Do you occasionally experience pain in form of tightness or minor aching across the chest? Chances are that you could be at high risk of having coronary heart disease (CHD).

Medics explain that this condition happens when a waxy substance called plaque builds up inside the coronary arteries - the arteries that supply oxygen-rich blood to the heart muscle.

Dr Evarest Ntaganda, the director of cardiovascular diseases at Rwanda Biomedical Centre, explains that plaque can harden or rupture over time and that when this happens, it narrows the coronary arteries which in the end reduces the flow of oxygen-rich blood to the heart.

Plaque is the deposit on walls of arteries.

"Ruptured plaque also hardens and narrows the coronary arteries. A blood clot, on the other hand, can form in the process and this can completely block blood flow. If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, a heart attack can occur,” he explains.

Dr Claude Nzindukiyimana of King Faisal Hospital, Kigali, says that blood is pumped from the heart to the lungs, where it collects oxygen. This oxygen-rich blood is then pumped back to the heart and then to organs throughout the body through arteries.

Coronary arteries are the heart’s network of blood vessels, he says, and that they are on the heart’s surface supplying the heart muscle with oxygen. If the coronary arteries narrow, the supply of oxygen-rich blood to the heart may become too low leading to coronary heart disease, he adds.

Ntaganda says coronary heart disease starts when certain factors lead to damage of the inner layers of the coronary arteries.

Factors such as high blood pressure can be a cause, he says.

"When this pressure rises and stays high over time, it can damage the heart and lead to plaque build-up because the force of blood pushes against the walls of the arteries as the heart pumps blood,” he explains.

Ntaganda adds that high levels of certain fats and cholesterol in the blood, high levels of sugar in the blood due to insulin resistance or diabetes, blood vessel inflammation are some of the other risk factors.

Smoking a major risk factor

Smoking harms nearly every organ in the body, including the heart. May 31 was World No Tobacco Day and efforts to encourage abstinence from all forms of tobacco consumption around the globe were preached.

According to research done by the National Heart, Lung and Blood Institute, smoking is a major risk factor for heart disease. When combined with other risk factors such as unhealthy blood cholesterol levels, high blood pressure, and overweight or obesity it further raises the risk of heart disease.

Any amount of smoking, even light smoking or occasional smoking, damages the heart and blood vessels. For some people, such as women who use birth control pills and people who have diabetes, smoking poses an even greater risk to the heart and blood vessels, the research indicates.

The chemicals in tobacco smoke can damage the function of the heart and the structure and function of your blood vessels. This damage increases the risk of atherosclerosis (hardening and narrowing of the arteries).

Dr Marie Aimee Muhimpundu, the head of non-communicable diseases at Rwanda Biomedical Centre, says smoking is one of major factors that lead to heart diseases.

She says that as smoke enters one’s body it affects many parts and not only lungs as some people think.

"We are used to thinking that because smoke enters through the mouth and then to the lungs, it affects only those parts but when you look critically, effects of tobacco start from the hair to the toes. And smoking affects the function of the heart too,” she says.

Nzindukiyimana says smoking increases inflammation and causes more cholesterol to deposit in coronary arteries.

"A woman who smokes 20 cigarettes a day is six times more likely to develop CHD than a woman who has never smoked. Men who smoke regularly are three times more likely to develop CHD compared to men who have never smoked,” he says.

Symptoms of CHD

Some of the symptoms of this condition include indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath, says Nzindukiyimana.

"The first symptom is usually chest pain. It can spread to the neck, arms and possibly the shoulder blades and the back. Coughing, graying of the face and an overall feeling of being unwell and a sense of terror that life is coming to an end are some of the other symptoms,” he says.

Ntaganda says that a common symptom of coronary heart disease is angina. Angina is chest pain or discomfort that occurs if an area of the heart muscle doesn’t get enough oxygen-rich blood. This pain can also be felt in the shoulders, arms or the back and sometimes it can   even feel like indigestion.

"Another common symptom of CHD is shortness of breath. This symptom occurs if CHD causes heart failure. When this happens, fluid builds up in the lungs making it hard to breathe,” he says.

Ntaganda says that leading a healthy lifestyle and regular checkups are one way of preventing the disease.

He says controlling blood cholesterol levels reduces the risk of CHD. Being physically active, limiting alcohol intake, avoiding tobacco, and consuming a healthy diet with reduced sugar and salt can also help, the medic adds.

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