Coronary Heart Disease

Coronary heart disease (CHD), also called coronary artery disease or ischaemic heart disease, occurs when the coronary arteries cannot supply enough oxygen-rich blood to the heart muscle. The most common cause is the accumulation of fatty deposits or plaque within the coronary arteries, known as atherosclerosis.[1]

As plaque builds up, the arteries narrow and blood flow to the heart decreases. If a plaque ruptures and a blood clot blocks the artery, it can result in a heart attack (myocardial infarction).[1]

Global Impact

Cardiovascular diseases are the leading cause of death globally, causing an estimated 19.8 million deaths in 2022, or approximately 32% of all global deaths. About 85% of cardiovascular deaths are due to heart attacks and strokes, and more than three-quarters of CVD deaths occur in low- and middle-income countries.[2]

Coronary heart disease is one of the major forms of cardiovascular disease and an important contributor to premature death and disability worldwide.[2]

Impact in India

Coronary heart disease represents a major public health burden in India, where cardiovascular diseases are among the leading causes of mortality. Ischaemic heart disease contributes substantially to cardiovascular deaths and disability in the country.[3]

The growing burden is associated with important cardiovascular risk factors including hypertension, diabetes, high cholesterol, tobacco use, unhealthy diet, physical inactivity, overweight and obesity.[2,3]

Risk Factors

Important risk factors for coronary heart disease include tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol, high blood pressure, high blood cholesterol, diabetes, overweight and obesity and air pollution.[2]

Signs and Symptoms

Coronary heart disease may develop gradually and can sometimes remain silent until a heart attack or another complication occurs.[4]

Common signs and symptoms include:

  • Chest pain or discomfort (angina)
  • Pain or discomfort spreading to the arms, shoulders, neck, jaw or back
  • Shortness of breath
  • Fatigue or weakness
  • Dizziness or light-headedness
  • Nausea
  • Cold sweating.[4]

Chest pain that occurs at rest, becomes severe or does not resolve may indicate a heart attack and requires immediate medical attention.[4]

Treatment and Management

Treatment depends on the severity of coronary heart disease, symptoms and associated health conditions. Management may include lifestyle changes, medicines and procedures to improve blood flow to the heart and prevent complications.[5]

    1. Lifestyle Modification: Stopping tobacco use, eating a heart-healthy diet, maintaining a healthy weight, exercising regularly and controlling blood pressure, cholesterol and blood glucose are important components of management.[5]
    2. Medications: Medicines may be prescribed to lower cholesterol and blood pressure, relieve angina and reduce the risk of blood clots and heart attacks. These may include statins, beta-blockers, ACE inhibitors, calcium-channel blockers, nitrates and antiplatelet medicines.[5]
    3. Percutaneous Coronary Intervention (PCI): Also known as coronary angioplasty, PCI opens narrowed or blocked coronary arteries. A stent may be placed to help keep the artery open.[5]
    4. Coronary Artery Bypass Grafting (CABG): CABG uses healthy blood vessels from another part of the body to create a new pathway around blocked coronary arteries and improve blood flow to the heart.[5]

Prevention

Many cases of coronary heart disease can be prevented or delayed by addressing modifiable cardiovascular risk factors. Avoiding tobacco, following a healthy diet, being physically active, maintaining a healthy weight and controlling blood pressure, cholesterol and blood glucose can substantially reduce cardiovascular risk.[2,5]

References

  1. National Heart, Lung, and Blood Institute. What is coronary heart disease?. Bethesda (MD): National Heart, Lung, and Blood Institute; 2024 Dec 27. Available from: https://www.nhlbi.nih.gov/health/coronary-heart-disease
  2. World Health Organization. Cardiovascular diseases (CVDs). Geneva: World Health Organization; 2025 Jul 31. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-%28cvds%29
  3. World Health Organization. Cardiovascular diseases: India. New Delhi: WHO Country Office for India. Available from: https://www.who.int/india/health-topics/cardiovascular-diseases
  4. National Heart, Lung, and Blood Institute. Coronary heart disease symptoms. Bethesda (MD): National Heart, Lung, and Blood Institute; 2024 Dec 27. Available from: https://www.nhlbi.nih.gov/health/coronary-heart-disease/symptoms
  5. National Heart, Lung, and Blood Institute. Coronary heart disease treatment. Bethesda (MD): National Heart, Lung, and Blood Institute; 2024 Dec 27. Available from: https://www.nhlbi.nih.gov/health/coronary-heart-disease/treatment