Coronary heart disease is also called ischaemic heart disease or coronary artery disease. It occurs when fats and other substances circulating in your blood stick together in clumps in the walls of your arteries — this is called atheroma.
Over time, your arteries become narrow as atheromas build up. This restricts the supply of oxygen-rich blood that your heart needs to beat properly — you might get painful angina attacks.
Sometimes, pieces of the atheroma break off and form a blood clot (thrombosis) which causes a life-threatening condition, such as a stroke or heart attack (myocardial infarction). A heart attack occurs when one or several of the arteries supplying your heart are completely blocked — this can happen even when you are resting.
Some of the symptoms of a heart attack are similar to angina and indigestion. However, unlike angina symptoms, heart attack symptoms are not relieved by taking angina medication (eg a nitrate tablet or spray). In some cases, a heart attack does not cause any symptoms — this is called a silent heart attack and is most common in people with diabetes and older people.
A common symptom of a heart attack is sudden pain in your chest — this is a medical emergency. It is therefore vital that the cause of your chest pain is diagnosed and treated as soon as possible. If you notice any of the following symptoms, call 999 immediately:
Another complication of coronary heart disease is heart failure. This occurs when your heart is no longer strong enough to pump blood efficiently around your body. This causes fluid build-up in your lungs, which makes it hard to breathe. Heart failure can occur suddenly (acute heart failure) or gradually (chronic heart failure).
Your heart is made of cardiac muscle. It pumps blood to your lungs and the rest of your body, delivering vital oxygen and nutrients. Your heart also needs a blood supply, which is delivered by your coronary arteries.
When excess fat builds up along the walls of your coronary arteries, over time, you can develop coronary heart disease. This build-up of fat forms hardened plaques called atheromas in a process called atherosclerosis. The atheromas narrow your coronary arteries, which prevents sufficient blood flow to your heart and can damage your heart tissue. If an atheroma ruptures, a clot can break off and completely block your coronary artery, which causes a heart attack.
Coronary heart disease is the leading cause of death in the UK.
You may not notice any symptoms of coronary heart disease. However, you may notice angina symptoms, such as:
Not everyone experiences the same symptoms of coronary heart disease. So if you think you are at risk, it is important to see your GP or doctor for a risk assessment. This will assess your possibility of developing angina, a heart attack, heart valve disease or a stroke.
Your GP will carry out a risk assessment and will ask you about:
They may carry out these tests:
If your doctor suspects coronary heart disease they will refer you for other tests. This may include blood tests to check for signs of heart problems as well as:
You may also be referred to a cardiologist, a doctor specialising in treating the heart and circulatory system.
Coronary heart disease is more likely as you get older but it is often manageable with lifestyle changes and/or treatment. It is caused by fatty deposits building up along the walls of the arteries supplying your heart with blood. This is more likely to occur if you do not exercise enough.
These fatty deposits harden to form plaques called atheromas through a process called atherosclerosis. This narrows the arteries and reduces blood flow to the heart.
Certain health conditions increase your risk of developing coronary heart disease. These are:
Risk factors for coronary heart disease
Lifestyle factors can also increase your risk of coronary heart disease. You are more likely to have coronary heart disease if you:
Other factors that increase your risk but that you can’t control are:
You can reduce your coronary heart disease symptoms, improve your heart function and therefore reduce your risk of a heart attack or a stroke by:
You may be prescribed medications to manage your coronary heart disease. Medications usually aim to reduce your blood pressure or widen your coronary arteries. Medications include:
Other medications to regulate your heart rate, reduce your blood pressure and improve your blood flow include calcium channel blockers and diuretics.
As these medications can have side effects, you may need to try several different ones to find the one that works best for you.
Bariatric (weight loss) surgery
If you need to lose a lot of weight, your GP may consider whether obesity surgery, such as a gastric sleeve, might help.
To check if a coronary angioplasty is an appropriate treatment for you, a special type of X-ray to check your blood vessels called a coronary angiogram will be performed.
Coronary angioplasty involves removing the atheroma in your coronary artery using a small wire with a balloon on the end which is fed into the artery. Sometimes a mesh tube, called a stent, is placed in the artery afterwards to hold it open.
Coronary angioplasty is sometimes performed as an emergency treatment for a heart attack.
Coronary artery bypass graft (CABG)
Also called a heart bypass, this treatment is used for more serious blockages of your coronary arteries. It involves redirecting blood flow from your blocked artery to your heart muscle using an artery from another part of your body.
To check if this treatment is appropriate for you, a coronary angiogram will first be performed.
A coronary artery bypass graft is performed while your heart continues to pump blood by itself, ie a heart-lung machine is not needed.
If your heart is severely damaged and medications are therefore not effective, or you have heart failure, you may need a heart transplant. This involves replacing your damaged heart with a healthy donor heart.
Reducing your blood pressure and cholesterol levels will help reduce your risk of coronary heart disease and consequently your risk of a stroke or a heart attack. You can help do this by:
If you have diabetes, it is also important to control your blood sugar levels by taking any prescribed medication, regularly exercising and maintaining a healthy weight and blood pressure. If you have diabetes, your blood pressure level should ideally be below 130/80mmHg.
If you are taking any prescribed medications for other health conditions, make sure you take them as instructed by your doctor and do not stop taking your medication without first speaking to your doctor.
What is the first stage of coronary heart disease?
Coronary heart disease is often diagnosed before any symptoms become apparent. However, you may start to notice that during physical activity, you become breathless and feel pain or discomfort in your chest that may feel like indigestion.
How long can you live with coronary heart disease?
Coronary heart disease is a lifelong condition. With treatment and lifestyle changes you can live a long life.
What are four types of heart diseases?
The four main types of heart disease, also known as cardiovascular disease, are coronary heart disease, strokes and mini-strokes, peripheral artery disease and aortic disease.
Is coronary heart disease curable?
Coronary heart disease can’t be completely cured but with lifestyle changes, medication and if needed, surgery, you can significantly improve your symptoms and heart function.
Does coronary artery disease ever go away?
No, coronary artery disease is a lifelong condition. But you can still lead a full life with treatment and lifestyle changes.
Does apple cider vinegar clean arteries?
No, drinking apple cider vinegar will not clean your arteries.
What are the signs of an unhealthy heart?
An unhealthy heart eg a heart affected by coronary heart disease may not cause any obvious symptoms. However, you may experience chest pain and breathlessness when you engage in physical activity or are stressed. You may also experience cramping, indigestion, heartburn, nausea, sweating, weakness, feeling faint and/or pain throughout your body.
What qualifies as heart disease?
Heart disease, or coronary heart disease, is defined as a narrowing of the coronary arteries that is pathological ie more than in a healthy individual. This can be determined using an angiogram, cardiac CT scan or MRI scan of your heart.