What is coronary heart disease?

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Key takeaways

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There is no single cause for coronary heart disease (also known as coronary artery disease).
Coronary heart disease is a leading cause of death in Australia.
There are controllable and non-controllable risk factors that can increase your chance of developing it.
Many people don't know they have coronary heart disease until they have angina or a heart attack.
Cardiac rehabilitation programs can complement the advice that your GP and/or cardiologist gives you.

What is coronary heart disease (CHD)?

Your heart’s job is to pump blood around your body. This blood is full of oxygen, which is needed by every cell in your body. To work properly, the heart also needs a continuous blood supply. Coronary arteries are the blood vessels that supply your heart muscle with its blood.

Coronary heart disease (CHD) or coronary artery disease occurs when a coronary artery clogs and narrows because of a buildup of plaque.

Plaque is made of fat, cholesterol and other materials. This plaque builds up in the wall of the arteries (called atherosclerosis) and can cause the arteries to narrow and stiffen. This happens over time and reduces the blood flow and vital oxygen to your heart muscle.

Without enough blood supply, the heart is starved of the oxygen it needs to work properly.

This can lead to angina or a heart attack.

Angina is a type of chest pain. A heart attack happens if the artery wall tears and plaque leaks into the bloodstream, causing a blood clot to form, reducing or stopping blood flow to the heart muscle.

Is coronary heart disease the same as cardiovascular disease?

Cardiovascular disease is any disease of the heart and/or blood vessels. CHD is a type of cardiovascular disease. As well as CHD, cardiovascular disease includes conditions such as:

Cardiomyopathy
Congenital heart conditions
Heart failure
Heart valve problems
Stroke

What are the risk factors for coronary heart disease?

There is no single cause for CHD. There are controllable and non-controllable risk factors that can increase your chance of developing it.

CHD risk factors you can manage:

High blood pressure
High cholesterol
High blood sugar levels (diabetes)
Unhealthy diet
Being physically inactive
Being overweight or obese
Smoking and/or vaping
Drinking too much alcohol

Risk factors you can't change:

Family history of premature CHD
Getting older
Being male
Being post-menopausal
Cultural background – people of certain cultural backgrounds, including First Nations peoples, have increased risk of CHD

How is coronary heart disease diagnosed?

Many people don’t have any symptoms of CHD, so they don’t realise they have it.

It might be diagnosed after you have experienced an episode of acute coronary syndromes (ACS), specifically angina or heart attack.

Alternatively, it might be discovered by your GP during an examination or Heart Health Check.

To diagnose CHD, your GP will review your symptoms, ask about your family history of heart disease and conduct a physical examination. They may request you have some tests including:

Blood tests
Electrocardiogram (ECG)
Stress test
Echocardiogram (ECHO)
Coronary angiogram or coronary computed tomography angiogram (CCTA)
Myocardial perfusion study (MPS)
Computerised tomography scan (CT scan)

How is coronary heart disease treated?

You can’t cure CHD; it’s a chronic condition that requires lifetime management.

If you have been diagnosed with CHD due to an episode of ACS (angina or heart attack), the treatment will first focus on restoring good blood flow to the heart to address your immediate risk. Following that, or if you have been diagnosed without symptoms, management can involve reducing your risk factors, taking medicines as prescribed and surgical procedures if recommended.

Procedures

Percutaneous coronary intervention (PCI) – a small balloon is used to widen a narrowed or blocked artery, restoring blood flow to the heart. During this procedure, a small mesh tube called a stent may be placed into the artery to keep it open.
Coronary artery bypass graft (CABG) surgery – bypass surgery involves taking a healthy blood vessel from another part of your body (usually your leg or arm) and attaching it around the blocked part of the vessel. This provides a different route for blood to flow through, improving its supply to the heart.

Medicines

Angiotensin converting enzyme (ACE) inhibitors – lower blood pressure and reduce the strain on the heart.
Anti-coagulants – reduce the risk of blood clots forming.
Antiplatelet agents (aspirin) – reduce the risk of clots forming and limit damage if you have a heart attack.
Beta blockers – lower blood pressure and regulate your heart rate and rhythm.
Calcium channel blockers – lower blood pressure, relieve chest pain and slow heart rate.
Nitrates (glyceryl trinitrate (GTN)) – increase blood flow to your heart. These are available in a spray or dissolvable tablet form.
Statins – lower bad cholesterol and triglycerides.

Heart-healthy changes

Healthy habits can help prevent CHD leading to angina or a heart attack. Healthy changes include:  

following a heart-healthy eating pattern
being more physically active 
achieving and maintaining a healthy weight 
not smoking or vaping
cutting down on alcohol 
finding healthy ways to manage stress.

Find out more about making heart-healthy changes. 

Living well with coronary heart disease

You can live a long and active life with CHD by making healthy changes and following the advice of your healthcare professional team. Other supports can include cardiac rehabilitation and the Heart Foundation’s MyHeart MyLife support program.  

Cardiac rehabilitation – cardiac rehabilitation is a program of support, exercise and education about heart health. The goal is to keep you feeling well and out of hospital. You can do cardiac rehabilitation in-person or online. There are also options to participate in a group. Speak to your doctor for more information.  Visit the Cardiac Services Directory to find a cardiac rehabilitation program near you.  
MyHeart MyLife support program – MyHeart MyLife is the Heart Foundation’s free digital support program for people living with heart disease and those who care for them. The program will help you understand how to best manage your condition for a healthier, happier life.  Find out more about MyHeart MyLife.

Always dial Triple Zero (000) to call an ambulance in a medical emergency.

References

Australian Bureau of Statistics. Causes of Death, Australia. 2024. Accessed 7 January 2025. www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release
Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–477. doi:10.1093/eurheartj/ehz425
Lima Dos Santos CC, Matharoo AS, Pinzón Cueva E, et al. The influence of sex, age, and race on coronary artery disease: a narrative review. Cureus. 2023;15(10):e47799. doi: 10.7759/cureus.47799
Brieger D, Cullen L, Briffa T, et al. National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Australian clinical guideline for diagnosing and managing acute coronary syndromes 2024. Heart, Lung & Circulation. In press.

What is coronary heart disease?

Key takeaways

What is coronary heart disease (CHD)?

Is coronary heart disease the same as cardiovascular disease?