Coronary heart disease & heart failure

For your heart to work properly, it needs a steady supply of oxygen-rich blood. This is delivered by the coronary arteries. If these arteries become narrowed or blocked—usually due to a build-up of fatty deposits called plaques—the heart muscle doesn’t get enough oxygen. This condition is known as coronary heart disease, or CHD.

CHD can cause chest pain (angina) or lead to a heart attack. Over time, it can also weaken the heart muscle, making it harder for the heart to pump blood effectively. This can eventually lead to heart failure, a long-term condition where the heart can’t meet the body’s needs as well as it should.

Understanding and managing CHD is an important step in preventing or slowing the progression of heart failure. If you have CHD or high blood pressure, working with your healthcare team to manage these conditions can make a big difference to your heart health.

How CHD develops into severe heart failure

Heart failure can develop for many reasons, but one of the most common causes is coronary heart disease (CHD). Other contributing conditions include high blood pressure, irregular heart rhythms, heart valve problems, and previous heart attacks.

CHD happens when the arteries that supply your heart muscle with oxygen-rich blood become narrowed or blocked. These arteries—called the coronary arteries—can become clogged with fatty deposits, reducing the flow of blood to the heart. When the heart muscle doesn’t get enough oxygen over time, it becomes weaker and less able to pump blood effectively.

If this lack of oxygen continues, the heart’s pumping ability can decline significantly. This can lead to chronic heart failure, a long-term condition where the heart can’t keep up with the body’s needs.

Managing CHD early—through lifestyle changes, medication, and regular check-ups—can help reduce the risk of developing heart failure later on.

In the early stages of heart failure, you might only notice symptoms during physical activity. Things like climbing stairs or walking uphill may leave you feeling unusually tired or short of breath. But as the condition progresses, the heart’s reduced ability to pump blood means symptoms can start to appear even when you're resting.

The impact of coronary heart disease (CHD) on your heart depends on which parts of the heart are affected by narrowed arteries. If the right side of the heart is weakened, blood can back up in the veins. This may lead to fluid build-up (oedema) in the legs, ankles, or even the abdomen and liver in more advanced cases.

If the left side of the heart is affected, blood may back up into the lungs. This can make breathing difficult, especially during physical activity. In more severe cases, breathlessness may occur even when lying down or at rest.

When both sides of the heart are affected, symptoms from both types of congestion can appear together—such as swelling in the legs and breathlessness.

Although heart failure is a long-term condition, it can often be managed effectively with the right treatment. That’s why it’s important to take any prescribed heart medications regularly and attend follow-up appointments. These treatments help reduce symptoms, improve quality of life, and may slow the progression of the disease.