Heart disease is a generic term that describes many different problems affecting the heart. It can affect your coronary arteries, heart valves, and heart muscle and can also affect your heart rate and rhythm. Heart disease is the number one killer of Americans.
Most common kinds of heart disease
Coronary Artery Disease (CAD)/Atherosclerosis (ath·ero·scle·ro·sis)
Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and narrow due to buildup of a material called plaque on their inner walls. The buildup of plaque is known as atherosclerosis. As the plaque increases in size, the insides of the coronary arteries get narrower and less blood can flow through them. Eventually, blood flow to the heart muscle is reduced, and because blood carries much-needed oxygen, the heart muscle is not able to receive the amount of oxygen it needs.
Angina is chest pain or discomfort that occurs when the heart does not get enough blood. People describe angina as discomfort, pressure, or pain in the chest, back, neck, shoulders, arms (especially the left arm), or jaw. Angina can be a warning of a heart attack.
Some heart attacks are sudden and intense, where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people aren’t sure what’s wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:
- Chest discomfort – Most heart attacks involve a discomforting feeling in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, or pain.
- Discomfort in other areas of the upper body – Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
- Shortness of breath – May occur with or without chest discomfort. Other signs – May include breaking out in a cold sweat, feeling nauseated, or light headed.
Heart attack symptoms can be different for men and women. As with men, women’s most common symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
If you or someone with you has chest discomfort, especially with one or more of the other signs, call 9-1-1 and get to a hospital right away. For more information about 9-1-1, please visit www.911.utah.gov/index.php
Heart Valve Disease
The heart has four chambers. The upper two are the right and left atria. The lower two are the right and left ventricles. Blood is pumped through the chambers, aided by four heart valves. The valves open and close to let the blood flow in only one direction. Each valve has a set of flaps (also called leaflets or cusps). When working properly, the heart valves open and close fully. A defective heart valve is one that fails to fully open or close. A person can be born with an abnormal heart valve, a type of congenital heart defect. Also, a valve can become damaged by:
- infections such as infective endocarditis
- rheumatic fever
- changes in valve structure in the elderly
Heart Failure and Cardiomyopathy (car·dio·my·op·a·thy)
Heart failure is a condition in which your heart can’t pump enough blood to meet your body’s needs. Key symptoms of heart failure include shortness of breath, a dry and hacking cough, weight gain, swelling, and fatigue.
Heart failure develops as a result of weakening of the heart muscle. This weakening is often brought on by other conditions that damage the heart muscle, including atherosclerosis, heart attack, high blood pressure, heart valve problems, and alcohol abuse. Heart muscle weakening and damage is often called cardiomyopathy, which literally means “heart muscle disease.” Cardiomyopathy can be classified as primary or secondary. Primary cardiomyopathy can’t be attributed to a specific cause, such as high blood pressure, heart valve disease, artery diseases, or congenital heart defects. Secondary cardiomyopathy is due to specific causes. It’s often associated with diseases involving other organs as well as the heart.
An arrhythmia is a change in the rhythm of your heartbeat. When the heart beats too fast, it’s called tachycardia (tach·y·car·di·a). When it beats too slow, it’s called bradycardia (brad·y·car·di·a). An arrhythmia can also mean that your heart beats irregularly (skips a beat or has an extra beat). At some time or another, most people have felt their heart race or skip a beat. These occasional changes can be brought on by strong emotions or exercise. They are usually not a cause for alarm. Arrhythmias that occur more often or cause symptoms may be more serious and need to be discussed with your doctor.
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Although the term “heart defect” can refer to many different heart problems, it’s often used to talk about defects affecting the wall (septum) that divides the two upper or two lower chambers of the heart. Three of the more common defects are: Atrial septal defect (ASD), Patent foramen ovale (PFO), and Ventricular septal defect (VSD).
Some risk factors cannot be changed, others require some lifestyle adjustments. It is important to be aware of risk factors so you can take the necessary steps to prevent further damage to your heart.
Am I at risk for Heart Disease?
Clinical and statistical studies have identified several factors that increase a person’s risk of having heart disease. Major risk factors are those that research has shown significantly increase the risk of heart disease. Other factors are associated with increased risk of cardiovascular disease, but their significance and prevalence haven’t yet been precisely determined. They’re called contributing risk factors.
Use My Life Check from the American Heart Association to assess your heart health and determine what you can do to lower your risk.
Risk factors you cannot change
Some risk factors cannot be changed. Still, it is important to be aware of them. Awareness gives you an opportunity to educate yourself and also to take measures to safeguard your health as much as possible in other ways. The unchangeable factors affecting your heart health are:
- Age: Your risk increases with age.
- Sex: Men of any age, and postmenopausal women, have a greater risk.
- Family History (heredity and race): Heart disease tends to run in families and is more common among some ethnic groups. For help in determining your family health history use the Family Health History Toolkit.
- Medical history: Past history of heart problems.
Risk factors you can change
High Blood Pressure (hypertension)
High blood pressure causes the heart to work harder, putting you at an increased risk for heart attack, stroke, heart failure, kidney, and eye problems. There are no symptoms to identify high blood pressure and therefore many people are unaware that they have it. The only way to detect high blood pressure is to have it checked regularly.
High Blood Cholesterol
Cholesterol is a soft, fat-like substance in your body. Cholesterol only comes from animal products or animal by-products such as beef, chicken, eggs, milk, etc. A high level of cholesterol in the blood (240 mg/dL or higher) is a major risk factor for heart attack and also increases your risk of having a stroke. High levels of HDL (“good”) cholesterol lower your risk of heart disease and stroke. People with a low level of HDL cholesterol (less than 40 mg/dL) have a higher risk of heart attack and stroke. A high LDL level (more than 160 mg/dL or more than 130 mg/dL if you have two or more risk factors for heart disease) reflects an increased risk of heart disease. That’s why LDL cholesterol is often called “bad” cholesterol.
Quitting smoking lowers a person’s risk of heart disease greatly, even after many years of smoking. Learn more about the impact of smoking on heart disease.
Two out of three people with diabetes die from heart disease or stroke. Diabetes is a chronic metabolic disorder affecting the body’s ability to make or use insulin. Insulin is the hormone that transports glucose (blood sugar) from digested nutrients into the body’s cells for energy and growth. There are two types of diabetes, type 1 and type 2. When the body cannot produce insulin, this is called type 1 diabetes. In order to control their blood sugar, the patient must use insulin injections. In type 2 diabetes, the body produces insulin but is unable to process it and/or use it correctly in most cases this may be controlled by diet and exercise. People with diabetes can manage their blood pressure and cholesterol to reduce their chance of heart attack or stroke. Learn more about diabetes.
Physical inactivity increases your risk of heart disease and stroke. You can reduce your risk by doing moderate-intensity physical activity for a total of 2 ½ hours per week.
Obesity is the second leading cause of preventable death in the United States. Only smoking exceeds obesity in contributing to the total U.S. death rate. The percentage of overweight or obese persons in Utah and the U.S. has increased dramatically over the past 10 years. Adults who are obese are also at a greater risk of high blood pressure, high cholesterol, diabetes, coronary heart disease, stroke, osteoarthritis, sleep apnea, respiratory problems, and endometrial, breast, prostate, and colon cancer.
Contributing Factors for Heart Disease
Researchers continually discover other factors that seem to relate to heart disease. The following are a few of these factors:
- Birth control pills
- C-reactive protein
- Alcohol Homocysteine
- Metabolic syndrome
Heart Disease Treatment & Rehabilitation
If treatment isn’t enough, cardiac rehabilitation allows patients to recover from heart problems or heart surgery, helps them heal faster, and reduces their risk for future cardiac problems.
Diagnosing and Treating Heart Disease
A heart disease treatment plan should be tailored to your specific condition, its severity and causes, and your current health and lifestyle. This may include more than a procedure. It may also mean making lifestyle changes and taking medications. The best thing to do is maintain open communication with your doctor about your risks and what is right for you. The following are procedures used to diagnose and treat heart disease.
- Exercise stress tests measure symptoms, blood pressure, and EKG (electrocardiogram) during exercise.
- Imaging procedures provide still or moving pictures through X-ray, fluoroscopy, MRI, or CT scans.
- Electrophysiology studies, or echocardiograms, examine heart rhythm disturbances using electrodes positioned over the patient’s heart.
- Ultrasound, like an echocardiogram, uses sound waves to produce images of your heart.
- Cardiac catheterization diagnoses and/or treats an obstruction. An angiogram introduces dye through a catheter to observe the heart’s blood vessel flow by X-ray; a balloon angioplasty procedure uses a tiny balloon-tipped catheter to help unclog blockages.
- Surgical procedures can bypass clogged arteries, replace valves, insert pacemakers, and defibrillators or replace the entire heart.
Cardiac rehab is a medically supervised program to help heart patients recover quickly and improve their overall physical and mental functioning. The goal is to reduce the risk of another cardiac event or to keep an already present heart condition from getting worse.
The benefits of participating in a cardiac rehab program are:
- Faster recovery
- Improved fitness
- Decreased symptoms
- Reduced fear and anxiety
- Improved confidence
- Lifelong changes are made
- Reduced risk of further heart problems
- Reduced risk of death
The services that cardiac rehabilitation might include are supervised exercise sessions and education about risk factors of heart disease, signs and symptoms of heart disease, and ways you can prevent another cardiac event. Most importantly, cardiac rehab will provide the social and emotional support you will need to adjust to your condition and make lifelong lifestyle changes to reduce your risk factors for further heart problems.
Physical Activity Guidelines for People with Heart Disease
Physical activity is an important part of managing heart disease or recovering from heart surgery. But there are a few things to keep in mind to make sure you are both active and safe.
Discuss the following with your doctor
- Medication changes. New medications can greatly affect your response to exercise; your doctor can tell you if your normal exercise routine is still safe.
- Heavy lifting. Lifting or pushing heavy objects and chores such as raking, shoveling, mowing, or scrubbing may be off limits for you. Chores around the house can be tiring for some people; make sure you only do what you are able to do without getting tired.
- Safe exercises. Get the doctor’s approval before you lift weights, use a weight machine, jog, or swim.
General Workout Tips for Those With Heart Disease
- Be sure any exercise is paced and balanced with rest.
- Ask your doctor about avoiding isometric exercises. Isometric exercises involve pushing or pulling against an immovable object.
- Don’t exercise outdoors when it is too cold, hot, or humid. High humidity may cause you to tire more quickly; extreme temperatures can interfere with circulation, make breathing difficult, and cause chest pain. Better choices are indoor activities such as mall walking.
- Make sure you stay hydrated. It is important to drink water even before you feel thirsty, especially on hot days.
- Avoid extremely hot and cold showers or sauna baths after exercise. These extreme temperatures increase the workload on the heart.
- Steer clear of exercise in hilly areas. If you must walk in steep areas, make sure to slow down when going uphill to avoid working too hard. Monitor your heart rate closely.
- If your exercise program has been interrupted for a few days (for example, due to illness, vacation, or bad weather), make sure to ease back into the routine. Start with a reduced level of activity, and gradually increase it until you are back where you started.
There are many precautions to keep in mind when developing an exercise program for yourself or a loved one with heart disease.
- Stop the exercise if you become overly fatigued or short of breath; discuss the symptoms with a doctor or schedule an appointment for evaluation.
- Do not exercise if you are not feeling well or have a fever. Heart patients should wait a few days after all symptoms disappear before restarting the exercise program, unless their doctor gives other directions.
- Stop the activity if you develop a rapid or irregular heartbeat or have heart palpitations. Check your pulse after you have rested for 15 minutes. If it’s still above 100-120 beats per minute, call the doctor for further instructions.
*If you experience pain don’t ignore it. If you have chest pain or pain anywhere else in the body, do not allow the activity to continue. Performing an activity while in pain may cause stress or damage to the joints.
Stop exercising if you
- Feel weak. Are dizzy or lightheaded.
- Have unexplained weight gain or swelling (call the doctor right away).
- Have pressure or pain in the chest, neck, arm, jaw, or shoulder.
- Have any other symptoms that cause concern.
Call the doctor if symptoms do not go away.