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Coronary heart diseaseCoronary 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.

Causes

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

Coronary heart disease is caused by the buildup of pla ue in the arteries to your heart. !his mayalso be called hardening of the arteries .

• "atty material and other substances form a pla ue build#up on the walls of your coronaryarteries. !he coronary arteries bring blood and oxygen to your heart.

• !his buildup causes the arteries to get narrow.

• $s a result% blood flow to the heart can slow down or stop.

&atch this video about' Coronary artery disease

$ ris factor for heart disease is something that increases your chance of getting it. ou cannotchange some ris factors for heart disease% but others you can change. See' Heart disease # risfactors

Symptoms

Symptoms may be very noticeable% but sometimes you can have the disease and not have anysymptoms. !his is especially true in the early stages of heart disease.

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

• *t may feel heavy or li e someone is s uee+ing your heart. ou may feel it under your breast bone (sternum)% but also in your nec % arms% stomach% or upper bac .

• !he pain usually occurs with activity or emotion% and goes away with rest or a medicinecalled nitroglycerin.

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• ,ther symptoms include shortness of breath and fatigue with activity (exertion).

&omen% elderly people% and people with diabetes are more li ely to have symptoms other thanchest pain% such as'

• "atigue

• Shortness of breath

• -eneral wea ness

Exams and Tests

our doctor or nurse will examine you. our doctor will often order more than one test beforema ing a diagnosis.

!ests may include'

• Coronary angiography ## an invasive test that evaluates the heart arteries under x#ray

• chocardiogram stress test

• lectrocardiogram ( C-)

• lectron#beam computed tomography ( /C!) to loo for calcium in the lining of thearteries ## the more calcium% the higher your chance for CHD

• xercise stress test

• Heart C! scan

• 0uclear stress test

Treatment

ou may be as ed to ta e one or more medicines to treat blood pressure% diabetes% or highcholesterol levels. "ollow your doctor1s directions closely to help prevent coronary artery diseasefrom getting worse.

-oals for treating these conditions in people who have coronary artery disease'

• /lood pressure less than or e ual to 234564 (even lower for patients with diabetes% idneydisease% or heart failure)

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• Hb$2c levels if you have diabetes at a level recommended by your doctor

• 7D7 cholesterol level less than or e ual to 244 mg5d7 (even lower for some patients)

!reatment depends on your symptoms and how severe the disease is. our doctor may give you

one or more medicines to treat heart disease% blood pressure% diabetes% or high cholesterol."ollow your doctor1s directions closely to help prevent coronary artery disease from gettingworse.

0ever stop ta ing your medicines without tal ing to your doctor first. Stopping heart medicinessuddenly can ma e your angina worse or cause a heart attac .

our doctor may refer you to a cardiac rehabilitation program to help improve your heart1sfitness.

8rocedures and surgeries used to treat CHD include'

• $ngioplasty and stent placement % called percutaneous coronary interventions (8C*s)

• Coronary artery bypass surgery

• 9inimally invasive heart surgery

Outlook (Prognosis)

veryone recovers differently. Some people can maintain a healthy life by changing their diet%

stopping smo ing% and ta ing medications exactly as the doctor prescribes. ,thers may needmedical procedures such as angioplasty or surgery.

$lthough everyone is different% early detection of CHD generally results in a better outcome.

When to Contact a Medical Professional

*f you have any ris factors for CHD% contact your doctor to discuss prevention and possibletreatment.

*mmediately contact your health care provider% call the local emergency number (such as 622)% or go to the emergency room if you have'

• $ngina or chest pain

• Shortness of breath

• Symptoms of a heart attac

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lternati!e "ames

Coronary artery disease: $rteriosclerotic heart disease: CHD: C$D

#eferences-a+iano ;9% <id er 89% 7ibby 8. 8rimary and secondary prevention of coronary heart disease.*n' /onow <,% 9ann D7% =ipes D8% 7ibby 8%eds. Braunwald's Heart Disease: A Textbook ofCardiovascular Medicine . 6th ed. 8hiladelphia% 8a' Saunders lsevier: >422'chap 36.

-reenland 8% $lpert ;S% /eller -$% et al. >424 $CC"5$H$ guideline for assessment ofcardiovascular ris in asymptomatic adults' a report of the $merican College of Cardiology"oundation5$merican Heart $ssociation !as "orceon 8ractice -uidelines. Circulation .>424:2>>(>?)e?@3#eABA.

Hansson - % Hamsten $. $therosclerosis% thrombosis% and vascular biology. *n' -oldman 7%Schafer $*% eds. Cecil 9edicine. >3th ed. 8hiladelphia% 8$' Saunders lsevier: >422'chap 4.

9osca 7% /enEamin ;% /erra % et al. ffectiveness#/ased -uidelines for the 8revention ofCardiovascular Disease in &omen##>422 Update'a guideline from the $merican Heart$ssociation. Circulation .>422:2>B(22):2>3B#2>A>.

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