The treatment for CHD varies depending on the symptoms and how much the disease has progressed. The general treatments include lifestyle changes, medications, and sometimes surgery.

Lifestyle changes may include:

• Losing weight
• A low saturated fat, low cholesterol diet to help reduce cholesterol
• Reducing sodium (salt) to keep high blood pressure under control
• Regular exercise
• Quitting smoking

Medications may include:

• Cholesterol-lowering medication
• Antiplatelet agents, such as aspirin, ticlopidine, or clopidogrel, to reduce the risk of blood clots
• Glycoprotein IIb-IIIa inhibitors, such as abciximab, eptifibatide, or tirofiban, to reduce the risk of blood clots
• Antithrombin drugs, such as blood-thinners (low-molecular heparin, unfractionated heparin), to reduce the risk of blood clots
• Beta-blockers to decrease heart rate and reduce oxygen use by the heart
• Nitrates such as nitroglycerin to dilate the coronary arteries and improve blood supply to the heart
• Calcium-channel blockers to relax the coronary arteries and all arteries in the body, thus reducing the workload for the heart
• ACE inhibitors, diuretics, or other medications to lower blood pressure

Percutaneous Coronary Interventions (PCI's) include:

• Coronary angioplasty (Balloon PTCA)
• Coronary atherectomy
• Ablative laser-assisted angioplasty
• Catheter-based thrombolysis and mechanical thrombectomy
• Coronary stenting (placing a tube in the artery to keep it open)
• Coronary radiation implant or coronary brachytherapy

Coronary brachytherapy consists of delivering beta or gamma radiation into the coronary arteries. This new treatment is reserved for patients who have undergone stent implantation in a coronary artery and developed problems, such as diffuse in-stent restenosis.

Brachytherapy is a promising technique but is currently limited by certain complications. In addition, the long-term effects of radiation are unknown, as coronary brachytherapy was only approved by the FDA in late 2000. FDA approval of brachytherapy is currently restricted to treatment of stent-related problems, although in some medical centers brachytherapy is being studied as a first-line treatment of coronary disease.

Surgical procedures include:

• Coronary artery bypass surgery
• Minimally invasive heart surgery

The outcome is variable. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications as long as they are closely monitored. Others may require more definitive interventions, such as PTCA or surgery. Although everyone is different, it is always essential to detect CHD early for the best outcome.

• Heart attack
• Unstable angina
• Sudden death

If you have any of the risk factors for CHD, you should contact your health care provider for appropriate prevention and treatment. If you experience angina, shortness of breath, or symptoms of a heart attack, contact your health care provider, call 911 or go to the emergency room immediately.