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Heart Disease (Coronary Heart Disease)

Facts and definition of heart disease

  • Heart disease develops when a combination of fatty material, calcium, and scar tissue (plaque) builds up in the arteries that supply the heart with blood. Through these arteries, called the coronary arteries, the heart muscle (myocardium) gets the oxygen and other nutrients it needs to pump blood. The plaque often narrows the artery so that the heart does not get enough blood.
  • This slowing of blood flow causes signs and symptoms of chest pain, or angina.
  • If plaque completely blocks blood flow, it may cause a heart attack (myocardial infarction) or a fatal rhythm disturbance (sudden cardiac arrest).
  • A major cause of death and disability, coronary heart disease claims more lives in the United States than the next 7 leading causes of death combined.
  • As a child, the inner lining of the coronary arteries is quite smooth, allowing blood to flow easily. As a person ages, the cholesterol and calcium content in the walls of the coronary arteries increases, making them thicker and less elastic.
  • Unhealthy habits, such as a diet high in cholesterol and other fats, smoking, and lack of exercise accelerate the deposit of fat and calcium within the inner lining of coronary arteries.
  • This process is known as atherosclerosis, or hardening of the arteries.
  • The deposits, or plaques, eventually obstruct the blood vessel, which begins to restrict blood flow.
  • Plaque is like a firm shell with a soft inner core containing cholesterol. As blood hits it during each heartbeat, the plaque may crack open and expose its inner cholesterol core, which promotes blood clotting. Clots may further reduce blood flow, causing severe pain (angina), or even block it all together.

What causes heart disease?

Coronary heart disease is caused by any problem with the coronary arteries that keeps the heart from getting enough oxygen- and nutrient-rich blood. The most common cause by far is atherosclerosis. Lack of sufficient blood is called ischemia, so coronary heart disease is sometimes called ischemic heart disease.

The cause of coronary heart disease is related to multiple risk factors. The following are the most common:

  • Heredity: Coronary heart disease runs in the family.
  • High cholesterol: Levels of cholesterol in the blood are above healthy levels. This usually involves high levels of low-density lipoprotein (LDL), the bad cholesterol, and low levels of high-density lipoprotein (HDL), the good cholesterol.
  • Tobacco abuse: This includes not only smoking any form of tobacco (cigarettes, cigars, pipes), but also chewing tobacco.
  • Obesity
  • High blood pressure (hypertension)
  • Diabetes
  • Lack of regular exercise
  • High-fat diet
  • Emotional stress
  • Type A personality (impatient, aggressive, competitive)
Medically Reviewed by a Doctor on 7/25/2016
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Patient Comments & Reviews

The eMedicineHealth doctors ask about Heart Disease:

Coronary Heart Disease - Causes

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Heart Attack Warning Symptoms and Signs

Classic symptoms of a heart attack may include:

  • Chest pain associated with shortness of breath
  • Profuse sweating
  • Nausea

The chest pain may be described as tightness, fullness, a pressure, or an ache. Unfortunately, many people do not have these classic signs. Other signs and symptoms of heart attack may include:

  • Indigestion
  • Jaw ache
  • Pain only in the shoulders or arms
  • Shortness of breath
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