What is Coronary Heart Disease?
Coronary heart disease (CHD) is a type of heart disease. The coronary arteries supply the heart muscle with the oxygen and nutrients it needs to function properly. When fat and cholesterol accumulate on the inner walls of the coronary arteries, it can lead to narrowing or blockage, depriving the heart muscle of oxygen and nutrients. In severe cases, this can affect heart function, potentially leading to heart failure or even death.
According to data from the Department of Health, heart disease is currently the second leading cause of death in Hong Kong, following cancer. Among various types of heart disease, coronary heart disease accounts for a significantly higher number of deaths than other heart conditions, and there has been a trend of increasing incidence among younger individuals. Regular check-ups can help maintain heart health and allow for early treatment of any emerging issues, preventing the worsening of heart disease.
What are the common symptoms of Coronary Heart Disease?
Atherosclerosis develops over a long period, so early-stage coronary heart disease may not present any symptoms until an event occurs, such as angina or shortness of breath. The common symptoms of coronary heart disease include:
- Shortness of breath or rapid breathing
Causes
What causes Coronary Heart Disease? What factors increase the risk of developing it?
Coronary heart disease is caused by the accumulation of fat and cholesterol on the inner walls of the coronary arteries, leading to their narrowing and a reduction in blood and oxygen supply to the heart muscle. Several risk factors can increase the likelihood of developing coronary heart disease:
- High Blood Pressure: Prolonged high blood pressure can result in the loss of elasticity in blood vessels and damage to the inner walls, increasing the risk of coronary heart disease.
- High Cholesterol: Cholesterol is categorized into triglycerides, low-density lipoprotein (LDL, or "bad" cholesterol), and high-density lipoprotein (HDL, or "good" cholesterol). High levels of LDL can accumulate on blood vessel walls, raising the risk of coronary heart disease.
- Sleep Apnea: Individuals with sleep apnea experience intermittent breathing interruptions during sleep, leading to decreased blood oxygen levels. This forces the heart to work harder to supply oxygen to the body, increasing the load on the heart and potentially leading to high blood pressure, coronary heart disease, arrhythmias, and heart failure.
- Diabetes: Prolonged high blood sugar levels can damage the cells in blood vessel walls and affect platelets, increasing the risk of vascular damage or blockage, which can lead to coronary heart disease.
- Smoking: Harmful substances in cigarettes can increase the likelihood of cholesterol accumulation in blood vessels and destabilize vessel walls, raising the risk of coronary heart disease.
- Obesity: There is a close relationship between obesity, high blood pressure, and cholesterol levels. Being overweight or obese can increase the risk of cardiovascular diseases.
- Lack of Exercise: Regular aerobic exercise supports cardiovascular health. A sedentary lifestyle can lead to vascular aging, increasing the chance of coronary heart disease.
- Unhealthy Dietary Habits (High in Fat, Alcohol Abuse): Consuming foods high in saturated and trans fats can lead to cholesterol buildup on blood vessel walls, resulting in hardening and blockage of the vessels. Excessive alcohol consumption can raise blood pressure, increasing the risk of coronary heart disease and stroke.
- Stress: High work pressure and a fast-paced lifestyle can trigger coronary heart disease.
- Age: As people age, their cardiovascular system gradually deteriorates and loses elasticity, making older individuals more susceptible to coronary heart disease compared to younger ones.
- Family History: Individuals with a family history of early-onset cardiovascular disease are at a higher risk of developing coronary heart disease.
How is Coronary Heart Disease diagnosed and checked?
Cardiologists will review your medical history and arrange various heart tests as needed to make an accurate diagnosis. The relevant heart examinations include:
- Blood Pressure Measurement
- Blood Tests** (for glucose and lipids)
- Electrocardiogram (ECG)
- Exercise ECG
- Echocardiogram
- Computerized Tomography (Coronary Angiography)
- Magnetic Resonance Imaging (MRI)
What are the treatment options for Coronary Heart Disease?
Cardiologists will develop an appropriate treatment plan based on the patient's condition. Treatment options include:
Medication
Patients typically begin with medication to relieve and reduce symptoms. These medications can help prevent the worsening of coronary heart disease and reduce the risk of sudden cardiac events.
Coronary Angioplasty (Balloon Angioplasty)A catheter with a small balloon at its tip is inserted through the femoral artery in the groin or the radial artery in the wrist to the site of the narrowed coronary artery. The balloon is inflated to widen the artery, and a metal stent is placed to keep it open. This procedure generally requires only local anaesthesia.
Coronary Artery Bypass Grafting (CABG)
During this procedure, specialists will first harvest blood vessels from other parts of the body. They will then create a bypass by grafting these vessels near the blocked artery, effectively rerouting blood flow to increase the supply of blood to the heart. Patients with more severe coronary heart disease may require this bypass surgery, which involves general anesthesia and opening the chest cavity, resulting in a more significant surgical trauma.
Coronary heart disease can cause various health issues for patients. To prevent coronary heart disease, it's important to maintain good lifestyle habits and a healthy way of living. Here are some preventive measures:
Regular Screening for High-Risk Factors for Heart Disease
Blood pressure, lipid levels, and blood sugar can reflect heart health. If abnormalities are detected, further examinations and timely treatments can prevent serious complications or even sudden cardiac events.
Quit Smoking and Alcohol
Eliminating tobacco and alcohol can help prevent the rapid hardening of arteries.
Maintain Appropriate Exercise
Regular moderate-intensity exercise promotes heart function while preventing vascular aging and improving blood circulation to the heart muscle.
Healthy Eating
Maintain a balanced diet by reducing the intake of foods high in saturated and trans fats, such as fatty meats and cakes. Additionally, avoid excessive salt and sugar consumption.
Maintain a Healthy Weight
Being overweight places additional strain on the heart. Pay attention if your Body Mass Index (BMI) reaches 25 or higher.
Regular Routine
Busy work and life pressures can lead to stress, increased blood pressure, and a higher risk of coronary heart disease.
Regular Follow-ups
For chronic conditions like high blood pressure and diabetes, regular and timely follow-ups are essential. Early detection of abnormalities allows for prompt treatment and helps prevent coronary heart disease.
FAQs
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Q：What is Angina?
A: Angina refers to chest pain, discomfort, or a feeling of pressure in the chest. It occurs due to the narrowing of the coronary arteries that supply blood to the heart, leading to insufficient blood flow and oxygen to the heart muscle. Patients often experience chest pain, while some may not feel pain but instead exhibit symptoms like shortness of breath or a noticeable decrease in physical stamina.
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Q：Do all patients with coronary heart disease require stent implantation (angioplasty)?
A: Not necessarily. Not all patients with coronary heart disease need to undergo stent implantation. However, the vast majority of patients will require medication to stabilize their blood vessels. Specialists will carefully evaluate each patient's specific situation before deciding whether stent implantation is necessary.
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Q：If there are symptoms of coronary heart disease, can a Holter monitor (dynamic electrocardiogram) detect abnormalities?
A: Overall, the sensitivity and specificity of a Holter monitor for diagnosing coronary heart disease are 68% and 77%, respectively. However, to accurately determine the degree of artery narrowing and the number of affected vessels, coronary CT angiography or traditional coronary angiography is necessary.
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Q：What are the complications of coronary heart disease?
A: Complications of coronary heart disease include myocardial infarction (heart attack), heart failure, and arrhythmias. These conditions can lead to serious or even permanent damage. Therefore, if you suspect you have coronary heart disease, you should seek medical attention without delay.
Reference
(1) Coronary Heart Disease. Elderly Health Service, Department of Health. 2016.
https://www.elderly.gov.hk/tc_chi/common_health_problems/hypertension_heart_disease/chd.htmlPlease note that all medical health articles featured on our website have been reviewed by Chiron Medical doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.
