Coronary heart disease

Heart Foundation Home > You & your heart > Cardiovascular conditions > Coronary heart disease

The underlying cause of coronary heart disease is a slow build up of fatty deposits on the inner wall of the blood vessels that supply the heart muscle with blood (the coronary arteries). These fatty deposits gradually clog the arteries and reduce the flow of blood to the heart. This process, called atherosclerosis, begins when people are young and can be well advanced by middle age.

There is no single cause for coronary heart disease, but there are 'risk factors' that increase your chance of developing it.

There are 'modifiable' risk factors (ones that you can change), including:

smoking - both active smoking and being exposed to second-hand smoke
high blood cholesterol
high blood pressure
diabetes
physical inactivity
being overweight
depression, social isolation and a lack of social support.

There are also risk factors that you can't change, such as being male, increasing age and having a family history of coronary heart disease.

While some of these risk factors (such as age and gender) can't be changed, the good news is that there are many steps that you can take to reduce your risk of developing coronary heart disease.

Warning Signs Action Plan for CHD patients

Learn the warning signs of heart attack.

Read and download our heart attack fact sheet and heart attack action plan for people with coronary heart disease (also available in other languages).

Many people don't know they have coronary heart disease until they have angina or a heart attack.

However, if your doctor thinks you are at risk of developing coronary heart disease, he or she may arrange a number of tests (see below) to check your heart health and determine what treatments you may need.

Electrocardiogram (ECG) and/or 'stress ECG'
During an ECG test, electrical leads are placed on your chest, arms and legs. These leads detect small electrical signals and produce a tracing on graph paper that illustrate the electrical impulses travelling through the heart muscle. Sometimes, an additional ECG test is done while you are exercising on an exercise bike or treadmill. This is known as an 'exercise ECG' or 'stress ECG' (also called a 'stress test').
Echocardiogram
An echocardiogram uses ultrasound waves to produce a picture of your heart as it beats. This lets your doctor see the structure of your heart and how well it is working.
Angiogram
This is a special X-ray that shows whether or not your coronary arteries are narrowed or blocked. Under a local anaesthetic, a small tube (catheter) is inserted into an artery in your arm or groin and guided into the heart. Dye is injected through the catheter into the coronary arteries and X-rays are taken. The X-rays give detailed information about the condition of these arteries.

For more information, see our Coronary angiography information sheet.

There is no cure for coronary heart disease. However, if you have coronary heart disease, there are a range of treatments your doctor might recommend to reduce your risk of future heart problems, and relieve or control symptoms.

Medicines
There is now a wide range of medicines to treat coronary heart disease and its risk factors, such as high blood pressure and high total blood cholesterol levels. Common medicines (or classes of medicines) include:

aspirin
anti-anginal medications (nitrates)
ACE inhibitors
beta-blockers
statins
clopidogrel
warfarin.

Taking these medicines as prescribed can greatly reduce your risk of further heart problems.

Remember: most medicines will need to be taken for the long term.

Polypills information sheet

Angioplasty and stent implantation
During coronary angioplasty, a small balloon is inflated inside one or more of your coronary arteries to open up an area of your arteries that has become very narrow. This will improve blood flow to your heart.

After angioplasty is performed, a special expandable metal tube (a 'stent') is usually put into your artery, expanded, and left in place to keep your artery open.

Bypass surgery
Coronary artery bypass graft surgery (often shortened to CABG and pronounced 'cabbage') is an operation in which a blood vessel is taken from your chest, leg or forearm and grafted to your coronary artery to let blood 'detour' past a narrowing in this artery. This improves blood flow to your heart muscle and reduces angina.

Implantable cardiac defibrillators (ICD)
An ICD is a small device that can be put into your chest and connected to your heart to monitor and correct your heartbeat.

It can either stop an arrhythmia (abnormal heart rhythm) by pacing your heart, or in more serious situations, it can give your heart a controlled electric shock to try to return it to its normal rhythm.

ICDs can also support your heartbeat like a pacemaker if it is beating very slowly, and collect and store information about your heart's electrical activitiy for your doctor to check.

Implantable cardiac defibrillators information sheet

Although there is no cure for coronary heart disease, modern treatments and healthy lifestyle choices can greatly reduce your risk of further heart problems and relieve or control symptoms.

To reduce your risk and aid your recovery:

take your medicines as prescribed
be smoke-free
enjoy healthy eating
be physically active
control your blood pressure and cholesterol
achieve and maintain a healthy body weight
maintain your psychological and social health.

If you have diabetes, you should generally aim to keep your blood glucose levels within the normal non-diabetic range and follow individual advice from their doctor or accredited diabetes educator.

Managing My Heart Health
"Managing my heart health" is an interactive resource for people with, or at high risk of, coronary heart disease. It aims to help you improve your heart health and reduce your risk of further heart problems. It includes:

tools to help you achieve your important heart health goals
vital information on heart health-related lifestyle, medical and psychological issues.

"Managing my heart health" also contains action plans, a medicines card and a handy record card ("Managing my heart health. At a glance") to help you and your health professional track your progress.

To order your free single copy, call our Health Information Service on 1300 36 27 87 or email us.

Download additional copies of the "Managing my heart health. At a glance" record card.

Cardiac Rehabilitation
The Heart Foundation and the World Health Organization recommend that people who have had a heart attack, heart surgery, coronary angioplasty, angina or other heart or blood vessel disease attend an appropriate cardiac rehabilitation and prevention program.

These programs help you to make practical, potentially life-saving changes to the way in which you live. They can help you and your family deal with physical, emotional, psychological, marital, sexual and work-related issues. The right rehabilitation program will help most people to reduce their risk of further heart problems.

Cardiac rehabilitation programs complement the advice that your GP and/or cardiologist gives you.