What Is Coronary Heart Disease?

Heart disease is caused by narrowing of the coronary arteries that feed the heart. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by cholesterol and fat deposits--a process called atherosclerosis--and cannot supply enough blood to the heart, the result is coronary heart disease (CHD). If not enough oxygen-carrying blood reaches the heart, you may experience chest pain called angina. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.

Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body and that your body needs to function normally. It is present in cell walls or membranes everywhere in the body, including the brain, nerves, muscle, skin, liver, intestines, and heart. Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs. If you have too much cholesterol in your bloodstream, the excess is deposited in arteries, including the coronary arteries, where it contributes to the narrowing and blockages that cause the signs and symptoms of heart disease

Symptoms of Coronary heart disease
Coronary heart disease causes chest pain (angina) and heart attacks. Blood brings oxygen and nutrients to the heart. When too little blood flows to the heart, angina results. When the blood flow is critically reduced, a heart attack occurs. A lack of blood flow to the brain or, in some cases, bleeding in the brain causes a stroke. Some other cardiovascular diseases are high blood pressure and rheumatic heart disease. 1

Chest pain (angina) or shortness of breath may be the earliest signs of CHD. A person may feel heaviness, tightness, pain, burning, pressure, or squeezing, usually behind the breastbone but sometimes also in the arms, neck, or jaws. These signs usually bring the patient to a doctor for the first time. Nevertheless, some people have heart attacks without ever having any of these symptoms.

It is important to know that there is a wide range of severity for CHD. Some people have no symptoms at all, some have mild intermittent chest pain, and some have more pronounced and steady pain. Still others have CHD that is severe enough to make normal everyday activities difficult. 2

Cause details for Coronary heart disease
Coronary heart disease, the most common form of heart disease, develops over many years. It can begin as far back as childhood. In a process known as atherosclerosis, fatty substances build up inside the walls of blood vessels. Blood components also stick on the surface inside vessel walls. The vessels narrow and "harden," becoming less flexible. The buildup and narrowing proceed gradually and result in decreasing blood flow and, eventually, the development of symptoms. But the buildup, or "plaque," may break open and suddenly produce a blood clot, limited blood flow, and symptoms. When blood flow to the heart is reduced, chest pain, or angina, can result. If blood flow is nearly or completely blocked, a heart attack can occur and cause muscle cells in the heart to die. Because the cells cannot be replaced, the result is permanent heart damage. 1

Like any muscle, the heart needs a constant supply of oxygen and nutrients that are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged and cannot supply enough blood to the heart, the result is CHD. If not enough oxygen-carrying blood reaches the heart, the heart may respond with pain called angina. The pain is usually felt in the chest or sometimes in the left arm and shoulder. (However, the same inadequate blood supply may cause no symptoms, a condition called silent angina.) 2

CHD is caused by a thickening of the inside walls of the coronary arteries. This thickening, called atherosclerosis, narrows the space through which blood can flow, decreasing and sometimes completely cutting off the supply of oxygen and nutrients to the heart.

Atherosclerosis usually occurs when a person has high levels of cholesterol, a fat-like substance, in the blood. Cholesterol and fat, circulating in the blood, build up on the walls of the arteries. The buildup narrows the arteries and can slow or block the flow of blood. When the level of cholesterol in the blood is high, there is a greater chance that it will be deposited onto the artery walls. This process begins in most people during childhood and the teenage years, and worsens as they get older.

In addition to high blood cholesterol, high blood pressure and smoking also contribute to CHD. On the average, each of these doubles your chance of developing heart disease. Therefore, a person who has all three risk factors is eight times more likely to develop heart disease than someone who has none. Obesity and physical inactivity are other factors that can lead to CHD. Overweight increases the likelihood of developing high blood cholesterol and high blood pressure, and physical inactivity increases the risk of heart attack. Regular exercise, good nutrition, and smoking cessation are key to controlling the risk factors for CHD. 2

Diagnosis of Coronary Heart Disease
The only certain way to diagnose and measure the extent of coronary heart disease is through the use of coronary angiography.  If your physician suspects that you have coronary heart disease, he will order the procedure.

Treatment list for Coronary heart disease
The list of treatments mentioned in various sources for Coronary heart disease includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

• Medications
• Low-dose aspirin - may help avoid heart attacks and blood clots.
• Beta-blockers - also reduces heart attack risk.
• Anti-hypertensives - if the person has high blood pressure.
• Nitroglycerine
• Nitrates
• Calcium-channel blockers
• Anticoagulant drugs
• Vasodilators
• Cholesterol-lowering drugs
• Digitalis
• ACE inhibitors
• Pain relief medications
• Surgery
• Bypass operation
• Balloon angioplasty
• Coronary artery bypass
• Lifestyle changes
• Control blood pressure
• Control cholesterol
• Regular exercise - under medical advice
• Good nutrition
• Quit smoking
• Control weight
• Low-fat diet
• Low saturated fat diet

Prevention of Coronary Heart Disease
Methods of prevention of Coronary heart disease mentioned in various sources includes those listed below. None of these methods guarantee prevention of Coronary heart disease.

• Control blood pressure
• Control cholesterol
• Regular exercise
• Good nutrition
• Quit smoking
• Control weight
• Low-fat diet
• Low saturated fat diet

To Dr. Lee

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