Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and a substance called plaque builds up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms.

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. According to the American Heart Association, more than 15 million people have some form of the condition.

Men in their 40s have a higher risk of CHD than women. But, as women get older, their risk increases so that it is almost equal to a man's risk.

Many things increase your risk for CHD. Bad genes (heredity) can increase your risk. You're more likely to develop the condition if someone in your family has had it -- especially if they had it before age 50. Your risk for CHD goes up the older you get.

The following factors also increase your risk of CHD:

  • Diabetes
  • High blood pressure
  • High LDL "bad" cholesterol
  • Low HDL "good" cholesterol
  • Menopause
  • Not getting enough physical activity or exercise
  • Obesity
  • Smoking

Higher-than-normal levels of inflammation-related substances may also increase your risk for a heart attack. Such substances include C-reactive protein and fibrinogen. Increased levels of a chemical called homocysteine, an amino acid, are also linked to an increased risk of a heart attack.

Possible Complications   

  • Heart attack
  • Heart failure
  • Unstable angina
  • Sudden death

 

Coronary heart disease (CHD) is a preventable disease that kills more than 110,000 people in England every year. More than 1.4 million people suffer from angina and 275,000 people have a heart attack annually. CHD is the biggest killer in the country.
Chest pain (angina) or shortness of breath may be the earliest signs of coronary heart disease. A person may feel heaviness, tightness, pain, burning, pressure, or squeezing, usually behind the breastbone but sometimes also in the arms, neck, or jaws. However, some people have heart attacks without ever having any of these symptoms.There is a wide range of severity for coronary heart disease. Some people have no symptoms at all, some have mild intermittent chest pain, and some have more pronounced and steady pain. Still others have coronary heart disease that is severe enough to make normal everyday activities difficult.

What are the major risk factors that can't be changed?

Increasing age — Over 83 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks.

Male sex (gender) — Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, it's not as great as men's.


Heredity (including Race) — Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians and a higher risk of heart disease. The high incidence of CHD is partly due to higher rates of obesity and diabetes. Most people with a strong family history of heart disease have one or more other risk factors. Just as you can't control your age, sex and race, you can't control your family history. Therefore, it's even more important to treat and control any other risk factors you have.

Symptoms   

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms.

Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

There are two main types of chest pain:

  • Atypical chest pain -- often sharp and comes and goes. You can feel it in your left chest, abdomen, back, or arm. It is unrelated to exercise and not relieved by rest or a medicine called nitroglycerin. Atypical chest pain is more common in women.
  • Typical chest pain -- feels heavy or like someone is squeezing you. You feel it under your breast bone (sternum). The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.

Adults with typical chest pain have a higher risk of CHD than those with atypical chest pain.

Exams and Tests 

Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a definite diagnosis.