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Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

Fact sheet
What is coronary heart disease?
How common is coronary heart disease?
Who is at risk of getting coronary heart disease?
How can you prevent coronary heart disease?
Who should be screened for coronary heart disease?
What are the symptoms of coronary heart disease?
Where can I find more information?

What is coronary heart disease?
Coronary Heart Disease is a condition which affects the vessels which supply the heart's muscle with blood, oxygen and nutrients. If these blood vessels (coronary arteries) become partially blocked, a person can have decreased heart function and may experience pain in the chest, arm, neck or jaw (angina). If the vessels become completely blocked, some of the heart muscle can die, which is called a heart attack (myocardial infarction).

Blood vessels can become narrowed from fat and cholesterol build-up inside the artery walls, which is a disease known as atherosclerosis. The disease process can start when conditions, like high blood pressure (hypertension), diabetes, high cholesterol and smoking, cause damage to artery walls. The body tries to repair the damage, but in the process, fat, cholesterol, calcium and other substances can be deposited in artery walls. Over time this build-up (plaque) can narrow the artery walls and can also develop a hard fibrous cap. If this fibrous cap ruptures, a blood clot can form and completely block the blood vessel, leading to a heart attack.

In some cases, a vessel can also be blocked by a spasm in the artery. Spasms can occur and lead to heart attacks in vessels with or without atherosclerosis.

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How common is coronary heart disease?
Coronary Heart Disease (CHD) is the leading cause of death in the United States and kills over 400,000 men and women each year. One out of every five deaths is due to CHD. One-third of people who have a heart attack do not survive it. In addition, over 12 million Americans are currently living with coronary heart disease pain and/or heart problems.

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Who is at risk?
Both men and women are at risk of developing CHD, however it is not usually seen in men younger than 40 or in women of reproductive age. There are many different factors that affect the risk of CHD. Some of these risk factors cannot be altered, like family history, advanced age and sex, but there are many others that can be changed or controlled, like smoking, exercise, body weight, cholesterol, blood pressure, and blood sugar. There are many lifestyle factors and medications that can help reduce the risk of atherosclerosis, coronary heart disease and heart attack.

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How can you prevent it?
There are many things that you can do to reduce your risk of heart disease, like:
  • not smoking
  • avoiding second-hand smoke (also called environmental tobacco smoke)
  • eating well
  • maintaining a healthy weight
  • exercising regularly
  • avoiding high blood pressure
  • treating diabetes but still have elevated risk
  • controlling your cholesterol levels

If you already have heart disease or risk factors for it, it is important to see your doctor regularly to address lifestyle issues and medications that can help treat your condition.

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Who should be screened?
For people without symptoms, there is no good screening test for CHD. If you have symptoms or risk factors, your doctor may want to do an electrocardiogram (EKG) to look at the electrical activity of your heart, or some other test to examine your heart function.

People of all ages should be screened periodically for risk factors of CHD: diabetes, high blood pressure, abnormal cholesterol levels and overweight/obesity.

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What are the symptoms?
The most common symptom of CHD is chest pain, but coronary heart disease can also be "silent" causing a heart attack or sudden death without any warning signs. The "classic" symptom of a heart attack is pain or pressure in the chest that can spread to the arm, shoulder, neck or jaw. This pain/pressure may also come with shortness of breath, sweating, nausea or lightheadedness. Some people experience abdominal pain, nausea, shortness of breath, palpitations or weakness without any chest pain. If you have any of these symptoms, see a doctor immediately.

For more information on Coronary Heart Disease, visit these web sites:

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