Introduction

Heart disease is the second killer disease (second only to cancer) in Hong Kong. Among the different types of heart disease, coronary heart disease is the commonest and it is increasing, especially among younger people.

Causes

• As one grows older, fatty tissue deposits as plaques on the inside walls of arteries. This becomes thicker and thicker so that the lumen of arteries becomes narrowed. This process is termed atherosclerosis.
• If the coronary artery is affected, there will be reduced blood supply to the heart, causing coronary heart disease.
• If the wall of the plaque ruptures, blood clots will be formed in the arteries. This will lead to blockage of the arteries and result in a heart attack.
• Risk factors for coronary heart disease include:
• high blood pressure
• high blood cholesterol
• smoking
• Family history of coronary heart disease
• Obesity or Diabetes mellitus
• Lack of exercise
• Chronic stress

Symptoms and Signs

• Sudden death without any previous symptoms
  • About 10% of patients with coronary heart disease do not have symptoms and only present as sudden death.
• Some people may have the following symptoms
  • Angina - Constricting chest pain. It usually occurs under physical exertion e.g. while doing exercise, brisk walking or under emotional stress. The pain gradually disappears after taking a rest.
• Acute myocardial infarction (heart attack) - Sudden onset of severe chest pain that may radiate to the neck, arm or jaw. The patient may develop profuse sweating, shortness of breath, nausea and vomiting or even pass out. Anyone with these symptoms should immediately seek medical treatment or attend the Accident & Emergency Department in a hospital.

Prevention of coronary heart disease

• Quit smoking and avoid excessive drinking.
• Regular exercise.
• Eat a balanced, low fat diet.
• Avoid overweight and obesity.
• Have a regular life and manage stress.
• Regular follow up for chronic illnesses e.g. hypertension and diabetes mellitus.