The heart is the body's most important muscle, needed to pump oxygen-rich, nutrient-rich blood around the body. Heart disease weakens that muscle.
Types of Heart Disease
In Coronary artery disease (CAD) plaque builds up in the arteries supplying the heart muscle with blood. This reduces blood flow, and makes blood clot formation more likely. Blood clots increase the blockage, sometimes blocking the artery completely. This destroys areas of the heart muscle.
Partial blockage causes angina. A larger blockage causes a more or less severe heart attack. Smaller areas of damage can weaken the heart over time, leading to arrhythmia and heart failure.
In arrhythmia disturbances in the heart's electrical nerve signals disrupt its normal rhythm. Most common is atrial fibrillation, when very fast and irregular contractions prevent the heart from pumping blood properly. Arrhythmia can lead to heart attacks or heart failure.
In heart failure the damaged heart muscle becomes too weak to pump enough blood to the rest of the body. Heart failure tends to worsen over time.
Symptoms
In their early stages high blood pressure, high cholesterol and diabetes have no or few apparent symptoms. Heart damage can begin before they are diagnosed and treated. CAD can progress without symptoms until the patient suffers a heart attack, heart failure or arrhythmia. Sometimes angina is the first sign of a serious problem.
Angina's main symptom is a feeling of pressure or a squeezing pain in the chest that may also be felt in the shoulders, arms, neck, jaws and/or back. The pain goes away with rest, and gets worse with activity or emotional stress.
Heart attack symptoms include:
* Lasting or recurring pain or discomfort in the center of the chest. Pain can be mild or severe, and can feel like pressure, squeezing or fullness.
* Stomach pain that feels like indigestion or heartburn.
* Discomfort in one or both arms, and/or in the back, neck and jaw.
* Shortness of breath, nausea, vomiting, lightheadedness or fainting.
* Cold sweats.
Early heart failure symptoms are shortness of breath during normal activities and tiredness. As the heart grows weaker symptoms include trouble breathing, fatigue, and swelling in the ankles, feet, legs, abdomen and, rarely, veins in the neck. Fluid build-up causes weight gain, frequent urination, and coughing that worsens when lying down at night.
Arrhythmia is quite common, but must be taken seriously when symptoms include chest pain, fainting, shortness of breath and/or dizziness, or when it is related to other conditions.
Tests
Doctors use various tests to diagnose and assess the progress of heart disease.
* Blood tests check for abnormal levels of certain fats, cholesterol, sugar and proteins.
* Chest xrays show the organs and structures of the chest.
* Echo-cardiograms (ECGs) show the heart's structure, size and shape, how well it is working and areas with poor blood flow or abnormal contractions.
* Electrocardiograms (EKGs) check the heart's speed and rhythm and find signs of previous or current damage. They can be used in portable Holter or event monitors to record heart activity over longer periods.
* Stress tests monitor the heart's reaction to increased physical activity, (abnormal changes in heart rate, rhythm, electrical activity) plus blood pressure, breathing and chest pain.
* Cardiac MRIs give a picture of the heart's structure and functioning.
* Coronary angiography and cardiac catheterization use dyes injected through a catheter and special xrays to look inside the coronary arteries.
Prevention
The best way to prevent or reduce the risk of heart disease is to live sensibly. Help the heart stay healthy by:
* Eating a healthy diet;
* Maintaining a healthy weight;
* Remaining active;
* Not smoking and avoiding second-hand smoke;
* Reducing stress.
Monitoring blood pressure, blood cholesterol and, if necessary, blood glucose levels help detect problems early, particularly as people age.
Treatment Advances
Ongoing improvements in imaging technology now allow doctors to better understand, evaluate and treat heart disease. These and other advances are leading to new methods of prevention and treatment, including recognizing and treating chronic vitamin D deficiency and treating depression. New drugs being developed include a pill incorporating several medications and one targeting an enzyme involved in clot formation. A new pump can assist the failing heart and allow it to recover.