Coronary heart disease

Alternative Names

Treatment

Treatment depends on your symptoms and how severe the disease is.

If you have coronary artery disease that does not cause symptoms, you can be treated with either medicine or angioplasty with stenting. Recent studies show that medicine and angioplasty with stenting have equal benefits. Angioplasty with stenting does not help you live longer, but it can reduce angina or other symptoms of CHD.

Angioplasty with stenting, however, can be a life-saving procedure if you are having a heart attack.

Medications used to treat CHD include:

• ACE inhibitors to lower blood pressure
• Blood thinners (antiplatelet drugs) to reduce your risk of blood clots
• Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
• Calcium channel blockers to relax arteries, lowering blood pressure and reducing strain on the heart
• Diuretics to lower blood pressure
• Nitrates (such as nitroglycerin) to stop chest pain and improve blood supply to the heart
• Statins to lower cholesterol

Procedures to treat and diagnose CHD are called percutaneous coronary interventions, or PCIs. Angioplasty and stenting are types of PCIs. Other types include:

• Coronary atherectomy
• Coronary radiation implant or coronary brachytherapy

Coronary brachytherapy delivers radiation into the coronary arteries. This treatment is only for patients who have had a stent-related problems.

Surgeries used to treat CHD include:

• Coronary artery bypass surgery
• Minimally invasive heart surgery

Lifestyle changes are very important. Your doctor may tell you to:

• Avoid or reduce the amount of salt (sodium) you eat
• Eat a heart healthy diet -- one that is low in saturated fats, cholesterol, and trans fat
• Get regular exercise and maintain a healthy weight
• Keep your blood sugar strictly under control if you have diabetes
• Stop smoking

Outlook (Prognosis)

Everyone recovers differently. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications exactly as the doctor prescribes. Others may need medical procedures such as angioplasty or surgery.

Although everyone is different, early detection of CHD generally results in a better outcome.

Possible Complications

• Heart attack
• Heart failure
• Unstable angina
• Sudden death

When to Contact a Medical Professional

If you have any of the risk factors for CHD, set up an appointment with your doctor to discuss prevention and possible treatment.

If you have angina, shortness of breath, or symptoms of a heart attack, immediately contact your health care provider, call the local emergency number (such as 911), or go to the emergency room.

References

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007; Published online before print February 19, 2007.

Smith SC Jr, Allen J, Blair SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006 May 16;113(19):2363-72. Erratum in: Circulation. 2006 Jun 6;113(22):e847.

Boden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007 Mar 26; [Epub ahead of print].

American Heart Association. Heart Disease and Stroke Statistics — 2007 Update. Dallas, Texas: American Heart Association; 2007.