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Coronary heart disease

Definition

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease.

Alternative Names

Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD

Causes

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.

Coronary heart disease is caused by the buildup of plaque in the arteries to your heart. This may also be called hardening of the arteries.

A risk factor for heart disease is something that increases your chance of getting it. You cannot change some risk factors for heart disease, but others you can change. See: Heart disease - risk factors

Symptoms

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms. This is especially true in the early stages of heart disease.

Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as:

Exams and Tests

Your doctor or nurse will examine you. Your doctor will often order more than one test before making a diagnosis.

Tests may include:

Treatment

You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor's directions closely to help prevent coronary artery disease from getting worse.

Goals for treating these conditions in people who have coronary artery disease:

Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat heart disease, blood pressure, diabetes, or high cholesterol. Follow your doctor's directions closely to help prevent coronary artery disease from getting worse.

Never stop taking your medicines without talking to your doctor first. Stopping heart medicines suddenly can make your angina worse or cause a heart attack.

Your doctor may refer you to a cardiac rehabilitation program to help improve your heart's fitness.

Procedures and surgeries used to treat CHD include:

Outlook (Prognosis)

Everyone recovers differently. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications exactly as the doctor prescribes. Others may need medical procedures such as angioplasty or surgery.

Although everyone is different, early detection of CHD generally results in a better outcome.

When to Contact a Medical Professional

If you have any risk factors for CHD, contact your doctor to discuss prevention and possible treatment.

Immediately contact your health care provider, call the local emergency number (such as 911), or go to the emergency room if you have:

References

Gaziano JM, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P,eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 49.

Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Forceon Practice Guidelines. Circulation. 2010;122(25)e584-e636.

Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 70.

Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women--2011 Update:a guideline from the American Heart Association. Circulation.2011;123(11);1243-1262.



Review Date: 6/22/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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