Question: What is (are) Coronary Heart Disease ?
Answer: Espaol Coronary heart disease (CHD) is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle. When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years. Atherosclerosis Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. Over time, ruptured plaque also hardens and narrows the coronary arteries. Overview If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina or a heart attack can occur. Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isnt restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious health problems or death. Over time, CHD can weaken the heart muscle and lead to heart failure and arrhythmias. Heart failure is a condition in which your heart can't pump enough blood to meet your bodys needs. Arrhythmias are problems with the rate or rhythm of the heartbeat. Outlook Lifestyle changes, medicines, and medical procedures can help prevent or treat coronary heart disease. These treatments may reduce the risk of related health problems.
Source: NHLBI

Question: What causes Coronary Heart Disease ?
Answer: Research suggests that coronary heart disease (CHD) starts when certain factors damage the inner layers of the coronary arteries. These factors include: Smoking High levels of certain fats and cholesterol in the blood High blood pressure High levels of sugar in the blood due to insulin resistance or diabetes Blood vessel inflammation Plaque might begin to build up where the arteries are damaged. The buildup of plaque in the coronary arteries may start in childhood. Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause angina (chest pain or discomfort). If the plaque ruptures, blood cell fragments called platelets (PLATE-lets) stick to the site of the injury. They may clump together to form blood clots. Blood clots can further narrow the coronary arteries and worsen angina. If a clot becomes large enough, it can mostly or completely block a coronary artery and cause a heart attack.
Source: NHLBI

Question: Who is at risk for Coronary Heart Disease? ?
Answer: In the United States, coronary heart disease (CHD) is a leading cause of death for both men and women. Each year, about 370,000 Americans die from coronary heart disease. Certain traits, conditions, or habits may raise your risk for CHD. The more risk factors you have, the more likely you are to develop the disease. You can control many risk factors, which may help prevent or delay CHD. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called bad cholesterol) and low HDL cholesterol (sometimes called good cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercurythe units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, lead to unhealthy cholesterol levels, and raise blood pressure. Smoking also can limit how much oxygen reaches the body's tissues. Insulin resistance. This condition occurs if the body can't use its own insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used for energy. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms overweight and obesity refer to body weight thats greater than what is considered healthy for a certain height. Metabolic syndrome. Metabolic syndrome is the name for a group of risk factors that raises your risk for CHD and other health problems, such as diabetes and stroke. Lack of physical activity. Being physically inactive can worsen other risk factors for CHD, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight or obesity. Unhealthy diet. An unhealthy diet can raise your risk for CHD. Foods that are high in saturated and trans fats, cholesterol, sodium, and sugar can worsen other risk factors for CHD. Older age. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. In men, the risk for coronary heart disease increases starting at age 45. In women, the risk for coronary heart disease increases starting at age 55. A family history of early coronary heart disease is a risk factor for developing coronary heart disease, specifically if a father or brother is diagnosed before age 55, or a mother or sister is diagnosed before age 65. Although older age and a family history of early heart disease are risk factors, it doesn't mean that youll develop CHD if you have one or both. Controlling other risk factors often can lessen genetic influences and help prevent CHD, even in older adults. Emerging Risk Factors Researchers continue to study other possible risk factors for CHD. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk of CHD and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls may trigger inflammation and help plaque grow. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk of CHD and heart attack. High levels of triglycerides in the blood also may raise the risk of CHD, especially in women. Triglycerides are a type of fat. Other Risks Related to Coronary Heart Disease Other conditions and factors also may contribute to CHD, including: Sleep apnea. Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can increase your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other CHD risk factors. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. Preeclampsia. This condition can occur during pregnancy. The two main signs of preeclampsia are a rise in blood pressure and excess protein in the urine. Preeclampsia is linked to an increased lifetime risk of heart disease, including CHD, heart attack, heart failure, and high blood pressure. For more detailed information, go to the Health Topics Coronary Heart Disease Risk Factors article.
Source: NHLBI

Question: What are the symptoms of Coronary Heart Disease ?
Answer: A common symptom of coronary heart disease (CHD) is angina. Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain. Another common symptom of CHD is shortness of breath. This symptom occurs if CHD causes heart failure. When you have heart failure, your heart can't pump enough blood to meet your bodys needs. Fluid builds up in your lungs, making it hard to breathe. The severity of these symptoms varies. They may get more severe as the buildup of plaque continues to narrow the coronary arteries. Signs and Symptoms of Heart Problems Related to Coronary Heart Disease Some people who have CHD have no signs or symptomsa condition called silent CHD. The disease might not be diagnosed until a person has signs or symptoms of a heart attack, heart failure, or an arrhythmia (an irregular heartbeat). Heart Attack A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. This can happen if an area of plaque in a coronary artery ruptures (breaks open). Blood cell fragments called platelets stick to the site of the injury and may clump together to form blood clots. If a clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isnt treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Heart With Muscle Damage and a Blocked Artery The most common heart attack symptom is chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that often lasts for more than a few minutes or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain. The feeling can be mild or severe. Heart attack pain sometimes feels like indigestion or heartburn. The symptoms of angina can be similar to the symptoms of a heart attack. Angina pain usually lasts for only a few minutes and goes away with rest. Chest pain or discomfort that doesnt go away or changes from its usual pattern (for example, occurs more often or while youre resting) might be a sign of a heart attack. If you dont know whether your chest pain is angina or a heart attack, call 911. All chest pain should be checked by a doctor. Other common signs and symptoms of a heart attack include: Upper body discomfort in one or both arms, the back, neck, jaw, or upper part of the stomach Shortness of breath, which may occur with or before chest discomfort Nausea (feeling sick to your stomach), vomiting, light-headedness or fainting, or breaking out in a cold sweat Sleep problems, fatigue (tiredness), or lack of energy For more information, go to the Health Topics Heart Attack article. Heart Failure Heart failure is a condition in which your heart can't pump enough blood to meet your bodys needs. Heart failure doesn't mean that your heart has stopped or is about to stop working. The most common signs and symptoms of heart failure are shortness of breath or trouble breathing; fatigue; and swelling in the ankles, feet, legs, stomach, and veins in the neck. All of these symptoms are the result of fluid buildup in your body. When symptoms start, you may feel tired and short of breath after routine physical effort, like climbing stairs. For more information, go to the Health Topics Heart Failure article. Arrhythmia An arrhythmia is a problem with the rate or rhythm of the heartbeat. When you have an arrhythmia, you may notice that your heart is skipping beats or beating too fast. Some people describe arrhythmias as a fluttering feeling in the chest. These feelings are called palpitations (pal-pih-TA-shuns). Some arrhythmias can cause your heart to suddenly stop beating. This condition is called sudden cardiac arrest (SCA). SCA usually causes death if it's not treated within minutes. For more information, go to the Health Topics Arrhythmia article.
Source: NHLBI

Question: How to diagnose Coronary Heart Disease ?
Answer: Your doctor will diagnose coronary heart disease (CHD) based on your medical and family histories, your risk factors for CHD, a physical exam, and the results from tests and procedures. No single test can diagnose CHD. If your doctor thinks you have CHD, he or she may recommend one or more of the following tests. EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can show signs of heart damage due to CHD and signs of a previous or current heart attack. Stress Testing During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to raise your heart rate. When your heart is working hard and beating fast, it needs more blood and oxygen. Plaque-narrowed arteries can't supply enough oxygen-rich blood to meet your heart's needs. A stress test can show possible signs and symptoms of CHD, such as: Abnormal changes in your heart rate or blood pressure Shortness of breath or chest pain Abnormal changes in your heart rhythm or your heart's electrical activity If you can't exercise for as long as what is considered normal for someone your age, your heart may not be getting enough oxygen-rich blood. However, other factors also can prevent you from exercising long enough (for example, lung diseases, anemia, or poor general fitness). As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in your heart and how well your heart pumps blood when it beats. Echocardiography Echocardiography(echo) uses sound waves to create a moving picture of your heart. The picture shows the size and shape of your heart and how well your heart chambers and valves are working. Echo also can show areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow. Chest X Ray A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure, as well as lung disorders and other causes of symptoms not related to CHD. Blood Tests Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels might be a sign that you're at risk for CHD. Coronary Angiography and Cardiac Catheterization Your doctor may recommend coronary angiography (an-jee-OG-rah-fee) if other tests or factors show that you're likely to have CHD. This test uses dye and special x rays to show the insides of your coronary arteries. To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-shun). A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream. Special x rays are taken while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels. Cardiac catheterization usually is done in a hospital. You're awake during the procedure. It usually causes little or no pain, although you may feel some soreness in the blood vessel where your doctor inserts the catheter.
Source: NHLBI

Question: What are the treatments for Coronary Heart Disease ?
Answer: Treatments for coronary heart disease include heart-healthy lifestyle changes, medicines, medical procedures and surgery, and cardiac rehabilitation. Treatment goals may include: Lowering the risk of blood clots forming (blood clots can cause a heart attack) Preventing complications of coronary heart disease Reducing risk factors in an effort to slow, stop, or reverse the buildup of plaque Relieving symptoms Widening or bypassing clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have coronary heart disease. Heart-healthy lifestyle changes include: Heart-healthy eating Maintaining a healthy weight Managing stress Physical activity Quitting smoking Heart-Healthy Eating Your doctor may recommend heart-healthy eating, which should include: Fat-free or low-fat dairy products, such as fat-free milk Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week Fruits, such as apples, bananas, oranges, pears, and prunes Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Vegetables, such as broccoli, cabbage, and carrots Whole grains, such as oatmeal, brown rice, and corn tortillas When following a heart-healthy diet, you should avoid eating: A lot of red meat Palm and coconut oils Sugary foods and beverages Two nutrients in your diet make blood cholesterol levels rise: Saturated fatfound mostly in foods that come from animals Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats andmeats. Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples: 1,200 calories a day 8 grams of saturated fat a day 1,500 calories a day 10 grams of saturated fat a day 1,800 calories a day 12 grams of saturated fat a day 2,000 calories a day 13 grams of saturated fat a day 2,500 calories a day 17 grams of saturated fat a day Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are: Avocados Corn, sunflower, and soybean oils Nuts and seeds, such as walnuts Olive, canola, peanut, safflower, and sesame oils Peanut butter Salmon and trout Tofu Sodium You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more. Dietary Approaches to Stop Hypertension Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt. The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH. Alcohol Try to limit alcohol intake. Too much alcohol canraise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is: 12 ounces of beer 5 ounces of wine 1 ounces of liquor Maintaining a Healthy Weight Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active. Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes (NHLBI) online BMI calculator or talk to your doctor. A BMI: Below 18.5 is a sign that you are underweight. Between 18.5 and 24.9 is in the normal range. Between 25 and 29.9 is considered overweight. Of 30 or more is considered obese. A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal. Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. Managing Stress Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as: A stress management program Meditation Physical activity Relaxation therapy Talking things out with friends or family Physical Activity Routine physical activity can lower many coronary heart disease risk factors, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent coronary heart disease. Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week. Read more about physical activity at: Physical Activity and Your Heart U.S. Department of Health and Human Services 2008 Physical Activity Guidelines forAmericans Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you. Quitting Smoking If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Read more about quitting smoking at Smoking and Your Heart. Medicines Sometimes lifestyle changes arent enough to control your blood cholesterol levels. For example, you may need statin medications to control or lower your cholesterol. By lowering your cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have: Coronary heart disease, peripheral artery disease, or had a stroke Diabetes High LDL cholesterol levels Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke. Your doctor also may prescribe other medications to: Decrease your chance of having a heart attack or dying suddenly. Lower your blood pressure. Prevent blood clots, which can lead to heart attack or stroke. Prevent or delay the need for a stent or percutaneous coronary intervention (PCI) or surgery, such as coronary artery bypass grafting (CABG). Reduce your hearts workload and relieve coronary heart disease symptoms. Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart healthy lifestyle, even if you take medicines to treat your coronary heart disease. Medical Procedures and Surgery You may need a procedure or surgery to treat coronary heart disease. Both PCIand CABG are used to treat blocked coronary arteries. You and your doctor can discuss which treatment is right for you. Percutaneous Coronary Intervention Percutaneous coronary intervention, commonly known as angioplasty, is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to compress the plaque against the wall of the artery. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery. The stent helps prevent blockages in the artery in the months or years after angioplasty. Read more about this procedure at PCI. Coronary Artery Bypass Grafting CABG is a type of surgery in which arteries or veins from other areas in your body are used to bypass (that is, go around) your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Read more about this surgery at CABG. Cardiac Rehabilitation Your doctor may prescribe cardiac rehabilitation (rehab) for angina or after CABG, angioplasty, or a heart attack. Nearly everyone who has coronary heart disease can benefit from cardiac rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems. The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists. Rehab has two parts: Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk for future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and how to deal with your fears about the future. Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests. Read more about this therapy at Cardiac Rehabilitation.
Source: NHLBI

Question: How to prevent Coronary Heart Disease ?
Answer: You can prevent and control coronary heart disease (CHD)by taking action to control your risk factors with heart-healthy lifestyle changes and medicines. Examples of risk factors you can control include high blood cholesterol, high blood pressure, and overweight and obesity. Only a few risk factorssuch as age, gender, and family historycant be controlled. Your risk for CHD increases with the number of risk factors you have. To reduce your risk of CHD and heart attack, try to control each risk factor you have by adopting the following heart-healthy lifestyles: Heart-healthy eating Maintaining a healthy weight Managing stress Physical activity Quitting smoking Know your family history of health problems related to CHD. If you or someone in your family has CHD, be sure to tell your doctor. If lifestyle changes aren't enough, you also may need medicines to control your CHD risk factors.
Source: NHLBI