Cardiovascular disease is the leading cause of death in the United States. More than 62 million Americans have some form of cardiovascular disease. Covenant HealthCare is aggressively tackling the issue of heart disease here in mid-Michigan.
There are many different types of heart disease – some are congenital (people are born with heart problems) while a majority of heart diseases develop over the course of time and affect people later in life.
Heart and blood vessel diseases are often referred to as “silent killers” because they usually develop over time and can go unnoticed. Many heart problems develop when the arteries, which supply blood to the heart, slowly clog with cells, fat and cholesterol (plaque). When the inner walls of arteries become narrow from a buildup of plaque, blood clots form and less blood can get through. This condition is known as atherosclerosis, or hardening of the arteries. Lack of blood flow to the heart can cause a heart attack, while lack of blood flow to the brain can result in a stroke.
Coronary Artery Disease
Blockage in the coronary arteries is called coronary artery disease—a condition in which the heart muscles don't get enough blood and oxygen. The most serious effect of coronary artery disease is sudden death without warning—something that usually happens in individuals who have had heart attacks or other heart damage.
Coronary artery disease can take the form of:
A form of coronary artery disease in which the blood flow to the heart muscle is reduced but produces very little pain or symptoms. When discomfort is experienced, it is usually during physical exertion.
Angina pectoris: pain or pressure in the chest, back, arm or jaw, which indicates that the heart muscle isn't receiving enough oxygen. Angina may be caused by a narrowing of the arteries or muscle spasms in the coronary arteries. These spasms may be induced by cigarette smoke, cold temperatures, strong emotions, and other sources. It is important to note that angina isn't a heart attack and doesn't usually cause permanent heart damage, even though it causes pain. The pain of angina can be relieved either by increasing the oxygen supply to the heart or by decreasing the heart's demand for oxygen.
Angina is discomfort or pain that means your heart is not getting enough oxygen and nutrients. The causes of angina are generally atherosclerosis or coronary artery spasm. Angina is not the same for everyone. While it usually occurs when the heart is working harder than normal, such as after a meal or during physical or emotional stress, it can also occur when resting. Traditionally, angina occurs primarily in the chest and radiates down the left arm. However, it can be any discomfort that radiates in the chest, across the shoulders, in the upper back, arms (both left and right), neck, throat, or jaw.
Symptoms of Angina
||Numbness or Tingling
||Shortness of Breath
||Sweating or Dizziness
If symptoms occur;
• Stop your activity, sit or lie down, and relax.
• Take a nitroglycerin (NT6) tablet or use NTG spray as prescribed by your physician.
• Be sure to notify your physician if these symptoms increase in frequency or severity but are not so severe that you feel the need to go to an emergency room.
If angina lasts longer than 15 minutes or worsens, call 911 or get to a hospital emergency room immediately. Never drive yourself.
Heart Attack (Myocardial Infarction)
When blood flow to part of the heart is blocked and part of the heart muscle is damaged or dies as a result. If the blockage is brief, and the heart eventually receives enough blood, oxygen, and nutrients, the damage is often reversible. This is why it is especially important for the heart attack victim to get medical help fast.
Warning signs of a heart attack include:
- Heavy feeling, pressure, or intense pain or squeezing in the chest that lasts for more than a few minutes.
- Pain that radiates to the shoulders, neck or arms.
- Lightheadedness or fainting
- Severe weakness
- Rapid heartbeat
- Shortness of breath
- Profuse Sweating
- Nausea or vomiting
If you experience any symptoms for more than 15 minutes and believe they are heart related, call 911 or have someone get you to the nearest emergency room as soon as possible.
Heart failure happens when the heart isn't pumping enough blood to meet your body’s needs. It does not mean that you are about to die, or even that your heart has stopped. It simply indicates that the heart is not squeezing as well as it should. Heart failure usually does not occur suddenly but gradually worsens over the time. Heart failure can be caused by:
- Coronary Artery Disease
- Heart Defects present at Birth
- Past Heart Attacks
- High Blood Pressure
- Diseases of the Heart Valves
- Cardiomyopathies (diseases that damage the heart muscles)
- Lung Disease such as Emphysema
If you have the following symptoms of heart failure, you should see a doctor:
- Swelling in the feet, ankles or legs, known as edema
- Fluid which builds up in the lungs, known as pulmonary congestion
- Other symptoms may include wheezing, sleep apnea, cough, and fatigue
Sometimes the heart’s electrical system does not function normally. It may race, become slow, irregular, skip beats or sometimes the heart’s electrical signal does not move in the proper sequence. This causes the heart to beat faster or slower than normal, or erratically. These abnormal rhythms are called arrhythmias. They can cause a variety of symptoms: dizziness, fainting, fatigue, shortness of breath and chest pain or rapid palpitations that may feel like flutters or pounding of the heart. If left untreated, arrhythmia’s can be life threatening. There are four major types of arrhythmias:
Bradycardia: Occurs when the heart’s electrical signal is delayed too long or blocked, resulting in a slower than normal heartbeat. If it happens only once in awhile, bradycardia is not a problem. However, if it continues over a long period of time, the body will not receive an adequate blood supply, which can be very serious. Heart disease and some drugs can cause bradycardia, and a physician should evaluate it to determine if treatment is required. Treatment can include discontinuing a medication and/or a pacemaker to make sure the heart beats at a normal rate.
Irregular or extra heartbeats: Even completely healthy people have irregular or extra heartbeats every once in awhile. In some cases, irregular or extra beats can lead to rapid heartbeats.
Ventricular Tachycardia (VT): Occurs when the heart’s electrical signal begins in the ventricles (lower chambers of the heart) and the heart beats too rapidly. When the ventricles pump too fast, they cannot deliver enough blood to the body. In some cases, VT can create a very rapid, erratic heartbeat (ventricular fibrillation), or cardiac arrest. If VT lasts for only a second or two, it may not be noticed and probably will not cause any serious problems. However, if it lasts longer, it can be very serious and should be evaluated by a physician.
Supraventricular Tachycardia (SVT): Occurs when the heart’s electrical signal begins above the ventricles (the lower chambers of the heart) causing the heart to beat very rapidly or erratically. As a result, the heart is strained, and the body receives an inadequate blood supply. There are three types of SVT; Atrial flutter, Atrial fibrillation, Paroxysmal SVT. A number of underlying conditions can lead to SVT. Medication and/or electrical shock treatment (cardioversion) can restore normal heartbeat. To prevent recurrences, additional treatment and medication may be necessary.
Poor blood supply to the heart, diseases of the heart valves or chemical imbalances in the body can cause VT. It often occurs during or after a heart attack. No matter how long it lasts, a physician must evaluate it. Normal heartbeat can be restored with electrical shock treatment (the paddles). Long-term control of VT may require an implanted defibrillator and/or medication.
Several diagnostic tests are available to identify arrhythmias including an electrocardiogram (ECG), Holter Monitor, a stress test, a tilt table test, and/or sometimes an electrophysiology study (EP) if necessary. In addition, if an arrhythmia is not revealed with routine testing then an implantable loop recorder may be indicated.
Obstruction defects – Heart Valve Problems: an obstruction is a narrowing that partly or completely blocks the flow of blood. Obstructions called stenoses can occur in the heart valves, arteries or veins.
- Pulmonary stenosis
- Aortic stenosis
- Bicuspid aortic valve
- Subaortic stenosis
- Mitral valve prolapse
Peripheral Arterial Disease
Like the heart, all tissues of the body need oxygen and other nutrients to survive and work. Fatty plaques or atherosclerosis can also affect arteries that supply oxygen-rich blood to other areas of the body. For example, peripheral arterial disease (PAD) occurs when the flow of oxygen-rich blood to the legs and feet is blocked or decreased. This blockage in the vessels deprives the feet and legs of oxygen and nutrients, and produces symptoms usually in the thigh, calf muscle and feet.
Symptoms of PAD
- Brown spots on the skin
- Changes in color of the skin on the leg: foot goes from pink to blue
- Loss of hair on the lower leg
- Numbness and tingling
- Pain or cramping after walking short distances
- Slow healing of wounds
Medications, catheter/surgical procedures, quitting smoking, following a diet low in cholesterol and fats, and loss of excess body weight are ways to reduce PAD.
A risk factor causes a person to be vulnerable to an unhealthy event or disease such as smoking and heart disease.
While the cause of heart and blood vessel disease is not fully understood we do know that heart disease is a chronic illness, which starts in childhood and progresses as we age. Through research, risk factors that contribute to the development and progression of cardiovascular disease have been identified.
Risk factors that cannot be changed (uncontrollable):
- Heredity or family history
Risk factors that can be changed or controlled:
- High cholesterol
- Cigarette smoking and tobacco use
- High blood pressure
- Lack of exercise
- Excess body fat
It is important to recognize which factors pertain to you and your lifestyle. While you cannot change uncontrollable risk factors, their presence makes it even more important that you do control the other risk factors with a healthy lifestyle combined with prescribed medications. Controlling these risk factors may slow, arrest, and in some cases, reverse the progress of heart disease.
Each controllable risk factor affects your health so it is important that you know what you can do to modify or eliminate them. No one is more in control of your health than you are. The Cardiac Rehabilitation Department at Covenant’s Cardiovascular Health & Wellness Center and your physicians and nurses will help you to broaden your knowledge about heart disease, but it is up to you to transform this knowledge into action!
Signs and symptoms
In people with heart disease, physical activity, emotional stress, and even eating can sometimes bring on symptoms. The most common, or classic, signs of a heart attack are:
- Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back
- Pain that spreads to the shoulders, neck or arms
- Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath
Other less common warning signs of heart attack may include:
- Atypical chest pain, stomach or abdominal pain
- Nausea or dizziness (without chest pain)
- Shortness of breath and difficulty breathing (without chest pain)
- Unexplained anxiety, weakness or fatigue
- Palpitations, cold sweat or paleness
All of these signs don't occur in every attack. Sometimes they go away and return. If some occur, get help fast. If you notice one or more of these signs in someone else, don't wait. Call 9-1-1 or your emergency medical services so the person can get to a hospital right away.