Coronary Heart Disease (CHD)

Symptoms

The main symptoms of coronary heart disease are:

• chest pain (angina)
• shortness of breath
• pain in your neck, shoulders, jaw or arms
• feeling faint
• feeling sick (nausea)

But not everyone has the same symptoms and some people may not have any before coronary heart disease is diagnosed.

Causes

Coronary heart disease is the term that describes what happens when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This process is known as atherosclerosis and the fatty deposits are called atheroma.

Atherosclerosis can be caused by lifestyle factors, such as smoking and regularly drinking excessive amounts of alcohol.

You're also more at risk of getting atherosclerosis if you have conditions like high cholesterol, high blood pressure (hypertension) or diabetes.

Diagnosis

If a doctor feels you're at risk of coronary heart disease, they may carry out a risk assessment.

They'll ask you about your medical and family history and your lifestyle, and they'll take a blood test.

Further tests may be needed to confirm coronary heart disease, including:

• electrocardiogram (ECG)
• echocardiogram
• chest x-ray

• coronary angiogram
  

Treatment Options

Coronary heart disease cannot be cured but treatment can help manage the symptoms and reduce the chances of problems such as heart attacks.

Treatment can include:

• lifestyle changes, such as regular exercise and stopping smoking
• medicines
• angioplasty – where balloons and stents are used to treat narrow heart arteries

• surgery
  

Prevention Tips

There are several ways you can reduce your risk of developing coronary heart disease (CHD), such as lowering your blood pressure and cholesterol levels.

Eat a healthy, balanced diet

A low-fat, high-fibre diet is recommended, which should include plenty of fresh fruit and vegetables (5 portions a day) and whole grains.

You should limit the amount of salt you eat to no more than 6g (0.2oz) a day as too much salt will increase your blood pressure. 6g of salt is about 1 teaspoonful.

There are 2 types of fat: saturated and unsaturated. You should avoid food containing saturated fats, because these will increase the levels of bad cholesterol in your blood.

Foods high in saturated fat include:

• meat pies
• sausages and fatty cuts of meat
• butter
• ghee – a type of butter often used in Indian cooking
• lard
• cream
• hard cheese
• cakes and biscuits
• foods that contain coconut or palm oil

However, a balanced diet should still include unsaturated fats, which have been shown to increase levels of good cholesterol and help reduce any blockage in your arteries.

Foods high in unsaturated fat include:

• oily fish
• avocados
• nuts and seeds
• sunflower, rapeseed, olive and vegetable oils

You should also try to avoid too much sugar in your diet, as this can increase your chances of developing diabetes, which is proven to significantly increase your chances of developing CHD.

Be more physically active

Combining a healthy diet with regular exercise is the best way of maintaining a healthy weight. Having a healthy weight reduces your chances of developing high blood pressure.

Regular exercise will make your heart and blood circulatory system more efficient, lower your cholesterol level, and also keep your blood pressure at a healthy level.

Exercising regularly reduces your risk of having a heart attack. The heart is a muscle and, like any other muscle, benefits from exercise. A strong heart can pump more blood around your body with less effort.

Any aerobic exercise, such as walking, swimming and dancing, makes your heart work harder and keeps it healthy.

Keep to a healthy weight.

Give up smoking

If you smoke, giving up will reduce your risk of developing CHD. 

Smoking is a major risk factor for developing atherosclerosis (furring of the arteries).

Reduce your alcohol consumption

If you drink, do not exceed the maximum recommended limits.

Men and women are advised not to regularly drink more than 14 units a week

If you want to cut down, try to have several drink-free days each week. Always avoid binge drinking, as this increases the risk of a heart attack.

Keep your blood pressure under control

You can keep your blood pressure under control by eating a healthy diet low in saturated fat, exercising regularly and, if needed, taking medicine to lower your blood pressure.

Your target blood pressure should be below 135/85mmHg. If you have high blood pressure, ask a GP to check your blood pressure regularly.

Keep your diabetes under control

You have a greater chance of developing CHD if you have diabetes. You can help lower your risk of heart problems by being physically active and controlling your weight.

It’s also important to have your blood pressure, cholesterol and blood sugar levels (HBA1C) checked regularly.

If you have diabetes and you are under the age of 80, your target blood pressure level should be below 140/90mmHg.

Take any prescribed medicine

If you have CHD, you may be prescribed medicine to help relieve your symptoms and stop further problems developing.

If you do not have CHD but have high cholesterol, high blood pressure or a history of family heart disease, your doctor may prescribe medicine to prevent you developing heart-related problems.

If you're prescribed medicine, it's vital you take it and follow the correct dosage. Do not stop taking your medicine without consulting a doctor first, as doing so is likely to make your symptoms worse and put your health at risk.