Diseases-Treatments Heart diseases

Coronary heart disease: Causes, symptoms and treatments

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Coronary heart disease refers to a narrowing of the coronary arteries, the blood vessels that supply oxygen and blood to the heart. It is also known as coronary artery disease. It is a major cause of illness and death.

Coronary heart disease (CHD) normally happens when cholesterol accumulates on the artery walls, creating plaques. The arteries narrow, reducing blood flow to the heart. Sometimes, a clot can obstruct the flow of blood to the heart muscle.

CHD commonly causes angina pectoris (chest pain), shortness of breath, myocardial infarction, or heart attack. It is the most common type of heart disease in the United States, where it accounts for 370,000 deaths every year.

Fast facts on coronary heart disease:

  • Coronary heart disease accounted for 23.5 percent of all deaths in the U.S. in 2015.
  • According to the Centers for Disease Control and Prevention (CDC), about 735,000 Americans have a heart attack each year.
  • Warning signs and symptoms include chest pain or discomfort and shortness of breath.
  • Examples of coronary heart disease include angina and heart attack.


CHD is believed to start with injury or damage to the inner layer of a coronary artery.

This damage causes fatty plaque deposits to build up at the site of the injury. These deposits consist of cholesterol and other cellular waste products. The accumulation is called atherosclerosis.

If pieces break off or rupture, platelets will clump in the area, attempting to repair the blood vessel. This clump can block the artery, reducing or blocking blood flow, and leading to a heart attack.

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Below is a 3-D model of CHD, which is fully interactive.

Explore the model using your mouse pad or touchscreen to understand more about CHD.

Coronary heart diseas, heart attack symptoms, congestive heart failure symptoms


1. Angina

The following are symptoms of angina:

  • Chest pain: People describe it as a squeezing, pressure, heaviness, tightening, burning, or aching across the chest. It usually starts behind the breastbone. The pain often spreads to the neck, jaw, arms, shoulders, throat, back, or even the teeth.
  • Related symptoms: Other symptoms include indigestionheartburn, weakness, sweating, nausea, cramping, and shortness of breath.

There are several main types of angina:

  • Stable angina: The discomfort may last for a short period of time, and it may feel like gas or indigestion. It happens when the heart is working harder than usual, such as during exercise. It has a regular pattern. It can happen over months or years. Rest or medication can relieve symptoms.
  • Unstable angina: This is often caused by blood clots in the coronary artery. It occurs at rest, it is surprising, it lasts longer, and it may worsen over time.
  • Variant angina: This type occurs at rest, and it is usually severe. It happens when there is a spasm in an artery that causes it to tighten and narrow, disrupting blood supply to the heart. Triggers include exposure to cold, stress, medicines, smoking, or cocaine use.
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2. Shortness of breath (dyspnea)

CHD can lead to shortness of breath. If the heart and other organs are getting too little oxygen, the patient may start panting. Any exertion may be very tiring.

3. Heart attack

Heart attack, or myocardial infarction, happens when the heart muscle does not have enough blood, and therefore oxygen. The muscle dies, and a heart attack occurs.

A heart attack commonly occurs when a blood clot develops from a plaque in one of the coronary arteries. The clot, if it is big enough, can stop the supply of blood to the heart. The blood clot is known as coronary thrombosis.

Symptoms of a heart attack include:

  • chest discomfort and mild pain, or a crushing chest pain
  • coughing
  • dizziness
  • shortness of breath
  • face seems gray
  • an overall feeling of being unwell and fear that life is coming to an end
  • nausea and vomiting
  • restlessness
  • perspiration and clammy skin

The first symptom is normally chest pain that spreads to the neck, jaw, ears, arms, and wrists, and possibly the shoulder blades, the back, or the abdomen.

Changing position, resting, or lying down brings no relief. The pain is often constant, but it can come and go. It can last from a few minutes to many hours.

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Coronary heart diseas, heart attack symptoms, congestive heart failure symptoms

CHD cannot be cured, but with today’s technology, it can be managed effectively.

Treatment involves lifestyle changes, and possibly some medical procedures and medications.

Lifestyle recommendations include quitting smoking, eating a healthy diet, and exercising regularly.

Medications include:

  • Statins: These are the only medications demonstrated to have a positive impact on outcomes in CHD, but if a person has another underlying cholesterol disorder, they may not work.
  • Low-dose aspirin: This reduces blood clotting, lowering the risk of angina or a heart attack.
  • Beta blockers: May be used to reduce blood pressure and heart rate, especially in a person who has already had a heart attack.
  • Nitroglycerin patches, sprays, or tablets: These control chest pain by reducing the heart’s demand for blood by widening the coronary arteries.
  • Angiotensin-converting enzyme (ACE) inhibitors: These lower blood pressure and help to slow or stop the progression of CHD.
  • Calcium channel blockers: This will widen the coronary arteries, allowing greater blood flow to the heart, and reduce hypertension.


Controlling blood cholesterol levels reduces the risk of CHD. Being physically active, limiting alcohol intake, avoiding tobacco, and consuming a healthy diet with reduced sugar and salt can all help.


Coronary heart diseas, signs of a heart attack, heart attack symptoms, congestive heart failure symptoms


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