What is coronary heart disease?

Coronary heart disease, also called coronary artery disease, is a chronic (long-lasting) disease and affects the blood vessels that supply blood to your heart. Coronary heart disease is the most common cause of death in Australia and although it cannot be cured, there are treatments that can reduce your risk of future heart problems and improve your symptoms.

Coronary heart disease occurs when the arteries that supply your heart with blood become blocked. If your heart doesn’t get enough blood, you may experience chest pain, feel out of breath, or have a heart attack.

Blockages form because cholesterol builds up in the walls of blood vessels, forming plaque. Over time, the plaque grows in size, making the blood vessel increasingly narrow and allowing less blood to pass through. This is called atherosclerosis.

Sometimes parts of the plaque can break off and leave the blood vessel damaged. When the body tries to repair this damage, a blood clot can form inside the blood vessel, stopping all or most of the blood flow, and resulting in a heart attack.

What are the symptoms of coronary heart disease?

Coronary heart disease develops slowly, and you may not experience any symptoms in the early stages of the disease. Many people only discover that they have coronary heart disease when they experience chest pain (angina) or have a heart attack.

Symptoms of heart attacks can vary between different people, and especially between men and women.

Women are more likely to experience:

• flu-like symptoms
• feelings of indigestion or heartburn
• back pain
• tightness or discomfort in the arms
• symptoms that last for several days

Both men and women generally experience:

• chest pain
• pain in the neck or left arm
• a feeling of being cold and sweaty
• nausea
• shortness of breath
• greater tiredness than usual.

If you feel a sudden pain in your chest, or you are concerned that you may be having a heart attack, call triple zero (000) and ask for an ambulance — this is an emergency.

What causes coronary heart disease?

There is no one cause of coronary heart disease, but risk factors can increase your chance of developing the condition.

Some risk factors are under your control, such as if you smoke or how often you exercise, and these can be changed to decrease your risk of developing coronary heart disease.

Other factors, such as your age or family history, can affect your risk of developing coronary heart disease but cannot be altered.

Risk factors that are under your control include:

• if you smoke
• how often you exercise
• social isolation
• being overweight or obesity

Some diseases also increase your risk of developing coronary heart disease. These include:

• high cholesterol
• high blood pressure
• high levels of sugar in the blood (diabetes)
• depression

If you have any of these conditions, talk with your doctor to ensure they are being managed as well as they can be.

Risk factors that are not under your control include:

• being male
• being older
• having a family history of coronary heart disease

When should I see my doctor?

If you're aged 45 and over, or 30 and over if you're of Aboriginal and/or Torres Strait Islander descent, you should arrange a Heart Health Check with your doctor to check your risk for developing coronary heart disease. Many people do not know that they are suffering from coronary heart disease until they experience chest pain for the first time or have a heart attack, so you should not wait until you begin noticing symptoms before speaking with your doctor.

If you feel a sudden pain in your chest, call triple zero (000) and ask for an ambulance – this is an emergency and you will need to be treated in hospital.

At your Heart Health Check, a doctor or nurse will check your blood pressure, cholesterol levels and blood sugar levels, and ask you about your lifestyle and family history. If needed, your doctor or nurse will work with you to create a plan to reduce your risk factors for coronary heart disease and keep your heart healthy.

Can coronary heart disease be prevented?

You can prevent coronary heart disease by reducing or eliminating your risk factors. A Heart Health Check with your doctor or nurse will help you to identify your risk factors, and to build a plan to change them.

If your doctor thinks you may already have coronary heart disease, they will ask you to take some tests to confirm their diagnosis. These may include:

• a blood test to check your cholesterol levels
• a blood pressure check
• an electrocardiogram or an echocardiogram
• an angiogram

If you have coronary heart disease, your doctor will help you build a personalised plan for improving your symptoms and preventing heart attacks.

If you have had a heart attack, it is even more important you manage your risk factors and follow your treatment plan. Make sure you check in frequently with your healthcare team.

Need a Heart Health Check?

If you don’t have a regular doctor, use the Healthdirect Service finder to find a health service near you.

How is coronary heart disease treated?

Coronary heart disease is treated through a combination of lifestyle changes, medicines and sometimes surgery. This will not cure your coronary heart disease, but will reduce your symptoms and lessen your chance of having a heart attack in the future.

Lifestyle changes

Maintaining a healthy lifestyle is very important to help you manage coronary heart disease, so your symptoms don’t get worse over time. This could include:

• becoming smoke-free — cigarette smoke damages your artery walls and reduces the amount of oxygen in your blood.
• improving your diet — a good diet can help you maintain a healthy weight and reduce the amount of cholesterol in your blood.
• reducing your stress — stress increases your blood pressure, so finding ways to relax can help your blood pressure stay at a healthy level.
• exercising regularly — staying fit will mean your heart does not have to work as hard to pump blood around your body.

If you are at risk of having a heart attack, have had a heart attack in the past, or are experiencing chest pain (angina), cardiac rehabilitation can help you make practical changes to your lifestyle.

Medicines

Coronary heart disease is also treated with medicines. These can help reduce your risk factors and treat your symptoms.

These may include some of the following:

• medicines to lower blood pressure and reduce strain on your heart, such as ACE inhibitors and angiotensin II receptor blockers (ARBs).
• beta-blockers to help your heart pump slower and stronger.
• medicines to reduce the level of cholesterol in your blood, such as statins.
• medicines to prevent blood clots forming in the blood vessels in your heart ('blood thinners'), such as aspirin.
• medicines to treat chest pain (angina), such as a nitrate mouth spray.

Surgical treatments

In some cases, you may need surgery to improve the blood flow to your heart. Surgical treatments include:

• angioplasty and stent implantation — a small balloon is inflated in the blocked blood vessel to clear the way for blood to flow through, and an expandable metal tube (stent) is left in place to keep the blood vessel open.
• bypass surgery (coronary artery bypass graft surgery) — to improve blood flow to your heart and reduce chest pain (angina).
• implantable cardioverter defibrillator (ICD) — a small device placed near your heart that detects and corrects abnormal heart rhythms.

What are the complications of coronary heart disease?

Coronary heart disease can cause serious complications which can be life threatening. Complications of coronary heart disease may include:

• heart attacks
• heart failure — weakening of the heart muscle
• angina — chest pain
• stroke — blood clots in the brain
• pulmonary embolism — blood clots in the lungs
• arrhythmia — faults in the heart’s electrical system

Resources and support

For more information and support, try these resources:

• Call the Heart Foundation Helpline on 13 11 12 for more information on heart health.
• See some of the latest Australian research on how COVID-19 impacts the heart, at the Victor Chang Cardiac Research Institute, and learn about research being done into coronary heart disease.

Other languages

Do you prefer to read languages other than English? The Heart Foundation has fact sheets on heart health translated into more than 25 different languages.