Heart Disease

Cardiovascular

The term “heart disease” encompasses a broad range of diseases that cause the heart and blood vessels to not work right. This includes coronary artery disease, congenital heart defects, valve disease, and problems with the heart rhythm. You may also hear heart disease referred to as “cardiovascular disease”, which stands for any heart or blood vessel condition that reduces the amount of blood flow to the heart.

Heart disease is the leading cause of death in the United States. It comes in many different forms and is caused by the coronary arteries becoming blocked or narrowed. This decreases the blood supply to your heart. It can come on slowly due to family history, poor diet, and lack of exercise. It can also be present as birth. This is known as congenital heart disease (CHD).

Around 610,000 people in the U.S. die from heart disease each year. That amounts to around 1 in every 4 people who die. It affects both men and women equally, but over half of the heart disease deaths are often males. Each year, over 735,000 people in the United States suffer from heart attacks.

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Symptoms

There are several types of heart disease with specific sets of symptoms unique to each and will be covered in the next section. Often, the symptoms of heart disease may be silent and a patient lives undiagnosed until symptoms of a heart attack or heart failure occur. These symptoms are an emergency and if you are having any one of the following, seek emergency care immediately:

Arrhythmia. Symptoms are fluttering feelings in the chest known as palpitations.

Heart attack. Occurs when part of the heart is not receiving enough or any blood. The longer the heart goes without proper blood supply the more damage occurs. Symptoms include chest pain or discomfort, shortness of breath, upper back or neck pain, indigestion, heartburn, nausea or vomiting, and extreme fatigue.

Heart failure. Occurs when the heart is unable to pump enough blood through the body starving the organs of blood and oxygen. Symptoms of heart failure include shortness of breath, swelling of feet, ankles, legs, abdomen, or in the veins of the neck.

Types

Coronary artery disease. This is the most common cause of death due to heart disease. This is where plaque builds up in the coronary arteries and decreases blood flow. The symptoms include:

  • Chest pain
  • Shortness of breath
  • heart attack (extreme cases)

Cardiomegaly. This is an enlarged heart where the heart muscle grows thicker, the heart grows larger, but it weakens due to the condition. The symptoms include:

  • Heart rhythm disturbances
  • Swelling in the lower extremities
  • Shortness of breath

Heart attack. A heart attack is the complete blockage of blood to the heart muscle. When this happens part of the heart muscle dies. The symptoms of a heart attack include:

  • Chest pain
  • Neck or jaw pain
  • Pain in the stomach
  • Shortness of breath
  • Anxiety or feeling of doom
  • Dizziness, cold sweats
  • Nausea
  • Vomiting

Symptoms vary from person to person and males from females. This is a medical emergency and if you experience these symptoms, call 9-1-1.

Abnormal heart rhythm. This is where your heart does not beat in the usual rhythm. Symptoms include:

  • Fast heartbeat
  • Heart skipping beats
  • Pounding heartbeat
  • Dizziness, chest pain
  • Fatigue
  • Shortness of breath
  • Feeling lightheaded
  • Feeling faint.

This can also be a medical emergency and needs emergency medical assistance.

Atrial fibrillation. This is an abnormal heart rhythm that becomes too fast to pump blood effectively out to the organs. The symptoms include:

  • Shortness of breast
  • Heart palpitations
  • Feeling tired
  • Confusion
  • Chest pain
  • Weakness
  • Feeling lightheaded

Heart valve disease. Heart valves can stop working correctly to regulate the blood flow inside the heart. One of the more common heart valve diseases is mitral valve prolapse. Symptoms include irregular heartbeat, shortness of breath, feeling tired, low activity level, swelling in the feet and ankles, and feeling lightheaded.

Cardiomyopathy. This is a disease of the actual heart muscle. The heart muscle becomes weakened and the ventricles become floppy. This hampers the ability to pump blood effectively. Symptoms are shortness of breath, feeling lightheaded, chest pain, feeling tired, swelling in the lower extremities, cough, and irregular heart rhythm.

Pericarditis. The sac around the heart becomes infected or inflamed. The symptoms are sharp chest pains, shortness of breath, swelling in the legs, weakness, cough, and heart palpitations.

Pericardial effusion. This is a collection of fluid around the heart. It is a complication of infections, heart surgery, cancer, or renal disease. Symptoms include a fast pulse, fever, chest pain, shortness of breath, cough, and trouble breathing during sleep or resting.

Risk Factors

Heart disease has many different risk factors. They include:

  • Smoking
  • Diabetes
  • Hypertension
  • High cholesterol
  • Family history of heart disease
  • Poor diet
  • Age over 55
  • Lack of exercise
  • Preeclampsia in pregnancy
  • Obesity
  • History of congenital heart defects

Diagnosis

If you have a family history of heart disease, you need to mention it during your annual physical with your doctor. Routine tests can be performed to screen you yearly. If you have symptoms of any of the heart conditions above, you need to see a doctor as soon as possible. Tests for heart disease include:

Electrocardiogram (EKG). Electrodes placed near the conduction points from the heart measure the electrical impulses from your heart. This tells your physician how your heart is working and if you have had a previous heart attack. These can also be performed while you are on a treadmill to see how your heart works during exercise (stress testing).

Echocardiogram. An ultrasound Doppler is used to look at your heart structures and how they are functioning.

Holter monitor. This is an electrocardiogram machine that you wear for 24 hours or longer. The electrodes are hooked up to you and you carry the machine with a shoulder strap. This can find any heart rhythm problems that a one-time EKG may not pick up.

Cardiac CT scan or MRI scan. This is another non-invasive test the doctor can use to get a picture of your heart. It is a type of x-ray that can scan your heart for issues. You just lay on a table as you are passed inside the scanner. You need to lie very still and for an MRI, remove all metal jewelry.

Cardiac catheterization. This test is invasive, meaning they need to enter your body to do the test. They place a catheter into the artery in your groin/leg area and pass it up into your heart. They inject a dye that can be seen on an x-ray monitor to see any irregularities or blockages. They can also do minor procedures to open blocked blood vessels or stop any electrical activity that may be causing an irregular heartbeat.

Treatments

The treatment you may need for heart disease depends on the diagnosis. Here are some of the treatments used and what they are used for:

Stent and angioplasty. Used to open up blockages and increase blood flow.

Coronary artery bypass grafting (CABG). Open heart surgery to graft veins harvested from elsewhere in the body to create new ways to increase blood flow.

Valve treatments. Placement of a balloon to open up the valve or surgical valve repair.

Cardioversion. If you have an irregular heart rhythm, the doctor can convert the heartbeat by shocking the heart back into a normal rhythm. This can also be done with heart medications in the hospital.

Ablation. This is a procedure that can be done while doing a cardiac catheterization. The doctor can insert an electrode and stop the part of the heart muscle from misfiring to cause irregular heartbeats.

Pacemaker or implanted defibrillators. A device that is implanted under the skin to keep the heart rhythm normal. It must be adjusted periodically, and certain precautions need to be taken around microwaves and airport scanning equipment.

Left ventricular assist. This is implanted into the chest next to the heart to help the left ventricle pump blood more effectively.

Heart transplant. In cases where the heart cannot be repaired or made to function correctly with medications, a transplant may be the only option available.

Heart disease may require one or more of the following medications:

Angiotensin-converting enzyme (ACE) inhibitors. These help to open up your blood vessels to allow more blood to flow through.

Angiotensin II receptor blockers. These block angiotensin, so the blood vessels relax and open up. They can also lower the amount of sodium to decrease fluid in the tissues.

Antiarrhythmic drugs. These can help keep your heart rhythm normal.

Antiplatelet and blood-thinning drugs. These help thin the blood to prevent blood clots from forming. This is helpful in diseases where the arteries are narrowing and plaque has formed increasing the risk for heart attack or stroke.

Beta-blockers. These can help lower blood pressure, slow the heart rate, and relieve anxiety associated with heart disease.

Calcium channel blockers. These medications help relax the walls of arteries and veins to increase blood flow and oxygen to the heart and brain.

Digoxin therapy. This drug increases the pumping ability of the heart.

Diuretics. Help the kidneys pull excess fluid from the body tissues.

Nitrates. These open up blood vessels quickly to help increase the blood flow rapidly.

Alternative Treatments and Home Remedies

Any alternative medicine that may help heart disease needs to be approved by your doctor. There can be serious drug interactions and side effects that can cause you harm. There are a few natural remedies that may help improve your health with heart disease, but make sure your doctor knows you are using them:

Fish oil/omega-3 fatty acids. The fatty acids in fish oil may help improve heart health and reduce inflammation. Use caution with blood thinners as they can thin the blood and have drug interactions.

CoQ10. Coenzyme Q10 and vitamin E may help reduce the risk of heart disease and is most effective in people who suffer from diabetes.

Multivitamins and minerals. Getting the right amount of multivitamins and minerals can be tricky with a diet. Ask your doctor which supplements are best and which you should watch out for. Some studies show that too much calcium intake may contribute to plaque formation in arteries. Some forms of vitamin B, such as folate may help improve heart health.

Lifestyle Changes

Here are a few lifestyle tips for dealing with heart disease:

Quit smoking right away. If you are at risk for heart disease or receive a diagnosis of heart disease, quit smoking right away and avoid second-hand smoke.

Get cholesterol checked. Make sure you keep track of your cholesterol numbers and try to lower them and keep them in a normal range. Your LDL should be below 130 mg/dL or even less than 100 mg/dL is even better.

Control your blood sugar levels. If you are diabetic, ask for the best range you should keep your blood sugar in. If you are not diabetic, aim to keep your blood sugar below 125 mg/dL.

Watch your blood pressure. Aim to keep your blood pressure right around 120/80 and keep a log of your blood pressure at home.

Eat healthily. Ask your doctor about a good diet to keep your heart and body healthy. You need to include plenty of fresh fruits and vegetables, whole grains, and lean proteins. Watch your intake of fats, salt, and sugar.

Get exercise. If your doctor gives the go-ahead, give your body at least 30 minutes of exercise a few times weekly. Your doctor may give you alternative exercises if you are recovering from a heart attack and have irregular heartbeats.

Watch your BMI. Try to keep your BMI lower than 25. Being overweight increases your risk of heart disease and/or repeat heart attacks.

Find a way to relieve stress. Take up a relaxing hobby, try meditation or yoga. These can help you manage your stress levels.

See your doctor regularly and keep lab appointments. Make sure you get in for your check-ups and follow-up labs.

References

Centers for Disease Control. (2015, August 15). Heart disease facts. Retrieved from Centers for Disease Control: https://www.cdc.gov/heartdisease/facts.htm

Mayo Clinic. (2014, July 29). Heart disease. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/heart-disease/basics/definition/con-20034056

National Heart, Lung, and Blood Institute. (2014, July 10). What are the risk factors for heart disease? Retrieved from https://www.nhlbi.nih.gov/health/educational/hearttruth/lower-risk/risk-factors.htm

U.S. National Library of Medicine. (2015, October 8). Heart diseases. Retrieved from MedLine Plus: https://www.nlm.nih.gov/medlineplus/heartdiseases.html

University of Maryland. (2012, May 28). Herbs and supplements. Retrieved from University of Maryland Medical Center: https://umm.edu/health/medical/reports/articles/heart-failure

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