Coronary Heart Disease (CHD) is our number one killer in Western developed nations. The two major forms of the disease are angina pectoris and myocardial infarction (heart attack).
Angina pectoris develops when the space inside of the coronary arteries become narrowed, but not completely closed. At rest the person is usually asymptomatic. When the person does some physical activity and the heart muscle has to work harder, the atherosclerotic artery cannot supply enough blood to feed the heart muscle. The result is a very typical gripping chest pain behind the sternum, usually radiating to the neck and left arm, rarely the right arm. The pain disappears with rest in the initial stages. As the disease progresses the person has to take medication such as glyceryl trinitrate or other nitrate drugs, which dilates the artery and improves circulation.
Myocardial infarction or heart attacks develop when the coronary artery closes up completely and the blood supply to the heart muscle stops. The result is death of that portion of the heart fed by that particular artery. Usually the heart attack is manifested by severe chest pain that is not connected with any physical activity and not helped by nitrates. The pain is usually accompanied by extreme fear, cold sweat, nausea and shock. In rare cases heart attack may be silent, without the pain. About half of all people who have a heart attack die in the first 2-3 hours.