CHD: A Non-Communicable Disease (AQA GCSE Combined Science: Trilogy: Biology): Revision Note

Exam code: 8464

Lára Marie McIvor

Written by: Lára Marie McIvor

Reviewed by: Dr Natalie Lawrence

Updated on

Loading video: 9.1.6 AQA GCSE Coronary Heart Disease

Coronary heart disease

  • The heart needs a supply of blood to deliver oxygen, glucose and other nutrients, and to remove waste products such as carbon dioxide

  • Blood is supplied to the heart by the coronary arteries

What is coronary heart disease?

  • In coronary heart disease (CHD) layers of fatty material build up inside the coronary arteries

  • If a coronary artery becomes partially or completely blocked by these fatty deposits, blood flow is reduced

    • The fatty deposits form a structure known as a plaque

  • This results in a lack of oxygen for the heart muscle, reducing aerobic respiration

    • Cells will have less energy and the heart may be unable to beat effectively

Diagram comparing a normal artery, with normal blood flow and open lumen, with a narrowed artery containing plaque, causing abnormal blood flow; cross-sections show the narrowing leading to coronary heart disease.
Fatty deposits can narrow the coronary arteries, reducing blood flow to the heart.

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Treating coronary heart disease

  • Treatment of CHD involves either:

    • increasing the width of the lumen of the coronary arteries using a stent

    • prescribing statins to lower blood cholesterol

Treating CHD: Stents

  • Stents can be used to keep the coronary arteries open

    • A narrow tube is threaded up through the groin up to the blocked vessel

    • A tiny balloon is then inflated

    • The balloon pushes the metal or plastic stent against the wall of the artery, increasing the width of the lumen

    • The balloon and tube are then removed

  • Stents are very effective at reducing the risk of a heart attack as they widen the lumen to increase blood flow to the coronary arteries, and the procedure is relatively simple

  • Stents also last a long time, which is a positive, however, there is a risk of blood clots (thrombosis) occurring

Advantages of stents

Disadvantages of stents

Effective at reducing the risk of a heart attack as they widen the lumen and increase blood flow

Last a long time

Simple, minor surgery to insert a stent

Risk of blood clots occurring

Risk of infection during surgery

Risk of damage to the blood vessel during surgery

How stents are inserted

Diagram of a coronary artery showing three stages of stent procedure: insertion, balloon expansion opening the artery, and metal stent left in place.
Inserting a stent into a blocked artery is a relatively simple surgical procedure

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Treating CHD: Statins

  • Statins are drugs that are widely used to reduce the levels of cholesterol in the blood

  • This slows down the rate of fatty material build-up in the blood, reducing the risk of CHD occurring

Advantages of statins

Disadvantages of statins

Reduce the levels of harmful cholesterol in the blood which reduces the risk of fatty deposits building up

Need to be taken regularly and long-term to remain effective

Take some time to have an effect

Side effects of statins include muscle and joint pain, kidney problems and neurological issues

Faulty heart valves

  • The heart valves play a vital role in ensuring blood is pumped from the ventricles to the arteries, in one direction only

  • In some people, heart valves may become faulty as a result of illness, old age or a heart attack

  • Valves can stiffen which can prevent them from opening fully to let blood flow through

    • This reduces the volume of blood pumped by the heart

  • Sometimes a faulty heart valve might develop a leak

    • This allows blood to flow from the ventricles back into the atria or the arteries back into the ventricles

  • Both issues reduce the effectiveness of the heart in pumping oxygenated blood around the body

  • Faulty heart valves can be replaced via surgery using:

    • biological valves from cows or pigs

    • mechanical valves

Valve replacement type

Advantages

Disadvantages

Biological valve

Highly effective

Less likely to leak

Need to be replaced after 12 - 15 years

Risk of immune rejection

Mechanical valve

Long-lasting

Less need to replace

Can increase the likelihood of blood clots

Lifelong need to take anticoagulant (anti-blood clotting) medication

Examiner Tips and Tricks

You may be asked to evaluate different methods of treatment for CHD and faulty valves.

You should carefully consider the benefits and risks associated with each type of treatment when doing this.

Heart transplants

  • In the case of heart failure a heart can be transplanted from a donor who has recently died

  • Waiting lists for organ transplants are often long, so an immediate solution can involve replacing the heart with an artificial heart made from plastic and metal

  • Artificial hearts may be used to:

    • keep patients alive while waiting for a heart transplant 

    • allow the heart to rest as an aid to recovery

Advantages

Disadvantages

Shorter waiting times

Less chance of the patient's immune system rejecting it

Do not work as well as real hearts

Increased risk of blood clots, leading to increased risk of stroke

Examiner Tips and Tricks

You should be able to evaluate the advantages and disadvantages of treating cardiovascular diseases with drugs, mechanical devices or transplants.

Issues to think about include:

  • the risk of surgical procedures vs. the benefits of a successful outcome

  • the ease of access to the treatment

  • the potential side effects/long-term impacts

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Lára Marie McIvor

Author: Lára Marie McIvor

Expertise: Content Creator

Lára graduated from Oxford University in Biological Sciences and has now been a science tutor working in the UK for several years. Lára has a particular interest in the area of infectious disease and epidemiology, and enjoys creating original educational materials that develop confidence and facilitate learning.

Dr Natalie Lawrence

Reviewer: Dr Natalie Lawrence

Expertise: Content Writer

Natalie has a MCantab, Masters and PhD from the University of Cambridge and has tutored biosciences for 14 years. She has written two internationally-published nonfiction books, produced articles for academic journals and magazines, and spoken for TEDX and radio.