Heart disease: types, warning signs and care

Medical disclaimer: This page is general health information for education only. It is not medical advice and is not a substitute for diagnosis or treatment by a qualified health professional. It has not been reviewed by a clinician. In an emergency, call 911 or your local emergency number.

What is heart disease?

Heart disease is a general term for several conditions that affect how the heart is built and how it works. The CDC uses “heart disease” to cover several types of heart conditions. It is one of many topics in our library of common health conditions.

Some types of heart disease, called congenital heart disease, are present at birth. Other types develop over a lifetime and can affect the heart’s arteries, valves, muscle, or rhythm. MedlinePlus describes heart disease as a type of cardiovascular disease, which means disease of the heart and blood vessels.

Heart disease is the leading cause of death in the United States. The CDC reports that 1 out of every 5 US deaths is due to heart disease.

This page explains heart disease in general terms. It does not cover congenital heart disease, heart valve disease, or cardiomyopathy (disease of the heart muscle) in detail.

Coronary artery disease: the most common type

Coronary artery disease is the most common type of heart disease in the United States. It is also called coronary heart disease or ischemic heart disease.

Coronary artery disease happens when fatty deposits called plaque narrow the arteries that feed the heart muscle. Less oxygen-rich blood can reach the heart muscle as the arteries narrow.

• About 1 in 20 US adults aged 20 and older have coronary heart disease.
• In 2022, coronary heart disease caused 371,506 deaths in the United States.
• Many people learn they have it only after chest pain, a heart attack, or cardiac arrest.
• Coronary microvascular disease affects the heart’s tiny arteries and is more common in women.

These figures come from the National Heart, Lung, and Blood Institute (NHLBI) overview of coronary heart disease. Coronary artery disease can lead to angina (chest pain from reduced blood flow), heart attack, heart failure, and arrhythmia (an irregular heartbeat).

In the United States, someone has a heart attack every 40 seconds. About 805,000 people in the United States have a heart attack each year. About 1 in 5 heart attacks are silent, which means the person is not aware of it. These numbers come from CDC heart disease facts.

A heart attack is not the same as cardiac arrest. Cardiac arrest means the heart suddenly stops beating. This section describes coronary artery disease only and does not apply to other types of heart disease.

Heart attack warning signs: call 911

A heart attack happens when blood flow to part of the heart muscle is suddenly blocked. It is a medical emergency, so call 911 right away.

The NHLBI list of heart attack symptoms includes:

• Chest pain, heaviness, or discomfort in the center or left side of the chest. This is the most common symptom.
• Pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or above the belly button.
• Shortness of breath at rest or with light activity.
• Sweating a lot for no reason.
• Feeling unusually tired for no reason, sometimes for days.
• Nausea and vomiting.
• Light-headedness or sudden dizziness.
• A fast or irregular heartbeat.

Not every heart attack starts with sudden, crushing chest pain. Symptoms can start slowly, stay mild, or come and go over several hours. Some heart attacks cause very mild symptoms or none at all.

How symptoms can differ in women

Women and men who have a heart attack often have chest pain. Women are more likely to also have pain in the shoulder, back, or arm, shortness of breath, unusual tiredness and weakness, upset stomach, or anxiety. These symptoms can happen with or without chest pain, according to the NHLBI page on heart attacks in women.

Our guide to heart attack symptoms in women covers silent heart attacks and why women may wait longer for care.

Call 911 even if you are not sure it is a heart attack. Do not drive yourself to the hospital. For general emergency steps, see our first aid basics. This symptom list does not replace emergency care. It does not cover cardiac arrest, when the heart suddenly stops beating.

Who is at risk for heart disease?

High blood pressure, high cholesterol, and smoking are the three key risk factors for heart disease.

Almost half of US adults have at least one of these three key risk factors. Your risk rises with the number of risk factors you have and how serious they are. The NHLBI risk factor guide lists these as well:

• Health conditions: diabetes, overweight and obesity, chronic kidney disease, metabolic syndrome, sleep apnea, and some autoimmune diseases.
• Habits: physical inactivity, heavy drinking, poor sleep, eating patterns high in saturated fat and refined carbohydrates, and stress.
• Factors you cannot change: age, family history, and genes.

A family history of early heart disease raises your risk. This is especially true if your father or brother was diagnosed before age 55, or your mother or sister before age 65. Learn more about two major risk factors on our pages about high blood pressure and how it is measured and diabetes and blood sugar.

Having a risk factor does not mean you will develop heart disease. Having none does not mean you are fully protected.

How clinicians evaluate heart disease

Clinicians diagnose coronary heart disease based on your symptoms, medical and family history, risk factors, and heart test results.

At regular checkups, a provider may check your blood pressure and body mass index and order blood tests for cholesterol, triglycerides (a type of blood fat), and diabetes. Some providers use a risk calculator to estimate the chance of a heart attack or stroke over the next 10 years. A high risk score does not mean something bad will happen to you.

If you have symptoms or a family history, the NHLBI guide to diagnosing coronary heart disease names these tests:

Your provider may refer you to a cardiologist, a doctor who specializes in heart disease. This section describes common tests and does not tell you which test you need. That choice depends on your symptoms and history.

What ongoing care involves

Ongoing care for heart disease usually combines lifestyle changes, regular follow-up visits, and a treatment plan set with your care team.

Treatment depends on the type of heart disease, how serious the symptoms are, and your other health conditions. The NHLBI guide to living with coronary heart disease describes these common parts of care:

• Heart-healthy habits, such as eating well, staying active, not smoking, and getting enough sleep.
• Medicines, taken exactly as prescribed and never changed without talking to your provider.
• Procedures or surgery for some people with serious coronary heart disease.
• Cardiac rehabilitation, a medically supervised exercise program shown to lower the risk of hospitalization and death.
• Support for mental health, since fear, anxiety, and depression are common.

Call your provider about new or worsening symptoms. Call 911 for heart attack warning signs. Our guide to preparing for a medical appointment can help you get more from each visit. This page does not give treatment or medicine advice for any individual, so your plan should come from your own care team.

Questions to bring to your appointment

These questions can help you talk with your provider about heart disease. They do not replace a personal medical evaluation.

• What type of heart disease do I have, or am I at risk for?
• Which of my risk factors can I change, and where should I start?
• What are my blood pressure, cholesterol, and blood sugar numbers, and what do they mean for me?
• Do I need any heart tests, and what will the results tell us?
• Which heart attack symptoms should I watch for, including less common ones?
• Would cardiac rehabilitation or a referral to a cardiologist help me?