Coronary heart disease (patient information)

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Coronary heart disease

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Coronary heart disease?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Overview

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart.

What are the symptoms of Coronary heart disease?

  • 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.
  • It may feel heavy or like someone is squeezing your heart.
  • You feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.
  • The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
  • Other symptoms include:
  • Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as:

What causes Coronary heart disease?

  • Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and other substances form a plaque build-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. This can cause chest pain (stable angina), shortness of breath, heart attack, and other symptoms, usually when you are active.
  • Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.

Who is at risk for Coronary heart disease?

  • Many things increase your risk for heart disease:
  • Men in their 40s have a higher risk of CHD than women. But as women get older (especially after they reach menopause), their risk increases to almost equal that of a man's risk.
  • Bad genes (heredity) can increase your risk. You are more likely to develop the condition if someone in your family has a history of heart disease -- especially if they had it before age 50. Your risk for CHD goes up the older you get.
  • Diabetes is a strong risk factor for heart disease.
  • Abnormal cholesterol levels: your LDL ("bad") cholesterol should be as low as possible, and your HDL ("good") cholesterol should be as high as possible to reduce your risk of CHD.
  • Smokers have a much higher risk of heart disease than nonsmokers.
  • Chronic kidney disease can increase your risk.
  • Already having atherosclerosis or hardening of the arteries in another part of your body (examples are stroke and abdominal aortic aneurysm) increases your risk of having coronary heart disease.
  • Other risk factors include alcohol abuse, not getting enough exercise, and having excessive amounts of stress.
  • Higher-than-normal levels of inflammation-related substances, such as C-reactive protein and fibrinogen are being studied as possible indicators of an increased risk for heart disease.
  • Increased levels of a chemical called homocysteine, an amino acid, are also linked to an increased risk of a heart attack.

How to know you have a Coronary heart disease?

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

When to seek urgent medical care

  • If you have any of the risk factors for CHD, contact your doctor to discuss prevention and possible treatment.
  • Immediately contact your health care provider, call the local emergency number (such as 911), or go to the emergency room if you have:

Treatment options

  • You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor's directions closely to help prevent coronary artery disease from getting worse.
  • Goals for treating these conditions in people who have coronary artery disease:
  • Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat CHD, including:
  • NEVER ABRUPTLY STOP TAKING ANY OF THESE DRUGS. Always talk to your doctor first. Stopping these drugs suddenly can make your angina worse or cause a heart attack.
  • Procedures and surgeries used to treat CHD include:
  • Lifestyle changes are very important. Your doctor may tell you to:
  • Avoid or reduce the amount of salt (sodium) you eat
  • Eat a heart healthy diet -- one that is low in saturated fats, cholesterol, and trans fats
  • Get regular exercise and maintain a healthy weight
  • Keep your blood sugar strictly under control if you have diabetes
  • Stop smoking

Medications to avoid

Patients diagnosed with Coronary heart disease should avoid using the following medications:


Where to find medical care for Coronary heart disease

Directions to Hospitals Treating Coronary heart disease

Prevention

  • Tips for preventing CHD or lowering your risk of the disease:
  • Avoid or reduce stress as best as you can.
  • Don't smoke.
  • Eat well-balanced meals that are low in fat and cholesterol and include several daily servings of fruits and vegetables.
  • Get regular exercise. If your weight is considered normal, get at least 30 minutes of exercise every day. If you are overweight or obese, experts say you should get 60 - 90 minutes of exercise every day.
  • Keep your blood pressure below 130/80 mmHg if you have diabetes or chronic kidney disease, and below 140/90 otherwise
  • Keep your cholesterol and blood sugar under control.
  • Moderate amounts of alcohol (one glass a day for women, two for men) may reduce your risk of cardiovascular problems. However, drinking larger amounts does more harm than good.
  • If you have one or more risk factors for coronary heart disease, talk to your doctor about possibly taking an aspirin a day to help prevent a heart attack or stroke. You may be prescribed low-dose aspirin therapy if the benefit is likely to outweigh the risk of gastrointestinal side effects.
  • New guidelines no longer recommend hormone replacement therapy, vitamins E or C, antioxidants, or folic acid to prevent heart disease. The use of hormone replacement therapy in women who are close to menopause or who have finished menopause is controversial at this time.

What to expect (Outlook/Prognosis)

Everyone recovers differently. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications exactly as the doctor prescribes. Others may need medical procedures such as angioplasty or surgery.

Although everyone is different, early detection of CHD generally results in a better outcome.

Possible complications

Source

http://www.nlm.nih.gov/medlineplus/ency/article/007115.htm


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