My name is Professor Kim Fox.
I'm a consultant cardiologist at the Royal Brompton Hospital.
Coronary heart disease is a narrowing of the coronary arteries
supplying blood to the heart.
You, as a patient, will notice chest pain
when you exert yourself.
The doctor may call this angina.
What is happening is the blood supply to the heart
is not adequate when you're walking,
hence the heart responds by causing pain in the chest.
Typically, the chest pain comes on when you're walking
and when you're under stress,
and goes away when you stop walking or the stress goes away.
If the pain is prolonged after walking,
or if the pain comes on at rest and is prolonged,
then there's a risk that you're having a heart attack,
and those would be the circumstances
when you need to call urgent medical attention.
Angina is important because in patients who have angina,
there is a risk in the future that they may go on to develop a heart attack.
However, the first thing I'd like to say to you
is that angina and people with angina
who have coronary heart disease
the prognosis, the outcome is excellent.
The first thing that needs to happen
when you've been told you may have coronary disease,
because you present with chest-pain angina,
is that you'll need to have some investigations
that will determine whether or not you do have the condition,
because many people have chest pain,
and don't have anything wrong with their heart at all.
If that shows that you do have angina,
that does show that you, therefore, have a coronary artery disease.
The situation will be discussed with your doctor,
who will then consider a number of treatments,
which can usually completely alleviate all the symptoms.
Patients when they have a heart attack
are certainly at greater risk than simply the episode of angina.
The most important symptom is chest pain.
Associated with that, you may be sweaty.
You may be pale, you may feel sick, you may vomit.
We have very sophisticated services
to treat heart attacks urgently.
In the vast majority of cases, this is very successful,
and the outcome of people with heart attacks
is extremely good.
On the background of all of this
is the importance of risk-factor control,
preventing the factors that will lead to a progression of the disease.
The most important is if you're a smoker,
you must stop smoking.
Other factors that need to be looked into
are whether your cholesterol is high,
and if your cholesterol is high, it needs to be treated.
Your blood pressure, if it's high, need to be treated.
If you have diabetes, that needs to be treated.
If you're overweight, you need to lose weight.
If you don't take any exercise, please take some exercise.
If you do all of these things,
then your chances of having a problem in the future
are remarkably reduced,
and this is very, very important.