Coronary Heart Disease (CHD)

What is coronary heart disease?

Coronary heart disease (CHD) is sometimes called coronary artery disease (CAD). It is the most common type of heart disease. CHD occurs in your coronary arteries, or vessels. These arteries carry blood and oxygen to your heart.

According to the Centers for Disease Control and Prevention (CDC), heart disease is a leading cause of death in the United States. It also can lead to disabilities.

Symptoms of coronary heart disease

It is possible to have CHD, but not have any symptoms. Typically, this happens in the early stages. Symptoms can vary in men and women.

The main symptom of CHD is chest pain or discomfort, known as angina. This happens when your heart lacks blood or oxygen. Angina can be stable or unstable. Stable angina only happens with activity or stress. Unstable angina can happen anytime and is more dangerous. Chest pain can feel tight and/or heavy. Some people describe it as a squeezing feeling. The pain can spread to your arms, neck, stomach, back, or jaw.

Shortness of breath is another common symptom of coronary heart disease. You also might feel tired or weak. Talk to your doctor about what to look for to help prevent and detect CHD.

Call 911 right away if you have any of the following abrupt symptoms. You might be having a heart attack or heart failure.

  • Ongoing angina or chest pain that changes.
  • Shortness of breath.
  • Dizziness or lightheadedness.
  • Nausea and/or vomiting.
  • Tiredness or weakness.
  • Sweating (with fever or chills).
  • Swelling in your legs, ankles, feet, stomach, or the veins in your neck.
  • Numbness, particularly in your arms or chest.

What causes coronary heart disease?

Coronary heart disease develops over a period time. It occurs as your arteries become narrowed or blocked. Plaque, made up of fatty substances, gets into your arteries. Plaque can build up and harden, creating a blocked or narrowed area. This makes it hard for blood and oxygen to reach your heart. It puts stress on your heart, vessels, and entire body. If the plaque bursts, it can form a blood clot and produce a heart attack. If your brain also lacks oxygen, you can have a stroke.

How is coronary heart disease diagnosed?

Your doctor can help you determine if you are at risk of CHD. They will check your cholesterol levels and blood pressure. They also will want to know about your lifestyle and family history.

Currently, the American Academy of Family Physicians (AAFP) recommends against ECG screening for adults who don’t have symptoms and are at low risk for CHD. The AAFP does not have enough data to recommend ECG screening for adults who don’t have symptoms, but are at medium or high risk for CHD.

If you have symptoms, see your doctor right away. Your doctor will perform tests to diagnose CHD.

  • Electrocardiogram (ECG or EKG) to measure the rhythm, speed, and evenness of your heartbeat.
  • Echocardiogram (ECG) to get an image of your heart using ultrasound.
  • Chest X-ray to get an image of your heart and chest area using radiation.
  • Exercise stress test to check your heart rate during activity.
  • Coronary angiogram to check your arteries for flow and blockage. This test uses injected dye to take X-rays and monitor blood flow.
  • Cardiac catheterization to check your arteries for flow and blockage. A catheter (thin tube) goes into your arteries from your groin, arm, or neck.
  • Cardiac computed tomography (CT) scan to get an image of your heart and arteries. This test uses radiation and contrast dye.


Can coronary heart disease be prevented or avoided?

There are risk factors that increase your chance of getting CHD. Some of them you can prevent, including:

  • Overweight or obesity. Your doctor can help you calculate your body mass index (BMI). You should balance the amount of calories you take in and put out.
  • Inactivity. According to the American Heart Association, adults should get at least 150 minutes of moderate exercise each week. This includes fast walking, bicycling, or swimming. Increase this number if you need to lose weight. Children and teens should get at least 60 minutes of exercise every day.
  • Poor diet. This plays a role in your body weight, cholesterol levels, and overall health. Learn how many calories you should consume in a day. Then, make it a point to eat foods high in nutrition. This includes, fruits, vegetables, whole grains, low-fat dairy, poultry, and fish. Limit your intake of fats, sodium (salt), sugar, and red meat.
  • Smoking and alcohol. These unhealthy habits affect your oxygen level. They can damage your blood vessels and tighten your airways. Women should have no more than one drink per day. Men should have no more than two drinks per day. Talk to your doctor if you need help quitting alcohol or smoking.

Other CHD risk factors that you can manage or treat include:

  • High cholesterol. Cholesterol is one substance that creates plaque. There are two types of cholesterol. Low-density lipoprotein (LDL) is bad. High-density lipoprotein is good. You should have low LDL and high HDL levels. You can help control these levels with medicine and a healthy lifestyle.
  • High blood pressure. For most people, your blood pressure is high when it is at or above 140/90. Age and certain health conditions can affect normal blood pressure levels. You can help control your blood pressure with medicine. A healthy lifestyle and reduced stress also help.
  • Certain health conditions, such as diabetes or preeclampsia.

Major risk factors that you can’t avoid include:

  • Age. Plaque continues to build as you get older. The risk of CHD increases for me. starting at age 45. It increases for women starting at age 55.
  • Gender and race. Men are at higher risk than women. African Americans can be more likely to get CHD than other races.
  • Family history.

Talk to your doctor for specific recommendations, as they vary by person.

Coronary heart disease treatment

A lot of things play a part in your treatment for CHD. These include age, health, degree of CHD, and other conditions.

You might be able to monitor mild or early cases of coronary heart disease. Less invasive treatment options include:

  • taking medicine to relieve symptoms and reduce risk factors
  • eating healthy
  • losing weight
  • being more active
  • stopping smoking
  • reducing stress.

You might need surgery to treat heart disease.

  • Coronary artery bypass: Your surgeon will redirect the path to your heart. It will go around the blocked or narrowed areas. The new path will allow blood and oxygen to get through.
  • Percutaneous coronary intervention (PCI): Your surgeon will insert and inflate a tiny balloon to fix your vessels. It will push back the plaque to allow blood and oxygen to pass through. They also might need to replace a part of your vessel. They can use tissue from another part of your body or a stent. This is a small, tube-shaped medical device. It provides support to keep your arteries open.

There are different approaches for heart surgery. Minimally invasive involves small cuts in your chest, between ribs. Open-heart requires a large cut in your chest to open your rib cage. Surgery can be done off-pump, where your heart beats on its own. Or your surgeon can use a heart-lung bypass machine to pump for your heart.

One other type of treatment is cardiac rehabilitation. Your doctor can prescribe this instead of or in addition to surgery. Cardiac rehab focuses on education and exercise. It also can include counseling to help you handle stress or emotions.

Living with coronary heart disease

Finding coronary heart disease early can help prevent it from getting worse. If left untreated, you could have a heart attack or get arrhythmias (irregular heartbeats). CHD also damage your heart to the point of death. Proper diagnosis and treatment help you for the future. This allows you to correct it with lifestyle changes and manage it with medicine or surgery. Surgery has various recovery timeframes.

Talk to your doctor about your specific outcomes and goals. You likely will need ongoing monitoring with doctor visits and tests. CHD does increase your risk for a heart attack. Make sure you know the warning signs and when to call 911.

Questions to ask your doctor

  • How severe is my CHD?
  • What can I do to prevent my disease from getting worse?
  • How do I know if I’m having a heart attack or stroke?
  • If I have a heart attack, am I at risk for a second one?