Definition

Coronary heart disease (CHD) is defined as a narrowing or blockage of the heart's coronary arteries, which is typically caused by the accumulation of fatty cholesterol material that forms plaque. Coronary heart disease is also known as coronary artery disease, ischemic heart disease, or heart disease.

According to the WHO, heart and blood vessel diseases are the leading causes of death worldwide. 17.9 million people died from CHD in 2016, 31% of all global deaths. More than three-quarters of deaths from heart and blood vessel disease occur in developing countries.

Causes

Various factors, including smoking and genetics, can damage blood vessels. When blood vessels are damaged, they are more likely to accumulate fat on their walls, resulting in plaque formation. When cholesterol plaque accumulates on the walls of the blood vessels in the heart's coronary arteries, it causes the blood vessels to block.

The accumulation of cholesterol fat in blood vessels can cause partial or complete blockage. These blockages can lead to obstruction in the delivery of nutrients and oxygen needed by the heart to live and function properly.

When blood vessels are completely blocked, the heart tissue receives no nutrients or oxygen. Furthermore, this can lead to the death of heart tissue. This condition will cause weakening of the heart muscle in pumping blood and can lead to heart failure and death.

Risk Factor

There are several factors that can increase the risk of coronary heart disease, such as:

• Obesity
• Not being physically active
• The habit of eating unhealthy foods
• Smoking
• Having a family history of heart disease, especially if the affected family is less than 50 years old
• Having high cholesterol levels, especially high LDL (bad cholesterol) and low HDL (good cholesterol) levels
• Have hypertension and diabetes
• Men above 45 years old or women who have experienced menopause

Symptoms

Coronary heart disease causes a variety of symptoms. The first and most common symptoms of this disease are those of a heart attack, which include:

• Angina or chest pain. Chest pain is the most common symptom associated with coronary heart disease. It occurs when too much cholesterol plaque sticks to the blood vessels, causing the flow of blood to narrow. This narrowing can cause chest pain
• Dizziness, weakness, fatigue, nausea
• Pain or discomfort that only affects the left shoulder, hand, neck, chin, or back
• Shortness of breath

In women, the symptoms of a heart attack are slightly different, such as:

• Discomfort in the shoulders, neck, abdomen, or back
• Indigestion or burning in the chest (heartburn)
• Cold sweat
• Unexplained anxiety

Over time, coronary heart disease can lead to the weakening of the heart muscle. Furthermore, it can lead to heart failure or other serious conditions where the heart is unable to pump blood properly.

Diagnosis

If you do not present as an emergency, the doctor will ask you questions about your symptoms, signs, and medical history, as well as any risk factors you may have. Furthermore, the doctor will conduct a physical examination to confirm the diagnosis.

In addition, the doctor will perform a supporting examination to confirm the diagnosis. Some of the supporting examinations that can be done in making a diagnosis include:

• ECG, or electrocardiograph. This is done by attaching electrodes to several points on your chest, arms, and legs. It will record your heart's electrical activity and detect heart attacks and rhythm disturbances
• Echocardiogram. This is done to help the doctor get a complete and detailed picture of the structure and function of your heart
• Blood test. This is done to determine the factors that cause coronary heart disease, such as triglyceride levels, LDL, HDL, glucose, and other tests
• Exercise stress tests. In this test, you will be tested on a treadmill to assess your heart function when you are working hard. It will also detect angina or chest pain and blockages in the coronary arteries of the heart
• Cardiac catheterization. This examination is performed to determine the specific condition of the narrowed or blocked coronary arteries in the heart. It involves inserting a small pipe into the heart's blood vessels via a large blood vessel in the thigh. This examination is performed in an operating room as it requires a sterile environment
• CT scan angiogram. This examination is done to obtain a 3D image of the heart and detect any blockages in the coronary arteries of the heart

Management

The doctor will administer medication to manage your risk factors for coronary heart disease. The type of treatment given may include:

• Treatment to lower cholesterol levels
• Treatment to lower blood pressure
• Treatment to stop angina or chest pain
• Treatment to reduce the risk of blood clots forming
• If you have diabetes, the doctor will give you medication to lower your blood sugar levels

If necessary, the doctor will recommend surgical intervention. This is done to remove cholesterol plaque buildup in the blood vessels, prevent blockages, and open up new pathways for blood to flow and nourish the heart.

Complications

Coronary heart disease can result in complications such as chest pain or angina, a heart attack, heart failure, or sudden cardiac arrest.

Coronary heart disease occurs when fatty cholesterol plaques block the coronary arteries. A blockage can lead to blood clotting. The formed blood clot can break off and enter the bloodstream, eventually reaching the brain. If the blood clot blocks a blood vessel in the brain, this will lead to a stroke. However, this tends to be rare.

Prevention

If you have any of the risk factors listed above, speak with a doctor about how to properly prevent coronary heart disease. Your doctor will advise you to live a healthy lifestyle, quit smoking, eat heart-healthy foods, drink less alcohol, exercise regularly, and avoid stress.

When to See a Doctor?

See a doctor immediately if you or a family member experiences heart attack symptoms, including chest pain and cold sweats, as they are the most common symptoms of coronary heart disease.

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