CORONARY HEART DISEASE (CHD)
This section examines what coronary heart disease is and the role of psychology
in understanding CHD in terms of beliefs about CHD, the psychological impact of
CHD, predicting and changing behavioural risk factors and patient rehabilitation (see
Figure 15.7).
What is CHD?
The term ‘coronary heart disease’ (CHD) refers to a disease of the heart involving coron-
ary arteries which are not functioning properly. The most important diseases are angina,
acute myocardial infarction (MI, heart attack) and sudden cardiac death. All these forms
of CHD are caused by atherosclerosis which involves a narrowing of the arteries due to
fatty deposits which obstruct the flow of blood. Angina is a powerful pain in the chest,
which sometimes radiates down the left arm. It develops when blood flow to the coronary
arteries is restricted to such as extent that the heart muscle is starved of oxygen. An
acute MI occurs when blood flow is restricted below a threshold level and some heart
tissue is destroyed. It also seems to happen when a blood clot has further restricted blood
flow to the heart. Sudden cardiac death typically occurs in patients who have already
suffered damage to the heart through previous MIs although it can occur in patients who
previously seem to have healthy arteries.
The prevalence of CHD
Coronary heart disease is responsible for 33 per cent of deaths in men under 65 and 28
per cent of all deaths. It is the leading cause of death in the UK and accounted for 4300
Fig. 15-7 The potential role of psychology in CHDOBESITY AND CORONARY HEART DISEASE 371