Coronary heart disease: Causes, symptoms, and treatment

Coronary heart disease refers to a narrowing of the coronary arteries, the blood vessels that supply oxygen and blood to the heart. It is also known as coronary artery disease. It is a major cause of illness and death.

Coronary heart disease (CHD) normally happens when cholesterol accumulates on the artery walls, creating plaques. The arteries narrow, reducing blood flow to the heart. Sometimes, a clot can obstruct the flow of blood to the heart muscle.

CHD commonly causes angina pectoris (chest pain), shortness of breath, myocardial infarction, or heart attack. It is the most common type of heart disease in the United States, where it accounts for 370,000 deaths every year.

Fast facts on coronary heart disease:

Coronary heart disease accounted for 23.5 percent of all deaths in the U.S. in 2008.

According to the Centers for Disease Control and Prevention (CDC), about 735,000 Americans have a heart attack each year.

Warning signs and symptoms include chest pain or discomfort and shortness of breath.

Examples of coronary heart disease include angina and heart attack.

What is coronary heart disease?

Picture of some scans of a heart
Coronary heart disease is one of the leading causes of death in the United States.

The heart is a muscle, about the same size as an adult human fist. Blood is pumped from the heart to the lungs, where it collects oxygen. This oxygen-rich blood is then pumped back to the heart and then to organs throughout the body through arteries.

The blood then returns to the heart through the veins and is pumped to the lungs again. This is called circulation.

Coronary arteries are the heart’s network of blood vessels. They exist on the surface of the heart, and they supply the heart muscle with oxygen. If the coronary arteries narrow, the supply of oxygen-rich blood to the heart may become too low, especially during physical activity.

At first, this reduction in blood flow may not produce any symptoms, but as fatty deposits, or plaques, build up in the coronary arteries, signs and symptoms may emerge.

Causes

CHD is believed to start with injury or damage to the inner layer of a coronary artery.

This damage causes fatty plaque deposits to build up at the site of the injury. These deposits consist of cholesterol and other cellular waste products. The accumulation is called atherosclerosis.

If pieces break off or rupture, platelets will clump in the area, attempting to repair the blood vessel. This clump can block the artery, reducing or blocking blood flow, and leading to a heart attack.

Below is a 3-D model of CHD, which is fully interactive.

Explore the model using your mouse pad or touchscreen to understand more about CHD.

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Symptoms

Angina

The following are symptoms of angina:

Chest pain: People describe it as a squeezing, pressure, heaviness, tightening, burning, or aching across the chest. It usually starts behind the breastbone. The pain often spreads to the neck, jaw, arms, shoulders, throat, back, or even the teeth.

Related symptoms: Other symptoms include indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath.

There are several main types of angina:

Stable angina: The discomfort may last for a short period of time, and it may feel like gas or indigestion. It happens when the heart is working harder than usual, such as during exercise. It has a regular pattern. It can happen over months or years. Rest or medication can relieve symptoms.

Unstable angina: This is often caused by blood clots in the coronary artery. It occurs at rest, it is surprising, it lasts longer, and it may worsen over time.

Variant angina: This type occurs at rest, and it is usually severe. It happens when there is a spasm in an artery that causes it to tighten and narrow, disrupting blood supply to the heart. Triggers include exposure to cold, stress, medicines, smoking, or cocaine use.

Shortness of breath (dyspnea)

CHD can lead to shortness of breath. If the heart and other organs are getting too little oxygen, the patient may start panting. Any exertion may be very tiring.

Heart attack

Heart attack, or myocardial infarction, happens when the heart muscle does not have enough blood, and therefore oxygen. The muscle dies, and a heart attack occurs.

A heart attack commonly occurs when a blood clot develops from a plaque in one of the coronary arteries. The clot, if it is big enough, can stop the supply of blood to the heart. The blood clot is known as coronary thrombosis.

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