by Eileen Swee Lian Goh

Created on: April 04, 2009   Last Updated: April 08, 2009

Heart disease is a leading cause of death worldwide and its strain on financial resources is a major concern in developed countries as well as developing nations.

TYPES OF HEART DISEASE

Heart disease may be classified as follows:-

1. Congenital

a) Structural defects. The commonest disorder belonging to this category is ventricular septal defect, frequently known as "hole-in-the-heart". Other examples of congenital structural heart disease are prolapse of the mitral valve of the heart, and narrowing (stenosis) or incompetence of the mitral and aortic valves.

b) Conduction anomalies. Disorders affecting the electrical conductivity of the heart may result in increased or decreased heart rate (tachycardia/fibrillation or bradycardia respectively) as well as irregular heart rhythm with extra beats (ectopics) or missed beats.

2. Non-congenital/Acquired

a) Ischaemic heart disease (IHD).

This is the commonest form of all heart diseases and includes angina, coronary artery disease (CAD) and heart attack (acute myocardial infarction or AMI).

IHD is a consequence of atherosclerosis or hardening and narrowing of the coronary artery caused by the build-up of cholesterol plaques on the arterial walls, with a resultant decreased blood flow to the heart tissues.

Angina is the mildest presentation of this disorder, and AMI, the most severe.

b) Heart disease secondary to other organ disorders.

The heart is closely associated with the lungs and blood vessels, and pathologies in the latter two are most likely to affect the heart. Conditions such as emphysema of the lungs and hypertension may result in pulmonary and hypertensive heart diseases respectively, which, if severe, can give rise to congestive heart failure.

Diabetes mellitus, caused by failure of the pancreas to produce sufficient insulin, also predisposes to heart disease.

c) Infection-related heart disease. The two commonest disorders in this category are rheumatic heart disease (caused by rheumatic fever) and syphilitic heart disease.

SYMPTOMS OF HEART DISEASE

These depend on the severity of the heart disease and include:-

a) Breathlessness.

b) Palpitations.

c) Rapid heart rate.

d) Weakness/dizziness.

e) Perspiration.

f) Nausea.

g) Chest pain, which varies according to the type of heart disease. In angina, the pain is often sharp and may radiate to the arms (especially, the left), shoulders, neck, throat, jaw and/or back. In early AMI, the pain may be a discomfort or feeling of heaviness or fullness, resembling indigestion or "heart-burn".

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