Cardiology

Heart disease is any condition that affects your heart’s ability to do its job, which is to pump blood throughout your body, feeding oxygen to all your tissues and organs. Sometimes, people are born with heart problems; this is called a congenital heart condition. More commonly, heart disease develops as we get older, usually rearing its ugly head for the first time in middle age or later. Heart disease is currently the number one killer in America. Key risk factors for developing heart disease include:

  • A family history of heart disease
  • Poor eating habits
  • Lack of exercise or a sedentary lifestyle
  • High stress
  • Smoking
  • Being male
  • Being overweight
  • Having uncontrolled high blood pressure
  • Having uncontrolled diabetes
  • Having high cholesterol

There are several types of heart disease, which can be divided into four groups:

  • Heart valve disease: Your heart has valves that control the flow of blood through its four chambers. You can be born with abnormalities in your heart valves, or they can be damaged by infection or changes that occur in your heart as a result of aging and poor lifestyle habits. Heart valve disease comes in two forms: stenosis, when the valves become too narrow for enough blood to pass through, and regurgitation, where the valve does not perform properly and allows blood to pass both forward and backward, instead of just forward. Your doctor can sometimes hear problems with your valves with a stethoscope as a heart murmur. Problems with your heart valves can lead to heart failure, in which one or more of the chambers of your heart cannot pump blood properly.
  • Coronary artery disease: The blood vessels leading to your heart can become damaged or blocked up by plaques, which are made up of cholesterol, calcium, and other material. Partially blocked arteries can lead to angina, where you develop chest pain, often upon exerting yourself. A heart attack occurs when one of the arteries becomes completely blocked.
  • Heart muscle disease: Many medical conditions directly or indirectly related to the heart, including coronary artery disease, diabetes, and heart valve disease, can eventually lead to damage to the heart muscles. When this happens, the muscles can no longer properly pump blood throughout your body. Eventually, this can lead to heart failure and arrhythmias.
  • Arrhythmias: Your heart needs to pump to a regular beat to effectively push blood throughout the body. When this beat becomes irregular, it’s called an arrhythmia. People who have other heart problems are more susceptible to arrhythmias.

How Do I Know I Have It?
Some signs of heart disease are pretty obvious while others are more vague, making the condition sometimes tricky to diagnose. Some key signs that your heart may not be working up to par include:

  • Shortness of breath
  • Weakness/fatigue
  • Leg swelling
  • Chest pain, especially with exertion
  • Signs of an impending heart attack that should send you immediately to the emergency room include a sudden onset of:
  • Crushing chest pain that may radiate down an arm or into your neck or jaw
  • Extreme shortness of breath
  • Stomach distress
  • Nausea and vomiting

As you can see, signs of heart disease or even a heart attack can mimic other diseases, even stomach flu, especially if you don’t happen to suffer from chest pain. If you’re not sure what is causing your symptoms, your best bet is to have a doctor check them out, especially if you have risk factors for heart disease.

Your doctor can confirm the diagnosis of heart disease through a physical exam and one or more of many available tests, the most common of which are:

  • Electrocardiogram (EKG or ECG): During this non-invasive test, electrodes are placed on your arms, legs, and chest to measure the electrical activity of your heart. The test can be performed while you are resting or while you are exercising (called a stress test), to see how the heart performs under both conditions. You may also be given a portable monitor to wear at home to see how your heart performs over several days.
  • Echocardiogram: This safe and non-invasive test allows doctors to see the heart, to make sure it is functioning properly. It is also helpful for identifying congenital heart defects.
  • Thallium or Cardiolite scan: For this test, a radioactive substance is injected into your blood system while you exercise. Then a special picture is taken of your heart, to see how well blood is flowing through the heart.
  • Cardiac catheterization and coronary angiography: During this procedure, a catheter is placed through your blood vessels and heart to see how well they are functioning. If a blockage in the vessels is detected, a balloon can be inserted right then and there to open the blockage, and a device called a stent may be placed in the new opening to prevent it from closing again.

What’s the Treatment?

There are several treatments for heart disease, and what your doctor chooses for you will depend on exactly what is wrong with your heart and how severe your problem is. Some treatment options include:

  • Medication: Drugs like digoxin, nitroglycerine, diuretics, ACE inhibitors, and beta-blockers all work in different ways to help improve the functioning of your heart. Your doctor may also give you other medication to help control conditions that are contributing to your heart disease, like cholesterol- or blood pressure-lowering drugs.
  • Angioplasty: As described above, an angioplasty can be performed to open blocked arteries
  • Bypass surgery: When one or more of the blood vessels leading to your heart is severely blocked or damaged, your doctor can take a blood vessel from your leg and use it to create a new route for blood to reach your heart. This is the same principle as bypass routes built on highways to divert cars away from high traffic areas.
  • Pacemaker: A pacemaker can be surgically implanted into your chest if your heart is unable to maintain a normal rhythm

One of the most important treatments for heart disease is lifestyle change. In addition to following your doctor’s advice about medication use, be sure to ask for advice about starting an exercise and diet plan.

What is a heart attack (myocardial infarction or MI)?

A heart attack, or myocardial infarction, occurs when one or more regions of the heart muscle experiences a severe or prolonged decrease in oxygen supply caused by blocked blood flow to the heart muscle.

The blockage is often a result of atherosclerosis – a buildup of plaque, known as cholesterol, and other fatty substances. Plaque inhibits and obstructs the flow of blood and oxygen to the heart, thus reducing the flow to the rest of the body.

If the blood and oxygen supply is cut off severely or for a long period of time, muscle cells of the heart suffer severe and devastating damage and die. The result is damage or death to the area of the heart that became affected by reduced blo

What are the warning signs of a heart attack?

The following are the most common symptoms of a heart attack. However, each individual may experience symptoms differently. Symptoms may include:

  • severe pressure, fullness, squeezing, pain and/or discomfort in the center of the chest that lasts for more than a few minutes
  • pain or discomfort that spreads to the shoulders, neck, arms, or jaw
  • chest pain that increases in intensity
  • chest pain that is not relieved by rest or by taking cardiac prescription medication
  • chest pain that occurs with any/all of the following (additional) symptoms:
    1. sweating, cool, clammy skin, and/or paleness
    2. shortness of breath
    3. nausea or vomiting
    4. dizziness or fainting
    5. unexplained weakness or fatigue
    6. rapid or irregular pulse
    7. severe stomach upset that comes on abruptly

Although chest pain is the key warning sign of a heart attack, it may be confused with indigestion, pleurisy, pneumonia, or other disorders. If you have any of the symptoms mentioned please seek medical advice.

Also, if you have a family history of heart disease, hypertension, diabetes or stroke, or if you are a heavy smoker, it is extremely important to have your heart checked on a yearly basis and monitor your blood pressure regularly.

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