Coronary heart disease (CHD)

Overview

Coronary heart disease (CHD) is a leading cause of mortality in the United Kingdom and across the world. CHD is also known as ischemic heart disease and coronary artery disease. Coronary heart disease (CHD) is a disease which affects the arteries that provide blood to the heart. Plaque accumulation narrows or stops one or more of your coronary arteries in (CHD). The most frequent symptom is chest pain (angina). (CHD) can cause a heart attack as well as other issues such as arrhythmia or heart failure.

What is Coronary heart disease (CHD)?

Coronary heart disease (CHD) is characterized by a narrowing or blockage of your coronary arteries, which is commonly caused by plaque accumulation. The coronary arteries deliver oxygen-rich blood to the heart. Plaque accumulation in these arteries reduces the amount of blood that can reach your heart. You may not realize anything is wrong with CHD until the plaque causes a blood clot. The blood clot functions similarly to a concrete barrier in the middle of the road. Traffic is stopped. Similarly, blood cannot reach your heart, resulting in a heart attack. You might have CHD for many years and have no symptoms until you suffer a heart attack. That is why CHD is known as a "silent killer."

Coronary Heart Disease Types (CHD)

Coronary heart disease is classified into two types:

Stable ischemic heart disease: This is a chronic type of stable ischemic heart disease. Over time, your coronary arteries gradually narrow. Your heart receives less oxygen-rich blood with time. You may experience some symptoms, but you are able to live with the disease on a daily basis.

Acute coronary syndrome: is a medical emergency that occurs suddenly. The plaque in your coronary artery ruptures unexpectedly, forming a blood clot that prevents blood flow to your heart. A heart attack is caused by this sudden obstruction.

How common is Coronary heart disease (CHD)?

Coronary heart disease (CHD) is a relatively frequent condition. Coronary heart disease affects about 18 million persons in the United States. That is nearly the population of New York City, Los Angeles, Chicago, and Houston combined.

In the United States in 2019, coronary heart disease killed 360,900 people. That is more than enough people to fill Yankee Stadium seven times over.

What effects does coronary heart disease have on the body?

A heart attack is the most common consequence of coronary heart disease. This is a potentially deadly medical emergency. Because it is not receiving enough blood, your heart muscle begins to die. You require immediate medical assistance in order to restore blood flow to your heart and preserve your life.

CAD can potentially weaken your heart over time and lead to issues such as:

Arrhythmias (like atrial fibrillation).
Arrest of the heart.
Shock from cardiogenic causes.
Failure of the heart.

What are the signs and symptoms of coronary heart disease?

For a long period, you may have no signs of coronary heart disease. CAD is a long-term condition. Plaque formation takes several years, if not decades. However, when your arteries thin, you may have modest discomfort. These symptoms signal that your heart is working harder to pump oxygen-rich blood throughout your body.

Chronic CAD symptoms include:

Stable angina: The most frequent symptom is stable angina. Stable angina is characterized by intermittent chest pain or discomfort that follows a regular pattern. It is more noticeable during physical exercise or mental hardship. When you relax or take nitroglycerin, it goes away (medicine that treats angina).
Dyspnea (shortness of breath): Some persons experience shortness of breath with light physical exercise.

A heart attack is sometimes the initial indication of CAD. Heart attack symptoms include:

Pain or discomfort in the chest (angina). Angina can cause minor to severe discomfort. Heaviness, tightness, pressure, hurting, burning, numbness, fullness, squeezing, or dull soreness are all possible sensations. The pain might move to your shoulder, arm, neck, back, or jaw.
Breathing difficulties or shortness of breath
Dizziness or lightheadedness
Palpitations in the heart.
Nausea, stomach pain, or vomiting might be indigestion.
Weakness.

Women and individuals with AFAB are more likely to suffer from extra, unusual symptoms such as:

Shortness of breath, weariness, and sleeplessness before to the heart attack
Back, shoulder, neck, arm, or stomach pain
The heart is racing.
Feeling warm or flushed

What causes coronary heart disease?

Coronary heart disease is the result of atherosclerosis. Atherosclerosis is the slow accumulation of plaque in your body's arteries. Coronary heart disease occurs when plaque obstructs blood flow in your coronary arteries. Plaque is made up of cholesterol, waste materials, calcium, and fibrin (a substance that helps your blood clot). As plaque accumulates along the arterial walls, the arteries constrict and stiffen.

Plaque can block or damage your arteries, limiting or stopping blood flow to a certain area of your body. When plaque accumulates in your coronary arteries, your heart muscle is deprived of oxygen and nutrients. As a result, your heart is deprived of the oxygen and nutrients it needs to function correctly. This is known as myocardial ischemia. It causes chest pain (angina) and puts you at risk for a heart attack. People who have plaque formation in their coronary arteries frequently have plaque buildup elsewhere in their bodies as well. This can result in diseases such as carotid artery disease and peripheral artery disease.

What are the risk factors for coronary heart disease?

Coronary heart disease is caused by a variety of risk factors. Some things are beyond your control. Others you may be able to manage by changing your lifestyle or taking drugs.

Uncontrollable risk factors (non-modifiable risk factors)

Age: As you become older, your chance of developing CHD rises. After the age of 45, men and persons with AMAB are at a greater risk. After the age of 55, women and persons with AFAB are at a higher risk.
Family history: If any of your biological family members have heart disease, you are at a higher risk. It's very critical to find out whether they have premature cardiac disease. This indicates that they were diagnosed at an early age (father or brother before age 55, mother or sister before age 65).

Risk factors in your Lifestyle

Consume a lot of saturated fat or processed carbs.
Insufficient physical activity
A lack of sleep
Tobacco usage, whether smoking, vaping, or otherwise.

Risk factors for cardiovascular disease

Atherosclerosis.
High blood pressure.
LDL ("bad") cholesterol levels are elevated.
Triglyceride levels are high (hypertriglyceridemia).

Other medical issues that increase your chances

Anemia.
Lupus and rheumatoid arthritis are examples of autoimmune disorders.
Kidney illness that is chronic.
Diabetes.
HIV/AIDS.
The metabolic syndrome
Overweight/obesity.
Sleep apnea and other sleep problems

Risk factors that impact women and persons who are born female

Menopause begins early (before age 40).
Endometriosis.
There has been a history of gestational diabetes, eclampsia, or preeclampsia.
Hormonal birth control is used.

How is coronary heart disease diagnosed?

A physical exam and tests are used by healthcare practitioners to detect coronary heart disease.

The physician will do the following during your physical exam:

Check your blood pressure.
Using a stethoscope, listen to your heart.
Inquire about your symptoms and how long you've experienced them.
Inquire about your medical background.
Inquire about your way of life.
Inquire about your family history. They'll be interested in learning about heart problems in your biological parents and siblings.

All of this information will assist your doctor in determining your risk of heart disease.

Tests that assist in the diagnosis of coronary heart disease

Your doctor may also suggest one or more tests to evaluate your heart function and identify CHD. These are some examples:

Blood tests: Test for compounds that might damage your arteries or raise your risk of heart disease.
Cardiac catheterization: This procedure inserts tubes into your coronary arteries to assess or confirm CHD. This is the gold standard for detecting CHD.
CT (computed tomography) (CT) Coronary angiogram: This procedure uses CT and contrast dye to create 3D images of your heart while it moves. Identifies coronary artery obstructions.
Coronary calcium scan: Determines the quantity of calcium in your coronary arteries' walls (a sign of atherosclerosis). This does not identify whether or not you have substantial blockages, but it does assist in determining your risk for CHD.
Echocardiogram (echo): This test uses sound waves to analyze the anatomy and function of your heart.
Electrocardiogram (EKG/ECG): A recording of your heart's electrical activity. Can identify previous or present heart attacks, ischemia, and cardiac rhythm problems.
Exercise stress test: Determines how your heart responds while it is working really hard. Can identify angina and obstructions in your coronary arteries.

What is the treatment for coronary heart disease?

CHD treatment frequently includes dietary adjustments, risk factor control, and medication. Some folks may benefit from a treatment or surgery as well. Your healthcare professional will discuss the best treatment strategy for you. It's critical to stick to your treatment plan if you want to reduce your chances of significant CHD problems.

Changes in lifestyle

Changes in lifestyle play an important part in CHD management. Among these modifications are:

Smoking, vaping, or using tobacco products is not permitted.
Consume a diet reduced in salt, saturated fat, trans fat, and sugar. The Mediterranean diet has been shown to reduce the risk of having a heart attack or stroke.
Exercise: Aim for 30 minutes of walking five days a week, or discover other things that you prefer doing.
Consume alcohol in moderation.
Before beginning any new workout regimen, consult with your physician. Your provider can also advise you on lifestyle adjustments that are specific to your requirements. Your provider may advise you to consult with a nutritionist about healthy eating plans and smoking cessation choices.

Management of risk factors

Managing your CHD risk factors can assist to decrease the course of your condition. Manage the following conditions with the help of your provider:

Diabetes.
Blood pressure is high.
High cholesterol levels.
Triglyceride levels are high (hypertriglyceridemia).
Overweight/obesity.

Medications

Medications can assist you in managing your risk factors as well as treating the symptoms of coronary heart disease. One or more of the drugs mentioned below may be prescribed by your doctor.

Medications that reduce blood pressure.
Cholesterol-lowering medications
Medications for the treatment of stable angina. Nitroglycerin and ranolazine are two examples.
Medications that lower the risk of blood clots.

Surgical procedures

Some patients require a treatment or surgery to control their coronary heart disease, such as:

Coronary angioplasty is another term for percutaneous coronary intervention (PCI). It is just mildly invasive. A tiny balloon is used by your physician to unblock your clogged artery and improve blood flow through it. Your doctor may also place a stent to keep your artery open.
Coronary artery bypass grafting (CABG): This operation provides a new conduit for your blood to travel through in order to bypass obstructions. This "detour" allows blood to travel back to your heart. CABG assists patients who have significant blockages in several coronary arteries.

Your physician will advise you on which of these treatment choices is appropriate for your specific situation.

How can I prevent coronary heart disease?

Coronary heart disease cannot always be avoided. This is due to the fact that some risk variables are beyond your control. However, there are some things you may do to reduce your risk. Many risk-reduction techniques might also help you manage your disease once you've been diagnosed.

You may reduce your risk of coronary heart disease and help keep it from worsening by doing the following:

Commit to quitting smoking and using tobacco in general. Quitting an addictive drug is difficult, and it is not simply a question of willpower. That is why it is critical to connect with services and support organizations that can assist. Inquire with your provider about local suggestions.
Consume a heart-healthy diet. This includes limiting your intake of saturated fat, trans fat, salt, and sugar. It also implies avoiding processed carbs (like white bread and pasta). Whole grains should be used in place of such items (like wheat bread and brown rice). It's also critical to understand how nutrition influences your cholesterol levels. disease. This is due to the fact that some risk variables are beyond your control. However, there are some things you may do to reduce your risk. Many risk-reduction techniques might also help you manage your disease once you've been diagnosed.
Get sufficient sleep. The average adult needs seven to nine hours of quality sleep every night. Many people, however, may find this objective challenging, if not impossible. Work schedules, child responsibilities, and other responsibilities may keep you from obtaining adequate rest. Discuss with your provider how to achieve the quality sleep you need to maintain your heart health.
Maintain a healthy weight. Discuss your ideal weight with your healthcare physician. Set reasonable objectives with your provider until you attain your optimum weight. Avoid very rigid short-term diets. Instead, make lifestyle adjustments that you will be able to maintain for a long time.
Evaluate your risk of heart disease. Beginning at the age of 20, see your physician for a risk assessment (or sooner if your provider recommends it). Your provider will take some basic measurements, such as your blood pressure and body mass index (BMI). A risk calculator may also be used to determine your future risk of heart disease.
Limit regular alcohol consumption. Too much alcohol might be harmful to your heart. Men and people with AMAB should limit their alcohol consumption to no more than two drinks each day. Women and people with AFAB should limit their alcohol consumption to one drink per day. However, drinking less is much better.
Increase overall movement. Exercise is planned and deliberate. It is critical to strive for 150 minutes of exercise every week (for example, 30-minute walks on five days of the week). However, you may incorporate more movement. Park further away from the entrance. Put your laundry away in tiny batches so that you can complete additional processes. Every time you go to the restroom, take a lap around your house. Or simply walk in place. The more you move, the better your heart will be. Of course, consult with your provider to determine what degree of activity is appropriate for you.
Maintain adherence to prescribed drugs. Medications are critical in lowering your risk of CHD and avoiding heart attacks if you currently have CHD. Many of these drugs are administered on an ongoing basis. It's critical to understand what they do and how they may help you avoid events and possibly live longer.

Conclusion

Coronary heart disease, also known as coronary artery disease (CAD), occurs when the coronary arteries become too narrow or cholesterol buildup forms in the walls. The coronary arteries are the blood channels that feed the heart with oxygen and blood. CHD develops when cholesterol deposits on the arterial walls, forming plaques. These plaques restrict the arteries, limiting blood flow to the heart, or they might induce inflammation and hardening of the blood vessel walls. A clot can occasionally impede blood flow, creating major health issues.