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Coronary heart disease

Date: 14 Oct 2013
By: admin_campbell
Comment: 0




NHS Choices Syndication


Coronary heart disease

'I felt like I'd been kicked in the chest'

A quick diagnosis and emergency treatment saved Lynn Connor’s life. She shares her story:

“I’d just got back from holiday in Cyprus and was feeling on top of the world. I had given all the grandchildren their presents when I suddenly felt like I was being kicked in the chest by a horse. I knew I had to get to a doctor quickly.

“My GP knew immediately I was having a heart attack and called an ambulance. I was lucky that I was given lifesaving, clot-busting drugs by the paramedics on the way to the hospital. That same night I was given an angioplasty, where a sort of balloon is put into your coronary artery to open it up. Five stents [which are like a stainless steel mesh] were then inserted to hold the artery open.

“Nobody knows what caused the attack, but my dad died of one when he was 66. Some people say it was because I smoked 20 cigarettes a day for 40 years. It could have been stress – my granddaughter had been diagnosed with cancer the same year. I believe it was probably a combination of things.

“After the operation, walking just 10 yards would totally wipe me out. Even eating was exhausting. But after a while I went on a cardiac rehabilitation programme. It starts off very gently. First I did warm-up exercises, then I progressed to step-ups and the cycling machine, until finally I could go on the treadmill. I couldn’t have done any of this without the help of my cardiac nurse, Lou, who was brilliant and very reassuring.

“I’ve always eaten a pretty healthy diet, but now I exercise more than I used to. I love swimming and I try to go every day, and I’ve given up smoking.

“I feel incredibly happy that I’m alive. Everyone else I’ve known who had a heart attack has died, but now I know that there can be life after a heart attack.”

Published Date
2013-05-23 10:02:11Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Coronary heart disease,Healthy eating






NHS Choices Syndication


Coronary heart disease

'I try to go to the gym once or twice a week for a workout'

Actor Rudolph Walker, 65, is a far cry from Patrick Trueman, the rum-swilling, fry-up-eating character he plays in EastEnders. In real life, he takes great care to ensure his heart stays in tip-top condition.

Rudolph’s star tips for a healthy heart:

1. Eat well

“I eat lots of fish and fresh vegetables, and only occasionally have red meat. I resist the temptation of the stodgy food on the EastEnders set by bringing in my own meals, such as vegetable soup.”

2. Get active

“I love playing tennis and cricket. But I don’t always get the chance, so I try to go to the gym once or twice a week for a cardiovascular workout on the running machine.”

3. Stop smoking

“I’m lucky – I’ve never smoked, even as a young man. I know it is hard for people to give up, but it is so important.”

4. Go easy on the alcohol

“I hardly drink – just the odd glass of wine. Drinking is fine, but only in moderation.”

5. Get checked out

“Every man over the age of 50 should have regular check-ups. I have one every six months to make sure everything is in working order, particularly my blood pressure and cholesterol levels.”

 

Published Date
2013-05-23 10:04:49Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Coronary heart disease,Getting active,Heart






NHS Choices Syndication


Coronary heart disease

'My heart was racing… the pain was awful'

After a heart attack, 36-year-old Debbie Siddons was too scared to pick up her 18-month-old baby. Rehabilitation helped her move on with her life.

It was the usual rush in the Siddons household as Debbie raced around getting her four children ready for school. But as she strode into the living room to summon her eldest, she was suddenly stopped in her tracks by a sharp pain in her chest.

“My heart was racing, the pain was awful and I had pins and needles in my lower jaw and down both arms,” she says. “I sat down on the sofa hoping the pain would stop, but it didn’t. I knew something was very wrong. I was on my own with the kids, so I got my eldest to bring me the phone. I called my mother-in-law and my father and told them I didn’t feel very well. My dad was over in 10 minutes. He took one look at me and called an ambulance.”

In the ambulance, paramedics gave Debbie an electrocardiogram (ECG) to test the electrical activity in her heart. She was then given an aspirin to chew. Once she got to the hospital, doctors gave her a drug to dissolve any clots in her blood that might have caused the heart attack.

“I knew it was serious, but I didn’t guess how serious,” she remembers. “When I got to the hospital, it was madness. Everyone was rushing around, hooking me up to machines. It didn’t take the doctor long to tell me I’d suffered a heart attack. It didn’t quite sink in until my mother-in-law got to the hospital and I had to tell her what had happened to me.”

Debbie stayed in hospital for a week. On the sixth day, she began to experience pins and needles in her left arm. Doctors were concerned that she might be having another heart attack. As a precaution, she was given another ECG and sent for an angiogram, a procedure that checks the arteries for blockages. The angiogram was clear and Debbie didn’t have another attack. The cause of her original attack is still unknown.

Back at home, she realised how much the experience had shaken her. “I was frightened to do anything. I was nervous about going up the stairs, and I was too scared to pick up my 18-month-old daughter in case I had another heart attack,” she says.

“Then I was sent for rehabilitation, which really helped. We learned about healthy eating and exercise, but a big part of it was finding the confidence to carry on with our lives. The nurses reassured me that I could live a perfectly normal life again and they were right. By the end of the six-week course, I’d got my confidence back.”

Two years on, Debbie still takes several drugs every day, including aspirin and a statin, to help prevent another attack. She sees a consultant once a year. But so far she hasn’t had another heart attack. “It was a very frightening experience but I came through it,” she says. “I’d urge anyone who’s had one to make the most of rehabilitation and use all the help they can get. It certainly helped me to move on.”

Published Date
2013-05-23 10:11:33Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Coronary heart disease,Heart attack,Rehabilitation






NHS Choices Syndication


Coronary heart disease

Causes of heart disease

Coronary heart disease (CHD) is usually caused by a build-up of fatty deposits on the walls of the arteries around the heart (coronary arteries).

The fatty deposits, called atheroma, are made up of cholesterol and other waste substances.

The build-up of atheroma on the walls of the coronary arteries makes the arteries narrower and restricts the flow of blood to the heart. This process is called atherosclerosis. Your risk of developing atherosclerosis is significantly increased if you:

Other risk factors for developing atherosclerosis include:

  • being obese or overweight
  • having a family history of CHD – the risk is increased if you have a male relative with CHD under 55 or a female relative under 65

Cholesterol

Cholesterol is a fat made by the liver from the saturated fat that we eat. Cholesterol is essential for healthy cells, but if there is too much in the blood it can lead to CHD.

Cholesterol is carried in the blood stream by molecules called lipoproteins. There are several different types of lipoproteins, but two of the main ones are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL, often referred to as bad cholesterol, takes cholesterol from the liver and delivers it to cells. LDL cholesterol tends to build up on the walls of the coronary arteries, increasing your risk of heart disease.

HDL, often referred to as “good cholesterol”, carries cholesterol away from the cells and back to the liver, where it is broken down or passed from the body as a waste product.

In the UK, the current government recommendation is that you should have a total blood cholesterol level of less than 5mmol/litre, and an LDL cholesterol level of under 3mmol/litre. This should be even lower if you have symptoms of CHD.

Want to know more?

High blood pressure

High blood pressure (hypertension) puts a strain on your heart and can lead to CHD.

Blood pressure is measured at two points during the blood circulation cycle. The systolic pressure is a measure of your blood pressure as the heart contracts and pumps blood out. The diastolic pressure is a measure of your blood pressure when your heart is relaxed and filling up with blood.

Blood pressure is measured in terms of millimetres of mercury (mmHg). When you have your blood pressure measured, the systolic pressure is the first, higher number to be recorded. The diastolic pressure is the second, lower number to be recorded. High blood pressure is defined as a systolic pressure of 140mmHg or more, or a diastolic pressure of 90mmHg or more.

Want to know more?

Smoking

Smoking is a major risk factor. Carbon monoxide (from the smoke) and nicotine both put a strain on the heart by making it work faster. They also increase your risk of blood clots.

Other chemicals in cigarette smoke damage the lining of your coronary arteries, leading to furring of the arteries. If you smoke, you increase your risk of developing heart disease by 24%.

Diabetes

While a high blood sugar level doesn’t directly increase the risk of developing CHD, it may lead to diabetes, which can more than double your risk of developing CHD.

Diabetes can lead to CHD because it may cause the lining of blood vessels to become thicker, which can restrict blood flow.

Read more about diabetes.

Thrombosis

A thrombosis is a blood clot within an artery (or a vein). If a thrombosis occurs in a coronary artery (coronary thrombosis), it will cause the artery to narrow, preventing the blood supply from reaching the heart muscle. This increases your chance of having a heart attack. Coronary thrombosis usually happens at the same place that the atherosclerosis is forming (furring of the coronary arteries).

Published Date
2013-11-22 15:23:07Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Blood,Coronary heart disease,Heart,Heart and vascular diseases,Heart attack,High cholesterol or lipids,Hypertension,Thrombosis






NHS Choices Syndication


Coronary heart disease

Diagnosis and risk assessment

Coronary heart disease (CHD) is usually diagnosed after a risk assessment and some further tests.

Risk assessment

If your doctor thinks you may be at risk of developing CHD, they may carry out a risk assessment for cardiovascular disease, heart attack or stroke. This may be carried out as part of an NHS Health Check.

Your doctor will ask about your medical and family history, check your blood pressure, and do a blood test to assess your cholesterol level.

Before having the cholesterol test, you may be asked not to eat for 12 hours so there is no food in your body that could affect the result. Your GP or practice nurse can carry out the blood test. A sample will be taken either using a needle and a syringe or by pricking your finger.

Your GP will also ask about your lifestyle, how much exercise you do and whether you smoke. All these factors will be considered as part of the diagnosis.

Further tests

To confirm a suspected diagnosis, you may be referred for more tests. A number of different tests are used to diagnose heart-related problems, including:

Electrocardiogram (ECG)

An ECG records the rhythm and electrical activity of your heart. A number of electrodes (small, sticky patches) are put on your arms, legs and chest. The electrodes are connected to a machine that records the electrical signals of each heartbeat.

Although an ECG can detect problems with your heart rhythm, an abnormal reading does not always mean there is anything wrong. Similarly, a normal reading does not always rule out heart problems.

In some cases, you may have an exercise ECG test, or “stress test”. This is when an ECG recording is taken while you are exercising (usually on a treadmill or exercise bike). If you experience pain while exercising, the test can help identify whether your symptoms are caused by angina, which is usually due to CHD.

X-rays

An X-ray may be used to look at the heart, lungs and chest wall. This can help rule out any other conditions that may be causing your symptoms.

Echocardiogram (echo)

An echocardiogram is similar to the ultrasound scan used in pregnancy. It produces an image of your heart using sound waves. The test can identify the structure, thickness and movement of each heart valve and can be used to create a detailed picture of the heart.

During an echocardiogram, you will be asked to remove your top and a small handheld device called a transducer will be passed over your chest. Lubricating gel is put onto your skin to allow the transducer to move smoothly and make sure there is continuous contact between the sensor and the skin.

Blood tests

In addition to cholesterol testing, you may need to have a number of blood tests to monitor the activity of the heart. These may include cardiac enzyme tests, which can show whether there has been recent damage to the heart muscle.

Coronary angiography

Coronary angiography, also known as a cardiac catheter test, can identify whether the coronary arteries are narrowed and how severe any blockages are. It also provides information about the pressure inside your heart chambers and how well your heart is functioning.

In an angiogram, a catheter (flexible tube) is passed into an artery in your groin or arm and guided into the coronary arteries using X-rays. A dye is injected into the catheter to show up the arteries supplying your heart with blood. A number of X-ray pictures are taken, which will highlight any blockages. It is usually performed under local anaesthetic.

A coronary angiogram is relatively safe and serious complications are rare. The risk of having a heart attack, stroke or dying during the procedure is estimated at about one or two in every 1,000. However, after having a coronary angiogram you may experience some minor side effects, including:

  • a slightly strange sensation when the dye is put down the catheter
  • a small amount of bleeding when the catheter is removed
  • a bruise in your groin or arm

Radionuclide tests

Radionuclide tests can indicate how strongly your heart pumps and show the flow of blood to the muscular walls of your heart. Radionuclide tests provide more detailed information than the exercise ECG test.

During a radionuclide test, a small amount of a radioactive substance called an isotope is injected into your blood (sometimes during exercise). If you have difficulty exercising, you may be given some medication to make your heart beat faster. A camera placed close to your chest picks up the radiation transmitted by the isotope as it passes through your heart.

Magnetic resonance testing (MRI)

An MRI scan can be used to produce detailed pictures of your heart. During an MRI scan, you lie inside a tunnel-like scanner that has a magnet around the outside. The scanner uses a magnetic field and radio waves to produce images.

Computerised tomography (CT) scan

A CT scan uses X-rays and a computer to create detailed images of the inside of your body. During a CT scan, you lie on a bed while a small tube that takes X-rays moves and rotates around your body.

 Want to know more?

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Published Date
2013-11-22 14:15:00Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Blood,Blood tests,Coronary heart disease,ECG,Electrophysiological testing,Getting active,Heart,Heart and vascular diseases,Heart attack,High cholesterol or lipids,Hypertension






NHS Choices Syndication


Coronary heart disease

Introduction

Coronary heart disease (CHD) is the leading cause of death both in the UK and worldwide.

It’s responsible for around 74,000 deaths in the UK each year. About 1 in 5 men and 1 in 8 women die from CHD.

In the UK, there are an estimated 2.7m people living with the condition and 2m people affected by angina (the most common symptom of coronary heart disease). 

CHD generally affects more men than women, but from the age of 50 the chances of developing CHD are similar for men and women.

As well as angina (chest pain), the main symptoms of CHD are heart attacks and heart failure. However, not everyone has the same symptoms and some people may not have any before CHD is diagnosed.

CHD is sometimes called ischaemic heart disease.

Read more about the symptoms of coronary heart disease.

About the heart

The heart is a muscle about the size of your fist. It pumps blood around your body and beats approximately 70 times a minute. After the blood leaves the right side of the heart, it goes to your lungs, where it picks up oxygen.

The oxygen-rich blood returns to your heart and is then pumped to the organs of your body through a network of arteries. The blood returns to your heart through veins before being pumped back to your lungs again. This process is called circulation.

The heart gets its own supply of blood from a network of blood vessels on the surface of your heart, called coronary arteries.

Why does coronary heart disease happen?

Coronary heart disease is the term that describes what happens when your heart’s blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This process is known as atherosclerosis and the fatty deposits are called atheroma.

Atherosclerosis can be caused by lifestyle habits and other conditions, such as:

Read more about the causes of coronary heart disease.

Diagnosing coronary heart disease

If your doctor feels you are at risk of CHD, they may carry out a risk assessment. This involves asking about your medical and family history, your lifestyle and taking a blood test.

Further tests may be needed to confirm a diagnosis of CHD, including:

Read more about diagnosing coronary heart disease.

Treating coronary heart disease

Although coronary heart disease cannot be cured, treatment can help manage the symptoms and reduce the chances of problems such as heart attacks.

Treatment can include lifestyle changes, such as doing regular exercise and stopping smoking, as well as medication and surgery.

Read more about treating coronary heart disease.

Recovery

If you have problems such as a heart attack, or have any heart surgery, it is possible to eventually resume your normal life.

Advice and support is available to help you deal with aspects of your life that may have been affected by CHD.

Read more about recovering from the effects of coronary heart disease.

Prevention

By making some simple lifestyle changes, you can reduce your risk of getting CHD. These include:

  • eating a healthy, balanced diet
  • being physically active
  • giving up smoking
  • controlling blood cholesterol and sugar levels

Keeping your heart healthy will also have other health benefits, and help reduce your risk of stroke and dementia.

Read more about preventing coronary heart disease.

Published Date
2014-08-13 12:40:03Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Coronary heart disease,Heart,Heart and vascular diseases,Heart attack






NHS Choices Syndication


Coronary heart disease

Preventing heart disease

There are several ways you can help reduce your risk of developing coronary heart disease (CHD), such as lowering your blood pressure and cholesterol levels.

There are a number of ways you can do this, which are discussed below.

Eat a healthy, balanced diet

A low-fat, high-fibre diet is recommended, including plenty of fresh fruit and vegetables (five portions a day) and whole grains. You should limit the amount of salt you eat to no more than 6g (0.2oz) a day as too much salt will increase your blood pressure. Six grams of salt is about one teaspoonful.

There are two types of fat: saturated and unsaturated. You should avoid food containing saturated fats because these will increase your cholesterol levels.

Foods high in saturated fat include:

  • meat pies 
  • sausages and fatty cuts of meat 
  • butter 
  • ghee, a type of butter often used in Indian cooking 
  • lard 
  • cream 
  • hard cheese 
  • cakes and biscuits 
  • foods that contain coconut or palm oil

However, a balanced diet should include a small amount of unsaturated fat, which will help reduce your cholesterol levels.

Foods high in unsaturated fat include:

  • oily fish 
  • avocados 
  • nuts and seeds 
  • sunflower, rapeseed, olive and vegetable oils

You should also try to avoid too much sugar in your diet as this can increase your chances of developing diabetes, which is proven to dramatically increase your chances of developing CHD.

Read more about healthy eating and eating less saturated fat.

Be more physically active

Combining a healthy diet with regular exercise is the best way of maintaining a healthy weight. Having a healthy weight reduces your chances of developing high blood pressure.

Regular exercise will make your heart and blood circulatory system more efficient, lower your cholesterol level, and also keep your blood pressure at a healthy level.

Read more about fitness and exercise.

Keep to a healthy weight

Your GP or practice nurse can tell you what your ideal weight is in relation to your build and height. Alternatively, find out what your BMI (body mass index) is by using a BMI calculator.

Read more about losing weight.

Give up smoking

If you smoke, giving up will reduce your risk of developing CHD. Smoking is a major risk factor for developing atherosclerosis (furring of the arteries). It also causes the majority of cases of coronary thrombosis in people under the age of 50.

Research has shown you are up to four times more likely to successfully give up smoking if you use NHS support together with stop-smoking medicines, such as patches or gum. Ask your doctor about this or visit NHS Smokefree.

Read more about stopping smoking.

Reduce your alcohol consumption

If you drink, stick to the recommended guidelines. The recommended daily amount of alcohol for men is three to four units a day and two to three units for women. Always avoid binge drinking.

Read more about drinking and alcohol.

Keep your blood pressure under control

You can keep your blood pressure under control by eating a healthy diet low in saturated fat, exercising regularly, and, if required, taking the appropriate medication to lower your blood pressure. Your target blood pressure should be below 140/85mmHg. If you have high blood pressure, ask your GP to check your blood pressure regularly.

Read more about high blood pressure.

Keep your diabetes under control

If you are diabetic, you have a greater risk of developing CHD. If you have diabetes, being physically active and controlling your weight and blood pressure will help manage your blood sugar level. If you are diabetic, your target blood pressure level should be below 130/80mmHg.

Take any medication prescribed for you

If you have CHD, you may be prescribed medication to help relieve your symptoms and stop further problems developing. If you do not have CHD but do have high cholesterol, high blood pressure or a history of family heart disease, your doctor may prescribe medication to prevent you developing heart-related problems.

If you are prescribed medication, it is vital you take it and follow the correct dosage. Do not stop taking your medication without consulting your doctor first, as doing so is likely to make your symptoms worse and put your health at risk.

Published Date
2013-11-22 15:10:12Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Coronary heart disease,Diabetes,Fats and fatty acids,Getting active,Healthy eating,Heart and vascular diseases,Heart attack,Heart disease prevention,Hypertension,Safe drinking,Weight management




Coronary heart disease (ischaemic heart disease) – NHS Choices































































Coronary heart disease 

Introduction 

In coronary heart disease, the heart's blood supply is blocked by a build-up of fatty substances in the coronary arteries 

Life with heart disease

Tips on living with a long-term condition, including healthcare, medicines and support

Pregnancy and heart disease

Find out how pregnancy can affect heart disease, the risks, birth options and treatment options

Flu and the flu vaccine

Your guide to flu symptoms and the flu vaccine, including who should be vaccinated this winter

Stop smoking widget

A 30-day stop smoking course that delivers daily support, advice and tips to your desktop

Coronary heart disease (CHD) is the leading cause of death both in the UK and worldwide.

It’s responsible for around 74,000 deaths in the UK each year. About 1 in 5 men and 1 in 8 women die from CHD.

In the UK, there are an estimated 2.7m people living with the condition and 2m people affected by angina (the most common symptom of coronary heart disease). 

CHD generally affects more men than women, but from the age of 50 the chances of developing CHD are similar for men and women.

As well as angina (chest pain), the main symptoms of CHD are heart attacks and heart failure. However, not everyone has the same symptoms and some people may not have any before CHD is diagnosed.

CHD is sometimes called ischaemic heart disease.

Read more about the symptoms of coronary heart disease.

About the heart

The heart is a muscle about the size of your fist. It pumps blood around your body and beats approximately 70 times a minute. After the blood leaves the right side of the heart, it goes to your lungs, where it picks up oxygen.

The oxygen-rich blood returns to your heart and is then pumped to the organs of your body through a network of arteries. The blood returns to your heart through veins before being pumped back to your lungs again. This process is called circulation.

The heart gets its own supply of blood from a network of blood vessels on the surface of your heart, called coronary arteries.

Why does coronary heart disease happen?

Coronary heart disease is the term that describes what happens when your heart’s blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This process is known as atherosclerosis and the fatty deposits are called atheroma.

Atherosclerosis can be caused by lifestyle habits and other conditions, such as:

Read more about the causes of coronary heart disease.

Diagnosing coronary heart disease

If your doctor feels you are at risk of CHD, they may carry out a risk assessment. This involves asking about your medical and family history, your lifestyle and taking a blood test.

Further tests may be needed to confirm a diagnosis of CHD, including:

Read more about diagnosing coronary heart disease.

Treating coronary heart disease

Although coronary heart disease cannot be cured, treatment can help manage the symptoms and reduce the chances of problems such as heart attacks.

Treatment can include lifestyle changes, such as doing regular exercise and stopping smoking, as well as medication and surgery.

Read more about treating coronary heart disease.

Recovery

If you have problems such as a heart attack, or have any heart surgery, it is possible to eventually resume your normal life.

Advice and support is available to help you deal with aspects of your life that may have been affected by CHD.

Read more about recovering from the effects of coronary heart disease.

Prevention

By making some simple lifestyle changes, you can reduce your risk of getting CHD. These include:

  • eating a healthy, balanced diet
  • being physically active
  • giving up smoking
  • controlling blood cholesterol and sugar levels

Keeping your heart healthy will also have other health benefits, and help reduce your risk of stroke and dementia.

Read more about preventing coronary heart disease.

Page last reviewed: 10/09/2012

Next review due: 10/09/2014

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The 21 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Somerset Terri said on 24 September 2014

Hi, i am a 46 year old female, I was getting chest pains for around 5 years, all pains I was getting was put down to me having an over active thyroid. After having my thyroid removed my pains calmed down for a couple of months, then started to return. My doctor gave me ecg’s but at a time when I wasn’t in pain. She sent me to the hospital eventually to have all the tests done and the consultant said he couldn’t find anything and that I needed to exercise more, I only weighed 9 stone and couldn’t stand for long due to leg pains, chest pains when walking etc.
I visited my dr on the Friday and I was told my heart was fine and that there was no need to worry, on the Sunday, after a year of these pains, not being able to work I was visiting a friend 100 miles from home and started to get severe chest pains. I went home and they started easing off. After half hour they started returning so I went to A&E where they got bad again. They did a blood test and came back and told me I had had a heart attack, and that I was having one whilst I was there.They kept me in overnight and the following day did an angioplasty. I had a different consultant. They fitted a stent in my main artery and told me it was 95 percent blocked and that my heart was building it’s own bypass also that I would need more stents done at a later date. After 10 months I have started to get the same symptoms back!
How come the original consultant didn’t pick any of this up.

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Healthy Fitness said on 03 July 2014

My two Cents :-

A study by the University of Wisconsin found that when people with coronary artery disease drank 20 fluid ounces of purple grape juice for just two weeks, their blood vessels became noticeably more elastic, and both platelet aggregation and LDL oxidation decreased. Due to its resveratrol content, wine consumption has been identified as one of the primary reasons for France’s low rate of heart disease.

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talKali said on 16 March 2014

I came from Malta and on the 24th Febuary 2014, during nightshift at a private hospital in malta, I experienced a heart attack. Then after an interval of around 5 minutes another major one with an obvious transportation to the major hospital , the cath lab and an angioplasty. After all this and when still recovering in the critical care unit (less then 48 hours) I had the worse experience of symptoms radiating upper back to chest with minimal time to control my breathing and thought it was the end of my life. I was so scared I told everyone present not to perform CPR if I die. In all three cases I kept conscious but honestly, I don’t want to go through it once more.
I am 58 years old and have been working for 40 years. I am also Diabetic Type 1. The problem I see now is that I want to stop working and enjoy what’s left from life…..

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asshvin said on 11 July 2013

I would like to find out regarding coronary angioplasty.
At present i am in india on holiday and had a complete medical checkup and my ECG stress test was positive and I underwent coronary Angiography, now the doctors say I need to have Coronary angioplasty done.
Please kindly advice if this is being done free of cost at
the NHS Hospital? And if at there cost involved, then what cost am I looking at?
I am a permanent resident in england with a indefinite stay. I live in croydon, london.

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cosmicman said on 12 June 2013

this page was so useful, i have just had a heart attack and when they tell you all the issues in the hospital it does’nt all go in but when you can sit back and read in a normal way what has happened it so much better and the videio on this page is excellent

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User735220 said on 27 December 2012

I have low blood pressure and was thinking about having it checked out. I will go privately to save the NHS money. All the people that think private medical cover is unfair should think again. If I have to go NHS I would spend my money on other things and then the NHS would collapse from the number of people using the service and the waiting times would increase. The NHS need people like me to pay for our own care and leave them to spend their money on people would need them. Make the ones who can afford it, to pay for their own health care and let the NHS help the really sick and needy.

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User619489 said on 07 May 2012

I went to my local NHS a &E in themiddleofthe night with chest pain.I was admitted into a new CCU ward to be looked after.Unfortunately,they forgot to give me evening dose of blood thinning injection,I wake up with most severe cheat pain.The only person who would come to my aid was a Phillpinoi who dd not speak much english and the emergency bells did not work!I got out of my Bed and found a English Doctor 200 yards away who helped me andget me the necessary drugs and moved me to ICU!
The consultant placed a stent the next morning and gave me my customary CD!
Next week I took the CD to a private cardilogist who looked at it in a very disappointing manner and said do not travel and keep hold of my mobile number.I thought he was after private insurance monies!

AT 2:30 am I wake up with chest pain and phoned him,He arranged for me to be admitted in a private Hospital at 3:00 am as I knew how to manage myself being a doctor myself!
He preformed an angiogram the next morning and placed 5 stents.I asked him why they did not do this at NHS Hospitals?

Answer:Tick box culture. how many patients did he see is what matters to the pct etc
how many people die of this nonsense??

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foresatish said on 03 November 2011

I visit your web blog nearly daily and i love what are you doing with it. Various intresting posts on many hot topics and trends and also you possess creativity at writing. I always come across new things with your help and for that i thank you with all my heart. Continue this amazing work that you are doing. Bye!

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Archangelbladewyn said on 10 March 2011

Good evening ‘Tamworth man’ have a word with your GP and ask him about ‘cardioversion’ which is one way of resolving your problem. I have had this procedure 5 years ago which corrected my AF. This was done in my local hospital on the NHS.

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tamworth man said on 26 February 2011

Artrial Fibrillation
I have AF now for a couple of years I was wondering if there is a cure /treatment so that ,one comes off Warfine and surgary etc. does any one know of anything that can assist anywhere in te world.
Thank you

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georgebuss said on 21 December 2010

@misswelsh1 why have you had to wait so long.
Are you high priority of Low????
People in private care get soon to really quick, I do think it is unfair, because not all of us can afford to go private. I think private health care should be abolished and all the money they make go to the NHS to grow their facilities even more and build more hospitals and buy better equipment and employ more doctors and nurses as their is a shortage in Neonatal nurses at the moment in most NHS run hospitals!

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georgebuss said on 21 December 2010

I find this stuff really interesting.
I am really interested in medicine and nursing and if I became a doctor I would love to be specialized in Cardiac Care Medicine. Or if I became a nurse I would like to do a practioner course and specialize in cardiac care.

The heart is just amazing the way it is built, it’s amazing to think something that small is supplying our whole body with oxygenated blood. How Amazing!!!!!

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DenisenPaul said on 23 August 2010

Well my post is a lot different then yours, i have a 7 weeks old daughter who has been born with 2 VSD (wholes in her heart)She is under cardiology and goes for her next heart scan on the 3rd September, to decide what there plans for our daughters future are.
I would like to thank the NHS for all there help BUT i stress and i mean the word stress, if it wasn’t for my pressure on the midwifes to get a pediatrician to check my daughter we would off been sent home not knowing, an she could of had a cardiac arrest at anytime…. So i wish the NHS would stop building all these new blocks and give back the jobs to the staff they need more then the outlook of a building,
Surely the NHS would benefit by patients having earlier on help instead of it being to late.

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misswelsh1 said on 10 May 2010

hi im a 31 year old singe mum of 2 … in july 2007 i had a shock of my like when i found out i needed open heart surgery 2 replace 3 valves !!!!! but its more of a shock that im still waiting nearly 3 years later . !! any1 else had to wait this long ???

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daisywright said on 19 January 2010

this is one of the impressive content I have ever read about heart disease.

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daisywright said on 19 January 2010

this one of the impressive information I have seen on heart disease.

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pricedot said on 29 September 2009

Hey People, I just returned from Hospital one week after i was admitted with a Cardiac Arrest , Now carry a few Stints upon my Person and thanks to the NHS staff who looked after me, i now Exercise, Stopped Smoking and eat more healthy than i ever did at Roadside Snackbars .

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imaging student said on 14 September 2009

German based research into MRI is demonstrating whole body angiographic studies in approx 20 minutes and less using high speed protocols (turboFLASH i think). whole body angiography has been proven to highlight disease vessels not detetected under conventional MRI, CT and digital subtration angiography.

is anyone out there aware of plans to bring this technology (or similar screening principles i.e. C-reactive protein based blood test) into the NHS/primary care?

it would make sense as atherosclerosis/CHD/Stroke are all interconnected!

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eden01 said on 08 September 2009

I am sorry that jay724 is having such a long wait to see a cardiologist, but I would take this as a positive sign. I am 31 years old, and I went to my doctor thinking i had severe indigestion – he gave me an immediate ECG, which came out ‘abnormal’. That day he referred me to a fast access clinic, where I was seen the following week. Precautionary drugs were prescribed, and an angiogram booked for three days time. (Monday, appt – Thurs, angio.)
Now I am on combination drugs, and awaiting an angioplasty to fit several stents and open things back up, and hoping to get some quality of life back.
Givene the horror stories of young women being ignored or humoured, I never expected to be taken seriously when I first visited my doc. Now, several hospital visits, a trip to A and E, and a few ops later, I am inclined to think that if you are not rushed to a cardiologists, your chance of survival is better than mine was. Maybe it is not urgent, in which case, although it’s scary, I would smile and be pleased your doctor does not think you are about to have a heart attack.

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jay724 said on 10 July 2009

If Coronary Heart disease is the ‘UK’s biggest killer’ why does it take so long to get a first appointment to see a cardiologist?
Surely, on the basis that ‘prevention is better than cure’ it would be more efficient to quickly diagnose and treat cardiac problems thus reducing the number of heart attacks and the resultant strain on ambulance and A&E services!!
My current wait to see a cardiologist is my first contact with the NHS for 10 years and quite frankly I’m not impressed!!!

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doctor2010 said on 01 June 2009

This fails to mention that a complete occlusion of a coronary artery is not necessary to precipitate a "heart attack" and that chronic high-grade stenosis of a coronary artery, in the absence of complete occlusion of a thrombus (clot), is sufficient to cause myocardial ischaemia leading to myocardial infarction or sudden death.

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Useful links

NHS Choices links

External links

Online clinic on heart disease

Open now – get your questions on heart disease answered by specialist doctors and nurses

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important






Symptom checker


If you have a health problem, our symptom checker can help you manage it or find out where to go for help

Find and choose services for Coronary heart disease


Looking for other services? View services A-Z

  • Link to gov.uk – The new place to find government services and information
  • The Information Standard - Certified member










NHS Choices Syndication


Coronary heart disease

Recovering from heart disease

After having heart surgery or problems like a heart attack, it is possible to resume a normal life.

Cardiac rehabilitation programme

If you have heart surgery, a member of the cardiac rehabilitation team may visit you in hospital to give you information about your condition and the procedure you are having. This care will usually continue after you have left hospital. For the first few weeks following your surgery, a member of the cardiac rehabilitation team may visit you at home or call you to check on your progress.

What happens in cardiac rehabilitation programmes can vary widely throughout the country, but most will cover the following basic areas:

  • exercise
  • education
  • relaxation and emotional support

Once you have completed your rehabilitation programme, it is important you continue to take regular exercise and lead a healthy lifestyle. This will help protect your heart and reduce the risk of further heart-related problems.

Want to know more?

Self-care

Self-care is an integral part of daily life, and is all about you taking responsibility for your own health and wellbeing with the support of those involved in your care. Self-care includes actions you take for yourself every day in order to stay fit and maintain good physical and mental health, prevent illness or accidents, and care more effectively for minor ailments and long-term conditions.

People living with long-term conditions can benefit enormously from being supported so they reach self-care. They can live longer, have less pain, anxiety, depression and fatigue, have a better quality of life, and be more active and independent.

Want to know more?

Support groups

If you have or have had a heart condition, or if you are caring for someone with a heart condition, you might find it useful to meet other people in your area who are in a similar situation. There are a number of heart support groups around the UK that organise regular exercise sessions, such as walking groups, as well as other social activities. Your GP or specialist can provide you with details about your nearest group.

Want to know more?

Relationships and sex

Coming to terms with a long-term condition such as heart disease can put a strain on you, your family and your friends. It can be difficult to talk with people about your condition, even if they are close to you. Be open about how you feel and let your family and friends know what they can do to help. But do not feel shy about telling them that you need some time to yourself.

Your sex life

If you have coronary heart disease (CHD) or you have recently had heart surgery, you may be concerned about having sex. Usually, as soon as you feel well enough you can resume sexual activity. Communicate with your partner and stay open-minded. Explore what you both like sexually. Simply touching, being touched and being close to someone helps a person feel loved and special.

Want to know more?

Returning to work

After recovering from heart surgery, you should be able to return to work, but it may be necessary to change the type of work you do. For example, you may not be able to do a job that involves heavy physical exertion. Your specialist will be able to advise you about when you can return to work and what type of activities you should avoid.

Want to know more?

Financial support

If you are unable to work after having heart surgery, you may be entitled to financial support, such as:

If you are caring for someone who has heart disease, you may also be entitled to financial support.

To find out if you are entitled to financial support, you can contact your local Social Security department. To request a claim form, you can call the benefit enquiry line on 0800 882 200.

Want to know more?

Published Date
2013-05-23 10:39:31Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
British Heart Foundation,Coronary artery bypass,Coronary heart disease,Heart,Heart attack,Heart surgery,Rehabilitation




Coronary heart disease (ischaemic heart disease) – NHS Choices































































Coronary heart disease 

Introduction 

In coronary heart disease, the heart's blood supply is blocked by a build-up of fatty substances in the coronary arteries 

Life with heart disease

Tips on living with a long-term condition, including healthcare, medicines and support

Pregnancy and heart disease

Find out how pregnancy can affect heart disease, the risks, birth options and treatment options

Flu and the flu vaccine

Your guide to flu symptoms and the flu vaccine, including who should be vaccinated this winter

Stop smoking widget

A 30-day stop smoking course that delivers daily support, advice and tips to your desktop

Coronary heart disease (CHD) is the leading cause of death both in the UK and worldwide.

It’s responsible for around 74,000 deaths in the UK each year. About 1 in 5 men and 1 in 8 women die from CHD.

In the UK, there are an estimated 2.7m people living with the condition and 2m people affected by angina (the most common symptom of coronary heart disease). 

CHD generally affects more men than women, but from the age of 50 the chances of developing CHD are similar for men and women.

As well as angina (chest pain), the main symptoms of CHD are heart attacks and heart failure. However, not everyone has the same symptoms and some people may not have any before CHD is diagnosed.

CHD is sometimes called ischaemic heart disease.

Read more about the symptoms of coronary heart disease.

About the heart

The heart is a muscle about the size of your fist. It pumps blood around your body and beats approximately 70 times a minute. After the blood leaves the right side of the heart, it goes to your lungs, where it picks up oxygen.

The oxygen-rich blood returns to your heart and is then pumped to the organs of your body through a network of arteries. The blood returns to your heart through veins before being pumped back to your lungs again. This process is called circulation.

The heart gets its own supply of blood from a network of blood vessels on the surface of your heart, called coronary arteries.

Why does coronary heart disease happen?

Coronary heart disease is the term that describes what happens when your heart’s blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This process is known as atherosclerosis and the fatty deposits are called atheroma.

Atherosclerosis can be caused by lifestyle habits and other conditions, such as:

Read more about the causes of coronary heart disease.

Diagnosing coronary heart disease

If your doctor feels you are at risk of CHD, they may carry out a risk assessment. This involves asking about your medical and family history, your lifestyle and taking a blood test.

Further tests may be needed to confirm a diagnosis of CHD, including:

Read more about diagnosing coronary heart disease.

Treating coronary heart disease

Although coronary heart disease cannot be cured, treatment can help manage the symptoms and reduce the chances of problems such as heart attacks.

Treatment can include lifestyle changes, such as doing regular exercise and stopping smoking, as well as medication and surgery.

Read more about treating coronary heart disease.

Recovery

If you have problems such as a heart attack, or have any heart surgery, it is possible to eventually resume your normal life.

Advice and support is available to help you deal with aspects of your life that may have been affected by CHD.

Read more about recovering from the effects of coronary heart disease.

Prevention

By making some simple lifestyle changes, you can reduce your risk of getting CHD. These include:

  • eating a healthy, balanced diet
  • being physically active
  • giving up smoking
  • controlling blood cholesterol and sugar levels

Keeping your heart healthy will also have other health benefits, and help reduce your risk of stroke and dementia.

Read more about preventing coronary heart disease.

Page last reviewed: 10/09/2012

Next review due: 10/09/2014

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Comments

The 21 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Somerset Terri said on 24 September 2014

Hi, i am a 46 year old female, I was getting chest pains for around 5 years, all pains I was getting was put down to me having an over active thyroid. After having my thyroid removed my pains calmed down for a couple of months, then started to return. My doctor gave me ecg’s but at a time when I wasn’t in pain. She sent me to the hospital eventually to have all the tests done and the consultant said he couldn’t find anything and that I needed to exercise more, I only weighed 9 stone and couldn’t stand for long due to leg pains, chest pains when walking etc.
I visited my dr on the Friday and I was told my heart was fine and that there was no need to worry, on the Sunday, after a year of these pains, not being able to work I was visiting a friend 100 miles from home and started to get severe chest pains. I went home and they started easing off. After half hour they started returning so I went to A&E where they got bad again. They did a blood test and came back and told me I had had a heart attack, and that I was having one whilst I was there.They kept me in overnight and the following day did an angioplasty. I had a different consultant. They fitted a stent in my main artery and told me it was 95 percent blocked and that my heart was building it’s own bypass also that I would need more stents done at a later date. After 10 months I have started to get the same symptoms back!
How come the original consultant didn’t pick any of this up.

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Healthy Fitness said on 03 July 2014

My two Cents :-

A study by the University of Wisconsin found that when people with coronary artery disease drank 20 fluid ounces of purple grape juice for just two weeks, their blood vessels became noticeably more elastic, and both platelet aggregation and LDL oxidation decreased. Due to its resveratrol content, wine consumption has been identified as one of the primary reasons for France’s low rate of heart disease.

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talKali said on 16 March 2014

I came from Malta and on the 24th Febuary 2014, during nightshift at a private hospital in malta, I experienced a heart attack. Then after an interval of around 5 minutes another major one with an obvious transportation to the major hospital , the cath lab and an angioplasty. After all this and when still recovering in the critical care unit (less then 48 hours) I had the worse experience of symptoms radiating upper back to chest with minimal time to control my breathing and thought it was the end of my life. I was so scared I told everyone present not to perform CPR if I die. In all three cases I kept conscious but honestly, I don’t want to go through it once more.
I am 58 years old and have been working for 40 years. I am also Diabetic Type 1. The problem I see now is that I want to stop working and enjoy what’s left from life…..

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asshvin said on 11 July 2013

I would like to find out regarding coronary angioplasty.
At present i am in india on holiday and had a complete medical checkup and my ECG stress test was positive and I underwent coronary Angiography, now the doctors say I need to have Coronary angioplasty done.
Please kindly advice if this is being done free of cost at
the NHS Hospital? And if at there cost involved, then what cost am I looking at?
I am a permanent resident in england with a indefinite stay. I live in croydon, london.

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cosmicman said on 12 June 2013

this page was so useful, i have just had a heart attack and when they tell you all the issues in the hospital it does’nt all go in but when you can sit back and read in a normal way what has happened it so much better and the videio on this page is excellent

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User735220 said on 27 December 2012

I have low blood pressure and was thinking about having it checked out. I will go privately to save the NHS money. All the people that think private medical cover is unfair should think again. If I have to go NHS I would spend my money on other things and then the NHS would collapse from the number of people using the service and the waiting times would increase. The NHS need people like me to pay for our own care and leave them to spend their money on people would need them. Make the ones who can afford it, to pay for their own health care and let the NHS help the really sick and needy.

Report this content as offensive or unsuitable

User619489 said on 07 May 2012

I went to my local NHS a &E in themiddleofthe night with chest pain.I was admitted into a new CCU ward to be looked after.Unfortunately,they forgot to give me evening dose of blood thinning injection,I wake up with most severe cheat pain.The only person who would come to my aid was a Phillpinoi who dd not speak much english and the emergency bells did not work!I got out of my Bed and found a English Doctor 200 yards away who helped me andget me the necessary drugs and moved me to ICU!
The consultant placed a stent the next morning and gave me my customary CD!
Next week I took the CD to a private cardilogist who looked at it in a very disappointing manner and said do not travel and keep hold of my mobile number.I thought he was after private insurance monies!

AT 2:30 am I wake up with chest pain and phoned him,He arranged for me to be admitted in a private Hospital at 3:00 am as I knew how to manage myself being a doctor myself!
He preformed an angiogram the next morning and placed 5 stents.I asked him why they did not do this at NHS Hospitals?

Answer:Tick box culture. how many patients did he see is what matters to the pct etc
how many people die of this nonsense??

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foresatish said on 03 November 2011

I visit your web blog nearly daily and i love what are you doing with it. Various intresting posts on many hot topics and trends and also you possess creativity at writing. I always come across new things with your help and for that i thank you with all my heart. Continue this amazing work that you are doing. Bye!

Report this content as offensive or unsuitable

Archangelbladewyn said on 10 March 2011

Good evening ‘Tamworth man’ have a word with your GP and ask him about ‘cardioversion’ which is one way of resolving your problem. I have had this procedure 5 years ago which corrected my AF. This was done in my local hospital on the NHS.

Report this content as offensive or unsuitable

tamworth man said on 26 February 2011

Artrial Fibrillation
I have AF now for a couple of years I was wondering if there is a cure /treatment so that ,one comes off Warfine and surgary etc. does any one know of anything that can assist anywhere in te world.
Thank you

Report this content as offensive or unsuitable

georgebuss said on 21 December 2010

@misswelsh1 why have you had to wait so long.
Are you high priority of Low????
People in private care get soon to really quick, I do think it is unfair, because not all of us can afford to go private. I think private health care should be abolished and all the money they make go to the NHS to grow their facilities even more and build more hospitals and buy better equipment and employ more doctors and nurses as their is a shortage in Neonatal nurses at the moment in most NHS run hospitals!

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georgebuss said on 21 December 2010

I find this stuff really interesting.
I am really interested in medicine and nursing and if I became a doctor I would love to be specialized in Cardiac Care Medicine. Or if I became a nurse I would like to do a practioner course and specialize in cardiac care.

The heart is just amazing the way it is built, it’s amazing to think something that small is supplying our whole body with oxygenated blood. How Amazing!!!!!

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DenisenPaul said on 23 August 2010

Well my post is a lot different then yours, i have a 7 weeks old daughter who has been born with 2 VSD (wholes in her heart)She is under cardiology and goes for her next heart scan on the 3rd September, to decide what there plans for our daughters future are.
I would like to thank the NHS for all there help BUT i stress and i mean the word stress, if it wasn’t for my pressure on the midwifes to get a pediatrician to check my daughter we would off been sent home not knowing, an she could of had a cardiac arrest at anytime…. So i wish the NHS would stop building all these new blocks and give back the jobs to the staff they need more then the outlook of a building,
Surely the NHS would benefit by patients having earlier on help instead of it being to late.

Report this content as offensive or unsuitable

misswelsh1 said on 10 May 2010

hi im a 31 year old singe mum of 2 … in july 2007 i had a shock of my like when i found out i needed open heart surgery 2 replace 3 valves !!!!! but its more of a shock that im still waiting nearly 3 years later . !! any1 else had to wait this long ???

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daisywright said on 19 January 2010

this is one of the impressive content I have ever read about heart disease.

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daisywright said on 19 January 2010

this one of the impressive information I have seen on heart disease.

Report this content as offensive or unsuitable

pricedot said on 29 September 2009

Hey People, I just returned from Hospital one week after i was admitted with a Cardiac Arrest , Now carry a few Stints upon my Person and thanks to the NHS staff who looked after me, i now Exercise, Stopped Smoking and eat more healthy than i ever did at Roadside Snackbars .

Report this content as offensive or unsuitable

imaging student said on 14 September 2009

German based research into MRI is demonstrating whole body angiographic studies in approx 20 minutes and less using high speed protocols (turboFLASH i think). whole body angiography has been proven to highlight disease vessels not detetected under conventional MRI, CT and digital subtration angiography.

is anyone out there aware of plans to bring this technology (or similar screening principles i.e. C-reactive protein based blood test) into the NHS/primary care?

it would make sense as atherosclerosis/CHD/Stroke are all interconnected!

Report this content as offensive or unsuitable

eden01 said on 08 September 2009

I am sorry that jay724 is having such a long wait to see a cardiologist, but I would take this as a positive sign. I am 31 years old, and I went to my doctor thinking i had severe indigestion – he gave me an immediate ECG, which came out ‘abnormal’. That day he referred me to a fast access clinic, where I was seen the following week. Precautionary drugs were prescribed, and an angiogram booked for three days time. (Monday, appt – Thurs, angio.)
Now I am on combination drugs, and awaiting an angioplasty to fit several stents and open things back up, and hoping to get some quality of life back.
Givene the horror stories of young women being ignored or humoured, I never expected to be taken seriously when I first visited my doc. Now, several hospital visits, a trip to A and E, and a few ops later, I am inclined to think that if you are not rushed to a cardiologists, your chance of survival is better than mine was. Maybe it is not urgent, in which case, although it’s scary, I would smile and be pleased your doctor does not think you are about to have a heart attack.

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jay724 said on 10 July 2009

If Coronary Heart disease is the ‘UK’s biggest killer’ why does it take so long to get a first appointment to see a cardiologist?
Surely, on the basis that ‘prevention is better than cure’ it would be more efficient to quickly diagnose and treat cardiac problems thus reducing the number of heart attacks and the resultant strain on ambulance and A&E services!!
My current wait to see a cardiologist is my first contact with the NHS for 10 years and quite frankly I’m not impressed!!!

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doctor2010 said on 01 June 2009

This fails to mention that a complete occlusion of a coronary artery is not necessary to precipitate a "heart attack" and that chronic high-grade stenosis of a coronary artery, in the absence of complete occlusion of a thrombus (clot), is sufficient to cause myocardial ischaemia leading to myocardial infarction or sudden death.

Report this content as offensive or unsuitable

Useful links

NHS Choices links

External links

Online clinic on heart disease

Open now – get your questions on heart disease answered by specialist doctors and nurses

Your NHS Health Check

Millions of people have already had their free “midlife MOT”. Find out why this health check-up is so important






Symptom checker


If you have a health problem, our symptom checker can help you manage it or find out where to go for help

Find and choose services for Coronary heart disease


Looking for other services? View services A-Z

  • Link to gov.uk – The new place to find government services and information
  • The Information Standard - Certified member










NHS Choices Syndication


Coronary heart disease

See what the doctor sees with Map of Medicine

The Map of Medicine is used by doctors throughout the NHS to determine the best treatment options for their patients. NHS Choices offers everyone in England exclusive and free access to this cutting-edge internet resource, which lets you see exactly what your doctor sees.

The information in the Map has been approved by the UK’s leading clinical experts, is based on the best available clinical evidence, and is continually updated. To take advantage of this unique resource go to:

Map of Medicine: coronary heart disease

Map of Medicine: acute coronary syndrome

Map of Medicine: smoking cessation

 

Published Date
2013-05-22 16:05:17Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Coronary heart disease




Coronary heart disease (ischaemic heart disease) – NHS Choices































































Coronary heart disease 

Introduction 

In coronary heart disease, the heart's blood supply is blocked by a build-up of fatty substances in the coronary arteries 

Life with heart disease

Tips on living with a long-term condition, including healthcare, medicines and support

Pregnancy and heart disease

Find out how pregnancy can affect heart disease, the risks, birth options and treatment options

Flu and the flu vaccine

Your guide to flu symptoms and the flu vaccine, including who should be vaccinated this winter

Stop smoking widget

A 30-day stop smoking course that delivers daily support, advice and tips to your desktop

Coronary heart disease (CHD) is the leading cause of death both in the UK and worldwide.

It’s responsible for around 74,000 deaths in the UK each year. About 1 in 5 men and 1 in 8 women die from CHD.

In the UK, there are an estimated 2.7m people living with the condition and 2m people affected by angina (the most common symptom of coronary heart disease). 

CHD generally affects more men than women, but from the age of 50 the chances of developing CHD are similar for men and women.

As well as angina (chest pain), the main symptoms of CHD are heart attacks and heart failure. However, not everyone has the same symptoms and some people may not have any before CHD is diagnosed.

CHD is sometimes called ischaemic heart disease.

Read more about the symptoms of coronary heart disease.

About the heart

The heart is a muscle about the size of your fist. It pumps blood around your body and beats approximately 70 times a minute. After the blood leaves the right side of the heart, it goes to your lungs, where it picks up oxygen.

The oxygen-rich blood returns to your heart and is then pumped to the organs of your body through a network of arteries. The blood returns to your heart through veins before being pumped back to your lungs again. This process is called circulation.

The heart gets its own supply of blood from a network of blood vessels on the surface of your heart, called coronary arteries.

Why does coronary heart disease happen?

Coronary heart disease is the term that describes what happens when your heart’s blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This process is known as atherosclerosis and the fatty deposits are called atheroma.

Atherosclerosis can be caused by lifestyle habits and other conditions, such as:

Read more about the causes of coronary heart disease.

Diagnosing coronary heart disease

If your doctor feels you are at risk of CHD, they may carry out a risk assessment. This involves asking about your medical and family history, your lifestyle and taking a blood test.

Further tests may be needed to confirm a diagnosis of CHD, including:

Read more about diagnosing coronary heart disease.

Treating coronary heart disease

Although coronary heart disease cannot be cured, treatment can help manage the symptoms and reduce the chances of problems such as heart attacks.

Treatment can include lifestyle changes, such as doing regular exercise and stopping smoking, as well as medication and surgery.

Read more about treating coronary heart disease.

Recovery

If you have problems such as a heart attack, or have any heart surgery, it is possible to eventually resume your normal life.

Advice and support is available to help you deal with aspects of your life that may have been affected by CHD.

Read more about recovering from the effects of coronary heart disease.

Prevention

By making some simple lifestyle changes, you can reduce your risk of getting CHD. These include:

  • eating a healthy, balanced diet
  • being physically active
  • giving up smoking
  • controlling blood cholesterol and sugar levels

Keeping your heart healthy will also have other health benefits, and help reduce your risk of stroke and dementia.

Read more about preventing coronary heart disease.

Page last reviewed: 10/09/2012

Next review due: 10/09/2014

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Comments

The 21 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Somerset Terri said on 24 September 2014

Hi, i am a 46 year old female, I was getting chest pains for around 5 years, all pains I was getting was put down to me having an over active thyroid. After having my thyroid removed my pains calmed down for a couple of months, then started to return. My doctor gave me ecg’s but at a time when I wasn’t in pain. She sent me to the hospital eventually to have all the tests done and the consultant said he couldn’t find anything and that I needed to exercise more, I only weighed 9 stone and couldn’t stand for long due to leg pains, chest pains when walking etc.
I visited my dr on the Friday and I was told my heart was fine and that there was no need to worry, on the Sunday, after a year of these pains, not being able to work I was visiting a friend 100 miles from home and started to get severe chest pains. I went home and they started easing off. After half hour they started returning so I went to A&E where they got bad again. They did a blood test and came back and told me I had had a heart attack, and that I was having one whilst I was there.They kept me in overnight and the following day did an angioplasty. I had a different consultant. They fitted a stent in my main artery and told me it was 95 percent blocked and that my heart was building it’s own bypass also that I would need more stents done at a later date. After 10 months I have started to get the same symptoms back!
How come the original consultant didn’t pick any of this up.

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Healthy Fitness said on 03 July 2014

My two Cents :-

A study by the University of Wisconsin found that when people with coronary artery disease drank 20 fluid ounces of purple grape juice for just two weeks, their blood vessels became noticeably more elastic, and both platelet aggregation and LDL oxidation decreased. Due to its resveratrol content, wine consumption has been identified as one of the primary reasons for France’s low rate of heart disease.

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talKali said on 16 March 2014

I came from Malta and on the 24th Febuary 2014, during nightshift at a private hospital in malta, I experienced a heart attack. Then after an interval of around 5 minutes another major one with an obvious transportation to the major hospital , the cath lab and an angioplasty. After all this and when still recovering in the critical care unit (less then 48 hours) I had the worse experience of symptoms radiating upper back to chest with minimal time to control my breathing and thought it was the end of my life. I was so scared I told everyone present not to perform CPR if I die. In all three cases I kept conscious but honestly, I don’t want to go through it once more.
I am 58 years old and have been working for 40 years. I am also Diabetic Type 1. The problem I see now is that I want to stop working and enjoy what’s left from life…..

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asshvin said on 11 July 2013

I would like to find out regarding coronary angioplasty.
At present i am in india on holiday and had a complete medical checkup and my ECG stress test was positive and I underwent coronary Angiography, now the doctors say I need to have Coronary angioplasty done.
Please kindly advice if this is being done free of cost at
the NHS Hospital? And if at there cost involved, then what cost am I looking at?
I am a permanent resident in england with a indefinite stay. I live in croydon, london.

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cosmicman said on 12 June 2013

this page was so useful, i have just had a heart attack and when they tell you all the issues in the hospital it does’nt all go in but when you can sit back and read in a normal way what has happened it so much better and the videio on this page is excellent

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User735220 said on 27 December 2012

I have low blood pressure and was thinking about having it checked out. I will go privately to save the NHS money. All the people that think private medical cover is unfair should think again. If I have to go NHS I would spend my money on other things and then the NHS would collapse from the number of people using the service and the waiting times would increase. The NHS need people like me to pay for our own care and leave them to spend their money on people would need them. Make the ones who can afford it, to pay for their own health care and let the NHS help the really sick and needy.

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User619489 said on 07 May 2012

I went to my local NHS a &E in themiddleofthe night with chest pain.I was admitted into a new CCU ward to be looked after.Unfortunately,they forgot to give me evening dose of blood thinning injection,I wake up with most severe cheat pain.The only person who would come to my aid was a Phillpinoi who dd not speak much english and the emergency bells did not work!I got out of my Bed and found a English Doctor 200 yards away who helped me andget me the necessary drugs and moved me to ICU!
The consultant placed a stent the next morning and gave me my customary CD!
Next week I took the CD to a private cardilogist who looked at it in a very disappointing manner and said do not travel and keep hold of my mobile number.I thought he was after private insurance monies!

AT 2:30 am I wake up with chest pain and phoned him,He arranged for me to be admitted in a private Hospital at 3:00 am as I knew how to manage myself being a doctor myself!
He preformed an angiogram the next morning and placed 5 stents.I asked him why they did not do this at NHS Hospitals?

Answer:Tick box culture. how many patients did he see is what matters to the pct etc
how many people die of this nonsense??

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foresatish said on 03 November 2011

I visit your web blog nearly daily and i love what are you doing with it. Various intresting posts on many hot topics and trends and also you possess creativity at writing. I always come across new things with your help and for that i thank you with all my heart. Continue this amazing work that you are doing. Bye!

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Archangelbladewyn said on 10 March 2011

Good evening ‘Tamworth man’ have a word with your GP and ask him about ‘cardioversion’ which is one way of resolving your problem. I have had this procedure 5 years ago which corrected my AF. This was done in my local hospital on the NHS.

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tamworth man said on 26 February 2011

Artrial Fibrillation
I have AF now for a couple of years I was wondering if there is a cure /treatment so that ,one comes off Warfine and surgary etc. does any one know of anything that can assist anywhere in te world.
Thank you

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georgebuss said on 21 December 2010

@misswelsh1 why have you had to wait so long.
Are you high priority of Low????
People in private care get soon to really quick, I do think it is unfair, because not all of us can afford to go private. I think private health care should be abolished and all the money they make go to the NHS to grow their facilities even more and build more hospitals and buy better equipment and employ more doctors and nurses as their is a shortage in Neonatal nurses at the moment in most NHS run hospitals!

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georgebuss said on 21 December 2010

I find this stuff really interesting.
I am really interested in medicine and nursing and if I became a doctor I would love to be specialized in Cardiac Care Medicine. Or if I became a nurse I would like to do a practioner course and specialize in cardiac care.

The heart is just amazing the way it is built, it’s amazing to think something that small is supplying our whole body with oxygenated blood. How Amazing!!!!!

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DenisenPaul said on 23 August 2010

Well my post is a lot different then yours, i have a 7 weeks old daughter who has been born with 2 VSD (wholes in her heart)She is under cardiology and goes for her next heart scan on the 3rd September, to decide what there plans for our daughters future are.
I would like to thank the NHS for all there help BUT i stress and i mean the word stress, if it wasn’t for my pressure on the midwifes to get a pediatrician to check my daughter we would off been sent home not knowing, an she could of had a cardiac arrest at anytime…. So i wish the NHS would stop building all these new blocks and give back the jobs to the staff they need more then the outlook of a building,
Surely the NHS would benefit by patients having earlier on help instead of it being to late.

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misswelsh1 said on 10 May 2010

hi im a 31 year old singe mum of 2 … in july 2007 i had a shock of my like when i found out i needed open heart surgery 2 replace 3 valves !!!!! but its more of a shock that im still waiting nearly 3 years later . !! any1 else had to wait this long ???

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daisywright said on 19 January 2010

this is one of the impressive content I have ever read about heart disease.

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daisywright said on 19 January 2010

this one of the impressive information I have seen on heart disease.

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pricedot said on 29 September 2009

Hey People, I just returned from Hospital one week after i was admitted with a Cardiac Arrest , Now carry a few Stints upon my Person and thanks to the NHS staff who looked after me, i now Exercise, Stopped Smoking and eat more healthy than i ever did at Roadside Snackbars .

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imaging student said on 14 September 2009

German based research into MRI is demonstrating whole body angiographic studies in approx 20 minutes and less using high speed protocols (turboFLASH i think). whole body angiography has been proven to highlight disease vessels not detetected under conventional MRI, CT and digital subtration angiography.

is anyone out there aware of plans to bring this technology (or similar screening principles i.e. C-reactive protein based blood test) into the NHS/primary care?

it would make sense as atherosclerosis/CHD/Stroke are all interconnected!

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eden01 said on 08 September 2009

I am sorry that jay724 is having such a long wait to see a cardiologist, but I would take this as a positive sign. I am 31 years old, and I went to my doctor thinking i had severe indigestion – he gave me an immediate ECG, which came out ‘abnormal’. That day he referred me to a fast access clinic, where I was seen the following week. Precautionary drugs were prescribed, and an angiogram booked for three days time. (Monday, appt – Thurs, angio.)
Now I am on combination drugs, and awaiting an angioplasty to fit several stents and open things back up, and hoping to get some quality of life back.
Givene the horror stories of young women being ignored or humoured, I never expected to be taken seriously when I first visited my doc. Now, several hospital visits, a trip to A and E, and a few ops later, I am inclined to think that if you are not rushed to a cardiologists, your chance of survival is better than mine was. Maybe it is not urgent, in which case, although it’s scary, I would smile and be pleased your doctor does not think you are about to have a heart attack.

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jay724 said on 10 July 2009

If Coronary Heart disease is the ‘UK’s biggest killer’ why does it take so long to get a first appointment to see a cardiologist?
Surely, on the basis that ‘prevention is better than cure’ it would be more efficient to quickly diagnose and treat cardiac problems thus reducing the number of heart attacks and the resultant strain on ambulance and A&E services!!
My current wait to see a cardiologist is my first contact with the NHS for 10 years and quite frankly I’m not impressed!!!

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doctor2010 said on 01 June 2009

This fails to mention that a complete occlusion of a coronary artery is not necessary to precipitate a "heart attack" and that chronic high-grade stenosis of a coronary artery, in the absence of complete occlusion of a thrombus (clot), is sufficient to cause myocardial ischaemia leading to myocardial infarction or sudden death.

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NHS Choices Syndication


Coronary heart disease

Symptoms of coronary heart disease

The most common symptoms of coronary heart disease (CHD) are chest pain (angina) and a heart attack.

You can also experience other symptoms, such as palpitations and unusual breathlessness. In some cases, people may not have any symptoms before they are diagnosed.

Angina

If your coronary arteries become partially blocked, it can cause chest pain (angina).

This can be a mild, uncomfortable feeling similar to indigestion. However, a severe angina attack can cause a painful feeling of heaviness or tightness, usually in the centre of the chest, which may spread to the arms, neck, jaw, back or stomach.

Angina is often triggered by physical activity or stressful situations. Symptoms usually pass in less than 10 minutes and can be relieved by resting or using a nitrate tablet or spray.

Heart attacks

If your arteries become completely blocked, it can cause a heart attack (myocardial infarction).

Heart attacks can cause permanent damage to the heart muscle and, if not treated straight away, can be fatal.

If you think you are having a heart attack, dial 999 for immediate medical assistance.

Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina, but it is often more severe. During a heart attack you may also experience the following symptoms:

  • sweating
  • lightheadedness
  • nausea
  • breathlessness

The symptoms of a heart attack can be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or heartburn. However, these symptoms can also be accompanied by a pain that affects the arms (particularly the left arm), the neck and the jaw.

A heart attack can happen at any time, including while you are resting. If heart pains last longer than 15 minutes, it may be the start of a heart attack.

Unlike angina, the symptoms of a heart attack are not usually relieved using a nitrate tablet or spray.

In some cases, you may have a heart attack without any symptoms, called a silent myocardial infarction. This is more common in people with diabetes.

Heart failure

Heart failure can also occur in people with CHD when the heart becomes too weak to pump blood around the body, which can cause fluid to build up in the lungs and makes it increasingly difficult to breathe.

Heart failure can happen suddenly (acute heart failure) or gradually over time (chronic heart failure).

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Published Date
2014-07-15 14:27:47Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
Angina,Beta-blockers,British Heart Foundation,Chest pain,Coronary heart disease,ECG,Heart,Heart and vascular diseases,Heart attack,Heart disease prevention,Heart failure,Heart specialists,Palpitations






NHS Choices Syndication


Coronary heart disease

Treating heart disease

Lifestyle changes

If you have been diagnosed with CHD, you can reduce your risk of further episodes by making simple lifestyle changes.

For example, stopping smoking after a heart attack will quickly reduce your risk of having a heart attack in the future to near that of a non-smoker.

Other lifestyle changes, such as eating more healthily and doing regular exercise, will also reduce your future risk of heart disease.

Read more about preventing CHD.

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Medicines

Many different medicines are used to treat CHD. Usually they either aim to reduce blood pressure or widen your arteries. Some heart medicines have side effects, so it may take a while to find one that works for you. Your GP or specialist will discuss the various options with you.

Antiplatelets

Antiplatelets are a type of medicine that can help reduce the risk of a heart attack by thinning your blood and preventing it from clotting. Common antiplatelet medicines include low-dose aspirin, clopidogrel, ticagrelor and prasugrel.

Statins

If you have a high blood cholesterol level, cholesterol-lowering medicine called statins may be prescribed. Examples include simvastatin, pravastatin and atorvastatin. They work by blocking the formation of cholesterol and increasing the number of LDL receptors in the liver, which helps remove the LDL cholesterol from your blood. This helps slow the progression of CHD, and will make having a heart attack less likely. Not all statins are suitable for everyone, so you may need to try several different types until you find one that is suitable.

Beta-blockers

Beta-blockers – including acebutolol, atenolol, bisoprolol, metoprolol and propranolol – are often used to prevent angina and treat high blood pressure. They work by blocking the effects of a particular hormone in the body, which slows down your heartbeat and improves blood flow.

Nitrates

Nitrates are used to widen your blood vessels. Doctors sometimes refer to nitrates as "vasodilators". They are available in a variety of forms, including tablets, sprays, skin patches and ointments such as glyceryl trinitrate and isosorbide mononitrate.

Nitrates work by relaxing your blood vessels, letting more blood pass through them. This lowers your blood pressure and relieves any heart pain you have. Nitrates can have some mild side effects, including headaches, dizziness and flushed skin.

ACE (angiotensin-converting enzyme) inhibitors

ACE inhibitors are commonly used to treat high blood pressure. Examples include ramipril and lisinopril. They block the activity of a hormone called angiotensin II, which causes the blood vessels to narrow. As well as stopping the heart working so hard, ACE inhibitors improve the flow of blood around the body. 

Your blood pressure will be monitored while you are taking ACE inhibitors, and regular blood tests will be needed to check that your kidneys are working properly. Around one in 10 people have kidney problems as a result of taking the drug.

If ACE inhibitors have been prescribed for you, do not stop taking them without first consulting your doctor. If you do, it is likely your symptoms will get worse quickly.

Side effects of ACE inhibitors can include a dry cough and dizziness.

Angiotensin II receptor antagonists

Angiotensin II receptor antagonists work in a similar way to ACE inhibitors. They are used to lower your blood pressure by blocking angiotensin II. Mild dizziness is usually the only side effect. Angiotensin II receptor antagonists are often prescribed as an alternative to ACE inhibitors, as they do not cause a dry cough.

Calcium channel blockers

Calcium channel blockers also work to decrease blood pressure by relaxing the muscles that make up the walls of your arteries. This causes the arteries to become wider, reducing your blood pressure. Examples include verapamil and diltiazem. Side effects include headaches and facial flushing, but these are mild and usually decrease over time.

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Procedures and surgery

If your blood vessels are narrow due to a build-up of atheroma (fatty deposits), or if your symptoms cannot be controlled using medication, surgery may be needed to open up or replace blocked arteries. Some of the main procedures used to treat blocked arteries are outlined below.

Coronary angioplasty

Coronary angioplasty is also known as percutaneous coronary intervention (PCI), percutaneous transluminal coronary angioplasty (PTCA), or balloon angioplasty.

Angioplasty may be a planned procedure for some people with angina, or an urgent treatment if the symptoms have become unstable. Having a coronary angiogram will determine if you are suitable for treatment. Coronary angioplasty is also performed as an emergency treatment during a heart attack.

During angioplasty, a small balloon is inserted to push the fatty tissue in the narrowed artery outwards. This allows the blood to flow more easily. A metal stent (a short, wire mesh tube) is usually placed in the artery to hold it open. Drug eluting stents can also be used. These release drugs to stop the artery from narrowing again.

Coronary artery bypass graft

Coronary artery bypass grafting (CABG) is also known as bypass surgery, heart bypass, or coronary artery bypass surgery.

It is performed in patients where the arteries become narrowed or blocked. A coronary angiogram will determine if you are suitable for treatment. Off-pump coronary artery bypass (OPCAB) is a type of coronary artery bypass surgery performed without the need for a heart-lung machine, and keeps blood and oxygen circulating around the body.

A blood vessel is inserted (grafted) between the aorta (the main artery leaving the heart) and a part of the coronary artery beyond the narrowed or blocked area. This allows the blood to bypass (get around) the narrowed sections of coronary arteries.

Heart transplant

In a small number of cases, when the heart is severely damaged and medicine is not effective, or when the heart becomes unable to adequately pump blood around the body (heart failure), a heart transplant may be needed. A heart transplant involves replacing a heart that is damaged or is not working properly with a healthy donor heart. 

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Published Date
2013-05-23 10:59:40Z
Last Review Date
2012-09-09 00:00:00Z
Next Review Date
2014-09-09 00:00:00Z
Classification
ACE inhibitors,Angina,Antihypertensive drugs,Aspirin,Atherosclerosis,Beta-blockers,Blood,British Heart Foundation,Cholesterol lowering drugs,Congestive heart failure,Coronary angioplasty,Coronary artery bypass,Coronary heart disease,Diuretics,Heart,Heart and vascular diseases,Heart attack,Heart failure,Heart specialists,Heart surgery,Heart transplant,High cholesterol or lipids,Hypertension,Nitrates,Stopping smoking


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