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Heart Disease and Heart Attack ( courtecy ;- MEDICINE.COM)
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Conditions that involve the heart, its vessels, muscles,
valves, or electric pathways.
What Is Heart Disease?
Heart disease refers
to conditions that involve the heart, its vessels, muscles, valves, or
internal electric pathways responsible for muscular contraction. Common heart
disease conditions include:
·
Coronary
artery disease
·
Heart
failure
·
Cardiomyopathy
·
Heart
valve disease
·
Arrhythmias
What Is a Heart Attack?
When a coronary artery becomes blocked (usually by a blood
clot), an area of heart tissue loses its blood supply. This reduction of
blood can quickly damage and/or kill heart tissue, so quick treatments in an
emergency department and/or catheterization suite are necessary to reduce the
loss of heart tissue. Loss of heart tissue due to a blockage can cause
symptoms such as chest pain, shortness of breath, weakness, and even death.
Quick treatments have reduced the number of deaths from heart attacks in recent
years; however, about 610,000 people die from heart disease in the US each
year (1 in every 4 deaths) according to the CDC
Heart Attack Symptoms
The following are
warning signs of a heart attack:
·
Chest
pain (may spread to the back, neck, arms and/or jaw)
·
Dizziness
·
Nausea,
vomiting
·
Rapid
or irregular heartbeats
·
Shortness
of breath
·
Some
people may exhibit anxiety, indigestion and/or heartburn (some women may
present with these as their predominant symptoms instead of chest pain)
·
Weakness
Heart Attack Symptoms in Women
Although some women present with symptoms of chest pain, a large
number of women will not present with chest pain. Instead, women commonly
have a different set of heart attack symptoms.
Know These Heart Attack Symptoms
·
Arrhythmias
·
Cough
·
Heartburn
·
Loss of appetite
·
Malaise
Such symptoms in women cause delays in diagnosis if the symptoms
are not considered as possible signs of heart disease. Delays in diagnosis
can cause further damage to heart tissue or even death.
Coronary Artery Disease Symptoms
Coronary artery disease (CAD) occurs when plaque, a sticky
substance, narrows or partially obstructs coronary arteries (like sticky
material stopping up a straw) and can result in reduced blood flow. This
reduced blood flow may cause chest pain (angina), a warning sign of potential
heart problems such as a heart attack. Plaque may also trap small blood
clots, completely blocking a coronary artery suddenly, resulting in a heart
attack.
How Plaque, Blood Clots can Cause Heart
Attack
Plaque can occur in coronary and other arteries (for example,
carotid arteries). Some plaque may be hard or firm on the outside, but soft
and mushy or sticky on the inside. If the hard shell-like area cracks open,
blood components like platelets and small blood clots form a large clot and
effectively block blood flow through the artery. The heart tissue downstream
from the clot then suffers from lack of blood and becomes damaged or dies.
Heart Attack Symptoms? Call 9-1-1
If you or an individual develop symptoms of a heart attack, do
not delay getting medical help. Call 911 or have someone call for you. Do not
drive yourself or others to a hospital as 911 emergency medical services
(EMS) personnel can begin basic treatment immediately. Delaying care can
result in increased heart damage or death.
Sudden Cardiac Arrest
A heart attack can cause other abnormalities besides blocking
blood flow. For example, sudden cardiac death may occur when the heart’s
electrical signals become erratic (arrhythmias). When the heart tissue that
is responsible for regular electrical stimulus of heart muscle contractions
is damaged, the heart stops effectively pumping blood. Death usually occurs
in a few minutes after the heart stops pumping blood. Consequently, rapid
coronary pulmonary resuscitation (CPR) and a restoration of the organized
electrical activity (usually done by electric shock with a defibrillator) may
restore effective pumping of blood. This can be lifesaving for some
individuals.
Erratic Heart Beat (Arrhythmia)
Patients who notice that their heartbeats are abnormally fast,
slow, or irregular may be experiencing irregular electrical impulses termed
arrhythmias. They may also have symptoms of weakness, shortness of breath,
and anxiety. Arrhythmias can alter, slow or even stop the heart’s ability to
pump blood. Consequently, individuals with arrhythmias should seek emergency
medical care especially if the arrhythmia is persistent or causes any
symptoms related to heart attack symptoms such as chest pain.
Cardiomyopathy
Cardiomyopathy is a condition indicated by abnormal heart
muscle. Abnormal muscles make it harder for your heart to pump blood to the
rest of the body.
Main Types of Cardiomyopathy
·
Dilated (stretched and thinned muscle)
·
Hypertrophic (thickened heart muscle)
·
Restrictive (rare problem where the heart
muscle does not stretch normally so the chambers do not fill with blood
properly)
Signs and Symptoms of Cardiomyopathy
·
Shortness of breath
·
Fatigue
·
Swelling of the feet, ankles and/or legs
·
Coughing when lying down
·
Dizzines
·
Chest pain
IrregHeart Failure
Heart failure (also termed congestive heart failure) means the
pumping action of the heart cannot meet the body’s demand for blood; it does
not mean that the heart fails to pump - it does mean a failure in an aspect
of the heart’s ability to complete an otherwise normal function. The symptCongenital Heart Defect
A congenital heart defect is a defect in the development of the
heart as an organ that is usually first noticed at birth although some are
not found until adulthood. There are many types of congenital heart defects
and a few need no treatment, but others may need surgical repair. The
American Heart Association lists at least 18 distinct types of congenital
heart defects - many of them have additional anatomical variations.
Congenital heart defects put those patients at higher risk to
develop arrhythmias, heart failure, heart valve infections, and other
problems. A cardiologist (often a pediatric cardiologist) needs to be
consulted on how to treat these defects. Recent advances have allowed
surgeons to repair many of these defects so that the patient can go on to
develop normally.
oms and signs are almost
identical to those seen with cardiomyopathy.
Heart Disease Testing: EKG
(Electrocardiogram)
The heart's electrical activity can be seen with an EKG (also
termed ECG or electrocardiogram). EKGs are tests that provide important
information to the physician about the heart rhythm, damage to the heart, or
a heart attack, and may provide several other important pieces of information
or clues to the patient's condition. In addition, EKGs can be compared to
past and future EKGs to see changes in the heart’s electrical activity over time
or after treatments
Heart Disease Testing: Stress Test
A stress test measures the ability of a person's heart to
respond to the body's demand for more blood during stress (exercise or work).
A continual measurement of the heart's electrical activity (a continual EKG
or rhythm strip) is recorded along with the heart rate and blood pressure as
a person's stress (exercise) is gradually increased on a treadmill. The
information helps to show how well the heart responds to the body's demands
and may provide information to help diagnose and treat problems. It can also
be used to see the effects of treatment on the heart.
Heart Disease Testing: Holter Monitor
Many people have intermittent symptoms such as intermittent
chest pain or occasional feelings of their heart beating faster or
irregularly. However, their EKG does not show any changes. To detect these
intermittent changes, a device called a Holter monitor can be worn for
several days to record the hearts’ electrical function.
A Holter monitor is similar to a stress test, but it is worn for
1 or 2 days and provides a continual EKG-like recording of the heart's
electrical activity during those days. Most doctors will ask the patient to
keep a logbook of the time they do certain activities (for example, walking a
mile starting at 7:20 AM and ending at 7:40 AM) and list any symptoms (for
example, "experienced shortness of breath or rapid irregular heartbeats
at 7:35 AM"). The Holter monitor's recordings can then be examined based
on when certain symptoms occurred.
Heart Disease Testing: Chest X-ray
Chest x-rays can provide limited information about the heart’s
condition. Chest X-rays are used to provide the doctor with a view of both
the heart and lungs to help determine if any abnormalities are present. These
two X-rays show a relatively normal heart on the left. In the right X-ray, an
enlarged heart (mainly the left ventricle) is easily seen and suggests the
heart's main pumping chamber is not functioning normally. In addition, x-rays
may show fluid accumulation in the lungs, possibly from heart failure.
Heart Disease Testing: Echocardiogram
An echocardiogram is a real-time moving picture of a functioning
heart made by using sound waves (ultrasound) to generate images.
Echocardiograms use the same noninvasive technology used to examine the fetus
during pregnancy. It can show how well heart chambers and heart valves are
functioning (for example, effective or poor pumping action, blood flow
through the valves), before and after treatments, as well as other features.
Heart Disease Testing: Cardiac CT Scan
Specialized cardiac computerized tomography (CT) scans or
‘cardiac CTs’ can provide detailed 3-D images of the heart. The images can be
manipulated to look for calcium buildup (plaque) in coronary arteries or
provide images of such internal structures of the heart like valves or wall
thickness. CTs can also be used to examine normal heart anatomy or congenital
defects. The information from a CT can provide insight into several heart
disease problems.
Heart Disease Testing: Cardiac
Catheterization
Plaque in cardiac arteries can be a severe problem, even
life-threatening, in some patients. Diagnosing plaque blockage of coronary
arteries and treatment for blockages has improved the lives of many patients
with coronary artery disease. Cardiac catheterization is a technique that may
provide both diagnostic information and therapeutic methodology in one
procedure. The technique is invasive.
How Cardiac Catheterization Works
·
A thin tube is placed in a blood vessel in
the leg or arm and threaded into the heart and into the opening of a coronary
artery.
·
Dye is put into the tube and goes into the
artery.
·
A special X-ray machine images the dye,
showing narrowing or blockage of the artery.
·
The same tube may be used with special tips
to open the coronary artery by angioplasty (small balloon is inflated) or
used to place a wire mesh (stent) that expands to hold the artery open.
Living With Heart Disease
Most types of heart disease are chronic but slowly progressive
like heart failure or cardiomyopathy. They begin with minor symptoms that
often slowly worsen and require long-term medical treatment.
Symptoms That May Resist Treatment
·
Ankle swelling
·
Fatigue
·
Fluid retention
·
Shortness of breath
Lifestyle changes may become necessary (for example, home
oxygen, limited activity
Heart Disease
Treatment: Medicines
Advances in medicines
that can help reduce the symptoms and slow the damage of heart disease have
helped the majority of heart disease patients. Drugs are available to do the
following:
·
Lower
blood pressure (anti-hypertensives)
·
Lower
heartbeat rates (beta blockers)
·
Lower
cholesterol levels to reduce plaque (diet, statins)
·
Help
stabilize abnormal heart rhythms (ablation, cardiac pacers)
·
Reduce
or prevent clotting in coronary arteries (blood thinners)
Improve the pumHeart Disease Treatment:
Angioplasty
Other treatments for heart disease involve special techniques
like angioplasty and stent placement.
Angioplasty Step by Step
·
A thin catheter or tube (stent) is placed
in a coronary artery and is threaded through an obstruction like a clot.
·
A balloon is inflated and pushes aside the
obstruction.
·
The balloon is then deflated leaving the
artery unblocked, thus allowing good blood flow.
·
Often, after angioplasty, an expandable
mesh tube is then inserted and expanded, reinforcing the artery to keep it
from collapsing.
·
Heart Disease Treatment: Bypass Surgery
Some patient's coronary arteries are not good candidates for
angioplasty and/or stents. Such patients may benefit from another treatment
technique termed bypass surgery. Bypass surgery occurs when a surgeon removes
a blood vessel from one part of the body (chest, legs, or arms) and uses it
to connect one open part of a coronary artery to another open part, thus
bypassing the area that has blocked blood flow. Often the surgeon may need to
bypass more than one artery.
The decision to try and stent a coronary artery versus doing
bypass surgery is usually recommended to the patient by their cardiologist
and a heart surgeon. Bypass surgery is usually done if coronary arteries are
narrowed or blocked in multiple places.
Who Is at Risk for Heart Disease?
Health conditions, lifestyle, age, and family history may
increase your risk for heart disease. Although men, even at a younger age,
have a higher risk for heart disease than women, heart disease is still the
number one killer of both sexes (about 611,000 total deaths/year). People
with a family history of heart disease, who smoke, and who are obese have a
higher risk of developing heart disease. About half of all Americans (47%)
have at least one of three key risk factor for heart disease including high
blood pressure, high cholesterol, or smoking.
Controllable Heart Disease Risks
Often, risk factors for heart disease can be managed or reduced
through simple methods. Common risk factors for heart disease include the following:
Heart Diseases Risks You Can Control
·
Diabetes
·
Elevated cholesterol
·
High blood pressure
·
Lack of physical activity
·
Stop smoking
These risk factors can be reduced simply by making healthy
lifestyle choices and taking medications. Your primary care doctor can help
you with your choices and medications.
Smoking Increases
Heart Disease Risk
Many researchers
suggest one of the best things a person can do to decrease the risk of heart
disease is to stop smoking cigarettes. Smoking increases a person's risk for
heart disease from 2 to about 4 times greater than nonsmokers. Smoking can
damage the heart muscle, its blood vessels, can raise blood pressure,
increase carbon monoxide levels, and reduce oxygen available to heart tissue.
People who do not
smoke but are exposed to second-hand smoke are at greater risk for heart
disease than those not exposed to second-hand smoke. Although over 135,000
people die each year from heart disease related to smoking, it is never too
late to quit smoking because once you quit, your risk of heart disease begins
to drop almost immediately.
Life After a Heart Attack
Don’t give up activities if you have a heart attack. If a person
suffers a heart attack, it is still possible to develop a healthy lifestyle.
Many doctors recommend that their patients participate in a cardiac rehab
program and learn how to avoid cigarettes, develop a healthy diet, and become
more active. All of these changes may help a person’s heart recover and
function better and to reduce the chance of additional heart problems.
Preventing Heart
Disease
Heart disease
prevention and risk reduction is possible by living a healthy lifestyle.
Basic components of a heart-healthy lifestyle include:
·
Never
smoke or stop smoking cigarettes (and using other tobacco products)
·
Eat
a nutritious diet (many vegetables and fruits, less fats, sugars, and meats)
·
Get
at least 30 minutes of exercise almost every day
·
Avoid
alcohol or consume no more than 1 drink per day for women and no more than 2
drinks per day for men
·
If
needed, achieve medical control of diabetes, high blood pressure, and
cholesterol
·
Encourage
friends and family to help you. Maybe they could benefit from your good
example
Heart Disease and Diet
A major key to preventing, recovering from, and slowing heart
disease is a heart-healthy diet. Most heart doctors recommend the following
foods.
Heart-Healthy Foods
·
Fruits
·
Legumes
·
Vegetables
·
Whole grains
Foods That May Help Reduce Cholesterol Levels
·
Nuts
·
Plant oils
·
Seeds
Eating fish about twice a week is a good source of protein
without the fats found in red meat. Some researchers have suggested that a
more vegetarian-like diet may actually reverse some aspects of coronary
artery disease like plaque size.
While heart disease is treatable by many methods, prevention or
healing by living a reasonable lifestyle seems to be one of the best ways to
reduce this widespread health problem
Reviewed by Charles Patrick Davis,
MD, PhD on Saturday, August
06, 2016
Heart Disease: Causes of
a Heart Attack
This tool does
not provide medical advice.
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