Coronary Disease

What is coronary heart disease?

Coronary heart disease (CHD) is the most common form of heart disease and describes a condition where the arteries around the heart (known as the 'coronary arteries' as they surround the heart like a crown - corona is Latin for crown) harden and narrow over time in a process known as 'atherosclerosis'.

It is also often referred to as 'coronary artery disease', 'ischemic heart disease' or simply 'heart disease'.

This narrowing of the arteries reduces the blood flow to the heart, which in turn can cause two conditions 1) angina, which manifests as a pain in the chest and 2) a heart attack (medical term - 'acute myocardial infarction'), which is caused by a major blockage of the artery by a blood clot.

What are the symptoms of coronary heart disease?

Unfortunately often the first symptom of CHD is a heart attack (medical term myocardial infarction), with no previous symptoms appearing at all. A person suffering a heart attack may have the following symptoms as the attack is occurring... Symptoms of a heart attack...

  • Uneven/fast heartbeat
  • Dizziness/lightheadedness
  • Sweating
  • Cold/clammy skin
  • Heartburn
  • Nausea
  • Vomiting
  • Pain or discomfort in the chest (often in the middle or left side)
  • Pain or discomfort in the arms, back, neck, jaw and stomach

If any of the symptoms above last for longer than 10 minutes or keep coming and going, you should immediately call for urgent medical assistance (ie call an ambulance - do not attempt to get to hospital yourself).

Symptoms of angina...

Pain or discomfort in the chest, arms, back, neck, jaw or stomach when moving around, exercising or going upstairs is a symptom of CHD and this is referred to as angins. If at any stage the pain seems different to usual, this may indicate a heart attack and you should seek urgent medical assistance as above.

How is Coronary Heart Disease diagnosed?

There are many methods to check whether or not a person has CHD. Your doctor may recommend...

  • Blood tests
  • ECG - this stands for electrocardiogram, a device which measures your heart's electrical activity
  • Echocardiogram
  • Stress test - this is an ECG/echocardiogram test performed while you are doing light exercise (eg on a treadmill)
  • Cardiac catheterisation - where a thin tube is manoeuvred via a blood vessel in the arm or leg up into the heart, where a dye is injected to check if any arteries in the heart are blocked. This test is called a coronary angiography and uses x-rays to detect any abnormalities during the test
  • Computed Tomography Coronary Angiography (CCTA) 
  • Myocardial Perfusion Imaging (MPI) - sometimes known as a 'nuclear stress test' this test is often a precursor to a full angiography and detects any lack of blood flow to the heart by tracking movement of radioactive 'tracers' using a PET scanner. Unlike a coronary angiography it is non-invasive

How is Coronary Heart Disease treated?

In the case of urgent medical assistance (eg where someone has suffered a heart attack), surgical options are...

  • Insertion of a stent - this tube shaped device is inserted into the artery to hold the blocked artery open
  • Bypass surgery (Coronary Artery Bypass Graft 'CABG') - the surgeon 'bypasses' the blood around the blocked section by grafting on a blood vessel taken from another part of the body

Can Coronary Heart Disease be cured?

Unfortunately it cannot, although steps can be taken to minimise the likelihood of getting CHD and to minimise the possibility of a heart attack where CHD has already been diagnosed. These steps include...

  • Stopping smoking
  • Eating plenty of fruit and vegetables
  • Cutting down on red meat and fatty food
  • Moderate physical activity (on most days)
  • Losing excess weight

Some medicines can also help...

• Cholesterol lowering drugs, called statins

• Medications to control blood pressure

• Medications (such as aspirin) that prevent blood clots

• Medications for diabetes sufferers