What is coronary heart disease?
Coronary heart disease is the most common type of heart disease characterized by a narrowing of the small blood vessels that supply blood and oxygen to the heart. The arteries of the heart become narrowed and blocked due to the buildup of cholesterol in their inner walls, a condition known as atherosclerosis. Blocking the arteries can restrict blood flow to the heart muscles and hence limiting the oxygen.
Coronary heart disease is a major public health problem worldwide. Studies have shown that the prevalence of coronary heart disease was reported to be 5.5% in Saudi Arabia.1
What causes coronary heart disease?
Studies suggest that coronary heart disease start when certain factors harm the inner layers of the arteries. These factors include:2
- Increase of cholesterol in the blood
- Hyperglycemia due to diabetes or insulin resistance
- Blood vessel inflammation
What are the risk factors of coronary heart disease?
Certain risk factors may increase the risk of getting coronary heart disease:3
- Older age
- Gender: Men are at higher risk of getting coronary heart disease.
- Family history: If a parent or a sibling is diagnosed with coronary heart disease, this will increase the risk for developing the disease.
- Smoking: Smoking can damage and narrow the arteries, increase cholesterol level and lead to hypertension.
- Hypertension: Uncontrolled high blood pressure can damage the arteries and thus narrowing the channel through which blood can flow.
- Unhealthy blood cholesterol level: A high level of low density lipoprotein and a low level of high density lipoprotein can increase the risk of atherosclerosis.
- Diabetes: An increased risk of coronary heart disease is associated with diabetes.
- Being overweight or obese
- Lack of physical activity
- High levels of stress
What are the signs and symptoms of coronary heart disease?
The build-up of cholesterol on the walls of arteries around the heart will decrease the supply of oxygen to the heart resulting in a number of symptoms:4
- Angina: Angina is the most common symptom of coronary heart disease characterized by a chest pain or discomfort. When the heart muscle does not get enough blood and oxygen, the patient experiences angina described as heaviness, pressure, aching, burning, numbness, squeezing or painful feeling in the chest, shoulder, arms, neck, back, or jaw.
- Shortness of breath
- Irregular heartbeats known as palpitations
- A faster heartbeat
- Weakness or dizziness
How is coronary heart disease diagnosed?
There is no single test to diagnose coronary heart disease. The doctor will recommend more than one test in order to diagnose the disease:5
- Medical and family history
- Risk factors for coronary heart disease
- Physical examination
- Electrocardiogram (ECG or EKG): This test records the heart’s electrical activity showing signs of heart damage due to coronary heart disease.
- Stress Testing: This test consists of exercising in order to increase the heart’s rate while heart tests are performed. A stress test can show possible signs and symptoms of coronary heart disease.
- Echography is used to check the inside of the heart.
- Chest X-ray can show pictures of the heart revealing signs of coronary heart disease.
- Blood tests: Abnormal levels of cholesterol, sugar and certain proteins can be a sign of coronary heart disease.
- Coronary angiography: This test consists of using a dye and X-rays to show the insides of the coronary arteries.
How is coronary heart disease treated?
Treatments for coronary heart disease include lifestyle changes, medications and procedures to restore and improve blood flow:6
- Lifestyle changes:
- Heart-healthy diet: A healthy diet is recommended for patients with coronary heart disease including fat-free dairy products, omega-3 fatty acids (salmon, tuna, and trout twice a week), fruits (apples, banana, oranges, pears and prunes), legumes (beans, lentils, peas, and chickpeas), vegetables (broccoli, cabbage and carrots), and whole grains (oatmeal, brown rice and corn). Red meat, oils and sugary foods and beverages should be avoided.
- Quitting smoking
- Exercising regularly
- Losing excess weight
- Reducing stress
- Cholesterol-modifying medications: These medications decrease the amount of cholesterol in the blood.
- Aspirin: Aspirin is a blood thinner that reduces blood clotting and prevents obstruction of the coronary arteries.
- Beta blockers: These medications decrease the blood pressure and reduce the risk of heart attacks.
- Nitroglycerin: This drug dilates the coronary arteries and reduces the heart’s demand for blood.
- Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers: These medications are similar in reducing the blood pressure and the risk of coronary heart disease.
- Procedures to restore and improve blood flow:
- Angioplasty and stent placement: This procedure consists of opening narrowed or blocked blood vessels that supply blood to the heart.
- Coronary artery bypass surgery: In this surgical procedure, coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart.
- Aljefree, Najlaa, and Faruk Ahmed. "Prevalence of Cardiovascular Disease and Associated Risk Factors among Adult Population in the Gulf Region: A Systematic Review." Advances in Public Health 2015 (2015).
- Al-Baghli, Nadira A., et al. "Awareness of cardiovascular disease in eastern Saudi Arabia." Journal of Family and Community Medicine 17.1 (2010): 15.
- Wilson, Peter WF, et al. "Prediction of coronary heart disease using risk factor categories." Circulation 97.18 (1998): 1837-1847.
- Coronary Artery Disease: Causes, Symptoms, Treatments (WebMD) http://www.webmd.com/heart-disease/guide/heart-disease-coronary-artery-disease?page=2#2 (Accessed January 07, 2016)
- How Is Coronary Heart Disease Diagnosed? (- NHLBI, NIH) http://www.nhlbi.nih.gov/health/health-topics/topics/cad/diagnosis (Accessed January 07, 2016)
- Coronary artery disease (Treatment). http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/treatment/txc-20165340 (Accessed January 07, 2016)