Heart Disease: Types, Causes, Symptoms, Diagnosis, and Treatment
Heart disease is a class of diseases that affect the structure and function of the heart. Heart disease is the same thing as cardiac disease, but not cardiovascular disease (CVD). Heart disease refers to just the heart (cardio), while cardiovascular disease refers to disorders of the heart (cardio) and blood vessels (vascular).
Heart diseases are often due to atherosclerosis, a condition that develops when fatty deposits called plaque builds up in the walls of the arteries. As the plaque accumulates over time, the insides of the arteries get narrower, making it harder for blood to flow through. If a blood clot forms in the narrowed artery and completely blocks the blood flow, it can lead to heart attack and stroke.
Heart disease is the leading cause of death for both men and women worldwide. More than half of the deaths that occur as a result of heart disease are in men.
Types of Heart Disease
Here are some common types of heart disease and their causes:
Coronary artery disease (CAD) – a condition that occurs due to narrowing of the blood vessels that supply blood and oxygen to the heart muscles. It is one of the most common forms of heart disease and the leading cause of heart attacks and angina (chest pain).
Heart arrhythmia (Cardiac dysrhythmia) – an abnormal rhythm of the heart. It may too quickly, too slowly, or with an irregular pattern. When the heart beats faster than normal, it is called tachycardia. When the heart beats too slowly, it is called bradycardia. The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heartbeat.
Arrhythmia occurs because the special nerve cells that produce the electrical signals of the heart (telling the heart when to pump) don’t work properly. It can also occur when another part of the heart starts to produce electrical signals, adding to the signals from the special nerve cells and disrupting the normal heartbeat.
Heart attack (myocardial infarction) – a condition in which an artery that supplies blood to the heart muscle becomes blocked. The most common cause of a heart attack is a blood clot that forms inside a coronary artery or one of its branches. This blocks the blood flow to a part of the heart.
Heart failure – a condition in which the heart muscle isn’t pumping enough blood to meet the body’s needs. This is caused by conditions that weaken the heart or affect its ability to pump blood, such as heart attack, high blood pressure, diabetes, heart enlargement, and severe lung disease.
Congenital heart disease – a problem in the structure of the heart that is present at birth. For most people, the cause of congenital heart disease is unknown. Certain cases may be due to heredity, infections during pregnancy, such as rubella, parents being closely related, or obesity in the mother.
Heart infections – an infection of the heart’s valves, inner lining, or other parts of the heart. Heart infections occur when an irritant such as bacteria, a virus, a parasite, or a chemical reaches your heart muscles.
Heart Disease Causes and Risk Factors
There are many risk factors for heart disease. Some of these risk factors can be controlled through lifestyle changes and/or medications, while others cannot, such as age and family history. The risk factors for heart disease include:
Your risk of developing heart disease increases as you age, especially after age 45 in men and age 55 or older in women.
Family history of early heart disease is another risk factor that can’t be changed. If you have parents, siblings, or children who had heart disease at an early age, you are at increased risk for heart disease.
High blood pressure
Known as hypertension, high blood pressure is one of the main causes of heart disease. When pressure in the blood vessels is too high, the heart must pump harder than normal to keep the blood circulating. Over time, high blood pressure can damage blood vessels, and increase your risk of heart attack and stroke.
High blood cholesterol
Too much bad cholesterol (LDL) in your blood can cause fatty material to build up in your artery walls, which can clog your blood vessels. The risk is particularly high if you have a high level of bad cholesterol and a low level of good cholesterol.
Being overweight or obese
Being overweight is a major risk factor for heart disease. In fact, obesity doubles your chance of heart disease. Losing just 10 percent of your body weight can lower this risk, however. Learn more about how to lose weight.
Being physically inactive
Lack of exercise is associated with a higher risk of heart disease. Try to aim for at least 150 minutes of moderate-to-vigorous physical activity each week. Exercise is also beneficial in lowering high blood pressure and maintain a healthy weight.
Foods that are high in saturated and trans fats and cholesterol increases the risk of heart disease. Thus, you should try to limit these foods.
It’s also important to limit foods that are high in sodium (salt) and added sugars as they can raise your risk of high blood pressure, which can lead to heart attack.
Smoking or exposure to secondhand smoke increase the risk of heart disease. Tobacco smoke contributes to the buildup of plaque in your arteries, increases the risk of blood clots, reduces the oxygen in your blood, increases your blood pressure and makes your heart work harder.
High glucose levels can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease.
Although the link between stress and heart disease isn’t clear, chronic stress may cause some people to drink too much alcohol which can increase your blood pressure and the risk of heart attack. Learn more about how to relieve stress.
Symptoms of Heart Disease
Symptoms of heart disease may vary from person to person and the symptoms can vary in severity from mild pain to more severe pain. Some common symptoms of heart disease include:
- Shortness of breath
- Chest pain or discomfort
- Heart palpitations
- Weakness or fatigue
If you experience any of these symptoms, see your doctor. Some of these symptoms can also be symptoms of a heart attack. If you think you are having a heart attack, call 911 or your emergency medical services.
Heart Disease Diagnosis
The diagnosis of heart disease will usually be made by asking about your symptoms and have your blood pressure checked. Your doctor may also want you to have specific tests to see how well your heart is working. These tests may include:
- Electrocardiogram (ECG)
This first test done to measures the electrical activity of the heart. This may show changes that indicate the heart muscle is not receiving enough oxygen. Electrical activity of the heart will be recorded using electrodes attached on the arms, legs and chest.
- Blood tests
These tests are used to detect the risk factors for heart diseases. Blood tests can measure the amount of C-reactive protein (CRP) and other protein markers like Apolipoprotein A1 and B in the bloodstream. High levels of these proteins are a sign of a recent heart attack.
- Stress test
A stress test evaluates if your heart muscle is getting enough blood and oxygen during activity. It is basically an electrocardiogram that is done during physical activity. Or you may receive a drug intravenously that stimulates your heart and mimic the effect of exercise. This test is often used for people who are unable to exercise for medical reasons.
This is an X-ray test that uses a special dye to produce an outline of any narrowing or blockages in the arteries. The dye is injected through a thin tube called a catheter that is insert into a vein in your groin or arm and guided into your coronary arteries. Heart function and efficiency can also be assessed during this test.
This is an imaging technique that using ultrasound waves to display the movements of the heart as it beats. The image produced allows doctors to measure precisely the dimensions of the heart. This can help identify whether an area of your heart has been damaged by a heart attack and isn’t pumping normally or at peak capacity.
Heart Disease Treatment
Treatment for heart disease will depend on the cause and the severity of the condition. In general, treatment may include lifestyles changes, medication, surgery or other procedures. The goal of treatment is to relieve symptoms and prevent complications from the diseases.
One of the best and simplest ways to reduce the risk of heart disease and manage the problems is to make some lifestyle changes. These include eating a balanced diet, exercising regularly, quit smoking, limit alcohol consumption, and maintain a healthy weight. Learn about how to reduce the risk of heart disease.
If lifestyle changes alone aren’t enough, your doctor may prescribe medications to control your heart disease. The type of medication will depend on the type of heart disease. Some common medication prescribed for heart disease include:
- Antiplatelet agents. These medications used to prevent the formation of blood clots. Examples of antiplatelet agents include aspirin, prasugrel, and clopidogrel (Plavix).
- Beta blockers. These medications used to relax the heart muscle, slow the heart rate and reduce the blood pressure, thus reducing the heart attack risk. Examples of beta-blockers include metoprolol (Lopressor), labetalol, and propranolol.
- ACE inhibitors. These medications used to lower blood pressure and reduce stress on the heart. Examples of ACE inhibitors include captopril, benazepril (Lotensin), and ramipril (Altace).
- Nitrates. These medications work to relax and widen the arteries, thus reducing blood pressure. Examples of nitrates include isosorbide dinitrate (Isordil), isosorbide mononitrate, and nitroglycerin.
- Calcium Channel Blockers. These medications work by regulating the amount of calcium that enters muscle cells in your heart and blood vessels. This lowers the blood pressure and reduces the heart’s workload. Examples of calcium channel blockers include amlodipine, diltiazem, and nifedipine.
Surgery or medical procedures
In addition to medications, your doctor may recommend specific procedures or surgery to treat your heart disease. The type of procedure will depend on the type of heart disease and the extent of the damage to your heart. These procedures include:
- Coronary artery bypass surgery
Bypass surgery is performed to improve blood flow problems to the heart muscle caused by the buildup of plaque (atherosclerosis) in the coronary arteries. The surgery involves using a piece of blood vessel (artery, vein) taken from elsewhere in the body to create a detour or bypass around the blocked portion of the coronary artery.
- Implantable pacemaker
It is performed to treat abnormal heart rates or rhythms (arrhythmia), particularly if they are not responded well to medication. The procedure works by implanting a small device called pacemaker in the chest or abdomen. The pacemaker sends electrical pulses to the heart to keep it beat at a normal rate. Having a pacemaker can significantly improve your quality of life if you have problems with a slow heart rate.
- Heart valve surgery
Heart valve surgery is a surgical procedure used to repair or replace a heart valve that isn’t working properly. For a heart valve replacement, you may receive a mechanical valve (made of metals or plastics) or a biological valve (made from animal or human tissue). Most surgery of this type is performed through a large incision in the chest. Sometimes, the surgery can be performed endoscopically (using long, flexible surgical instruments that are inserted through small incisions in skin).
Heart valve repair can be performed by inserting a catheter through a blood vessel and threading it to the heart valve. How your surgery is done will depend on the type of surgery you need.
- Heart transplant
Heart transplant is surgery to remove a diseased heart and replace it with a healthy heart from a deceased donor to improve the quality of life. Most heart transplants are done on patients who have end-stage heart failure, a condition in which the heart is severely damaged or weakened, and were failed in other treatment options. End-stage heart failure may be caused by conditions such as coronary heart disease, viral infections, or hereditary conditions.