Coronary heart disease, or coronary artery disease, is the single leading cause of death of men and women in the U.S. In fact, according to the April 2005 issue of the New England Journal of Medicine, cardiovascular diseases are expected to be the main cause of death globally within the next 15 years, due to both increasing prevalence in developing countries and the rising incidence of obesity and diabetes in the Western world.
Identification
Coronary heart disease is a disease of the coronary arteries. Coronary arteries are the vessels that supply the heart muscle with blood. In certain individuals, these vessels may become narrowed or blocked by the build up of plaque; a collection of fat, cholesterol, calcium and other products; a condition known as atherosclerosis.
If the plaque build up or atherosclerosis increases to the extent that, the coronary arteries become significantly narrowed and affects the blood supply to the heart muscle, angina, a type of chest pain, may occur.
If the plaque ruptures, a blood clot can form on the surface of the plaque causing the coronary artery to become completely blocked, preventing blood from reaching the heart and ultimately causing death of the heart muscle. This is known as a myocardial infarction or heart attack.
Risk Factors
Being older, being male or a postmenopausal female or having a family history of early heart disease are risk factors for developing coronary heart disease. However, reversible risk factors for atherosclerosis include high cholesterol, cigarette smoking, high blood pressure, diabetes, obesity and lack of exercise.
Complications
Angina is chest pain caused by reduced blood supply to the heart. There are two types of angina, stable angina and unstable angina. Stable angina occurs on exertion but disappears with rest or medication, usually within a few minutes. Unstable angina on the other hand, does not follow a typical pattern and may occur during rest or present as worsening chest pain that cannot be relieved. Unstable angina requires immediate medical attention, as it may indicate an impending heart attack.
Heart failure can occur when the heart muscle becomes progressively more damaged from poor coronary artery blood supply. Sometimes it may occur over a short period of time for example after a heart attack. When the heart muscle starts to fail, blood, which normally travels from the lungs to the heart, begins the back up into the lungs, as the heart becomes too weak to pump the blood to the rest of the body. Signs and symptoms of heart failure include shortness of breath, cough, tiredness and swelling of the feet, ankles and legs.
An arrhythmia is an irregular heartbeat. Many healthy people experience an occasional arrhythmia with no ill effects. However, in the case of coronary heart disease, damage to the heart muscle prevents the heart's electrical system from working properly and the resulting arrhythmia can be serious and may even be life-threatening. Signs and symptoms of a serious arrhythmia include lightheadedness, weakness, fainting, shortness of breath and even chest pain.
Warning
Any individual with coronary heart disease is at increased risk of having a heart attack. Possible signs and symptoms of a heart attack include chest pain, discomfort in other areas of the upper body such as the arms or neck, shortness of breath and sweating. It is important not to delay calling 911, as this can be life saving.
Considerations
While certain risk factors cannot be controlled, simple lifestyle measures such as avoiding smoking, maintaining a healthy weight, exercising regularly, and following a healthy balanced diet, can be delay or even prevent coronary heart disease.
References
- "New England Journal of Medicine"; Inflammation, Atherosclerosis and Coronary Artery Disease; Goran K. Hansen, MD, PhD; April 2005
- Mayo Clinic: Coronary Artery Disease
- National Heart Lung and Blood Institute Diseases and Conditions Index: Coronary Artery Disease
- American Heart Association: Warning Signs of a Heart Attack
