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Coronary Heart Disease

Coronary heart disease results from build-up of waxy substance (plaques) in the walls of arteries that supply blood to the heart. This process of plaque build-up is called as atherosclerosis. Over many years, plaque can grow, harden and reduce flow of oxygen-rich blood to heart muscle causing Angina.  Sometimes, the cap of plaque can suddenly rupture with formation of overlying blood clot that can cut-off blood supply, resulting in myocardial infarction (commonly referred to as heart attack).


Coronary heart disease, is the most common form of cardiovascular disease. The lifetime risk of developing coronary heart disease is substantial. In a well asymptomatic 40-year-old, approximately one in two men and one in four women, will suffer from CHD sometime during their life. CHD kills 1 Australian every 27 minutes (Heart Foundation, Australia).

Coronary heart disease is more likely with

  • increasing age
  • in close relatives of an affected family member
  • Elevated cholesterol
  • Hypertension (High blood pressure)
  • Diabetes
  • Smoking
  • Obesity
  • Excessive stress or depression

Traditionally CHD was thought to be disease of middle-aged men. Women, however, remain equally susceptible. According to one estimate (Australian Institute of Health and Welfare) coronary heart disease remains number #1 killer in females, far more common than any female cancers. Women are relatively protected until menopause but the risk escalates rapidly thereafter.

Classic symptom is chest pain (angina) felt behind the sternum (also known as breast bone). Patients may notice simultaneous discomfort in the Jaw, shoulder, or arm.  Unfortunately, this classic presentation is not very common. Patients can have diverse complains similar to reflux, indigestion,  mildly ache, shortness of breath or just uneasy sensation during or after every day physical activity.  Prolonged discomfort (more than 30 minutes) could result from heart attack and immediate medical attention must be sought.

Obesity is associated with high blood pressure, abnormal blood levels of cholesterol, reduced ability to dispose blood sugar (insulin resistance); all these can increase risk of coronary heart disease. Obesity is also associated with disordered breathing, which can further increase the risk of heart failure.

Fortunately, you can do a lot to reduce your risk of getting heart disease. Speak with your doctor. A consultation and simple blood test can estimate your future risk. Stress testing can determine your exercise tolerance and blockages in heart artery. Health lifestyle and behavioural choices like smoking cessation, healthy diet, regular physical activity and weight loss are important.

Any degree of weight loss lowers your risk of heart disease. Weight loss lowers your blood pressure thus reducing workload on heart. It lowers pressure in pulmonary (lung) artery, especially in patients with sleep apnea, resultant improved energy levels and breathing. It can also have favourable impact on your blood sugar and cholesterol levels.

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