Coronary heart disease (CHD), also called coronary artery disease (CAD),
ischaemic heart disease,
atherosclerotic heart disease, is the end result of the accumulation of
atheromatous plaques within the walls of the
arteries that supply the
myocardium (the muscle of the
heart) with oxygen and nutrients. While the symptoms and signs of coronary heart disease are noted in the advanced state of disease, most individuals with coronary heart disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, often a "sudden"
heart attack, finally arise. After decades of progression, some of these
atheromatous plaques may rupture and (along with the activation of the
blood clotting system) start limiting
blood flow to the
heart muscle. The disease is the most common cause of
sudden death, and is also the most common reason for death of men and women over 20 years of age. According to present trends in the United States, half of healthy 40-year-old males will develop CHD in the future, and one in three healthy 40-year-old women. According to the
Guinness Book of Records,
Northern Ireland is the country with the most occurrences of CHD.
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