CORONARY HEART DISEASE
Many of these deaths could be prevented because CHD is related to certain aspects of lifestyle. Risk factors for CHD include high blood pressure, high blood cholesterol, smoking, obesity, and physical inactivity--all of which can be controlled. Although medical treatments for heart disease have come a long way, controlling risk factors remains the key to preventing illness and death from CHD.
What is CHD?
Like any muscle, the heart needs a constant supply of oxygen
and nutrients that are carried to it by the blood in the coronary
arteries. When the coronary arteries become narrowed or clogged
and cannot supply enough blood to the heart, the result is CHD.
If not enough oxygen-carrying blood reaches the heart, the heart
may respond with pain called angina. The pain is usually felt
in the chest or sometimes in the left arm and shoulder. (However,
the same inadequate blood supply may cause no symptoms, a condition
called silent angina.)
When the blood supply is cut off completely, the result is a
heart attack. The part of the heart that does not receive oxygen
begins to die, and some of the heart muscle may be permanently
damaged.
What Causes CHD?
CHD is caused by a thickening of the inside walls of the coronary arteries. This thickening, called atherosclerosis, narrows the space through which blood can flow, decreasing and sometimes completely cutting off the supply of oxygen and nutrients to the heart.
Atherosclerosis usually occurs when a person has high levels of cholesterol, a fat-like substance, in the blood. Cholesterol and fat, circulating in the blood, build up on the walls of the arteries. The buildup narrows the arteries and can slow or block the flow of blood. When the level of cholesterol in the blood is high, there is a greater chance that it will be deposited onto the artery walls. This process begins in most people during childhood and the teenage years, and worsens as they get older.
In addition to high blood cholesterol, high blood pressure and smoking also contribute to CHD. On the average, each of these doubles your chance of developing heart disease. Therefore, a person who has all three risk factors is eight times more likely to develop heart disease than someone who has none. Obesity and physical inactivity are other factors that can lead to CHD. Overweight increases the likelihood of developing high blood cholesterol and high blood pressure, and physical inactivity increases the risk of heart attack. Regular exercise, good nutrition, and smoking cessation are key to controlling the risk factors for CHD.
What are the Symptoms of CHD?
Chest pain (angina) or shortness of breath may be the earliest signs of CHD. A person may feel heaviness, tightness, pain, burning, pressure, or squeezing, usually behind the breastbone but sometimes also in the arms, neck, or jaws. These signs usually bring the patient to a doctor for the first time. Nevertheless, some people have heart attacks without ever having any of these symptoms.
How is CHD Diagnosed?
There is no one simple test--some or all of the following
procedures may be needed. These diagnostic procedures are used
to establish CHD, to determine its extent and severity, and
to rule out other possible causes of the symptoms.
After taking a careful medical history and doing a physical examination, the doctor may use some tests to see how advanced the CHD is. The only certain way to diagnose and assess the extent of CHD is coronary angiography (see below); other tests can indicate a problem but do not show exactly where it is.
How is CHD Treated?
CHD is treated in a number of ways, depending on the seriousness of the disease. For many people, CHD is managed with lifestyle changes and medications. Others with severe CHD may need surgery. In any case, once CHD develops, it requires lifelong management.
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