Coronary artery disease

What is it?

The coronary arteries carry blood and oxygen to the heart muscle.² Over the years, fatty deposits containing cholesterol build up inside their walls (atherosclerosis).^2,1 The arteries narrow, so the heart gets less blood than it needs, and a blockage can cause a heart attack.² In some people, the heart's tiny blood vessels are damaged instead; this type is more common in women.²

It is the most common type of heart disease in the United States and a leading cause of death for both men and women.^2,1 The risk rises with age, and men tend to get it earlier.² Smoking, high blood pressure, high cholesterol, diabetes, obesity and too little activity raise the risk.² It runs in families: the risk is higher if a parent, brother or sister had heart disease before 50.²

The first signs

Some people have no signs, and only find out when they have a heart attack.^2,1 Signs may start or get worse when you are active or under stress, and may go away with rest.²

• chest pain, pressure or tightness (angina);^2,1
• pain that spreads to the neck, jaw, shoulders or arms;^2,1
• shortness of breath;^1,2
• unusual tiredness, feeling faint or feeling sick.^2,1

Chest pain that does not go away, or that comes on at rest, may be a heart attack: call the emergency number straight away.²

How doctors find out

Your doctor asks about your symptoms, your family and your lifestyle, checks your blood pressure, and does blood tests for cholesterol and sugar.² A risk score can estimate your chance of a heart attack or stroke in the next 10 years.² Tests that can confirm it include an ECG, an echocardiogram, a chest X-ray, and a coronary angiogram, which is an X-ray that checks the blood vessels.^1,3

Current treatment

Treatment combines lifestyle changes with medicines such as blood thinners, statins and blood pressure medicines, and some people also need angioplasty with a stent or bypass surgery.Source: NHS

Will it get worse?

The symptoms can get worse over time as more fatty deposits build up.² Over time it can lead to angina, a heart attack, heart failure or an irregular heartbeat.² A healthy lifestyle may slow the disease down, and treatment can help reduce the chances of problems such as a heart attack.^2,1

Medicines: what helps, and what to watch for

Many different medicines are used to treat heart disease.³ Blood thinners such as low-dose aspirin or clopidogrel stop clots forming and lower the risk of a heart attack.³ Statins lower cholesterol.³ Beta blockers slow the heartbeat and help with angina.³ Nitrates widen the blood vessels and ease chest pain.³ Other medicines lower blood pressure.³

Good to know:

• nitrates can cause mild headaches, dizziness and flushed skin;³
• ACE inhibitors, such as ramipril, can cause a dry cough and dizziness, and you need regular blood tests to check your kidneys;³
• calcium channel blockers can cause headaches and a flushed face, which are usually mild and short-lived.³

Exercise and therapy help too

• cardiac rehabilitation after a heart attack: often weekly sessions that last 6 to 12 weeks, in a group, online or at home, with suitable exercise, advice on taking your medicines, stress management and support for anxiety and low mood;⁴
• people who go to cardiac rehabilitation are less likely to have another heart attack or go into hospital;⁴
• be active, eat a healthy, balanced diet and keep a healthy weight;^1,2

Procedures and surgery, for some people

In a coronary angioplasty, a small balloon pushes the fatty deposits outwards to widen a narrowed artery, and a small metal tube (stent) is usually left in to keep it open.³ It can be planned, or done urgently during a heart attack.³ In bypass surgery, a blood vessel is attached so that blood can flow around the narrowed or blocked part.³ Occasionally a heart transplant may be needed, when the heart is severely damaged and medicines do not work, or when the heart cannot pump enough blood.³

Is there a cure?

No.¹ Coronary heart disease cannot be cured, but treatment eases the symptoms and lowers the chance of a heart attack.¹

See the 1,536 trials you can join

Sources

Written in plain words by Frontlight from these pages:

1. NHS: Coronary heart disease
2. MedlinePlus: Coronary Artery Disease
3. NHS: Coronary heart disease – Treatment
4. NHS: Coronary heart disease – Recovery