Coronary Heart Disease

Coronary heart disease (CHD) is the most common form of heart disease and the leading cause of death for Americans. Fortunately, CHD can be prevented or controlled. The information below gives an overview of CHD and its prevention, diagnosis, and treatment, including what you can do to protect your heart health and additional resources available.

What Is CHD?

The heart is a muscle that works 24 hours a day. To perform well, it needs a constant supply of oxygen and nutrients, which is delivered by the blood through the coronary arteries.

That blood flow can be reduced by a process called atherosclerosis, in which plaques or fatty substances build up inside the walls of blood vessels. The plaques attract blood components, which stick to the inside surface of the vessel walls. Atherosclerosis can affect many blood vessels, causing them to narrow and harden. It develops over many years and can begin early, even in childhood.

In CHD, atherosclerosis affects the coronary arteries. The fatty buildup, or plaque, can break open and lead to the formation of a blood clot. The clot covers the site of the rupture, also reducing blood flow. Eventually, the clot becomes firm. The process of fatty buildup, plaque rupture, and clot formation recurs, progressively narrowing the arteries. Less and less blood reaches the heart muscle.

When too little blood reaches a part of the body, the condition is called ischemia. When this occurs with the heart, it’s called cardiac ischemia. If the blood supply is nearly or completely, and abruptly, cut off, a heart attack results and cells in the heart muscle that do not receive enough oxygen begin to die. The more time that passes without treatment to restore blood flow, the greater the damage to the heart. Because heart cells cannot be replaced, the cell loss is permanent.

CHD Risk Factors

Certain behaviors and conditions increase the risk that someone will develop CHD. They also can increase the chance that CHD, if already present, will worsen. While some of these risk factors cannot be modified, most can.

Risk factors include:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Overweight/obesity
  • Physical inactivity
  • Cigarette smoking
  • Age – 45 and older for men, 55 and older for women
  • Family history of early CHD

Explore the menu options to the left to learn more about the preventable risk factors and what you can do to lessen your risks.

What Are the Symptoms of CHD?

Symptoms of CHD vary. Some people feel no discomfort, while others have chest pain or shortness of breath. Sometimes the first symptom of CHD is a heart attack or cardiac arrest (a sudden, abrupt loss of heart function).

Chest pain also can vary in its occurrence. It happens when the blood flow to the heart is critically reduced and does not match the demands placed on the heart. Called angina, the pain can be mild and intermittent, or more pronounced and steady. It can be severe enough to make normal everyday activities difficult. The same inadequate blood supply also may cause no symptoms, a condition called silent ischemia.

Often, particularly in men, angina is felt behind the breastbone and may radiate up the left arm or neck. It may also be felt in the shoulder, elbows, jaw, or back. Angina is usually brought on by exercise, lasts 2 to 5 minutes, does not change with breathing, and is eased by rest.

Women may get a less typical form of angina that feels like shortness of breath or indigestion, and can linger or occur in a different location than behind the breastbone. This less typical form may not be brought on by exertion or be eased by rest. In fact, it may occur only at rest.

A person who has any symptoms should talk with his or her doctor. Without treatment, the symptoms may return, worsen, become unstable, or progress to a heart attack.

Warning signs of a heart attack include discomfort or pain in the center of the chest; discomfort in the arm(s), back, neck, jaw, or stomach; shortness of breath; breaking out in a cold sweat; nausea; and light-headedness. Those with CHD should talk with their doctor about the symptoms of a heart attack and the appropriate steps to take to get emergency care. The key to surviving a heart attack is fast action. Learn the heart attack warning signs and if you or someone else experiences any of them, call 9-1-1 immediately.

Source: National Heart, Lung, and Blood Institute

Heart Disease Resources

Heart Health Screening Recommendations
American Heart Association

Risk Assessment Tool for Estimating Your 10-Year Risk of Having a Heart Attack
National Heart, Lung, and Blood Institute

My Family Health Portrait (Family History)
Department of Health and Human Services

Prevention and Treatment of Heart Attack
American Heart Association

Heart Attack Survival Plan
National Heart, Lung, and Blood Institute

Act In Time To Heart Attack Signs
National Heart, Lung, and Blood Institute

© 2018 National Volunteer Fire Council. All Rights Reserved.