Heart Disease

1 What is Heart Disease?

The term “heart disease” is often used interchangeably with “Cardiovascular disease”.

It is an umbrella term that refers to various disorders of your heart and blood vessel diseases, such as coronary artery disease, abnormal heart rhythms (arrhythmias), and heart defects at the time of your birth (congenital heart defects).

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It also covers conditions like narrowed or blocked blood vessels that can lead to heart attack, chest pain (angina), stroke or any other condition that affects your heart's muscle, valves or rhythm.

Cardiologists

Heart healthy lifestyle is the key to prevent and manage almost all kinds of heart disease.

2 Symptoms

The symptoms of heart disease are highly disease specific.

Symptoms due to narrowed, blocked or stiffened blood vessels (Atherosclerotic disease)

Various symptoms of heart disease could be due to narrowed, blocked or stiffened blood vessels.

These abnormal blood vessels restrict blood supply to your heart, brain or other parts of your body. Men and women may experience different set of symptoms.

For example, chest pain is more common in men whereas breath, nausea and extreme fatigue are more common in women.

Some symptoms of this type of heart disease are:

Consult your doctor if any symptom worries you or you have certain conditions/ behaviors such as smoking, sedentary lifestyle that increase your risk.

Symptoms caused by abnormal heartbeats (heart arrhythmias)

Cardiac or Heart arrhythmias refer to a condition in which there is an abnormal or irregular heartbeat. Heart arrhythmia symptoms can include:

  • Fluttering in your chest
  • Fast heart rate (tachycardia)
  • Slow heart rate (bradycardia)
  • Chest pain or discomfort
  • Shortness of breath
  • Dizziness
  • Fainting (syncope) or near fainting

Symptoms caused by heart defects

Heart defects that you are born with (Congenital Heart Disease) become symptomatic soon after the birth. The symptoms in children could include:

  • Pale gray or bluish skin color (cyanosis)
  • Swelling in the legs, abdomen or areas around the eyes
  • Shortness of breath in infants during feeding lead to poor weight gain
  • Many less serious congenital heart diseases become symptomatic only during adulthood.

Signs and symptoms of non-life threatening congenital heart diseases include easy shortness of breath during slight exercise or activity, swelling in the hands, ankles or feet.

Heart disease symptoms caused by weak heart muscle (dilated cardiomyopathy)

In early stages, cardiomyopathy may not produce any symptoms. The symptoms become apparent as the disease progresses. The symptoms may include:

  • Breathlessness with exertion or at rest
  • Swelling of lower limb
  • Tiredness
  • Irregular heartbeats that feel rapid, pounding or fluttering
  • Dizziness,
  • Tendency to faint and fainting

Heart disease symptoms caused by heart infections

The three types of heart infections, namely Pericarditis, Myocarditis and Endocarditis may produce symptoms like:

  • Fever
  • Shortness of breath
  • Tiredness 
  • Swelling in your legs or abdomen
  • Changes in heartbeat 

Heart disease symptoms caused by valvular heart disease

  • Fatigue 
  • Shortness of breath
  • Irregular heartbeat 
  • Swollen feet or ankles 
  • Chest pain 
  • Fainting (syncope) 

When to see a Doctor?

Seek emergency medical help if you have Chest pain, shortness of breath and fainting, without or without family history of heart diseases.

3 Causes

Most heart diseases result due to narrowed arteries caused by fat deposition in the interior of the arteries, atherosclerosis.

Various causes of atherosclerosis like diet high in fat, sedentary lifestyle, obesity and smoking are modifiable.

Abnormal heart beats could result due to various inherited and external factors like:

  • Congenital heart defects
  • High blood pressure 
  • Diabetes 
  • Smoking 
  • Excessive consumption of alcohol or caffeine 
  • Drug abuse 

Causes of cardiomyopathy

Cardiomyopathy may be inherited or caused by ischemic heart disease, infections and toxins.

  • Causes of heart infection: Pericarditis, endocarditis and myocarditis are caused by bacteria, virus or chemical.
  • Causes of valvular heart disease: It could be due to birth defect or rheumatic fever, infectious endocarditis and connective tissue disorders.

4 Making a Diagnosis

The diagnosis of heart diseases begins with physical exam and conversation about your personal and family medical history.

Talk to your doctor if you have any symptoms that worry you, especially if you are at a higher risk due to family history of the disease. Your doctor may refer you to a heart specialist (cardiologist).

Prepare yourself before an appointment to make the conversation clear, concise and more fruitful. Here are some tips that might help you:

  • List out the symptoms you're experiencing.
  • Write down key personal information. Do not forget key points like family history of heart disease, stroke, high blood pressure or diabetes.
  • Make a list of medications, vitamins or supplements you're taking. 

Write down questions to ask your doctor.

Some relevant questions are:

  • What is the most probable cause of my symptoms?
  • What are the tests that I need to undergo?
  • What are the treatment options?
  • Is there any food to avoid? 
  • How much of physical activity do I need? 
  • How often should I be screened for heart disease? 

What to expect from your doctor?

Your doctor may ask questions like:

  • When was the first time you started experiencing the symptoms and how severe are they?
  • Is there anything that improves or worsens your symptoms? 
  • Do you have a family history of heart disease, diabetes, high blood pressure or other serious illness? 

Diagnostic Tests for Heart Diseases

Besides blood tests and a chest X-ray, tests to diagnose heart disease can include:

  • Electrocardiogram (ECG): An ECG is used to assess electrical and muscular functions of the heart.
  • Holter monitoring: A Holter monitor records a continuous ECG, usually for 24 to 72 hours and may be used to detect heart rhythm irregularities which a regular ECG exam is unable to detect.
  • Echocardiogram: This noninvasive exam, which includes an ultrasound of your chest, shows detailed images of your heart's structure and function. 
  • Cardiac catheterization Coronary catheterization (angiogram): A catheter is passed through an artery in the leg to the coronary arteries followed by injection of a liquid dye into the catheter. As the dye moves, its movement can be detected to determine if there is any disturbance in the flow of blood, probably due to narrowing of the arteries.
  • Cardiac computerized tomography (CT) scan: This technique used X-rays to create images of your heart and chest.
  • Cardiac magnetic resonance imaging (MRI): Cardiac MRI produces still and moving pictures of your heart by using radio waves and magnetic field.
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5 Treatment

The treatments for heart diseases depend on specific condition. For example, antibiotics are used to treat a heart infection.

Generally, following treatment approaches are implemented:

  • Lifestyle change like low-fat and low-sodium diet, regular physical activity, smoking cessation and limited alcohol intake.
  • Medications: Your doctor may prescribe medications that keep your heart disease in check. Lifestyle modifications and medications often yield better results. The types of medications are specific to the heart diseases like antihypertensive agents are prescribed for controlling high blood pressure. 
  • Medical procedures or surgery: If medications cannot control or treat the condition, your doctor may go for specific procedures or surgery. The type of procedure will depend on the type of heart disease and the extent of the damage to your heart.

6 Prevention

There is no way to prevent certain heart diseases like congenital heart diseases but other heart conditions can be prevented by adopting heart healthy habits like:

  • quitting smoking,
  • controlling other health conditions, such as high blood pressure, high cholesterol and diabetes, exercising, limiting salt and fat intake, maintaining a healthy weight and managing stress.

7 Lifestyle and Coping

Making certain lifestyle changes can help you prevent or manage many heart diseases.

Try following tips to keep your heart healthy and prevent/manage heart diseases:

  • Quit smoking: Smoking is single major cause for many heart diseases, especially atherosclerosis. Quit now to prevent heart diseases and their complications.
  • Keep your blood pressure in check: Optimal blood pressure is less than 120 mm Hg systolic and 80 mm Hg diastolic. Try keeping your blood pressure within the optimal range by adopting heart healthy habits like quitting smoking, exercising and limiting salt intake.
  • Check your cholesterol: Aim for an LDL level below 130 milligrams per deciliter (mg/dL), or 3.4 millimoles per liter (mmol/L). If you have other risk factors for heart disease, you should aim for an LDL below 100 mg/dL (2.6 mmol/L). If you're at very high risk of heart disease or if you've already had a heart attack or have diabetes, aim for an even lower LDL level, below 70 mg/dL (1.8 mmol/L). 
  • Keep diabetes under control: If you have diabetes, keeping your blood sugar under control can help reduce the risk of heart disease. 
  • Limit salt and fat intake
  • Exercise
  • Keep weight in check
  • Manage stress

Knowing that you have a heart disease can leave you in a state of frustration, anxiety and sometimes depression.

There are things to worry but on a brighter there are many ways to cope with this situation. These include:

  • Cardiac rehabilitation: Cardiac rehabilitation involves levels of monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risk of heart problems.
  • Support groups: Be social and stay close to your friends and family. If you think that’s not enough, think of joining a support group. Sharing the condition with similar people can help you in many ways.
  • Continued medical checkups: If you have a chronic heart condition, make sure you are getting checked regularly by your physician. Regular check-ups help to ensure that your condition is under control.

Making certain lifestyle changes can help you prevent or manage many heart diseases.

Try following tips to keep your heart healthy and prevent/manage heart diseases:

  • Quit smoking: Smoking is single major cause for many heart diseases, especially atherosclerosis. Quit now to prevent heart diseases and their complications.
  • Keep your blood pressure in check: Optimal blood pressure is less than 120 mm Hg systolic and 80 mm Hg diastolic. Try keeping your blood pressure within the optimal range by adopting heart healthy habits like quitting smoking, exercising and limiting salt intake.
  • Check your cholesterol: Aim for an LDL level below 130 milligrams per deciliter (mg/dL), or 3.4 millimoles per liter (mmol/L). If you have other risk factors for heart disease, you should aim for an LDL below 100 mg/dL (2.6 mmol/L). If you're at very high risk of heart disease or if you've already had a heart attack or have diabetes, aim for an even lower LDL level, below 70 mg/dL (1.8 mmol/L). 
  • Keep diabetes under control: If you have diabetes, keeping your blood sugar under control can help reduce the risk of heart disease. 
  • Limit salt and fat intake
  • Exercise
  • Keep weight in check
  • Manage stress

Knowing that you have a heart disease can leave you in a state of frustration, anxiety and sometimes depression.

There are things to worry but on a brighter there are many ways to cope with this situation. These include:

  • Cardiac rehabilitation: Cardiac rehabilitation involves levels of monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risk of heart problems.
  • Support groups: Be social and stay close to your friends and family. If you think that’s not enough, think of joining a support group. Sharing the condition with similar people can help you in many ways.
  • Continued medical checkups: If you have a chronic heart condition, make sure you are getting checked regularly by your physician. Regular check-ups help to ensure that your condition is under control.

8 Risks and Complications

There are several risks and complications associated with heart diseases.

Risks

  • Age: As you age, your arteries are more likely to be narrowed and heart muscles more likely to be weakened or thickened.
  • Sex: Men are generally at greater risk of heart disease. However, women's risk increases after menopause
  • Family history: Many heart diseases can be inherited. A family history of heart disease is a major risk factor for coronary artery disease
  • Smoking: Nicotine present in tobacco products increases your risk of atherosclerosis. Heart attacks are more common in smokers than in nonsmokers. 
  • Poor diet: Consumption of excess fat, salt, sugar and cholesterol is a contributing factor for the development of heart disease. 
  • High blood pressure: Uncontrolled high blood pressure over a long period of time causes hardening and thickening of your arteries. 
  • High blood cholesterol levels: High blood levels of cholesterol may cause plaques and atherosclerosis.
  • Diabetes: Diabetes is risk factor for heart disease. 
  • Obesity: Excess weight typically worsens other risk factors. 
  • Physical inactivity: Sedentary lifestyle and heart diseases are closely linked. Physical inactivity is also a risk factor for other contributing causes.

Complications

  • Heart failure: It is the most common complication of heart disease. Heart failure is a condition in which your heart cannot function properly and fails to meet the body demands. Heart failure can result from many forms of heart disease, including heart defects, cardiovascular disease, valvular heart disease, heart infections or cardiomyopathy.
  • Heart attack: In heart attack, a portion of your heart is damaged due to inadequate blood supply. Atherosclerosis can restrict blood supply within your heart and cause a heart attack. 
  • Stroke: When the brain tissues do not receive sufficient blood supply, they die. This condition is called ischemic stroke. A stroke is a medical emergency. 
  • Aneurysm: An aneurysm is a balloon like bulge in the wall of your artery. Aneurysm rupture can cause internal bleeding, which is often fatal. 
  • Peripheral artery disease: Atherosclerosis may lead to insufficient blood supply in the peripheral arteries and can lead to peripheral artery disease. 
  • Sudden cardiac arrest: Sudden cardiac arrest is a condition in which your heart suddenly stops beating. It is a medical emergency and if not treated immediately, it can cause sudden cardiac death.
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