Coronary heart disease
Coronary heart disease is a narrowing of the small blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called coronary artery disease.
Coronary artery disease (CAD) overview - Animation
A look at coronary artery disease (CAD) including causes, symptoms, health risks, and treatment.
Coronary Artery Disease Quiz
Coronary artery disease is …Correct AnswerThe 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?Correct AnswerThe 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.Correct AnswerThe 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?Correct AnswerThe 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.Correct AnswerThe 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 911.
Which heart problems can be caused by CAD?Correct AnswerThe 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.Correct AnswerThe 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?Correct AnswerThe 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?Correct AnswerThe 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.Correct AnswerThe 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!
CHD is the leading cause of death in the United States for men and women.
CHD is caused by the buildup of plaque in the arteries to your heart. This may also be called hardening of the arteries or atherosclerosis.
Hardening of the arteries
Atherosclerosis, sometimes called "hardening of the arteries," occurs when fat, cholesterol, and other substances build up in the walls of arteries. ...Read Article Now Book Mark Article
- Fatty material and other substances form a plaque buildup 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 you can change others.
Risk factor for heart disease
Coronary heart disease (CHD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disea...Read Article Now Book Mark Article
Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.
In some cases, symptoms may be very noticeable. But, you can have the disease and not have any symptoms. This is more often true in the early stages of CHD.
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.Read Article Now Book Mark Article
Angina is a type of chest discomfort or pain due to poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium). S...Read Article Now Book Mark Article
- It may feel heavy or like someone is squeezing your heart. You may feel it under your breast bone (sternum). You may also feel it in your neck, arms, stomach, or upper back.
- The pain most often occurs with activity or emotion. It goes away with rest or a medicine called nitroglycerin.
- Other symptoms include shortness of breath and fatigue with activity (exertion).
Angina causes and symptoms - Animation
Learn about the symptoms and causes of angina pectoris.
Some people have symptoms other than chest pain, such as:
- Shortness of breath
- General weakness
Chest pain - Animation
When people have chest pain, they're often concerned they're having a heart attack. I'm Dr. Alan Greene and I'd like to talk to you for a moment about the different kinds of chest pain and when it may be an emergency. It turns out, there are lots of different kinds of chest pain. In fact, almost everything in the chest can hurt in one way or another. Some of the causes are really nothing more than a minor inconvenience. Some of them though are quite serious, even life threatening. You can have chest pain sure from the heart, but also from pneumonia. You can have chest pain from asthma. You can have chest pain from a blood clot in the lungs. It can be from nothing more than a strain of some of the muscles between the ribs, or nerves. You can also have chest pain that comes from acid reflux of from a stomach ulcer, gallstones. Many, many things can cause chest pain. You want to call 911 if you are having sudden, crushing chest pain or if your chest pain radiates into the jaw or the left arm. You want to call 911 if your chest pain also causes shortness of breath, or dizziness, nausea, or vomiting. You want to call 911 if you know you have heart disease and you do occasionally have pain but your pain is getting significantly worse than it is ordinarily. Or comes on with less activity than it does otherwise. But whatever the cause of chest pain, unless you're sure what causing it, it's worth contacting your physician to find out what may be going on. It's not a symptom to ignore.
Exams and Tests
Your health care provider will examine you. You will often need more than one test before getting a diagnosis.
Tests to evaluate for CHD 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.
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.Read Article Now Book Mark Article
High cholesterol levels
Cholesterol is a fat (also called a lipid) that your body needs to work properly. Too much bad cholesterol in your blood can increase your chance of...Read Article Now Book Mark Article
Goals for treating these conditions in people who have CHD:
- The most commonly used blood pressure target for people with heart disease is less than 130/80, but your provider may recommend a different blood pressure target.
- If you have diabetes, your HbA1c levels will be monitored and brought down to the level your provider recommends.
- Your LDL cholesterol level will be lowered with statin or other medicines.
Treatment depends on your symptoms and how severe the disease is. You should know about:
- Other medicines used to treat angina.
- What to do when you have chest pain.
- Being active when you have heart disease.
- Eating a heart-healthy diet.
Never stop taking your medicines without first talking to your provider. Stopping heart medicines suddenly can make your angina worse or cause a heart attack.
You may be referred to a cardiac rehabilitation program to help improve your heart's fitness.
Procedures and surgeries used to treat CHD include:
Everyone recovers differently. Some people can stay healthy by changing their diet, stopping smoking, and taking their medicines as prescribed. Others may need medical procedures such as angioplasty or surgery.
In general, early detection of CHD generally leads to a better outcome.
When to Contact a Medical Professional
If you have any risk factors for CHD, talk to your provider about prevention and possible treatment steps.
Call your provider, call the local emergency number (such as 911), or go to the emergency room right away if you have:
- Angina or chest pain
- Shortness of breath
- Symptoms of a heart attack
Take these steps to help prevent heart disease.
- If you smoke or use tobacco, stop. There are many resources available to help you stop smoking and tobacco use.
- Learn how to eat a heart-healthy diet by making simple substitutions. For example, choose heart-healthy fats over butter and other saturated fats.
A heart-healthy diet is low in saturated fat. Saturated fat can increase your bad cholesterol and clog your arteries. A heart-healthy diet also lim...Read Article Now Book Mark Article
- Get regular exercise, ideally at least 30 minutes most days. If you have heart disease, talk with your provider about starting an exercise routine.
- Maintain a healthy body weight.
- Lower high cholesterol with lifestyle changes, and if needed, statin medicines.
Your body needs cholesterol to work well. But cholesterol levels that are too high can harm you. In the US, blood cholesterol is most often measured...Read Article Now Book Mark Article
- Lower high blood pressure using diet and medicines.
- Talk with your provider about aspirin therapy.
- If you have diabetes, keep it well-managed to help prevent heart attack and stroke.
Even if you already have heart disease, taking these steps will help protect your heart and prevent further damage.
Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Internal review and update on 07/23/2023 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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