What is coronary heart disease?

Coronary heart disease happens when the innermost layer of the coronary arteries becomes inflamed and narrowed. This is caused by a buildup of fatty deposits called plaque. These deposits may start in childhood and continue to thicken and enlarge throughout life. This thickening is called atherosclerosis. It can reduce or block blood flow to the heart. A blood clot may also form on top of the plaque. Either of these can lead to a heart attack and even death.

The coronary arteries supply blood to the heart muscle (myocardium). Like all other tissues in the body, the heart muscle needs oxygen-rich blood to work, and oxygen-depleted blood must be carried away. The coronary arteries run along the outside of the heart. They have small branches that supply blood to the heart muscle. The 2 main coronary arteries are the left main and right coronary arteries.

Coronary heart disease is also called coronary artery disease.

What causes coronary heart disease?

The most common cause of coronary heart disease is atherosclerosis. That’s when the inner lining of an artery becomes inflamed and builds up with plaque. It causes the artery to narrow or become blocked.

Who is at risk for coronary heart disease?

You may be at risk for coronary heart disease if you:

• Smoke.

• Have high LDL cholesterol, high triglyceride levels, and low HDL cholesterol.

• Have high blood pressure.

• Are not physically active.

• Are obese or overweight.

• Eat a diet high in saturated fat.

• Have diabetes.

• Have a family history of heart disease.

What are the symptoms of coronary heart disease?

The symptoms of coronary heart disease will depend on the severity of the disease. Some people have no symptoms. Others have episodes of mild chest pain (angina) when they are active. Some people have more severe chest pain even at rest.

If too little oxygen-richblood reaches the heart, you may have angina. When the blood supply is completely cut off, the result is a heart attack. The heart muscle starts to die. Some people may have a heart attack and never notice the symptoms. This is called a "silent" heart attack.

The symptoms of coronary heart disease include:

• Heaviness, tightness, pressure, burning, or pain in the chest behind the breastbone.

• Pain spreading to the arms, shoulders, jaw, neck, or back.

• Shortness of breath.

• Weakness and severe tiredness (fatigue) especially during periods of activity.

• Nausea.

• Too much sweating

• Chest pain that eases with rest.

• Chest pain that happens even at rest.

• Dizziness or feeling lightheaded.

Fainting (syncope) may be a symptom of a heart attack in older adults.

The symptoms of coronary heart disease may look like other health problems. Always see your health care provider for a diagnosis.

How is coronary heart disease diagnosed?

Your health care provider will ask about your health history and do a physical exam. You may also need these tests:

How is coronary heart disease treated? 

Treatment for coronary heart disease may include:

What are possible problems caused by coronary heart disease?

Problems caused by coronary heart disease include:

• Heart attack.

• Heart failure.

• Abnormal heart rhythms.

• Death.

How can I help prevent coronary heart disease?

You can help prevent coronary heart disease by controlling your risk factors. These include:

• Not smoking.

• Exercising regularly.

• Eating a heart-healthy diet.

• Maintaining a healthy weight.

• Managing stress.

• Keeping your cholesterol, blood sugar, and blood pressure in a healthy range.

Key points about coronary heart disease

• Coronary heart disease is when the innermost layer of the coronary arteries become inflamed and narrowed from a buildup of plaque, or fatty deposits.

• The main cause is atherosclerosis. It can reduce or block the flow of blood to the heart.

• Unhealthy lifestyle habits raise the risk for this disease. These include smoking and not being physically active.

• High blood pressure, diabetes, and high cholesterol can also raise the risk for it.

• Coronary heart disease runs in families.

• Symptoms include chest pain and shortness of breath.

• Treatment includes medicines that lower blood pressure, control diabetes, and lower cholesterol. Procedures may also be done to open the coronary arteries, letting blood flow to the heart.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• If you can, bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when you should report them to your health care provider.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is advised and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.