Health Conditions : Heart Disease

Number of people affected:
26.5 million (CDC) and another 7% of the population is undiagnosed

Who gets it:
Smokers, people with high blood pressure or high blood cholesterol, overweight obese people who are physically inactive, diabetics and those with a family history.

Symptoms:
Shortness of breath, persistent coughing/wheezing, increased heart rate, fatigue

Treatments:
Medications, lifestyle changes, and/or surgery

Doctors to see:
Primary care doctor and cardiologist

The heart is made up of many parts working together to pump blood. In a healthy heart, all the parts work well so that your heart pumps blood normally.

Heart disease can disrupt a heart's normal electrical system and pumping functions. Diseases and conditions of the heart’s muscle make it difficult for your heart to pump blood normally. Damaged or diseased blood vessels make the heart work harder than normal. Problems with the heart’s electrical system, called arrhythmias, can make it difficult for the heart to pump blood efficiently.

Heart disease is caused by narrowing of the coronary arteries that feed the heart. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, the result is coronary heart disease (CHD). If not enough oxygen-carrying blood reaches the heart, you may experience chest pain called angina. If the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.

The four most common types of cardiovascular disease:

• Coronary heart disease (which includes heart attack and angina pectoris or chest pain)
• Stroke
• High blood pressure
• Heart failure

Each type of heart disease -- coronary artery disease, heart attack, etc. – has different symptoms, although many heart problems have similar symptoms.

Signs of heart trouble include:

• Discomfort, pressure, heaviness, or pain in the chest, arm or below the breastbone
• Discomfort radiating to the back, jaw, throat or arm
• Fullness, indigestion or choking feeling (may feel like heartburn)
• Sweating, nausea, vomiting or dizziness
• Extreme weakness, anxiety or shortness of breath
• Rapid or irregular heartbeats
• Palpitations (irregular heart beats, skipped beats or a "flip-flop" feeling in the chest)
• A faster heartbeat
• Pounding in the chest

Doctors typically conduct these tests when heart disease is suspected:

• EKG
• Chest X-ray
• Stress Test - tests how your heart responds to exertion
• Echocardiogram - similar to an ultra-sound
• Heart MRI
• Cardiac Catheterization - also called a coronary angiogram, means running a catheter into the heart
• Electrophysiology Test - takes measurements of heart rhythm
• CT Heart Scan - Visualizes the heart’s anatomy
• Myocardial Biopsy - a catheter to remove a piece of your heart tissue for examination
• Pericardiocentesis - using a needle to get a sample of the fluid in the sac surrounding the heart

Treatments

• Medications
  ACE inhibitors, angiotensin II receptor blockers (ARB), Antiarrhythmics, Antiplatelet Drugs, Aspirin, Beta blockers, Calcium channel blockers, Digoxin, Vasodilators, Warfarin (brand Coumadin)
• Procedures
  Brachytherapy (radiation), Valvuloplasty (non-surgical balloon procedure), pacemaker, implantable cardioverter defibrillator (ICD), heart valve surgery, transplant, biventricular pacing
• Emergency procedures
  CPR, Automated External Defribrillators (AEDs), cardioversion

Age is the major risk factor for cardiovascular disease. Heart disease and stroke incidence rises steeply after age 65, accounting for more than 40 percent of all deaths among people age 65 to 74 and almost 60 percent at age 85 and above. People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease and high blood pressure leading to heart failure. In women, menopause often causes an increase in their LDL-cholesterol and a decrease in their HDL- cholesterol level, and after the age of 50, women often have higher total cholesterol levels than men of the same age.

Other risk factors include:

Heredity/family history
The genes influence how high the LDL-cholesterol is by affecting how fast LDL is made and removed from the blood.

Diet
Two main nutrients in the foods you eat make LDL-cholesterol level go up: saturated fat, a type of fat found mostly in foods that come from animals; and cholesterol, which comes only from animal products.

Weight
Excess weight tends to increase the LDL-cholesterol level.

Physical activity/exercise
Regular physical activity may lower LDL-cholesterol and raise HDL-cholesterol levels.

-National Heart, Lung and Blood Institute

There's no set timeline for recovery from heart trouble. Depending on the type of heart disease, your loved one may experience some or all of these issues:

Weakness, fatigue, and shortness of breath. After getting the go-ahead from the doctor, get your loved moving, little by little. Encourage them to get dressed, take a shower and walk for 5 minutes, several times a day.

Leg swelling. This is common after surgery. Elevate the legs when sitting or lying down, and encourage movement and activity.

Sleep problems. Minimize pain and discomfort at night. Arrange pillows to help your loved one find the most comfortable sleeping position. Discourage your loved one from napping during the day.

Depression. It is very common for heart patients to be depressed following a surgery. Watch for warning signs, such as feelings of hopelessness or worthlessness, loss of interest in life, increased or decreased appetite. Notify your doctor if the symptoms last more than a week.

Decreased mental function. A decrease in mental function is common, but usually temporary following surgery. Give your loved one time to recover. If symptoms persist, contact your doctor.