What is coronary heart disease?

Your heart is the most important muscle as it pumps blood all over your body. To work properly, it needs a continuous blood supply. Coronary arteries are the blood vessels that supply your heart muscle with its blood. This blood is full of oxygen, which is needed by every cell in your body. 

What is coronary heart disease (CHD)? 

Coronary heart disease (CHD) or coronary artery disease occurs when a coronary artery clogs and narrows because of a buildup of plaque.  

Plaque is made of fat, cholesterol and other materials. This plaque builds up inside artery walls and can cause the arteries to narrow and stiffen. This reduces the blood flow and vital oxygen to your heart muscle. The process of arthrosclerosis, the buildup of plaque in the wall of the arteries, happens over time. 

Without an enough blood supply, the heart is starved of the oxygen it needs to work properly. This can cause chest pain called angina. If the artery wall tears and plaque leaks into the bloodstream, it can cause a blood clot to form, blocking the blood vessel. If the blood flow to the heart muscle is stopped, or the heart does not get enough blood flow, a heart attack (injury to the heart muscle) can occur.  

Why is plaque a problem for my arteries? 

Heart disease is the leading cause of death of Australians. In 2018, an average of 2 people died of CHD each hour. This equates to 48 Australians dying every single day.  

Yet many Australians don’t know that they have coronary heart disease until they have a heart attack – which can be life-threatening – or angina. You may not know that you’re living with growing plaque buildup in the walls of your coronary arteries because you have no symptoms.  

The best way to know your risk of heart attack is to have a Heart Health Check with your doctor and to know your risk factors. 

Is coronary heart disease the same as cardiovascular disease? 

Cardiovascular disease is any disease of the heart and/or blood vessels. It includes conditions such as:

• Cardiomyopathy 
• Congenital heart conditions 
• Coronary heart disease 
• Heart failure 
• Heart valve problems 
• Stroke. 

What are the risk factors for coronary heart disease? 

There is no single cause for coronary heart disease. There are controllable and non-controllable risk factors that can increase your chance of developing it.  

Coronary heart disease risk factors that you can change include:  

• Unhealthy eating  
• Being physically inactive 
• Being overweight or obese 
• Smoking – either being a smoker or inhaling other people’s smoke (passive smoking) 
• Diabetes 
• High blood pressure 
• High cholesterol 
• Lack of good social support. 

Coronary heart disease risk factors that you can’t change: 

• Family history of coronary heart disease 
• Getting older 
• Ethnicity – Māori, Pasifika people and those from South Asian countries are at higher risk of heart disease 
• Being male 
• Being a post-menopausal woman 
• Severe mental illness. 

How is CHD diagnosed? 

To diagnose CHD, your doctor will review your symptoms, ask about a family history of heart disease and conduct a physical examination. Your doctor may order you to have some tests including: 

• Blood tests 
• Electrocardiogram (ECG) 
• Stress test 
• Echocardiogram (ECHO) 
• Coronary angiogram or coronary computed tomography angiogram (CCTA) 
• Myocardial perfusion study (MPS) 
• Computerised tomography scan (CT scan). 

How to manage your CHD 

You can’t cure CHD; it’s a chronic condition that requires lifetime management to reduce your risk of a heart attack or stroke. Management of CHD involves reducing your risk factors, taking medications as prescribed and undergoing surgical procedures if recommended. See your doctor regularly, keep up-to-date with your vaccinations and always go to your medical appointments.  

Make lifestyle changes  

1. Eat a heart healthy diet and maintain a healthy weight 
2. Spend more time being physically active 
3. Don’t smoke  
4. Control your cholesterol levels  
5. Control your blood pressure  

Take your prescribed medications as instructed 

Your doctor may prescribe one or more of the following:  

• Angiotensin converting enzyme (ACE) inhibitors  - these can lower blood pressure and reduce the strain on the heart. 
• Anti-coagulants - these can reduce the risk of blood clots forming. 
• Antiplatelet agents  - these can reduce the risk of clots forming and limit damage if you have a heart attack. 
• Beta blockers  - these can lower blood pressure and regulate your heart rate and rhythm. 
• Calcium channel blockers  - these can lower blood pressure, relieve chest pain and slow heart rate. 
• Nitrate medications (Anginine, GTN) - can increase blood flow to your heart. These are available in a spray or dissolvable tablet form. 
• Statins - these can lower bad cholesterol and triglycerides. 

Attend cardiac rehabilitation  

Cardiac rehabilitation programs help you to learn about managing heart disease and how to engage in healthy physical activity. 

How is CHD treated? 

Your doctor may suggest one of the below procedures. 

Angioplasty and stents 

Angioplasty uses a special balloon to widen a narrowed or blocked artery. This restores blood flow to the heart. During this procedure, the surgeon may put a small mesh tube called a stent into the artery to keep it open.

Coronary Artery Bypass Graft (CABG) Surgery 

Bypass surgery improves blood flow to the heart to treat angina. During the surgery, the cardiologist takes a blood vessel from another part of your body (usually your leg or arm) and uses it to make a new pathway for blood to flow around a blocked artery. 

Where to get help 

• Always dial Triple Zero (000) to call an ambulance in a medical emergency 
• See your GP and/or cardiologist  
• Ask your doctor, or hospital staff about a cardiac rehabilitation service.