Coronary Heart Disease Overview

Coronary heart disease is a condition which is characterised by the interruption or blockage of blood flow to the heart, caused by fat build-up in the coronary arteries. People who smoke, drink a lot of alcohol and have a diet high in fat and sugar are particularly susceptible to coronary heart disease. It is one of the leading causes of death worldwide and there are currently around 2.3 million people in the UK living with the condition.

What are the signs and symptoms of Coronary heart disease?

  • Chest pain (angina)
  • Breathlessness
  • Pain throughout the body
  • Feeling faint
  • Nausea

People with coronary heart disease are at risk of developing other conditions, such as:

  • Stroke
  • Heart attacks

How is Coronary heart disease diagnosed and treated?

GPs may suggest that someone at risk of coronary heart disease be assessed for heart disease. Someone is considered at risk if they have a family history of the disease, if they are overweight or if they are a smoker.

An assessment will typically involve a blood pressure check and a blood test to assess cholesterol levels.

Since symptoms are shared by other conditions such as asthma, a chest x-ray, MRI scan and various other tests can also help confirm coronary heart disease.

There is no cure but treatments to improve quality of life and prevent the condition worsening can include:

  • Stopping smoking to prevent worsening of Coronary heart disease
  • Balanced diet to reduce blood pressure, lower cholesterol and reduce risk of diabetes (risk factors of coronary heart disease)
  • Regular exercise to improve heart health
  • Blood-thinning medicine to reduce the likelihood of a blood clot, such as low-dose aspirin
  • Beta-blocker medication to reduce blood pressure
  • Nitrates to widen blood vessels (in tablet, spray or skin patch form)
  • Statins to reduce cholesterol levels

In serious cases when the heart has become too damaged to benefit from other treatments, a heart transplant may be necessary. Arterial bypasses or stents are other surgical procedures which work by opening up a blocked artery, or rerouting, the flow of blood to improve blood flow to the heart.

There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with Coronary heart disease:

  • An employer can enquire sensitively as to the sorts of reasonable adjustments that the employee with Coronary heart disease may have had in the past, such as relocation of their work station away from an open window if the air outside is particularly polluted.
  • Even if the employee does not wish to disclose their Coronary heart disease, an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
  • Given that Coronary heart disease can evolve over time, with certain symptoms worsening as the person ages, it is important to maintain regular communication with the employee who has Coronary heart disease so that the reasonable adjustments remain appropriate.

What reasonable adjustments are possible for employees with Coronary heart disease?

Employers have a legal duty to make reasonable adjustments for employees with Coronary heart disease if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has Coronary heart disease. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of Coronary heart disease:

  • Time off to attend appointments, receive treatment and to rehabilitate, particularly after a surgical procedure. Discussion with the employee of how to manage a phased return to work is also recommended.
  • Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. If the person has difficulty breathing, they may wish to avoid carrying out outdoor work during cold weather.
  • Raising awareness so that colleagues understand the employee’s coronary heart disease and can help ensure the employee feels comfortable at work. This may also encompass general education of employees on the common risk factors such as unhealthy diet and excessive drinking.

Coronary heart disease Signposting

British Heart Foundation – charity which funds research into heart and circulatory diseases, as well as provides resources for people of all ages living with all types of heart condition, including information on risk factors for heart disease (0300 330 3311).

Heart Research UK – charity which provides information on prevention and treatment of heart conditions, including coronary heart disease, as well as investing in research into heart health and community groups (0113 234 7474).

Heart UK – charity dedicated to educating people about cholesterol and how high cholesterol can lead to heart disease. It also provides resources on diet for improving and maintaining heart health and information to health professionals caring for people with raised cholesterol (0345 450 5988).

Other Research Resources

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