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Coronary Heart Disease (CHD)
CHD is the most common type of heart disease. CHD occurs when the
coronary arteries, that supply blood to the heart muscle, become
hardened and narrowed due to the plaque buildup. The plaque buildup
and the narrowing and hardening of the arteries is called
atherosclerosis. Plaques are a mixture of fatty substances including
cholesterol and other lipids. Blood flow and oxygen supply to the
heart can be reduced or even fully blocked with a growing plaque.
Plaques may also rupture and cause blood clots that block arteries.
CHD can lead to a heart attack. Angina can also occur. Angina is
chest pain or discomfort that occurs when the heart muscle is not
getting enough blood. Over time, CHD can weaken the heart muscle and
lead to heart failure, a serious problem where the heart cannot pump
blood the way that it should. Also, irregular heart beats, called
arrhythmias, can develop.
The most common symptom of CHD is angina. In some people the first
sign of CHD is a heart attack. Doctors can assess a patient’s risk
status by checking several factors, including blood pressure, blood
cholesterol and glucose, history of heart disease, and other
factors. Doctors can perform several tests to assess CHD in patients
who are at high risk or have symptoms. These may include one or more
of these tests:
ECG or EKG (electrocardiogram), which measures the electrical
function and the rate and regularity of your heartbeat.
Echocardiogram, which creates a picture of the heart.
Exercise stress test, to measure how well the heart pumps at greater
than usual workloads when it needs more oxygen.
Chest x–ray, a picture of the organs and structures inside the
chest.
Cardiac catheterization, a thin, flexible tube is passed through an
artery in the groin or arm to reach the coronary arteries. The tube
lets your doctor check the inside of your arteries to see if there
is any blockage. Your doctor also can measure the pressure and blood
flow in the heart's chambers, collect blood samples from the heart,
and examine the arteries of the heart by x–ray.
Coronary angiography, which is usually performed along with cardiac
catheterization. A dye is injected through the catheter into the
coronary arteries. The doctor can then take an x–ray to see the flow
of blood through the heart and check for blockages.
For persons with CHD, treatment will involve addressing those
factors that put them at risk for CHD and heart attack. The doctor
may recommend lifestyle changes to help reduce risk. Medicines and
medical treatments may be needed. Medicines are available to treat
high blood cholesterol, high blood pressure, irregular heart beats,
blood flow, and other potential problems. Some advanced treatments
and surgical procedures may be used to help restore blood flow to
the heart muscle.
In principle, all people can take steps to lower their personal risk
of heart disease and heart attack by addressing their risk factors.
People who already have heart disease especially need to control
their risk factors.
Heart Attack
A heart attack is also called a myocardial infarction. If the blood
supply to the heart is severely reduced or completely blocked, heart
muscle cells may not receive enough oxygen and begin to die. The
more time that passes without treatment to restore blood flow, the
greater the damage to the heart. This damage can cause irregular
heart rhythms or even sudden cardiac arrest or stopping of the heart
beat. Death can result. Coronary artery disease is the chief
underlying cause of a heart attack. A less common cause of a heart
attack is a severe spasm of a coronary artery that reduces the blood
supply to the heart.
When a person is having a heart attack, emergency care is needed
that may include cardiopulmonary resuscitation (CPR), electrical
shock (called defibrillation), and other advanced emergency medical
care. Emergency medical personnel and doctors can quickly perform
emergency treatment and transport the person to the hospital.
Bystanders might also be trained to perform CPR and to use an
automated external defibrillator, if one is available, until
emergency medical personnel arrive. Once at the hospital, doctors
can perform several tests to quickly determine if the person is
having or has had a heart attack and the best course of action to
restore blood flow.
Because a heart attack is a medical emergency, it is important to
recognize the signs and symptoms of a heart attack and to act
immediately by calling 9–1–1. A person's chance of surviving a heart
attack is increased the sooner emergency treatment is administered.
A heart attack survivor may have a damaged heart that affects the
heart rhythm, pumping action, and blood circulation. This puts heart
attack victims at greater risk of having another heart attack or
other events such as a stroke, kidney problems, and peripheral
arterial problems. Cardiac rehabilitation is usually recommended for
heart attack survivors after the emergency event has stabilized.
Cardiac rehabilitation guides the patient to make changes that can
help improve cardiovascular fitness and quality of life. These
changes may include dietary changes, physical activity, smoking
cessation, and other issues such as medication schedules and stress
management. Heart attack survivors should seek their doctor's advice
about daily activities such as returning to work, driving, physical
and sexual activity, and air travel.
Other Conditions and Related Terms:
Angina
Chest pain or discomfort that occurs when the heart muscle is not
getting enough blood. Angina may feel like pressure or a squeezing
pain in the chest. The pain may also occur in the shoulders, arms,
neck, jaw, or back, and it may feel like indigestion. Angina is a
symptom of coronary heart disease. Angina may be stable or unstable.
Stable angina is chest pain that occurs on physical exertion or
under mental or emotional stress. Unstable angina is chest pain that
occurs even while at rest, without apparent reason.
Acute Coronary Syndrome
A term that is sometimes used to describe people who have either an
acute myocardial infarction or unstable angina.
Aortic Aneurysm and Dissection
A condition where the aorta stretches or dilates (aneurysm) and
ruptures (dissection). A ruptured aneurysm is an emergency
situation.
Arrhythmias
Irregular, or abnormally fast or slow, beating of the heart. The
heart beat is controlled by electrical impulses. When the timing or
frequency of these electrical impulses are disrupted, arrhythmias
develop. Some arrhythmias are quite serious. An example is
ventricular fibrillation, a severely abnormal heart rhythm that
causes death unless treated right away by providing an electrical
shock to the heart (called defibrillation). Others are less severe
but can develop into more serious conditions over time. A particular
concern is atrial fibrillation. Atrial fibrillation is rapid,
irregular beating of the upper chambers of the heart. The chambers
can quiver instead of beating in a regular pattern. Blood is not
fully pumped out of them and may pool and clot. For more
information, see our atrial fibrillation fact sheet.
Cardiomyopathy
A weakening of the heart muscle or a change in heart muscle
structure. It often results in inadequate heart pumping or other
heart function abnormalities. These can result from various causes,
including prior heart attacks, viral or bacterial infections, and
others.
Congenital Heart Disease
Malformations of heart structures, present during pregnancy or at
birth. These may be caused by genetic factors or by adverse
exposures during pregnancy. Examples include holes in the walls that
divide the heart chambers, abnormal heart valves, and others.
Congenital heart defects can disrupt the normal flow of blood
through the heart. Congenital heart defects are the most common type
of major birth defect.
Heart Failure
This may also be called congestive heart failure or chronic heart
failure. Heart failure is a condition where the heart cannot pump
enough blood and oxygen to meet the needs of other body organs.
Heart failure does not mean that the heart has stopped, but that it
cannot pump blood the way that it should. Heart failure is a serious
condition. There is no cure for heart failure at this time, except a
heart transplant. Once diagnosed, medicines are needed for the rest
of the person's life. See our heart failure fact sheet.
Peripheral Arterial Disease (PAD)
Hardening of the arteries that supply blood to the arms and legs.
PAD is usually the result of atherosclerosis, the buildup of plaque
and narrowing of the arteries. Blood flow and oxygen to the muscles
in the arms and legs can be reduced or even fully blocked. Painful
leg muscles, numbness, swelling in the ankles and feet, and weak
pulse in the feet are some of the signs and symptoms of PAD.
Rheumatic Heart Disease
This condition is damage to the heart valves and other heart
structures due to inflammation and scarring caused by rheumatic
fever, which occurs from streptococcal infection.
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