1. coronary heart disease

2. the heart and blood flow From head and arms To right lung From right lung From legs and feet To legs and feet Aorta to all parts of the body To left lung From left lung

3. cardiovascular disease and coronary heart disease cardiovascular disease ( CVD, heart and circulatory disease) all diseases of the heart and blood vessels (e.g stroke, congenital heart defects, valvular heart disease, peripheral arterial disease) coronary heart disease (CHD, ischaemic heart disease) disease of the coronary arteries due to atherosclerosis

4. the coronary arteries

5. atherosclerosis Atheroma Artery wall Blood within the artery Atheroma (fatty deposits) building up Fat deposits develop, restricting blood flow through the artery

6. coronary artery with atheroma Atheroma Coronary Artery with atherosclerosis Coronary Artery

7. atheroma Atheroma (fatty layer) Cross SectionLongitudinal Section

8. angina and heart attack angina narrowed coronary artery tightness or ache in the chest, breathlessness, sick feeling, dizziness comes on with exertion or emotion goes away with rest - usually 2-10 mins heart attack due to sudden blockage of the coronary artery chest pain “like a band”, indigestion, breathlessness, sickness, looking pale comes on at any time doesn’t go away - if still there in 15 minutes call 999

9. clarifying some terms Heart failure the pumping action of the heart is less efficient, possibly caused by raised blood pressure, heart attack, or valve defect Heart attack (myocardial infarction) a coronary artery is suddenly blocked by a blood clot Cardiac arrest the heart stops beating when it quivers or fibrillates causing the person to collapse Stroke an artery leading to the brain is suddenly blocked with a blood clot or a bleed

10. main risk factors for coronary heart disease smoking inactivity obesity and overweight high blood pressure raised blood cholesterol diabetes family history of coronary heart disease excessive alcohol intake

11. smoking Smoking aggravates the lining of the arteries and speeds up the process of atherosclerosis carbon monoxide Takes the place of oxygen in the blood nicotine Raises heart rate and blood pressure transiently

12. physical inactivity 30 minutes a day at least 5 days a week which can be split into 15 minute periods regular, moderate intensity activity brisk walking, swimming, cycling, dancing, skipping, tennis, etc. enough to feel warm & slightly short of breath, but still able to hold a conversation

13. obesity caused by excessive calorie intake, and inactivity can lead to high blood pressure, raised blood cholesterol levels, and diabetes increases your risk of coronary heart disease and heart failure

14. high blood pressure the force of blood in the arteries is over 140/85mmHg can be lowered with more activity, weight loss, cutting salt and alcohol

15. high blood cholesterol levels cholesterol is a fatty substance needed for body cells it is carried on proteins called low-density or high density lipoproteins (LDLs or HDLs) saturated fats can increase levels – and sometimes people have inherited raised cholesterol levels

16. diabetes inability of the pancreas to produce enough insulin to control blood sugar levels uncontrolled blood sugar encourages the build up of fatty deposits within the arterial walls around 1.3 million people have diabetes in the UK. This may reach 2 million people by 2010

17. hormone replacement therapy oestrogen in the body may improve cholesterol levels and may make the artery more elastic however, hormone replacement therapy has not shown significant protection against coronary heart disease present evidence suggests that HRT should not be prescribed solely to reduce the risk of coronary heart disease