Coronary Heart Disease (CHD) – part 2

Coronary Heart Disease (CHD) – part 22018-10-05T17:29:38+00:00

What are the symptoms of CHD?

Initially, anyone suffering from CHD may not be aware of their condition, particularly in the early stages. As the condition progresses, the main symptoms are chest pain (angina) and shortness of breath.

Pain typically occurs when you are exercising, as the heart is being ‘asked’ to work harder and any reduction in blood supply will cause it to ‘cramp’. It feels like a crushing pain and often spreads down the left arm and can be associated with a heart attack.

When the pain occurs during rest, this is a sign that the condition is worsening and more urgent treatment may be required. Similarly, if the frequency and severity increases, this can also be an indicator.

The other symptom of CHD may be that the heart becomes less efficient pumping blood around the body. This is known as heart failure, which is often accompanied by shortness of breath, and swelling of the ankles, feet and legs.

If you begin to experience any of these symptoms, medical advice should be sought as soon as possible.

The more serious consequences of CHD

It should be noted that pain does not always occur, and the result of this is that CHD may lead to a heart attack or sudden death without any prior warning symptoms.

If too little or no blood reaches the heart muscle due to a blocked artery, the affected part of the heart will (infarct) die. This is known as a heart attack.

Rarely, the electrical system which regulates the heart is disrupted and this may result in sudden death.

Diagnosis and Treatment

Initially, anyone suffering from CHD will not be aware of their condition. It is only when they start to get short of breath or experience the pain of angina that they will go to see the doctor.

At this stage the doctor will probably conduct an ECG (electrocardiogram) to assess any issues that may be related to CHD.

Further investigations may involve an angiogram. For this test a dye is injected into the arteries and its flow is monitored by the use of an X-ray machine. Any blockages will be easily detected and their severity assessed. More sophisticated tests can now be performed less invasively such as CT coronary angiograms, and functional MRI scans.

Lifestyle management

  • Exercise has been associated with an increase in the ‘good’ cholesterol HDL-C
  • Weight management
  • Smoking is the most preventable cause of CHD
  • Balanced diet – low fat (especially saturated fats) and high fibre are the fundamental approaches
  • Stress management – stress does not have a direct effect on CHD, but coping mechanisms (e.g. comfort eating, smoking, excess alcohol) may have a detrimental effect

Treatment

There are specific drugs available for the treatment of the symptoms of CHD, i.e. angina and heart failure.

If the blood vessels have a significant blockage, a procedure called angioplasty may be recommended.

This is a surgical procedure, where a small balloon is inflated inside the blocked artery. This widens the affected artery and a small metal mesh, called a stent, can be left in place to stop the artery from blocking again.

A more advanced procedure may be a bypass operation, which uses grafts of healthy blood vessels to re-route blood around the site of a blockage.

As always, prevention is better than cure!