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Coronary heart disease (CHD) is the most common cause of death and disability in the United Kingdom. It causes around 94,000 deaths in the UK each year and around one in five men and one in seven women will die from the disease.

Coronary heart disease is usually caused by atherosclerosis, where fatty deposits (atheroma) develop in the walls of the arteries.  Atherosclerosis causes symptoms when it partially or completely blocks the arteries that supply the heart muscle with blood. This manifests as a number of conditions including stable angina (where atheroma restricts blood flow) and acute coronary syndromes (where clot formation occurs on the atheroma and causes an abrupt narrowing or complete blockage of the artery). These are described in the relevant sections.

There are two ways to improve blood flow to heart muscle when the arteries become blocked. Percutaneous Coronary Intervention (PCI) and surgical coronary artery bypass grafting (CABG).

PCI is performed under local anaesthetic. A small balloon is inserted and inflated to widen the narrowing. In most cases a ‘stent’, a metal mesh scaffold, is then implanted to keep the artery open.

PCI is used in a stable setting to alleviate the symptoms of angina, and in a more urgent or emergency setting to restore coronary blood flow during a heart attack.