NIH - Medical Encyclopedia Coronary heart disease

"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. Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and a substance called plaque builds up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms. Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. … 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.

There are two main types of chest pain:

• Atypical chest pain -- often sharp and comes and goes. You can feel it in your left chest, abdomen, back, or arm. It is unrelated to exercise and not relieved by rest or a medicine called nitroglycerin. Atypical chest pain is more common in women.

• Typical chest pain -- feels heavy or like someone is squeezing you. You feel it under your breast bone (sternum). The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin. Adults with typical chest pain have a higher risk of CHD than those with atypical chest pain.

Other symptoms include: • Shortness of breath • Heart attack -- in some cases, the first sign of CHD is a heart attack…

Tips for preventing CHD or lowering your risk of the disease: • Avoid or reduce stress as best as you can. • Don't smoke. • Eat well-balanced meals that are low in fat and cholesterol and include several daily servings of fruits and vegetables. • Get regular exercise. If your weight is considered normal, get at least 30 minutes of exercise every day. If you are overweight or obese, experts say you should get 60 to 90 minutes of exercise every day. • Keep your blood pressure, blood sugar, and cholesterol under control"

Highlighted Articles

[Heart disease and stroke] (Tidsskr Nor Laegeforen. 2007)

"Most cases of heart disease and stroke are caused by atherosclerosis, and the two diseases have much in common with regards to risk factors, treatment and prognosis. Heart disease may also be a direct cause of stroke. About one in four cerebral infarctions are due to embolism from the heart to the brain, mainly because of atrial fibrillation, but also because of diseases such as acute myocardial infarction, dilated cardiomyopathy and prosthetic heart valves (cardioembolic stroke). Stroke can also be caused by a cardiogenic fall in blood pressure in patients with stenoses in pre- or intracerebral arteries (haemodynamic stroke). Patients with symptoms of atherosclerosis in one artery system should be treated as if they have a high risk of developing symptoms from other artery systems. The possibility of a cardiac embolic source should always be considered in patients with acute brain infarctions."

Optimal Medical Therapy with or without PCI for Stable Coronary Disease (NEJM 2007)

"Background In patients with stable coronary artery disease, it remains unclear whether an initial management strategy of percutaneous coronary intervention (PCI) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) is superior to optimal medical therapy alone in reducing the risk of cardiovascular events. … Conclusions As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy."