Christie Clinic - Medicine for Your Life

Our website is currently having technical difficulties. To view the site, please click here

Health Encyclopedia

Health Encyclopedia

An invaluable resource of health information.

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.

See also:

  • Alternative Names

    Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD

  • Causes, incidence, and risk factors

    Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and a substance called plaque build 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. This can cause 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.

    Many things increase your risk for heart disease:

    • Men in their 40s have a higher risk of CHD than women. But as women get older (especially after they reach menopause), their risk increases to almost equal that of a man's risk. See: Heart disease and women
    • Bad genes (heredity) can increase your risk. You are more likely to develop the condition if someone in your family has had a history of heart disease -- especially if they had it before age 50. Your risk for CHD goes up the older you get.
    • Diabetes is a strong risk factor for heart disease.
    • High blood pressure increases your risk of coronary artery disease and heart failure.
    • Abnormal cholesterol levels: your LDL ("bad") cholesterol should be as low as possible, and your HDL ("good") cholesterol should be as high as possible.
    • Metabolic syndrome refers to high triglyceride levels, high blood pressure, excess body fat around the waist, and increased insulin levels. People with this group of problems have an increased chance of getting heart disease.
    • Smokers have a much higher risk of heart disease than nonsmokers.
    • Chronic kidney disease can increase your risk.
    • Already having atherosclerosis or hardening of the arteries in another part of your body (examples are stroke and abdominal aortic aneurysm) increases your risk of having coronary heart disease.
    • Other risk factors including alcohol abuse, not getting enough exercise, and excessive amounts of stress.

    Higher-than-normal levels of inflammation-related substances, such as C-reactive protein and fibrinogen are being studied as possible indicators of an increased risk for heart disease.

    Increased levels of a chemical called homocysteine, an amino acid, are also linked to an increased risk of a heart attack.

  • Symptoms

    Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms.

    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.

    • It may feel heavy or like someone is squeezing your heart. You feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.
    • The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
    • Other symptoms include shortness of breath and fatigue with activity (exertion).

    See: Heart failure for symptoms of heart failure

  • Signs and tests

    Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a definite 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 those who have coronary artery disease are:

    • LDL cholesterol level less than or equal to 100 mg/dL
    • Glycosylated hemoglobin (HbA1c) levels less than or equal to 7%
    • Blood pressure less than or equal to 120/80 mmHg

    Taking aspirin with or without clopidogrel (Plavix) helps prevent blood clots from forming in your arteries and reduces your risk of having a heart attack. Ask your doctor if you should be taking these.

    Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat CHD, including:

    • ACE inhibitors to lower blood pressure and protect your heart
    • Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
    • Calcium channel blockers to relax arteries, lowering blood pressure and reducing strain on the heart
    • Diuretics to lower blood pressure and treat congestive heart failure
    • Nitrates (such as nitroglycerin) to stop chest pain and improve blood supply to the heart
    • Statins to lower cholesterol

    NEVER ABRUPTLY STOP TAKING ANY OF THESE DRUGS. Always talk to your doctor first. Stopping these drugs suddenly can make your angina worse or cause a heart attack.

    Procedures and surgeries used to treat CHD include:

    Lifestyle changes are very important. Your doctor may tell you to:

    • Avoid or reduce the amount of salt (sodium) you eat
    • Eat a heart healthy diet -- one that is low in saturated fats, cholesterol, and trans fat
    • Get regular exercise and maintain a healthy weight
    • Keep your blood sugar strictly under control if you have diabetes
    • Stop smoking

    See also: Healthy heart diet

  • Expectations (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.

  • Complications
  • Calling your health care provider

    If you have any of the 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:

    • Angina
    • Shortness of breath
    • Symptoms of a heart attack
  • Prevention

    See your health care provider regularly.

    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 - 90 minutes of exercise every day.
    • Keep your blood pressure below 130/80 mmHg if you have diabetes or chronic kidney disease, and below 140/90 otherwise
    • Keep your cholesterol and blood sugar under control.

    Moderate amounts of alcohol (one glass a day for women, two for men) may reduce your risk of cardiovascular problems. However, drinking larger amounts does more harm than good.

    If you have one or more risk factors for coronary heart disease, talk to your doctor about possibly taking an aspirin a day to help prevent a heart attack or stroke. You may be prescribed low-dose aspirin therapy if the benefit is likely to outweigh the risk of gastrointestinal side effects.

    New guidelines no longer recommend hormone replacement therapy, vitamins E or C, antioxidants, or folic acid to prevent heart disease. The use of hormone replacement therapy in women who are close to menopause or who have finished menopause is controversial at this time.

  • References

    Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007; Published online before print February 19, 2007.

    Smith SC Jr, Allen J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006 May 16;113(19):2363-72. Erratum in: Circulation. 2006 Jun 6;113(22):e847.

    Morrow DA, Gersh BJ. Chronic coronary artery disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 54.

    Boden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007 Mar 26; [Epub ahead of print].

    U.S. Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150:396-404.

Review Date: 4/23/2009

Reviewed By: Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., 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. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2014 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
Christie Clinic at the Family Medical Center in Paris
727 East Court Street Paris, IL 61944 Dermatology: 366-1248; Vein and Vascular: 366-2670
Christie Clinic Christie Clinic on University Photo Christie Clinic on University
101 West University Avenue Champaign, IL 61820 Main Phone: (217) 366-1200
Billing Services: (217) 366-1382
Toll Free: (888) 391-0412
Christie Clinic Christie Clinic on Windsor/Convenient Care Photo Christie Clinic on Windsor/Convenient Care
1801 West Windsor Road Champaign, IL 61822 (217) 366-8000
Christie Clinic Christie Clinic at Presence Covenant Photo Christie Clinic at Presence Covenant
1400 West Park Street Urbana, IL 61801 (217) 366-1200
Christie Clinic Christie Clinic in Rantoul Photo Christie Clinic in Rantoul
209 West Borman Drive Rantoul, IL 61866 (217) 892-9671
Christie Clinic Christie Clinic in Mahomet/Convenient Care Photo Christie Clinic in Mahomet/Convenient Care
1001 Commercial Drive Mahomet, IL 61853 Main Number: (217) 586-6600 Convenient Care: (217)366-8130
Christie Clinic Christie Clinic in Tuscola Photo Christie Clinic in Tuscola
300 North Main Street Tuscola, IL 61953 (217) 253-9258
Christie Clinic CU Sleep Photo CU Sleep
1207 South Mattis Avenue Champaign, IL 61821 (217) 355-1684
Christie Clinic Christie Clinic Cancer Center Photo Christie Clinic Cancer Center
109 West University Avenue Champaign, IL 61820 (217) 366-5180
Christie Clinic Convenient Care in County Market (Kirby & Duncan) Photo Convenient Care in County Market (Kirby & Duncan)
2901 West Kirby Avenue Champaign, IL 61821 (217) 366-8130
Christie Clinic Christie Clinic in Urbana/Convenient Care Photo Christie Clinic in Urbana/Convenient Care
1710 East Windsor Road Urbana, IL 61802 (217) 344-9440
Christie Clinic Christie Clinic in Danville on Logan Photo Christie Clinic in Danville on Logan
800 North Logan Avenue Danville, IL 61832 (217) 431-8930
Christie Clinic Christie Clinic on Fox Drive Photo Christie Clinic on Fox Drive
2110 Fox Drive, Suite B Champaign, IL 61820
Christie Clinic Christie Clinic in Monticello at Kirby Medical Group Specialty Clinic Photo Christie Clinic in Monticello at Kirby Medical Group Specialty Clinic
1109 B North State Street Monticello, IL 61856 (217) 366-1304
Gibson Area Hospital
1120 N Melvin Gibson City, IL 60936 (217) 784-2240
Christie Clinic Christie Clinic in Mattoon Photo Christie Clinic in Mattoon
105 B Professional Plaza Mattoon, IL 61938 (217) 345-3000
Christie Clinic Sarah Bush Lincoln Health System Photo Sarah Bush Lincoln Health System
1000 Health Center Drive Mattoon, IL 61938 (217) 258-2588
Christie Clinic The Champaign SurgiCenter Photo The Champaign SurgiCenter
1702 S. Mattis Avenue Champaign, IL 61821 (217) 326-2030
Christie Clinic The Carle Foundation Hospital Photo The Carle Foundation Hospital
611 West Park Street Urbana, IL 61801 (217) 383-3311
Iroquois Memorial Hospital
200 E. Fairman Ave. Watseka, IL 60970 (815) 432-5841
Christie Clinic Christie Clinic in Savoy Photo Christie Clinic in Savoy
501 North Dunlap Avenue Savoy, IL 61874 Transformations: (217) 366-7460 Internal Medicine: (217) 366-5434 Ophthalmology: (217) 366-1250
Christie Clinic on West Park Street
1405 West Park Street Urbana, IL 61801 217-366-1237
Christie Clinic in Monticello
107 West Main Street Monticello, IL 61856 217.762.3352
Christie Clinic Christie Clinic in Decatur Photo Christie Clinic in Decatur
100 South Water Street Suite 103 Decatur, IL 62523 217-362-0661- telephone
Christie Clinic Christie Clinic in Danville on Vermilion/Convenient Care Photo Christie Clinic in Danville on Vermilion/Convenient Care
3545 North Vermilion Street Danville, IL 61832 (217) 442-8611