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Coronary heart disease is a condition in which the heart's arteries (blood vessels) become narrower. It is also known as coronary artery disease.
On this page: The cause · Why is it a problem? · Risk factors · Diagnosis · Treatment
The cause: blocked arteries
Coronary heart disease is caused by a process known as atherosclerosis: the gradual build-up of substances such as cholesterol in the arteries of the heart. Often called plaque, or atheroma, this substance makes the arteries narrower, so the heart has to work harder to pump blood through them.
Why is it a problem?
Atherosclerosis underpins most cardiovascular disease. It usually begins in early adulthood, or long before any symptoms develop.Often people live for many years with this build-up increasing, and have no symptoms. But it can lead to serious complications, such as:
- Coronary thrombosis. Sometimes a blood clot forms at a narrowed point in the artery, blocking the flow of blood altogether. This is called coronary thrombosis or coronary occlusion.
- Angina – chest pain or discomfort.
- Heart attack.
Risk factors
The build-up of blockages in the arteries is the result of a number of factors, acting on their own or in combination. The most common are:
- smoking
- high cholesterol
- lack of regular physical activity
- excess weight, and obesity
- high blood pressure
- diabetes
- family history of heart disease
- depression and social isolation.
While you cannot change some risk factors, with others such as smoking or lack of fitness, there are things you can do to reduce your risk of developing more atherosclerosis.
Diagnosis
Talking with your doctor about your symptoms, risk factors and medical history is an important part of the process.
To help make a diagnosis, your doctor will listen to your chest for any abnormal sounds. He may also order some tests:
- Electrocardiogram (ECG). This shows whether any parts of your heart are not getting enough oxygen.
- Exercise stress test. This gives an idea of how much activity you can do without your heart being starved of oxygen.
- Other tests can show where and how serious the blockages are.
Treatment
Coronary artery disease doesn't go away, so it is treated according to how bad the symptoms are, and where and how serious the blockages are. Treatments include medication, stents and coronary artery bypass.
