Coronary heart disease

What is coronary heart disease?

Coronary heart disease is what happens to the heart vessels if they become blocked with fatty deposits. If a lot of fat builds up, it can lead to the vessels in the heart becoming furry. When this happens, it leads to the blood vessels becoming narrower, which can cause life-threatening heart problems such as a heart attack.

The condition is sometimes called ischaemic heart disease or coronary artery disease.

What are the symptoms of coronary heart disease?

Coronary heart disease has a range of symptoms, but the most common symptom is chest pain. These are the different ways coronary heart disease can present:

Angina

This happens when the vessels in your heart become slightly blocked, and it varies in severity. Angina symptoms include:

• Chest pain or discomfort

• Pain, either when you’re carrying out activities or when you’re resting

• A severe angina attack can lead to more severe chest pain, with pain spreading into the back, jaw, neck and arm.

Angina symptoms are often relieved by GTN spray. If the pain doesn’t go away with GTN spray, it’s more likely to be a heart attack and you should seek help immediately.

Heart attack

A heart attack happens when the vessels in the heart become entirely blocked, which means blood cannot flow through them.

Heart attack symptoms typically include:

• Central chest pain which is prolonged, usually lasting longer than 10 minutes

• Pain that feels like something heavy is sitting on your chest

• The pain might spread to your left arm, neck and jaw, or your back

• A faster heartbeat

• Feeling sweaty, light-headed or clammy

• Feeling sick or vomiting

Sometimes heart attacks don’t present in the most common way, and you have symptoms such as stomach ache, back pain and heartburn.

If you or someone you know has symptoms of a heart attack, call 999 immediately.

How common is coronary heart disease?

In the UK, 2.3 million people are living with coronary heart disease. Coronary heart disease is a major form of death in the UK and worldwide, with 1 in 8 men and 1 in 14 women dying from the condition each year.

What causes coronary heart disease?

Coronary heart disease happens because of fatty deposit build up in the blood vessels of the heart, which is known as atherosclerosis. This can lead to the vessels becoming more narrow and stiff, which affects blood reaching the different parts of the heart.

What increases your risk of developing coronary heart disease?

Your risk of developing coronary heart disease is increased with:

• Smoking – long-term use can put pressure on the heart and can contribute to furring of the vessels

• High blood pressure – if your blood pressure is high, it means your heart has to work harder to pump blood. This leads to the muscles of the heart becoming weaker

• Diabetes – diabetes can lead to the walls of the vessels of the heart becoming thicker, which can affect how much blood can flow through the vessels

• High cholesterol

• A family history of coronary heart disease

• Reduced exercise

How is coronary heart disease diagnosed?

If a doctor thinks you’re at risk of coronary heart disease, they may refer you for tests, such as:

• Blood tests – to look at cholesterol levels

• ECG – this looks at the electrical activity of the heart

• Stress test – this is where you have an ECG monitoring device attached to you while on a treadmill for 10 minutes. This is to assess how well the heart works under pressure

• Echocardiography – this is a scan that shows how much blood your heart can pump out every minute

• Coronary angiogram – this is where a dye is injected into you so that the vessels of the heart can be visualised on a scan. This shows whether there are any areas where the vessels are narrowed.

How is coronary heart disease prevented?

You can do certain things to try and help prevent coronary heart disease. These include:

• Stopping smoking

• Maintaining a healthy lifestyle – this includes having a healthy diet and exercising regularly

If you’re at risk, you might be given certain medications to try and reduce the risk of having a serious event as a result of coronary heart disease. These include:

• Statins – these are to help reduce levels of cholesterol

• Aspirin and clopidogrel – these are examples of blood thinning medications which help reduce the risk of blood clots

• ACE inhibitors, angiotensin receptor blockers, calcium channel blockers and beta blockers – these are all examples of medications which help reduce blood pressure

• Nitrates such as GTN – these are medications which help widen your blood vessels, so that more blood can flow through.

How is coronary heart disease treated?

If you do have a serious event, such as angina which is not resolving or a heart attack, you might have a procedure performed.

Coronary angiography and stent insertion

This process is similar to a coronary angiogram, except instead of just visualising the vessels of the heart, a balloon is inserted into the blocked vessel which aims to reduce the narrowing because of fatty deposit build up. After this, a stent is inserted to help hold the artery open. These processes allow for blood to flow easily.

Coronary artery bypass surgery

This is where a vessel is inserted to connect the large artery which supplies the heart, and a vessel beyond the blocked artery, to establish blood flow to the region where the blockage is.

When should I speak to a doctor?

If you have symptoms of severe chest pain, you should call 999 in the first instance, as it could be life-threatening.

How can Livi help?

A Livi doctor will ask you questions about your symptoms. They’ll make an individual assessment, recommend a treatment or refer you to a specialist if needed.