Everything you need to know about heart disease

Types of heart disease

Heart disease refers to any condition affecting the cardiovascular system. Each type of heart disease affects the heart and blood vessels in different ways.

Coronary artery disease

Research suggests that up to half of heart disease cases are due to coronary artery disease (CAD).

CAD develops when plaque clogs the arteries that supply blood to the heart. This causes the arteries to harden and narrow. Plaque contains cholesterol and other substances. A plaque buildup in the arteries is called atherosclerosis.

As a result, the blood supply reduces, and the heart receives less oxygen and fewer nutrients. In time, the heart muscle weakens, increasing the risk of heart failure and arrhythmia (irregular heartbeat).

Plaque in the arteries can rupture from blockages and cause blood flow to stop, which can lead to a heart attack.

Congenital heart defects

Someone with a congenital heart defect is born with a heart problem. Types of congenital heart defects include:

• Atypical heart valves: Valves may not open properly or may leak blood.
• Septal defects: There is a hole in the wall between either the lower chambers or the upper chambers of the heart.
• Atresia: One of the heart valves is missing.

Congenital heart disease can involve major structural issues, such as the absence of a ventricle or problems with unusual connections between the main arteries that leave the heart.

Minor congenital heart defects may not cause any noticeable symptoms and only become apparent during a routine medical check.

Arrhythmia

Arrhythmia refers to an irregular heartbeat. It occurs when the electrical impulses that coordinate the heartbeat do not work correctly. The heart may beat too quickly, too slowly, or erratically.

Types of arrhythmias include:

• tachycardia, a rapid heartbeat.
• bradycardia, a slow heartbeat.
• premature contractions, an early heartbeat.
• atrial fibrillation, a type of irregular heartbeat.

Arrhythmia may cause a fluttering or a racing heart. In some cases, arrhythmias can be life threatening or have severe complications.

Dilated cardiomyopathy

In dilated cardiomyopathy, the heart chambers become dilated, meaning that the heart muscle stretches and becomes thinner. As a result, the heart becomes weaker and cannot pump blood properly.

Potential causes of dilated cardiomyopathy include past heart attacks, arrhythmias, and toxins. Sometimes, there is no apparent cause.

Dilated cardiomyopathy can lead to complications such as arrhythmias, blood clots, and heart valve issues.

Myocardial infarction

Myocardial infarction, or a heart attack, involves an interruption of the blood flow to the heart. This can damage or destroy part of the heart muscle.

CAD is the most common cause of heart attack. However, it can also occur if an artery suddenly narrows or spasms.

Heart failure

When someone has heart failure, their heart is still working, but not as well as it should be. Congestive heart failure is a type of heart failure that can occur from problems with the pumping or relaxing function. It requires prompt treatment.

Heart failure can result from untreated CAD, high blood pressure, arrhythmias, and other conditions. These conditions can affect the heart’s ability to pump or relax properly.

Heart failure can be life threatening, but early treatment can help prevent complications.

Hypertrophic cardiomyopathy

This condition usually develops when a genetic problem affects the heart muscle. It tends to be an inherited condition.

The walls of the muscle thicken, and contractions become harder. This affects the heart’s ability to take in and pump out blood. In some cases, an obstruction can occur.

There may be no symptoms, and many people do not receive a diagnosis until later in life. However, hypertrophic cardiomyopathy can worsen over time and lead to various heart problems.

Anyone with a family history of this condition can speak with a healthcare professional about screening, as receiving treatment can help prevent complications.

Mitral valve regurgitation

This occurs when the mitral valve in the heart does not close tightly enough, allowing blood to flow back into the heart.

As a result, blood cannot move through the heart or body efficiently. This can put pressure on the heart’s chambers. In time, the heart can become enlarged, and heart failure can occur.

Mitral valve prolapse

Mitral valve prolapse happens when the valve flaps of the mitral valve do not close properly. Instead, they bulge into the left atrium, and can cause a heart murmur.

Genetic factors and connective tissue problems can cause this condition. This condition is not usually life threatening, but some people may need treatment.

Aortic stenosis

In aortic stenosis, the aortic valve is thick or fused and does not open correctly. This makes it hard for the heart to pump blood from the left ventricle into the aorta — the main artery that carries blood from the heart.

People may be born with aortic stenosis due to congenital anomalies of the valve, or it may develop over time due to calcium deposits or scarring.

Symptoms of heart disease

Heart disease symptoms depend on the specific condition someone has. Some heart conditions cause no symptoms at all.

That said, the following symptoms may indicate a heart problem:

• chest pain
• difficulty breathing
• fatigue and lightheadedness
• swelling due to fluid retention, or edema

In children, the symptoms of a congenital heart defect may include cyanosis, or a blue tinge to the skin, and an inability to exercise.

Heart attack symptoms

Some heart conditions, such as a heart attack, require urgent medical attention. Symptoms that could indicate a heart attack include:

• chest pain
• breathlessness
• heart palpitations
• nausea
• stomach pain
• sweating
• arm, jaw, back, or leg pain
• a choking sensation
• swollen ankles
• fatigue
• an irregular heartbeat

Heart attack can lead to cardiac arrest, which is when the heart stops and the body can no longer function. People need immediate medical attention if they have any symptoms of a heart attack.

If cardiac arrest occurs, the person will need:

• immediate medical help (call 911)
• immediate cardiopulmonary resuscitation
• a shock from an automated external defibrillator, if available

Causes and risk factors of heart disease

Heart disease can develop when there is:

• damage to all or part of the heart
• a problem with the blood vessels leading to or from the heart
• a low supply of oxygen and nutrients to the heart
• a problem with the heart’s rhythm

In some cases, there is a genetic cause. However, certain lifestyle factors and medical conditions can also increase the risk, including:

• high blood pressure
• high cholesterol
• smoking
• high blood sugar and diabetes
• a high intake of alcohol
• overweight and obesity
• dietary choices
• age over 50 years
• kidney disease
• low activity levels

The World Health Organization (WHO) mentions poverty and stress as two key factors contributing to a global increase in heart and cardiovascular disease.

Treatment for heart disease

The treatment options will vary depending on the type of heart disease a person has.

Medications

Various medications can help treat heart conditions, including:

• Anticoagulants: Also known as blood thinners, these medications can prevent clots. They include warfarin (Coumadin) and the direct oral anticoagulants dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis).
• Antiplatelet therapies: These include aspirin, and they can also prevent clots.
• Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors can help treat heart failure and high blood pressure by causing the blood vessels to expand. Lisinopril (Prinivil) is one example.
• Angiotensin II receptor blockers: These can also control blood pressure. Losartan (Cozaar) is one example.
• Angiotensin receptor neprilysin inhibitors: These can help unload the heart and interrupt the chemical pathways that weaken it.
• Beta-blockers: Metoprolol (Lopressor) and other beta-blockers can reduce the heart rate and lower blood pressure. They can also treat arrhythmias and angina.
• Calcium channel blockers: Calcium channel blockers can lower blood pressure and prevent arrhythmias by reducing the pumping strength of the heart and relaxing the blood vessels. One example is diltiazem (Cardizem).
• Cholesterol-lowering medications: Statins, such as atorvastatin (Lipitor), and other types of drugs can help reduce levels of low-density lipoprotein cholesterol in the body.
• Diuretics: These medications can reduce the heart’s workload, lower blood pressure, and remove excess water from the body. Furosemide (Lasix) is one example.
• Vasodilators: Vasodilators are medications to lower blood pressure and can also help ease chest pain. They relax the blood vessels. Nitroglycerin (Nitrostat) is one example.

A doctor will work with a person to find a suitable medication. If side effects occur, it may be necessary to review the treatment plan.

Surgery

Heart surgery can help treat blockages and heart problems when medications are not effective. Some types of surgery include:

• Coronary artery bypass surgery: Coronary artery bypass grafting is the most common surgery. A surgeon can use a healthy blood vessel from another part of the body to repair a blocked one, allowing blood to pass through.
• Coronary angioplasty and percutaneous coronary intervention: This procedure widens narrow or blocked coronary arteries with a balloon. Cardiologists may also insert a stent, which is a wire mesh tube that allows easier blood flow.
• Valve replacement or repair: A surgeon can replace or repair a valve that is not functioning correctly.
• Repair surgery: A surgeon can repair congenital heart defects, aneurysms, and other problems.
• Device implantation: Pacemakers, balloon catheters, and other devices can help regulate the heartbeat and support blood flow.
• Laser treatment: Transmyocardial laser revascularization can help treat angina (chest pain).
• Maze surgery: A surgeon can create new paths for electrical signals to pass through. This can help treat atrial fibrillation.

Preventing heart disease

The following lifestyle measures may reduce the risk of heart disease:

• Eat a balanced diet: Eat a heart-healthy diet rich in whole grains, fresh fruits, and vegetables. It may also help to limit processed foods and added fat, salt, and sugar.
• Exercise regularly: Exercise can help strengthen the heart and circulatory system, reduce cholesterol, and maintain blood pressure. Most adults should aim for 150 minutes of moderate-intensity exercise per week.
• Maintain a moderate body weight: Overweight and obesity can increase the risk of heart disease. Maintaining or achieving a moderate weight may lower this risk.
• Quit or avoid smoking: Smoking is a major risk factor for heart and cardiovascular conditions.
• Limit alcohol intake: The AHA recommends limiting or completely avoiding alcohol to reduce the risk of heart disease.
• Manage underlying conditions: Seek treatment for conditions that affect heart health, such as high blood pressure, obesity, and diabetes.

Taking these steps can benefit overall health and reduce the risk of heart disease and its complications.

Summary

Heart disease is a common health problem. There are several different types of heart disease. Some stem from genetic problems and are not preventable.

In many cases, however, a person can take steps to prevent heart disease and its complications. These steps include following a healthy diet, getting plenty of exercise, and seeking advice when the first symptoms of heart disease appear.

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