Coronary heart disease

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Acute MI	Anterior heart arteries	Cholesterol producers	Heart, front view
Heart, section through the middle	Posterior heart arteries

Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD

The treatment for CHD depends on your symptoms and the severity of disease. General treatments involve lifestyle changes, medications, and medical procedures, including surgery.

Lifestyle changes may include:

• Maintaining a healthy body weight
• Eating a heart healthy diet which avoids saturated fats, cholesterol, and trans fat
• Reducing sodium (salt) to keep high blood pressure under control
• Regular exercise
• Strict control of diabetes
• Quitting smoking

Medications may include:

• Cholesterol-lowering medication such as a statin
• Antiplatelet (blood-thinning) drugs such as aspirin, warfarin, or clopidogrel, which reduce the risk of blood clots
• Beta-blockers to decrease heart rate, lower blood pressure, and reduce oxygen use by the heart
• Nitrates such as nitroglycerin to dilate the coronary arteries, stop chest pain, and improve blood supply to the heart
• Calcium-channel blockers to relax the coronary arteries and all arteries in the body, reducing the workload for the heart and lowering blood pressure
• ACE inhibitors, diuretics, or other medications to lower blood pressure

Percutaneous Coronary Interventions (PCI's) include:

• Coronary angioplasty (Balloon PTCA)
• Coronary atherectomy
• Coronary stenting (placing a tube called a stent in the artery to keep it open)
• Coronary radiation implant or coronary brachytherapy

Coronary brachytherapy consists of delivering beta or gamma radiation into the coronary arteries. This new treatment is reserved for patients who have undergone stent implantation in a coronary artery and developed problems, such as diffuse in-stent restenosis.

Surgical procedures include:

• Coronary artery bypass surgery
• Minimally invasive heart surgery

The outcome is different for every person. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications as long as they are closely monitored. Others may require medical procedures such as PCI or surgery.

Although everyone is different, it is always essential to detect CHD early for the best outcome.

• Heart attack
• Unstable angina
• Sudden death

If you have any of the risk factors for CHD, you should contact your health care provider for appropriate prevention and treatment. If you experience angina, shortness of breath, or symptoms of a heart attack, contact your health care provider, call 911 or go to the emergency room immediately.

Review Date: 08/28/2006
Reviewed By: Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network.