The paper also looks at the future of the spread of CHD and other such so-called “lifestyle” illness and the impact this will have on the healthcare systems of the less developed world. The paper also looks at the social determinants of cardiovascular diseases, including CHD. The other thing that is examined in this document is the place for self care and self management of chronic illnesses especially in the homes and in the communities where a lot of such illnesses need to be managed, with the intention of reducing the need for making too many trips to the hospital for the patient and also ensuring that his or her psychosocial needs are met right at the place where they live. The report uses the case study of a CHD patient to ensure that the lessons learned and best practices in self management of chronic illnesses can be utilised and used as teaching tools not just for the patient but also for those members of their families and their community that are charged with the task of taking care of them and following up on their needs as patients and family members. Coronary heart disease is a condition caused by the build up of fat and cholesterol deposits in the walls of the arteries of the heart. These deposits result in the constriction of the arteries which leads to a reduction of the flow of blood to the heart. This build up of deposits happens gradually over time and usually the first signs that this manifests itself in are in breathlessness and chest pains. The first symptoms of CHD include chest pain or angina. Coronary heart disease can often lead to heart attacks, irregular heartbeat and heart failure. Coronary heart disease kills more people in the United Kingdom than any other disease, with about 82,000 deaths reported annually. A further 2.7 million are estimated to be living with the condition (NHS(b), 2012). In the United States there are over 7 million people living with CHD and every year more than 600,000 die of CHD and related illnesses (Surgical Associates of Texas, 2005). The prevalence of CHD is highest among those over 65 years of age (19.8%) while the prevalence among the men in the population is much higher than that in women, at 7.8% and 4.6% respectively (CDC, 2011). There are certain factors that increase the risk of contracting CHD. These include smoking, being overweight, a sedentary lifestyle with lack of exercise, excessive intake of alcohol, family history of heart disease, high blood pressure and diabetes (Canvin, 2012). CHD is diagnosed by various tests that are conducted which include blood tests to see the amount of fat and cholesterol in the blood, an electrocardiogram (ECG), chest x-ray, CT and MRI scans (Canvin, 2012; Heart Foundation, n.d.). Other tests include the angiogram, also called cardiac catheterization, where a dye is injected into the body via a thin tube known as a catheter. The images taken showing how the dye flows through the body are used to determine how effective blood flows through the body. Another test is the stress test where typically a client is placed on a treadmill at changing inclines and speeds and any abnormalities in the rate and rhythm of the heartbeat is measured. Additionally a dye can be introduced into the body intravenously and then x-rayed to show how effectively blood is being pumped through the body (Milano, 2013). CHD has no cure once diagnosed.