What heart disease is
"Heart disease" is a broad term, but the most common kind is coronary heart disease (CHD). It happens when the arteries that carry blood to the heart get narrowed by a slow build-up of fatty material. When the heart can't get enough blood and oxygen, problems follow — most often chest pain (angina) and, at its most serious, a heart attack.
The NHS describes coronary heart disease as a major cause of death in the UK, but also one that's very often managed well with the right treatment and lifestyle support. Many people live full, active lives with it for years.
A related condition is heart failure — which sounds frightening but doesn't mean the heart has stopped. It means the heart has become too weak to pump blood around the body as well as it should, so people may feel breathless and tired, and fluid can build up (often in the legs, ankles, or lungs).
You don't need to be an expert in any of this. What matters is recognising when someone needs help, supporting their day-to-day routine, and knowing the difference between "report this" and "call 999 now".
Angina — chest pain that's a warning sign
Angina is chest pain caused by the heart not getting enough blood, usually during effort or stress. The NHS describes it as a feeling of heaviness or tightness in the centre of the chest, which can spread to the arms, neck, jaw, back, or stomach. It's often brought on by activity or upset, and it usually eases within about 10 minutes with rest.
Many people with angina are prescribed a GTN spray or tablet (glyceryl trinitrate) to use when it comes on. This is their prescribed medicine, used in their way — your role is to help them use what they've been prescribed as their care plan describes, not to decide on or give medicines yourself. The usual pattern people are taught is to stop and sit down, use their GTN, and rest.
Angina itself isn't usually an emergency — but it's an important warning sign that the heart needs care, so changes in someone's angina (more often, more severe, or coming on at rest) should be reported.
Heart attack — a 999 emergency
A heart attack is when the blood supply to part of the heart is suddenly blocked. This is always an emergency. The signs the NHS lists include:
- chest pain or discomfort that's severe, or doesn't go away
- pain spreading to the arms, jaw, neck, back, or stomach
- feeling sick, sweaty, light-headed, or short of breath
- a feeling of heaviness or tightness, sometimes mistaken for indigestion
Two things help you tell a heart attack from angina: the pain is usually more severe and lasts longer, and it is not relieved by resting or a GTN spray. A useful rule taught by heart services: if chest pain lasts longer than about 15 minutes, or GTN hasn't helped after using it as prescribed, treat it as a heart attack.
What to do: call 999 straight away. Help the person sit down and stay calm and still while you wait. Don't delay to "see if it passes". A heart attack can happen at any time, even at rest, and getting help fast saves heart muscle and lives. Follow your training and their care plan. (Note: it can also happen with very few symptoms — a "silent" heart attack — which is more common in older people and people with diabetes, so always take chest symptoms seriously.)
Heart failure — what to watch for
For someone living with heart failure, your steady eye day to day is genuinely valuable. Helpful things to notice and report include:
- more breathlessness than usual — when active, lying flat, or at night
- swelling in the ankles, legs, or tummy
- sudden weight gain over a few days (often a sign of fluid building up)
- more tiredness, or struggling with things they managed before
People with heart failure are often asked to weigh themselves regularly and follow "sick day" advice — your part is to support that routine and to pass on changes, not to adjust any treatment.
How you help, safely
Most of what helps is everyday and squarely within your role:
- Support a heart-healthy routine. Encourage balanced meals, gentle activity as their plan allows, and not smoking — all of which the NHS links to better heart health.
- Support their medicines routine. Many people take several heart medicines. Help them keep to their routine in the way their care plan sets out — but you don't decide on, change, or give medicines outside your training and the plan.
- Notice and report. Changes in chest pain, breathlessness, swelling, or energy are all worth passing on.
- Help them get to appointments. Heart reviews, blood tests, and cardiac rehab all matter; supporting someone to attend protects their health.
- Know the emergency line. Chest pain that's severe, lasts beyond ~15 minutes, or isn't eased by their GTN means call 999.
And the boundaries: you don't diagnose, you don't decide on or change heart medicines, and you don't give medicines unless you've been trained and it's in the care plan. Those belong to the person, their family, and their heart team. When in doubt, ask.
The takeaway
Heart disease is common and, with the right care, very manageable. Your part is to understand the basics, support the person's routine and care plan, and know the difference between something to report and a 999 emergency. Recognising a heart attack and acting fast is one of the most important things any carer can do — and the rest is the steady, everyday support that helps someone live well with their heart.
Where this comes from
- NHS — Coronary heart disease; Heart attack; Heart failure (nhs.uk)
- NHS — angina and GTN guidance (nhs.uk)
- British Heart Foundation — living with heart conditions (bhf.org.uk)
This article is general information to build awareness. It is not medical advice and not a substitute for a person's care plan or their heart team. Always follow the care plan and current professional guidance, and call 999 in an emergency.