Cardiovascular disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 15, 2016
StartDiseasesCardiovascular disease

Cardiovascular disease, also called heart disease, refers to a number of diseases dealing with the heart and blood vessels. Disorders that fall under this umbrella can involve the blood vessels becoming blocked as well as problems with the heart valves, cardiac muscles, or the rhythm of the heart.

Contents

Definition & Facts

In the United States, cardiovascular disease is the primary cause of death for both men and women. This means that one death out of every four is the result of heart disease, which is about 610,000 people annually. Death from heart disease is most common in the southeastern United States, and least common in Minnesota and some of the western states. The most common type of heart disease is coronary heart disease (CHD), and more than 370,000 people die from it every year.

Symptoms & Complaints

The most common problem stemming from cardiovascular disease is a heart attack. Symptoms of a heart attack will typically involve:

An arrhythmia of the heart, which means that the heart is beating irregularly, will have the following symptoms:

Heart failure occurs when the heart ceases to pump blood as usual. Symptoms can include:

Causes

Each of the various heart diseases has its own unique set of causes. The main cause of cardiovascular disease is atherosclerosis, or a building up of plaques within the arteries. The plaques accumulate and cause the arterial walls to thicken and grow stiff, which can reduce blood flow.

Some of the most common reasons why this happens are because of an ongoing unhealthy diet, not exercising enough, smoking and being overweight. Causes of a heart arrhythmia include: birth defects of the heart, diabetes, high blood pressure, alcohol abuse, excessive caffeine consumption, stress, smoking, some medications, and drug abuse.

The cause of a heart infection may include bacteria, parasites, or viruses. A heart attack is caused by clogged arteries, which leads to the forming of a blood clot on top of the plaque that blocks the artery. Primary causes of a heart attack include:

Other factors include a family history of heart attacks, stress, exertion, and excitement.

Diagnosis & Tests

A diagnosis for a heart attack or other cardiovascular disease problems involves taking a complete medical history of the patient, giving a physical examination, an electrocardiogram (ECG or EKG) – which electronically records the electrical impulses of the heart, and a blood test. The blood test is capable of detecting the presence of certain enzymes which can reveal whether or not a heart attack has taken place.

An echocardiogram will make an ultrasound of the chest, enabling doctors to see the function of the heart. Doctors may also use cardiac catheterization, in which a catheter will be inserted into a vein or artery and moved towards the heart. Through the device, doctors may inject a dye which on an X-ray, will show how fluid is moving through the heart, and check to see how well valves and blood vessels perform.

A CT scan or MRI may also be used to determine the problem. Exercise stress tests may also be given, during which time the heart will be monitored with an ECG or EKG, along with monitoring of the breathing, blood pressure, the heart rate. A Holter monitor may be worn for a 24 to 72 hour period to determine if there are any abnormalities that were not detected by an ECG.

Treatment & Therapy

For those who have had a heart attack, a procedure called a thrombolysis may be done. This involves putting a substance in the body that will dissolve clots. In order to be effective, it must be performed within three hours of the heart attack. If not, patients are likely to need a coronary angioplasty or other procedure to increase the supply of blood to the heart.

It may also be necessary to perform surgery to remove the clot or open an artery that has become clogged. In some cases, a device will need to be implanted to assist the heart if it is weakened or irregular. An artificial cardiac pacemaker may be installed to help ensure regular beats of the heart, but it may only need to be temporary. Another device, called an implantable cardioverter-defibrillator, is capable of detecting the heart's rhythm, and it is capable of shocking the heart to prevent sudden death.

A left ventricular assist device (LVAD) is used in patients whose main heart chamber is not strong enough to continue working as it should. The LVAD is a pump that pumps the blood through the body and is often used when a patient's heart is failing and they are waiting for a heart transplant.

A blood thinner will usually be given to help prevent clotting. Other medications may also be given, such as nitrates to increase the flow of blood.

Prevention & Prophylaxis

Most heart problems can be prevented and the risk reduced by making simple lifestyle changes. The same ones will also be given after a heart attack or a diagnosis of a cardiovascular disease. These steps can often remedy the problem and help keep it under control. They often include: