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Coronary Heart Disease (CHD)

A middle aged man in a grey jumper has both of his hands placed where his heart would be – he looks in pain. The words – Coronary Heart Disease (CHD) – can be seen

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Coronary Heart Disease (CHD)

Contrary to the shock it might cause the person experiencing it, a heart attack does not develop overnight. It is the result of a progressive condition known as coronary heart disease (CHD).

Every year, around 64,000 deaths are registered in the UK due to coronary heart disease. It is one of the most common heart conditions affecting people from all around the globe.

What is Coronary Heart Disease?

The term "coronary" refers to the arteries that supply the heart with blood. Coronary heart disease (CHD) is a medical condition that occurs when the blood supply to the heart is blocked due to the presence of fatty substances inside the arteries. These fatty substances are commonly referred to as plaque.

What Causes Coronary Heart Disease?

The heart is a muscular organ that pumps blood to all parts of your body. Blood is important for the survival of any organ, as it contains nutrients and oxygen that nourishes each one.

To receive blood, the heart has arteries all over its surface. These arteries are known as coronary arteries.

Sometimes, cholesterol can build up around the walls of these arteries. Consequently, the supply of blood to the heart is then reduced. When this happens, a person usually experiences chest pain and fatigue on exertion, as the heart is being deprived of its vital nutrients and oxygen. Over time, this fat build-up increases. Eventually, if left untreated, the inside of the arteries may become completely blocked.

Coronary heart disease can be caused by a number of factors. Some of these include:

  • Smoking
  • Heavy alcohol intake
  • Lack of exercise, or a sedentary lifestyle
  • Obesity
  • Diabetes mellitus
  • Hypertension
  • Family history of cardiovascular diseases
  • High LDL cholesterol and low HDL cholesterol
  • High levels of triglycerides, especially in women
  • High levels of stress
  • Unbalanced diet
  • Being male, or being a post-menopausal woman.
Word symptoms over a sunset with a lighthouse at the right
Photo by Anand Dandekar from Pexels

While most patients present with the same symptoms, the symptoms of CHD may vary from person-to-person depending on the degree of blockage caused by the build-up of fat, the number of arteries affected and the general health of the patient.

The most common symptoms of CHD are:

  • Central chest pain, or left-sided chest pain that radiates to the left arm and jaw. Chest pain caused by the heart is termed as angina
  • A sensation of heaviness, pressure, or tightness, on the chest
  • Shortness of breath, especially when performing activities that require effort
  • Nausea, heartburn, or abdominal pain
  • Weakness
  • Cold sweat
  • Light-headedness, or dizziness

Note – patients suffering from diabetes may not experience chest pain.

Complications of CHD

The biggest mistake one can make is leaving coronary artery disease untreated. Untreated CHD can progress to more severe, irreversible heart conditions, such as heart failure and abnormal heart rhythms.

Diagnosing Coronary Heart Disease

To diagnose CHD, your doctor will want to carry out certain tests on your heart. Below are the usual tests used to confirm a diagnosis of CHD.

  • ECG – is a small machine attached to a number of leads that are placed onto the chest to record details about the heart. An assistant will put some gel onto your chest before placing the leads. You should not feel afraid – this test is completely pain-free.
  • Blood tests – a series of blood tests, such as a full blood count, electrolytes and troponin levels will be sent for analysis.
  • Cardiac ultrasound – sometimes, cardiologists perform a cardiac ultrasound to “visualise” the walls of the heart to deduce if your heart is  pumping blood effectively.
  • Coronary angiography – is a medical procedure used to determine the percentage of blockage in the coronary arteries. Your cardiologist will first inject a dye that will travel through your blood vessels to reach your coronary arteries. X-ray images of the coronary arteries will then be recorded.
Living with the condition

Photo by JZhuk on iStock

There is currently no complete cure for CHD. However, with the right treatment, most patients can manage the symptoms of coronary heart disease and prevent further complications.

CHD is very often the consequence of unhealthy lifestyle habits. Hence, making lifestyle changes is a major component in its management.

If left untreated, the build-up of cholesterol may increase over time and may eventually clog the arteries completely, leading to a heart attack.

Lifestyle habits that may looking at include:

Eat a Healthy Balanced Diet

Health experts recommend eating a healthy balanced diet, one that is rich in fibre and low in fat. A balanced diet should also contain at least 5 portions of fruits and vegetables per day.

You should also watch your intake of salt and sugar. Excess salt is a well-known contributing factor to high blood pressure, which is in turn a risk factor for coronary heart disease.

Exercise Regularly and Maintain a Healthy Body Mass Index (BMI)

Routine exercise can make the heart more efficient at pumping blood.

Research shows that physical activity…

• increases the contractions exerted by the heart

• improves the transmission of electrical impulses within the walls of the heart

• increases the diameter of the coronary arteries and

• promotes the formation of new collateral arteries.

Additionally, studies show that regular physical activity helps in the reduction of blood pressure.

Keep Blood Pressure Under Control

Keeping your blood pressure under control is one of the best steps you can take to protect your heart from damage. When the pressure at which blood flows through your arteries is too high, its walls may be subjected to a lot of strain.

This may sometimes injure the inner lining of the arteries. Any injury to the inner lining of the arteries increases the risk of developing clogged arteries. Hence, you should always aim at keeping your blood pressure under control. Health experts recommend checking your blood pressure regularly as hypertension may not present with symptoms.

The NHS provides an online tool that allows you to find out what your blood pressure readings mean. You can find it here: Tool to Find Out What Your Blood Pressure Readings Mean

Quit Smoking

Cigarettes contain over 4,000 harmful chemicals, most of which are well-known for their impacts on health, in particular the heart.

Studies show a clear link between the number of cigarettes smoked per day and the risk of developing coronary heart disease. Scientists agree that the chemicals found in cigarettes can damage the arteries of the heart, hence putting it more at risk of developing plaques.

Thus, quitting smoking is a vital step towards protecting your heart from damage. There are numerous stop smoking clinics and programs that facilitate this process. These programs are well-established, most of which comprise of a five-step program.

Patients who still experience difficulties in eliminating smoking are usually offered nicotine patches, or gums for a short period of time to counter the effects of nicotine deprivation.

The NHS describes all the effects of smoking in this article. You can find the stop smoking guide by the NHS here.

Limit Alcohol Intake

The effect of alcohol intake on the risk of CHD is ambiguous. Research shows that light to moderate alcohol consumption lowers the risk of CHD, while heavy consumption increases the risk. Other studies argue that the genetic composition of an individual may influence the outcome alcohol exerts onto the heart.

Get Professional Medical Help

If you are experiencing frequent chest pain, it is advisable to seek help from a medical professional, as heart problems do not readily disappear on their own.

Your GP will want to prescribe certain medications to prevent further plaque from building up within your arteries. The most common medications prescribed for coronary heart disease include:

  • Statins – work by decreasing the level of cholesterol inside the blood. This reduces the risk of developing heart attacks.
  • Blood thinners – such as clopidogrel and aspirin are usually given to prevent the formation of blood clots.
  • Nitrates – are given to widen the size of the coronary arteries, hence allowing more blood to reach the heart. Very often, nitrates provide instant relief from chest pain.
  • Beta Blockers – are medications that slow down the rate at which your heart beats. This allows your heart to get adequate rest.

You can find more information about how the NHS manages CHD by clicking on the following link: NHS CHD Treatment

Reduce Stress

Stress is a potential risk factor for heart diseases. While further research is needed to understand the link between the heart and an individual’s stress levels, scientists agree that chronic stress may increase blood pressure levels, promote unhealthy eating patterns, increase cholesterol levels, promote cigarette smoking and alcohol consumption, all of which are major risk factors for cardiovascular diseases.

It is considered better if each individual learns to manage stress through relaxation techniques instead of reaching out for comfort foods and unhealthy ‘’stress-relieving’’ habits, such as smoking.

Help Support Assistance and Guidance

There are various support groups out there, all ready to give you a helping hand. We’ve compiled a list of some useful organizations dedicated to the management of heart problems:

British Heart Foundation – click here to visit their website.

Heart Research UK – you can visit the website through this link.

Heart UK – the Cholesterol Charity – you can visit the website by clicking on this link.

Heart Research Institute UK – find out more about Heart Research Institute UK here.

Blood Pressure UK – to visit their website, click here.

Glossary and some scrabble tiles

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Cardiovascular health – relates to the circulatory system which comprises of the heart and the blood vessels that transport blood around the body.

Coronary arteries – are the vessels that supply the heart with nutrient-rich blood and oxygen.

Heart Attack – is a medical emergency that occurs when the arteries supplying the heart become blocked.

Plaque  is a semi-hardened build-up of cholesterol, blood components and inflammatory molecules inside the arteries.