Heart Disease
Basic Information

Heart Disease

Your heart is one of your body's most important organs. Essentially a pump, the heart is a muscle made up of four chambers separated by valves and divided into two halves. Each half contains one chamber called an atrium and one called a ventricle. The atria (plural for atrium) collect blood, and the ventricles contract to push blood out of the heart. The right half of the heart pumps oxygen-poor blood (blood that has a low amount of oxygen) to the lungs where blood cells can obtain more oxygen. Then, the newly oxygenated blood travels from the lungs into the left atrium and the left ventricle. The left ventricle pumps the newly oxygen-rich blood to the organs and tissues of the body. This oxygen provides your body with energy and is essential to keep your body healthy.

The general term used to cover malfunctions of the heart is Heart Disease, or sometimes Cardiac Disease ("Cardiac" is a Latin term for the heart). Though there are multiple forms of heart disease, our disc...

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What is heart disease and what are the risk factors?

  • The general term used to cover malfunctions of the heart is Heart Disease, or sometimes Cardiac Disease as "Cardiac" is a Latin word that means heart.
  • The two most common types of Heart Disease are Heart Attack and Heart Failure.
  • Some risk factors are out of your control, but many of them can be avoided by choosing to live a healthy lifestyle.
  • Some of the risk factors you cannot control are:
    • Gender: Men have a greater risk than women for developing heart disease. Men also are at greater risk of having a heart attack at a younger age. However, heart disease is the number one killer of women (just like men).
    • Age: Simply put, the older you get, the greater risk you run for developing heart disease. It is estimated that four out of five individuals who die of coronary heart disease are 65 years of age or older.
    • Family History: A family history of heart disease, high blood pressure (hypertension), and diabetes increases the chance you will develop heart disease.
  • Some of the more controllable risk factors include:
    • High Cholesterol: Too much cholesterol, a type of fat molecule, in your blood, puts you at increased risk of heart disease.
    • High Blood Pressure: Uncontrolled blood pressure increases your risk of heart disease.
    • Obesity: People who are overweight are more likely to have high blood pressure and high cholesterol levels.
    • Smoking: Smoking is a major risk factor for heart attacks.
    • Diabetes: A diabetic person's risk of developing heart disease is equal to the risk of a person who has had a previous heart attack.
    • Stress, drinking too much alcohol, and depression have also been linked to cardiovascular disease.

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What is a heart attack and what are the symptoms?

  • The heart cannot take oxygen and nutrients directly from the blood it moves through the body.
  • Instead, the blood that feeds the heart has to pass through the coronary arteries which run along the outside surface of the heart muscle.
  • A Heart Attack (also known as a myocardial infarction or "MI"), occurs when the supply of oxygen and nutrients to the heart through these coronary arteries becomes interrupted.
  • In a heart attack, the blood supply to the heart muscle becomes blocked in a section of the coronary artery system, in many cases causing a section of the heart muscle to die or sustain permanent damage.
  • In the event the victim survives the attack, the newly dead area of heart muscle eventually scars over, causing the heart to pump with reduced efficiency afterwards.
  • There is no single set of symptoms that signals an impending heart attack.
  • Symptoms can include (but may not be limited to) the following:
    • Chest Pain: Angina is a term for chest pains and a feeling of intense pressure (as though a heavy weight has been set on the chest) caused by a lack of blood supply to the heart muscle.
    • Radiating Pain and Numbness: Intense pain and chest pressure may spread outward to the shoulders, neck and arms (especially the left arm). The pain can occur with varying degrees of intensity.
    • Dizziness or Lightheadedness
    • Nausea and Vomiting
    • Sweating
    • Shortness of Breath
    • Anxiety and/or a Sense of Nervousness (sometimes combined with an impending sense of doom).
    • Pale Coloration of the skin
    • Heart Rate Increase or Irregularity
    • Indigestion or a choking feeling similar to heartburn
  • It is also possible to have a heart attack without experiencing any symptoms at all, which is known as a "silent" myocardial infarction. Older adults or people who have diabetes are most at risk for this uncommon type of heart attack.

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How is a heart attack diagnosed and treated?

  • It is important that you call 911 if you find yourself (or someone that you are with) experiencing symptoms or the warning signs of a heart attack.
  • The longer treatment is delayed, the more likely it is that irreversible damage will occur to the heart muscle.
  • At the hospital, the doctor will ask questions and perform tests to determine whether or not the symptoms are truly being caused by a heart attack.
  • The doctor will ask questions about the medical history and risk factors for heart disease such as whether you smoke, your family history, and cholesterol history.
  • One or more of the following tests to determine whether or not you have actually had a heart attack, may be performed:
  • ECG. An ECG (also referred to as an EKG or electrocardiogram) measures the electrical activity of the heart. Changes in the heart's activity levels can signal a heart attack. The EKG also monitors your heart rate for irregular heart rates that can occur during a heart attack.
  • Blood Tests. Heart muscle cells contain unique enzymes that help them to function and when heart muscle cells are broken during a heart attack, the contents of the cells, including these enzymes, get spilled into the bloodstream. Doctors can measure the levels of these heart muscle enzymes in your blood to determine if you have had a heart attack.
  • Echocardiography(ECHO). An ECHO is an ultrasound of the heart and is particularly useful at identifying which heart structures have been damaged during a heart attack and the amount of function lost.
  • Stress Test. If your doctor is uncertain whether your chest pain is caused by your heart, he or she may perform a stress test. There are several types of stress tests, but their purpose is to observe your heart while it is under stress. During a stress test the doctor is looking for changes that show your heart is not getting enough blood flow to some of its muscles.
  • The treatment of a heart attack generally begins immediately after diagnosis.
  • The sooner the blockage constricting the coronary arteries is alleviated, the less permanent damage your heart muscle will incur.
  • Heart attacks are often treated with a combination of medicines and other medical procedures designed to restore blood flow to affected areas of the heart muscle.
  • Medications used to treat heart attacks include those designed to slow your heart down so it doesn't work as hard (known as beta-blockers), medications to break-up existing clots (called thrombolytics) and aspirin or antiplatelet medicines to help stop more blood clots from forming.
  • Medical procedures used to treat heart attacks include angioplasty with stent placement and bypass surgery.

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What is heart failure and what are the symptoms?

  • The term "Heart Failure" is used to describe a condition where someone's heart is unable to pump enough blood to support all of his or her body's organs, muscles and other tissues.
  • The heart continues to work during heart failure, but not efficiently enough to adequately support the body's needs.
  • Over 5 million people in the United States have heart failure and it is a major cause of hospitalization for people older than 65 years.
  • Heart failure can affect one or both sides of the heart.
  • Heart ventricles, responsible for pumping blood out into the body, can become defective in two different ways.
  • They can lose their ability to contract and can no longer generate enough force to push the blood through the body effectively.
  • They can lose their ability to relax and cannot open enough to fill completely, and the volume of blood available for pumping is drastically reduced.
  • Either condition results in a decreasing rate of blood flow throughout the body's circulatory system which often leads to fluids backing up in various tissues, which is called an edema.
  • There are multiple symptoms that can indicate heart failure.
  • Most of these symptoms are related to the fluid back-up that occurs as a result of heart failure.
  • Edema/Fluid Retention - If you gain three to five pounds in the span of a day, this weight gain can most likely be attributed to fluid retention. Your kidneys may retain fluids when they perceive less than normal blood flow. This extra fluid will build up in various tissues, often causing visible swelling of the limbs, most often in the legs, ankles, and feet.
  • Congested Lungs - In addition to your legs and ankles, fluid can buildup in your lungs during heart failure. This causes symptoms including shortness of breath, a cough that is often worse at night, and suddenly awakening in the middle of the night short of breath.
  • Dizziness and Fatigue - All of your muscles and body organs require regular blood flow to supply them with the oxygen and nutrients they need to function. When your organs and muscle cells become deprived of these nutrients, you may feel weak, dizzy or tired for no apparent reason.

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What causes heart failure?

  • Some individuals who develop heart failure may have simply been born with a structural defect in a portion of their heart while others develop the disease as a result of medical conditions that have not been controlled.
  • The major causes of heart failure include:
    • Coronary Artery Disease, which disrupts blood flow in the coronary arteries that supply blood to the heart itself.
    • Diabetes, which involves high blood sugar levels, can cause damage to many organs such as the heart and kidneys.
    • Hypertension, which is also known as high blood pressure, causes the heart muscle to become thicker and stiff, decreasing the heart's ability to relax and adequately collect blood for pumping.
    • Heart Valve Dysfunction causes the heart to need to pump harder so as to keep up with the body's demand for oxygen and the elevated strain this process places on the heart can lead to heart failure.
    • Cardiomyopathy: Damage and weakening of the heart muscle can lead to reduced efficiency and heart failure. Cardiomyopathy has many causes including viral infections, alcoholism, autoimmune diseases (e.g., rheumatoid arthritis, lupus), high blood pressure, and heart attacks.
    • Lung Disease: When the lungs are damaged and they do not provide adequate oxygen for exhausted blood to pick up, the heart pumps faster so as to compensate, placing strain on the heart which can lead to heart failure.
    • Thyroid disease: both too much and too little thyroid medicine can result in heart failure that usually is reversible with treatment.
    • Arrhythmia is a condition in which the heart beats irregularly rather than rhythmically and it interferes with normal blood flow.

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How is heart failure diagnosed and treated?

  • The earlier heart failure is diagnosed and properly treated, the faster you can start down the path to recovery and with less long-term damage.
  • When discussing your symptoms with your doctors, be prepared to honestly answer questions concerning your medical history, your drug and alcohol use, and smoking habits.
  • Your doctor may also order one or more of the following medical tests to further diagnose your condition:
    • Blood Tests - The doctor will most likely request a blood sample so that he or she can check levels of various hormones and enzymes in your blood.
    • An X-ray - Your doctor may order an x-ray photograph of your chest area to give the doctor an indication of the size of your heart and whether there is any fluid buildup in or around the lungs.
    • An Echocardiogram, which is used to show the structures of the heart, and can show how well the heart is pumping and which areas are not functioning properly.
    • The doctor may also make a referral to a cardiologist for other heart testing including an angiogram (to look for blood vessel blockage), a holter monitor (to look for irregular heartbeats), and a stress test (to look for signs of coronary artery disease).
  • Treatments for heart failure vary based on the severity of the disease process.
  • Surgical and medical procedures as well as the following lifestyle changes may be recommended:
    • Quit Smoking - smoking raises your blood pressure, increases your body's need for oxygen and increases your chance of heart disease.
    • Lose Weight - Losing weight eases strain on the heart, while also improving diabetes, blood pressure and cholesterol control.
    • Limit Sodium - in heart failure your body has too much fluid and by limiting sodium you can help limit the fluid retained.
    • Limit Fluids and Alcohol
    • Exercise has been shown to improve quality of life and decrease death from heart failure.
    • Check your weight regularly as a sudden increase in your weight may suggest that you are retaining more fluid and that you are experiencing a worsening of your heart failure that may require medication adjustment.
    • In addition to lifestyle changes, your physician may place you on medications specifically for your heart failure. This may include diuretics to help remove the excess fluid, beta-blockers to slow your heart rate and improve the relaxation of the heart, and ACE inhibitors which have been shown to decrease symptoms of heart failure.
    • If your heart failure is not controlled through medications, your doctor may recommend surgery. This could include a Coronary Artery Bypass, Heart Valve Replacement or Repair, a Left Ventricle Assist Device (called a LVAD) and a Heart Transplant, which is generally used as a last resort after all other treatment options have been exhausted.

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What are strategies for promoting a healthy heart?

  • A diagnosis of heart disease should be a wake-up call alerting you to examine your own habits to see if any of them might be harmful to you or if they are likely worsening your heart disease.
  • There are several important things you can do which will help reduce the symptoms and progression of your heart disease.
  • Quit Smoking - the first change you should make is to quit smoking if you are a smoker. While this is often one of the hardest lifestyle changes to make, it is also one of the most important.
  • Eat A Healthy Diet - the dietary choices you make can contribute to or lessen your heart disease risk.
  • Keep in mind that healthy food doesn't have to taste bad and you don't need to view your diet changes as an end to your enjoyment of eating.
  • While sodium (salt) is necessary for the body to function properly, too much sodium can cause problems, especially for those individuals who have heart failure.
  • In extreme cases of heart disease your doctor may want to regulate how much fluid (liquids) you take in.
  • Foods high in saturated fats and trans fats such as red meat, whole milk, cheeses, prepared baked goods and many processed/prepackaged foods can increase your cholesterol levels, and should be eaten in limited quantities.
  • You should limit the amount of dietary fat you take in each day.
  • Make healthier protein choices by focusing on fish, chicken, lentils and beans, and soy products.
  • Eat Smaller Portions More Frequently, rather than skipping meals.
  • Get regular exercise - aerobic activities (e.g, biking, jogging, walking, and swimming) raise your heart rate and strengthen your cardiovascular system.

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