Heart disease: symptoms, types, causes and treatment

The NHS says the most common symptoms of coronary heart disease are chest pain (angina) and breathlessness, but some people may not have any symptoms before they are diagnosed. Its overview lists the main symptoms as chest pain, shortness of breath, pain in the neck, shoulders, jaw or arms, feeling faint and feeling sick.

The British Heart Foundation says CHD develops slowly over time and the symptoms can be different for everyone, and that some people do not know they have it before they have a heart attack. It describes angina as chest pain or an uncomfortable feeling that happens when blood flow to the heart muscle is reduced.

The NHS describes coronary heart disease as what happens when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries. Over time the artery walls can become furred up with fatty deposits, a process called atherosclerosis, and the deposits are called atheroma. It is sometimes called ischaemic heart disease or coronary artery disease.

The British Heart Foundation explains that if a piece of atheroma breaks off, a blood clot forms around it to try and repair the damage to the artery wall, and this clot can block the coronary artery and cut off the supply of blood and oxygen to the heart muscle, which is known as a heart attack.

The NHS uses the wider term cardiovascular disease (CVD) for a group of conditions that affect your heart and blood vessels. The table below shows the main types it lists.

The NHS says treatment for coronary heart disease can help manage the symptoms and reduce the risk of further problems. It can be managed effectively with a combination of lifestyle changes, medicine and, in some cases, surgery. With the right treatment, symptoms can be reduced and the functioning of the heart improved.

For medicines, the NHS says many different ones are used, and they usually aim to reduce blood pressure, widen your arteries or prevent blood clots. Heart medicines should not be stopped suddenly without the advice of a doctor, as there is a risk this may make symptoms worse. The British Heart Foundation lists medications, coronary angioplasty with or without a stent, and heart bypass surgery as treatment options.

The NHS says atherosclerosis can be caused by lifestyle factors such as smoking and regularly drinking excessive amounts of alcohol, and that you are more at risk if you have conditions such as high cholesterol, high blood pressure or diabetes. For cardiovascular disease generally it lists age (it mainly affects people over 50), sex (men are more likely to get CVD than women), ethnicity (South Asian, Black African or African Caribbean backgrounds), and having family members with CVD.

The British Heart Foundation lists high blood pressure, high cholesterol, diabetes, smoking, living with excess weight or obesity, not doing enough physical activity, family history of CHD and getting older. It says men have a higher risk from a younger age, women's risk lower before the menopause but increasing during and after it, and that transgender people may have a higher risk.

The NHS says that if a doctor feels you are at risk of coronary heart disease they may carry out a risk assessment, asking about your medical and family history and lifestyle and taking a blood test. Further tests may be needed to confirm it, including an electrocardiogram (ECG), an echocardiogram, a chest X-ray and a coronary angiogram.

The British Heart Foundation adds exercise stress tests, radionuclide tests, MRI scans and CT scans to the list of tests that may be used, and says that a free NHS Health Check is available if you are between 40 and 74 years old and live in England, to assess your risk.

The NHS says you can reduce your risk of coronary heart disease by making simple lifestyle changes: eating a healthy, balanced diet, being physically active, giving up smoking and controlling blood cholesterol and sugar levels. It adds that keeping your heart healthy also helps reduce the risk of stroke and dementia.

For cardiovascular disease generally, the NHS says that if you have a high chance of getting it you may be advised to take statins, and suggests reducing fatty foods, exercising regularly, keeping to a healthy weight, cutting down on alcohol and stopping smoking. It says the NHS Health Check is a free check-up for people aged 40 to 74 to check the health of the heart and blood vessels.

The NHS says to call 999 if you have chest pain that feels tight or like squeezing, chest pain that is spreading to your arms, neck or jaw, severe difficulty breathing (gasping, choking or not able to get words out), lips or skin that are pale, blue or grey, or if someone has passed out and is not responding normally. Do not drive yourself to A&E.

The NHS says to call NHS 111 if you are suddenly more short of breath than usual, or have chest pain and feel sick, or have chest pain and a racing, slow, skipping or fluttering heartbeat.

While you are waiting for help, the NHS suggests sitting and resting in a comfortable position, taking a 300mg aspirin if you have one and are not allergic, and using your GTN spray if you have angina. If someone stops responding and stops breathing, start CPR.

On the NHS, heart disease is usually found and followed up through your GP, NHS Health Checks, and cardiology services. Emergency heart attacks are treated through 999 and hospital cardiac services. Ongoing medicines such as statins, blood thinners and blood pressure treatments are usually prescribed and followed up by a GP or specialist.

Some people also use private cardiology clinics for tests such as ECGs, echocardiograms and stress tests. The tests and treatments described above are the same, and emergency symptoms should always be treated as a 999 matter rather than waiting for a private appointment.