Written with men in mind. Most of this guide applies to everyone. Details specific to women — such as screening ages and risks that differ — are not covered yet; female health guides are being written.
What it is
The heart muscle gets its own blood supply from the coronary arteries. In coronary heart disease, fatty plaque builds up inside these arteries and narrows them, so less oxygen-rich blood reaches the heart.[1] A heart attack happens when blood flow to part of the heart muscle is suddenly blocked; without quick treatment, that muscle starts to die.[2]
Coronary heart disease (also called coronary artery disease or ischemic heart disease) is caused by atherosclerosis — plaque made of cholesterol deposits in the artery wall.[1][3] Most heart attacks are caused by coronary artery disease. A heart attack is different from cardiac arrest, though it can trigger one.[2]
Myocardial infarction results from acute coronary occlusion, usually plaque rupture with thrombosis, producing ischaemic necrosis of the supplied myocardium.[2] Evaluation of chronic coronary disease uses risk factors, ECG, stress testing, coronary calcium scoring, CT coronary angiography or invasive angiography.[4] Management combines risk-factor control, lipid-lowering, antiplatelet and anti-anginal therapy, and revascularisation (PCI or CABG) where indicated.[5]
See the heart and its coronary arteries in 3D.
See it in 3DHow common it is
What happens with age
Age is a risk factor: plaque builds up over decades, and risk rises as you get older.[7] The good news is that plaque build-up may be slowed, stopped or even reversed with a heart-healthy lifestyle and, when needed, medicines.[1]
Causes and risk factors
Things you can't change
Things you can change
Symptoms worth reporting to a doctor
- Chest pain or discomfort, which may come with effort and ease with rest (angina)
- Shortness of breath
- Unusual tiredness with activity
Many people don't know they have coronary heart disease until they have chest pain, a heart attack or cardiac arrest.[1] Erection problems can share the same causes as heart disease, so they're worth mentioning to your clinician too.[8][9]
Get urgent care if…
Screening: who, when and how
There's no single screening test for heart disease, but these checks find the risk factors early:
- Blood pressure: all adults from 18; every year from 40.[11]
- Cholesterol and statin discussion: from 40 to 75, a statin is recommended for adults with at least one risk factor and a 10-year risk of 10% or more (grade B).[12]
- Prediabetes and type 2 diabetes: at 35–70 for adults with overweight or obesity.[13]
How it's diagnosed
- Blood tests
- Cholesterol, triglycerides, blood sugar and markers of inflammation.[4]
- Electrocardiogram (ECG)
- Records the heart's electrical activity and rhythm.[4]
- Stress test
- Watches the heart during exercise (or medicine that mimics it) for signs of low blood flow.[4]
- Coronary calcium scan and CT angiography
- CT scans that show calcium or narrowing in the coronary arteries.[4]
- Invasive coronary angiography
- Dye injected through a catheter shows blockages on X-ray.[4]
Types of treatment
- Heart-healthy living. Eating patterns such as DASH, regular activity, quitting smoking and vaping, 7–9 hours of sleep and a healthy weight.[5]
- Medicines. To lower cholesterol (such as statins), control blood pressure, prevent clots (such as low-dose aspirin when prescribed) and relieve angina.[5]
- Opening or bypassing arteries. Angioplasty (PCI), usually with a stent, or coronary artery bypass surgery (CABG) for severe disease.[5]
Which option fits depends on the details of each person’s situation. Your care team decides with you.
What you can do
Questions to ask your doctor
- What is my 10-year risk of heart attack or stroke?
- Should I take a statin?
- Are my blood pressure and blood sugar in a healthy range?
- Is my chest discomfort angina? What should I do if it happens again?
- Is cardiac rehabilitation right for me after a heart attack?
Myth vs. fact
Guided lesson
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Start chapter 1 freeRelated topics
Abdominal aortic aneurysm (AAA)
A bulge in the body's main artery that usually causes no symptoms. Men 65–75 who have ever smoked should have a one-time ultrasound.
Erectile dysfunction (ED)
Trouble getting or keeping an erection is common and treatable — and it can be an early clue to heart and blood-vessel problems worth checking.
High blood pressure
Half of US men have it, and most people feel nothing. A simple check finds it; habits and medicines control it.
Type 2 diabetes and prediabetes
Blood sugar that stays too high. Millions have it without knowing — and prediabetes can often be stopped from progressing.
Sources
- NIH National Heart, Lung, and Blood Institute. Coronary Heart Disease. Checked 23 October 2026.
- NIH National Heart, Lung, and Blood Institute. Heart Attack. Checked 23 October 2026.
- NIH National Heart, Lung, and Blood Institute. Atherosclerosis. Checked 23 October 2026.
- NIH National Heart, Lung, and Blood Institute. Coronary Heart Disease: Diagnosis. Checked 23 October 2026.
- NIH National Heart, Lung, and Blood Institute. Coronary Heart Disease: Treatment. Checked 23 October 2026.
- Centers for Disease Control and Prevention. Heart Disease Facts. Checked 23 October 2026.
- Centers for Disease Control and Prevention. Heart Disease Risk Factors. Checked 23 October 2026.
- NIH National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Erectile Dysfunction. Checked 23 October 2026.
- American Heart Association News. Erectile dysfunction may be warning sign for more serious health problems (2018). Checked 23 October 2026.
- Centers for Disease Control and Prevention. Heart Attack Symptoms, Risk, and Recovery. Checked 23 October 2026.
- US Preventive Services Task Force. Hypertension in Adults: Screening (April 2021). Checked 23 October 2026.
- US Preventive Services Task Force. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults (August 2022). Checked 23 October 2026.
- US Preventive Services Task Force. Prediabetes and Type 2 Diabetes: Screening (August 2021). Checked 23 October 2026.
- US Department of Health and Human Services. Physical Activity Guidelines for Americans: Top 10 Things to Know. Checked 23 October 2026.
The owner of this website is not a doctor. Human Atlas provides educational anatomy information and does not diagnose, stage, or treat disease. Talk to a qualified clinician about anything concerning your own health.