An Overview of Heart Disease

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Heart disease is the generic term used for a wide variety of heart conditions that can affect the heart muscle, valves, vessels, structure, electrical system, or coronary arteries. Heart disease includes conditions such as cardiac arrhythmias, high blood pressure, coronary artery disease, valve disorders, and congenital heart defects. Though each disease affects the heart differently, the ultimate problem with all varieties of heart disease is that, in one way or another, they can disrupt the vital pumping action of the heart. Heart disease is the leading cause of death in the United States for both men and women.

The Cardiac System

The heart is fundamentally a powerful and tireless pump. It consists of muscular chambers that contract to push the blood through the vascular system and a series of valves that keep the blood moving efficiently and in the right direction. There's a self-regulating electrical system that determines your heart rate and coordinates the sequential beating of the various cardiac chambers.

To do all this muscular work around the clock, your heart needs a large and continuous supply of oxygen-rich blood. The coronary arteries are the vessels that supply this blood to the heart muscle, so they are critically important to the heart and to life.

Types

The normal function of the heart and the vascular system can be disrupted by a large variety of conditions. Several umbrella categories are often used to bucket them.

Atherosclerotic Disease

While many, many disease processes can affect the blood vessels, the term “cardiovascular disease” commonly encompasses the blood vessel (vascular) disorders that are related either to atherosclerosis, hypertension, or heart disease. Atherosclerosis is a disease in which plaque, made up of fat, calcium, cholesterol, and other substances builds up and hardens in your arteries, intruding on blood flow.

There are different types of atherosclerotic diseases, including coronary artery disease, carotid artery disease, and peripheral artery disease.

Coronary artery disease (CAD) is prevalent in Western societies, can lead to heart attacks, and is the most common type of heart disease. In CAD, atherosclerotic plaques form in the lining of the coronary arteries, hardening and narrowing the arteries.

Atherosclerosis and high blood pressure (hypertension) can not only lead to coronary artery disease, but also carotid artery disease, which affects the carotid arteries on both sides of your neck, and peripheral artery disease, which can affect almost any other artery in the body. Strokes and transient ischemic attacks (TIAs) are also often due to atherosclerotic disease.

Cardiac Arrhythmias

Cardiac arrhythmias are disorders of the heart’s electrical system. The electrical system of the heart is responsible for setting the heart rate (how fast the heart beats) and coordinating the organized, sequential contraction of the heart muscle in the atria and the ventricles.

Disorders of the heart’s electrical system generally tend to produce either heart rates that are too slow (bradycardia), or heart rates that are too fast (tachycardia). With either slow or fast cardiac arrhythmias, the normal sequence of heart muscle contraction may also be disrupted.

Heart Valve Disease

The four heart valves (tricuspid, pulmonary, mitral, and aortic) play a critical role in cardiac function. They assure that when the heart beats, the blood moves freely through the cardiac chambers and flows in the right direction.

In general, heart valve disease produces two general types of problems. Either the valve becomes partially obstructed, which impedes blood flow (called stenosis), or the valve becomes leaky, allowing blood to flow in the wrong direction when the heart muscle contracts (called regurgitation). In either case, if the valvular disease becomes severe enough, heart failure can result. In addition, a valvular disease often produces cardiac arrhythmias, especially atrial fibrillation.

Heart Infections

Though our hearts can usually fight off infections, they can still occur. These infections are more common in adults who are 60 years or older, especially those with an underlying heart condition. Types of infections include endocarditis (inflammation in your heart's chamber and valves), pericarditis (inflammation in the protective sac around your heart), and myocarditis (inflammation in the muscular area of the heart).

Heart Failure

Heart failure is an all too common end result of many different types of heart disease. In heart failure, heart damage of one form or another leaves the heart unable to perform all the work it must to fulfill the body’s needs. Blood is no longer pumped effectively throughout the body and stays in the heart.

It can be chronic or sudden. Numerous symptoms may result; some degree of disability is common, as is an early death. However, treatment of heart failure has advanced significantly in recent decades, and many people with heart failure are now able to live quite well for many years.

Symptoms

The symptoms of heart disease depend on what condition you have. However, the most common ones that are found in many of the different types of heart disease include chest pain or discomfort, palpitations, lightheadedness or dizziness, fainting, fatigue, and shortness of breath.

Heart Disease Signs and Symptoms

Causes

Because there are many types of heart disease, there are many different causes. Some causes are unclear and some are obvious, such as a genetic abnormality, a birth defect, or as the result of certain underlying conditions or medication or drug use. Many of the risk factors for heart disease are based on lifestyle choices, such as diet, activity level, weight, smoking, and making sure chronic conditions are treated and controlled.

Heart Disease Causes and Risk Factors

Diagnosis

To diagnose heart disease, your doctor will do a thorough medical history, perform a detailed physical exam, and choose from a variety of tests. Depending on what your doctor is looking for, these tests may include an electrocardiogram, an echocardiogram, ambulatory monitoring, a cardiac computerized tomography (CT) scan, a cardiac magnetic resonance imaging (MRI) study, stress testing, an electrophysiology study, or a tilt table study.

How Heart Disease Is Diagnosed

Treatment

The treatments for heart disease are variable and depend on what type you have. For pretty much all kinds of heart disease, lifestyle changes such as a heart-healthy diet, daily exercise, weight loss, smoking cessation, and stress management are key. In the event that these changes don't help, your doctor may prescribe medications. There are many options that may be considered, from ACE inhibitors to anticoagulants, beta blockers to calcium channel blockers, and more. There are also surgeries, special procedures, and medical devices that can be used for severe or special cases.

How Heart Disease Is Treated

Coping

If you're diagnosed with heart disease, rest assured that treatments have come a long way and people with it are living longer than ever. Coping with heart disease means making some lifestyle changes, learning about the symptoms to watch for, and perhaps taking medications. Lifestyle modifications that you may need to implement include smoking cessation, eating a healthy diet, getting regular exercise, losing weight, and learning to cope with stress.

Coping With Heart Disease

Prevention

The most common forms of heart disease are largely preventable if you pay attention to your cardiac risk factors and take reasonable steps to reduce them. Ideally, you should work with your doctor to perform a formal risk assessment, but you can do a reasonably accurate risk assessment yourself as well. If your risk is low, that's great. Just keep in mind the things you ought to be doing (and not doing) to keep it that way. On the other hand, if your cardiac disease risk is substantially elevated, use that as motivation to influence the risk factors you have some control over.

Reducing or eliminating risk factors as soon as possible is ideal. And often, the high-risk people who are most successful in doing this are the ones who do adopt a "change it all now" attitude. For example, they'll stop smoking, adopt an exercise program, and change their diet all at once. Improving their heart health becomes a driving force by which all choices are made.

Tackling each risk factor one by one with a more gradual approach to lifestyle changes, in this case, may not be as effective. While you are working to quit smoking, for example, a poor diet and lack of exercise may be continuing to pose risks that can have a serious effect on your heart health. Likewise, a sole focus on changing one habit may push the addressing of others to the bottom of the list—or off the priority list entirely, with time.

Given the consequences of heart disease, making as many of the changes you need to make as soon as you can make them is worth your time and effort. That said, everyone is different, and whatever works for you is, in the end, the best approach. The success that comes with time is better than change that never happens at all. Share your approach, your achievements, and your struggles with your doctor, who can help guide you along the way.

A Word From Verywell

People who educate themselves and take an active role in making clinical decisions tend to have the best medical outcomes. There are many different kinds of heart disease, and they all have different causes, severities, and treatments. If you have heart disease, you are likely to live a much longer and healthier life if you learn all you can about your particular cardiac problem. With that knowledge, you will be able to work more closely with your doctor and adopt the kinds of treatments that are best suited to you.

Heart Disease: Signs, Symptoms, and Complications
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