Coronary heart disease (CHD) happens when your coronary arteries get narrower and reduce the blood flow to the heart. It is the usual underlying cause of a heart attack.

Coronary heart disease is associated with age and is a lifelong condition that affects many people.

Coronary arteries are like small pipes that supply blood to your heart. They get narrower when fatty material gradually builds up inside and clogs them. The fatty material is called plaque. The process of plaque building up is called atherosclerosis. This can start when you are young and may be well advanced by middle age.

Stable plaque is generally not harmful but if it narrows the arteries too much, they may sometimes not deliver enough blood to your heart. The first effects of this are pain and discomfort called angina. Angina needs to be treated.

Unstable plaque has more fat, a thin cap and is inflamed. It may not severely narrow the artery, but it can develop a crack on the surface, exposing the contents of the plaque to the blood. Blood cells try to seal the gap in the surface with a blood clot. The blood clot partially or completely blocks the artery.

A heart attack occurs when a blood clot completely blocks the flow of blood and seriously reduces blood flow to the heart muscle. If you have had a heart attack, you have coronary heart disease.

There are risk factors that increase your chance of getting coronary heart disease.

Symptoms
Many people don’t know they have heart disease until they have chest pain (angina or a heart attack).

If you are worried about your risk of heart disease, see your doctor or health practitioner to discuss your risks.

Diagnosis
Your doctor will get some tests done to check your heart health. They may include:

• electrocardiogram (ECG)
• coronary angiogram or coronary computed tomography angiogram (CCTA)
• echocardiogram (heart ultrasound)
• blood tests
• myocardial perfusion study.

Treatment
There’s no cure for coronary heart disease. But there are treatments and lifestyle changes that can help you avoid a heart attack.

Medicines
Your doctor will prescribe medicines to treat your coronary heart disease and the risk factors of a heart attack, like high blood pressure or high cholesterol.

It’s really important to take your medicines as prescribed because they can greatly reduce your risk of a heart attack.