Heart disease or cardiovascular (from the Greek kardia, or heart, and the Latin vasculum, the diminutive of vas, or vessel) diseases is the number one leading causes of death in the world today. Heart disease is first by a wide margin, causing more than twice as many fatalities as cancer, and stroke is the second leading cause of death globally.
It therefore is only logical that our chief concern should be with this major cause of death in the world.
For your own protection it is essential to know when to seek prompt help from either your doctor or a hospital. The chances of surviving a heart attack improve immeasurably when the victim goes to the hospital immediately; yet there is often a delay because people do not know what symptoms signal a heart attack
Symptoms of Heart Disease
Spotting heart disease or disorders in time may well prevent either a heart attack or serious damage later on. There are certain general symptoms that indicate something may be wrong with your heart, and these are sufficiently important to warrant seeing a doctor at once if you discover any of them.
2, Nocturnal dyspnea is an acute shortness of breath that occurs suddenly at night—usually after an hour or two of sleep—and wakens the sufferer with a choking sensation. This often happens when the person has congestive heart failure, and it calls for a prompt visit to a doctor
3. Orthopnea is breathlessness that take place when the sufferer is lying down; it is relieved by sitting or standing up. This, too, is usually connected with a heart problem and also demands a prompt medical consultation
4. Edema, or swelling, of the body tissues—the ankles in particular—may be another warning sign. You can determine whether it is edema by simply pressing your fingers into the area; indentation of the skin that persists after you take your finger away indicates edema
5. Angina pectoris is literally a strangling pain in the chest. It is characterized by paroxysmal pain behind the breastbone, accompanied by a feeling of suffocation. The distress is usually brought on by hard exercise, unusual excitement or even a heavy meal. It lasts only a minute or two and is relieved by a few minutes’ rest or special medication. Tell your doctor about it at once because it indicates serious heart problems
6. Other symptoms that may warn of heart disorders include dizziness, fainting spells, blueness of the lips, asthma-like attacks, extreme fatigue, and spitting or coughing up blood. Such symptoms demand a medical examination.
Palpitation or fluttering of the heart and the episodic rapid beating of the heart (paroxysmal tachycardia) are not necessarily danger signals. Many healthy people sometimes have extra heart beats or suddenly feel that their hearts have flopped over or have stopped for a moment. The spells of rapid heart beating that certain nervous or worried people experience may last for hours or even days without causing serious heart trouble, but they do not warrant a medical consultation and opinion.
Preventing damage to the heart beforehand is obviously better than trying to minimize the effect of heart disorders afterward. This is why identification of the risk factors in heart disease is important. By recognizing these, doctors can single out persons who may be susceptible to heart trouble and treat them now with the intention of preventing later problems.
Types of Heart Diseases
Coronary Artery Disease
The coronary arteries supply blood to the heart muscle. Because the muscle is being used continuously, it needs an uninterrupted full blood supply or it suffers irreparable damage known as myocardial infarction, the death of tissue in the heart muscle. Most commonly, coronary artery disease is either coronary occlusion or coronary thrombosis
In coronary occlusion the bore of the artery is narrowed by arteriosclerosis, or hardening of the arteries, which reduces the volume of blood supplied to the heart muscle. This choking off of blood flow can even reach the point of total occlusion in which no blood comes through.
In coronary thrombosis a blood clot either forms locally or is brought to a particular spot by the bloodstream from elsewhere in the body. Sometimes after major surgery part of a blood clot may break loose and be carried through the body until it sticks in a vessel too narrow to let it pass through.
When either of these conditions cuts off the blood supply to the heart muscle, the tissues no longer supplied with blood will die. If the blockage affects a large part of the muscle, a massive coronary attack occurs and the patient may die.
About 80 percent of the victims or myocardial infarction survive the initial attack, although over 15,000,000 people die of heart attacks annually. Three out of four heart attack victims are men, usually between the age of 50 and 70. Because the first hour after the attack is the critical period when most victims die, it is vital to call a doctor immediately and to move the victim to a hospital that has an emergency coronary care unit.
Modern ambulances and their personnel are well equipped to care for the heart attack victim while transporting him to the hospital. The lives of many heart attack victims have been saved by means of cardiopulmonary resuscitation, a combination of mouth-to-mouth breathing and closed chest massage.
The heart attack victim is usually given an injection of morphine or other powerful painkiller to relieve his severe agony. Oxygen is supplied through a mask or by an oxygen tent to relieve the work burden of the heart and to supply extra oxygen to the vessels around the blood-starved heart muscles.
While at least four weeks of bed rest were once considered mandatory after a heart attack, there is a growing tendency today to get the patient up and about as soon as possible. The survivor of a heart attack is gradually brought back to nearly normal activities within about three months.
However, there may be curtailment of certain activities such as strenuous sports. Smoking is forbidden, and the person must keep his weight down, but alcohol may be allowed in moderation. With the growing knowledge about all aspects of medicine, it is best to depend on the doctor for the specifics of treatment—for example, the use of anticoagulant drugs.
In a sense angina pectoris is the result of the heart’s enormous activity. A muscle that is used constantly needs a large, uninterrupted blood supply to bring oxygen and food and to take away the burned-out by-products.
When coronary artery disease or arteriosclerosis and the resulting coronary occlusion cut down on this blood supply, any additional demand leaves the muscles short of oxygen and triggers the frequently agonizing pain of angina pectoris.
Medication to increase the blood supply—such as nitroglycerin tablets—or even a few minutes of rest are usually sufficient to end the pain. An operation may relieve the condition by bringing additional blood supplies to the heart muscles.
Congestive Heart Failure
This is the inability of the heart to carry out its function of pumping the blood in adequate quantities. Almost any kind of heart disease can lead to this failure, which increases venous pressure and may lead to edema in tissues in the ankles, lungs, liver, or other parts of the body. Restriction of salt in the diet and the use of diuretics to cause the kidneys to rid the body of salt and water have materiality brightened the outlook for patients who suffer from this disorder
Rheumatic Heart Disease
This results from rheumatic fever and accounts for more than 90 percent of all heart problems in persons under 30 years of age. About half of the rheumatic fever patients suffer heart complications that commonly leave permanent scars. The damage may later cause congestive heart failure. The introduction of penicillin and other antibiotics to treat rheumatic fever has vastly reduced the dangers of rheumatic heart diseases.
Modern surgery has made possible the relief of some types of heart valve damage and even the replacement of defective valves with artificial substitutes. Often the patients are able to lead long, healthy lives, thanks to new medical and surgical techniques
This is an infection of the thin membranes that line the inside of the heart. The disease is caused by bacterial infections, which can now be successfully treated with antibiotics. Persons with heart defects or rheumatic hearts should ask their doctors what precautions to take to prevent bacterial endocarditis
Heart Rate Disturbances
Cardiac and arrhythmias are variations in the normal rhythmic heartbeat. The range is enormous. For example, most children have normal variations that coincide with different phases of their breathing. At the other extreme are the ineffectual heart-muscle contractions that can lead to sudden death.
Mild variations in heartbeat can often benign and occur frequently to elderly people. Paroxysmal tachycardia is a fast, regular heartbeat of over 100 beats a minute and is usually harmless. But the speedup can be dangerous if it is a complication of a heart disease, occurs to an aged person, or lasts longer than a few days.
Heart flutter and fibrillation can cause as many as 300 beats a minute; depending on which part of the heart is involved, it can be tolerated for many years, or it can lead to death.
This condition occurs when the nervous impulses that control the heart’s beating are slowed or brought to a virtual halt. The heart slows down and, in extreme cases, can suffer cardiac arrest or heart stoppage. When the heartbeat rhythm is too erratic, an electrical pacemaker can be surgically implanted to keep the heart beating at its correct rate. Cardiac arrest can be treated with cardiopulmonary resuscitation to keep the victim alive, then with an electric defibrillator to restart the heartbeat. Upon recovery the patient may be virtually normal in every way.
Drugs and surgery are used today to treat heart disease, although there is still considerable controversy and disagreement over their uses and value. Heart patients should always question the use of new medications because the interaction of several drugs has caused major problems, and certain medications can induce adverse reactions in some patient. Rely on your doctor’s judgment about any new medicines on the market.
Many forms of surgery—including open-heart operations and even occasional heart transplant—are used today for a variety of heart problems. These ailments range from heart murmurs (remedied by the implantation of artificial valves) to angina pectoris (often helped by the transplantation of blood vessels to supply an ailing heart). If you have a heart disorder, it pays to consult your doctor about possible new developments in the treatment of heart disease.
Mechanisms Underlying the Sensation of Dyspnea by I. Fukushi, M. Pokorski and Y. Okada
Compression Therapy for Leg Oedema in Patients with Heart Failure by T. Urbanek, M. Juśko and W. Kuczmik
Coronary Arteries Shake Up Developmental Dogma by Shing Hu and Natasza Kurpios
Angina Pectoris: Evaluation in the Office by Mark Kelemen