💡 What is Coronary Heart Disease?
Coronary heart disease (CHD) — also called ischaemic heart disease or coronary artery disease — happens when the blood vessels that supply your heart muscle (coronary arteries) become narrowed or blocked by a build-up of fatty deposits called atheroma or plaque.
This reduces the blood flow to your heart, which can cause:
- Angina — chest pain or discomfort, especially during activity
- Heart attack — if a coronary artery becomes completely blocked
- Heart failure — if the heart muscle is damaged over time
CHD is the leading cause of death in the UK, but it's largely preventable and treatable. Many people live full, active lives with CHD when it's well managed.
Good to know: CHD develops gradually over many years. The earlier it's detected, the more can be done to slow or stop its progression.
⚠️ Risk Factors
Some risk factors you can change, others you can't — but knowing them helps you take action where possible.
Modifiable (you can change these)
Non-modifiable (can't change, but important to know)
🩺 Recognising the Symptoms
CHD can develop silently for years before causing symptoms. When symptoms do occur, they may include:
- Angina — chest pain, tightness, or heaviness, often triggered by activity or stress
- Breathlessness — especially during physical activity
- Fatigue — feeling unusually tired
- Palpitations — awareness of your heartbeat
Some people have no symptoms at all until they have a heart attack.
Heart attack warning signs — call 999:
- Chest pain or tightness that doesn't go away
- Pain spreading to arm, neck, jaw, or back
- Feeling sick, sweaty, or light-headed
- Severe breathlessness
- Overwhelming sense of anxiety or doom
Don't wait — call 999 and chew an aspirin (300mg) if not allergic.
🔬 How is CHD Diagnosed?
Your GP may refer you for tests if they suspect CHD:
- ECG (electrocardiogram) — records your heart's electrical activity
- Blood tests — cholesterol, diabetes, kidney function
- Exercise stress test — ECG while walking on a treadmill
- Echocardiogram — ultrasound scan of your heart
- CT coronary angiogram — detailed scan of coronary arteries
- Invasive coronary angiogram — dye injected to show blockages (also allows treatment)
💊 How is CHD Treated?
Treatment aims to relieve symptoms, slow progression, and reduce heart attack risk.
Lifestyle changes
Stop smoking, eat heart-healthy diet, exercise regularly, maintain healthy weight, limit alcohol
Medications
Statins (cholesterol), aspirin (blood thinning), ACE inhibitors (heart protection), beta-blockers, GTN spray (angina relief)
Angioplasty & stents
A thin tube opens the narrowed artery and a stent (mesh tube) keeps it open
Bypass surgery (CABG)
Blood vessels from elsewhere in the body are used to bypass blocked arteries
❓ Questions to Ask Your GP or Cardiologist
At your next appointment, consider asking:
- How severe is my coronary heart disease?
- What is my QRISK3 score (my 10-year heart attack/stroke risk)?
- What lifestyle changes will make the biggest difference for me?
- What medications do you recommend and why?
- Do I need any procedures like angioplasty or bypass surgery?
- What symptoms should I watch out for?
- Is cardiac rehabilitation available for me?
- How often should I have check-ups?
- Can I still exercise? What's safe for me?
- Should my family members be checked for heart disease?