Heart Disease

The term heart disease is used when describing several condition.  Conditions which are included as types of heart disease are:

• Arrhythmia: an irregular heart rhythm.
• Atherosclerosis: hardening of arteries.
• Cardiomyopathy: condition that leads to the hardening or weakening of heart muscles.
• Congenital Heart Defects: irregularities that someone is born with.
• Coronary Artery Disease: buildup of plaque in arteries.
• Heart infections: infections caused by bacteria, viruses or parasites.
• Heart valve disease: damaged valves lead to narrowing, leaking, or improper closing.
• Myocardial Infarctions (Heart Attack): the flow of blood to the heart is disrupted.
• Congestive Heart Disease: the heart's ability to pump is diminished (MNT, 2020)(Healthline, 2017)(Mayo, 2021).

There are symptoms of each of these conditions.  Individuals may experience a myriad of symptoms or possibly no symptoms at all.  Symptoms for each of the conditions include:

• Arrhythmias: 
• lightheadedness
• racing heartbeat
• slow pulse
• fluttering
• fainting spells
• dizziness
• chest pain
• Atherosclerosis
• chest pain
• shortness of breath
• coldness in extremities
• numbness in extremities
• unusual/unexplained pain
• weakness in extremities
• Congenital heart defects
• blue tinged skin
• swelling in extremities
• shortness of breath
• fatigue
• irregular heart rhythm
• Coronary Artery Disease
• fatigue
• bloating
• swollen legs
• shortness of breath
• rapid pulse
• Heart infections
• chest pain
• weakness
• fatigue
• shortness of breath
• coughing
• fever
• chills
• skin rash
• Cardiomyopathy
• breathlessness
• swelling of legs, ankles and feet
• fatigue
• irregular heartbeats
• dizziness
• lightheadedness
• fainting
• Heart valve disease
• fatigue
• shortness of breath
• irregular heartbeats
• swollen feet or ankles
• chest pain
• fatigue
• Myocardial Infarction
• chest pain
• shortness of breath
• heart palpitations
• nausea
• stomach pain
• sweating
• arm, jaw, or leg pain
• chocking sensation
• swollen ankles
• fatigue
• irregular heartbeat (Mayo, 2020)(Healthline, 2017)(MNT, 2020).

There are several risk factors for Hear disease.  These risk factors of Heart disease include:

• Age:  increased risk with increased age.
• Sex:  although generally speaking men are at greater risk, risk for women increases after menopause.
• Family History:  having a positive family history for heart disease increases risk.
• Smoking: Nicotine and Carbon Monoxide damage blood vessels.
• Poor diet:  increased amounts of fat, salt, sugar and cholesterol increases risk.
• Hypertension: uncontrolled Hypertension hardens arteries.
• High Cholesterol: increased cholesterol level increases risk of plaque formation.
• Diabetes: Diabetes and Heart Disease share risk factors.
• Obesity: increased weight increases risk.
• Physical Activity: lack of exercise increases risk.
• Stress: damages arteries.
• Poor dental health: if antigens enter the blood, they can increase risk.
• Ethnicity: Native Americans have lower risk. (Mayo, 2020)(Healthline, 2017)(MNT, 2020).

In order to diagnose heart disease, a combination of a physical exam, blood tests, noninvasive tests and invasive tests should be completed.  During the physical exam, a family history and personal history should be completed.  Blood tests completed should include:

• Cholesterol levels
• High Sensitivity C-Reactive protein: test for inflammation
• Lipoprotien(a): type of cholesterol determined by genes
• Brain Natriuretic Peptide: protein made by heart and blood vessels.  More is released when heart is damaged.
• Troponin T: protein in heart muscle.  Increased levels associate with increased risk.

Both noninvasive and invasive tests can be done in order to diagnose heart disease and the type of heart disease.  

Noninvasive tests include:

• Electrocardiogram (EKG): records electrical signals of heart.
• Holter Monitoring: records heart rhythm for 24 to 72 hours.
• Echocardiogram: creates image of heart using sound waves.
• Stress Test: tests heart's response to exercise or medications.
• Cardiac Computerized Tomography: X-rays create a series of images of heart.
• Cardiac Magnetic Resonance Imaging: radio waves create series of images of heart.
• Carotid Ultrasound: provides imaging of carotid arteries.

Invasive tests include:

• Cardiac Catherization: a sheath is inserted in a vein or artery in groin or arm, guided by x-ray to the heart where pressure can be measured and dye can be injected to help view blood flow, blood vessels and valves. 
• Electrophysiology study: catheter used to attach electrodes to heart in order to send electric pulses and to record the heart's responses (Mayo, 2020)(Healthline, 2017)(MNT, 2020).

The treatment of heart disease depends on the type and severity of heart disease.  Treatments fall into three categories:  Lifestyle changes, medications, and surgery.

Lifestyle changes are:

• Diet: rich in fruits and vegetables
• Manage stress
• Control Diabetes
• Exercise
• Tobacco cessation
• Decrease alcohol consumption
• Maintain a healthy weight

Medications use may include:

• Anticoagulants (blood thinners): prevent blood clots.
• Antiplatelet therapies: prevent blood clots.
• Angiotensin-Converting Enzyme Inhibitors: cause blood vessels to expand lowering blood pressure.
• Angiotensin II Receptor Blockers: control blood pressure.
• Angiotensin Receptor Neprilysin Inhibitors: open narrowed arteries.
• Beta Blockers: decrease heart rate and blood pressure.  Treat arrhythmias and angina.
• Calcium Channel Blockers: decrease blood pressure and prevent arrhythmias through relaxing blood vessels.
• Cholesterol lowering medications: decrease cholesterol levels.
• Digitalis: increases heart's ability to pump.
• Diuretic: remove water in order to decrease heart's workload.
• Vasodilators: decrease blood pressure by relaxing blood vessels.
• Antiarrhythmics: treat irregular heart rhythms.
• Nitrates: treat angina and chest pain due to blocked blood vessels.

Surgeries that may be useful in correcting or treating heart conditions include:

• Coronary Artery Bypass Surgery: a healthy blood vessel is used to repair a blocked blood vessel.
• Valve Replacement/Repair: valve that is improperly functioning is replaced and repaired.
• Device Implantation: devices such as balloon catheters or pacemakers are implanted (Mayo, 2020)(Healthline, 2017)(MNT, 2020).

For resources and more information on heart disease go to the American Heart Association's, Heart Help website at https://www.heartfoundation.org.nz/your-heart/hearthelp.

To learn about Heart Disease, watch video below.

https://www.youtube.com/watch?v=nYiAcPEQnsA&t=7s

American Heart Association. (2021) Heart Help.  American Heart Association. Retrieved at https://www.heartfoundation.org.nz/your-heart/hearthelp

Healthline, (2017) Everything you need to know about Heart Disease.  Healthline.  Retrieved from https://www.healthline.com/health/heart-disease#symptoms-of-heart-disease

Mayo Clinic. (2020) Heart Disease.  Mayo Clinic.  Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-disease/diagnosis-treatment/drc-20353124

Medical News Today. (2020) Everything there is to know about Heart Disease.  Medical News Today.  Retrieved from https://www.medicalnewstoday.com/articles/237191