, early detection of CHD generally results in a better outcome.

Calling your health care provider

If you have any risk factors for CHD, contact your doctor to discuss prevention and possible treatment.

Immediately contact your health care provider, call the local emergency number (such as 911), or go to the emergency room if you have:

  • Angina or chest pain
  • Shortness of breath
  • Symptoms of a heart attack

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