Coronary Heart Disease

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Coronary heart disease, the most common type of heart disease caused by atherosclerosis, the buildup of fatty material called plaque on the inside of the coronary arteries (see Arteriosclerosis). Over the course of many years, this plaque narrows the arteries so that less blood can flow through them and less oxygen reaches the heart muscle.

The most common symptom of coronary heart disease is angina pectoris, a squeezing chest pain that may radiate to the neck, jaw, back, and left arm. Angina pectoris is a signal that blood flow to the heart muscle falls short when extra work is required from the heart muscle. An attack of angina is typically triggered by exercise or other physical exertion, or by strong emotions. Coronary heart disease can also lead to a heart attack, which usually develops when a blood clot forms at the site of a plaque and severely reduces or completely stops the flow of blood to a part of the heart. In a heart attack, also known as myocardial infarction, part of the heart muscle dies because it is deprived of oxygen. This oxygen deprivation also causes the crushing chest pain characteristic of a heart attack. Other symptoms of a heart attack include nausea, vomiting, and profuse sweating.

One of the primary risk factors for coronary heart disease is the presence of a high level of a fatty substance called cholesterol in the bloodstream. High blood cholesterol is typically the result of a diet that is high in cholesterol and saturated fat, although some genetic disorders also cause the problem. Other risk factors include smoking, high blood pressure, diabetes mellitus, obesity, and a sedentary lifestyle.

Coronary heart disease cannot be cured, but it can often be controlled with a combination of lifestyle changes and medications. Patients with coronary heart disease are encouraged to quit smoking, exercise regularly, and eat a low-fat diet. Doctors may prescribe a drug such as lovastatin, simvastatin, or pravastatin to help lower blood cholesterol. A wide variety of medications can help relieve angina, including nitroglycerin, beta blockers, and calcium channel blockers. Doctors may recommend that some patients take a daily dose of aspirin, which helps prevent heart attacks by interfering with platelets, tiny blood cells that play a critical role in blood clotting.

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