Cardiovascular Disease

Cardiovascular disease (CVD) is a collection of diseases affecting the heart and blood vessels. Some of the common CVDs include:

  • Coronary heart disease: Abnormalities in arteries supplying blood to the heart muscles affect the normal beating of the heart. It manifests in 2 forms, namely heart attack and angina (temporary blood loss to the heart causing chest pain).
  • Stroke: Lack of blood to the brain due to sudden blockage or bleeding of the artery that supplies blood to it. This may lead to brain damage and impairment in your normal activities such as movement, thinking and communication.
  • Heart failure and cardiomyopathy: A condition in which your heart cannot maintain the required blood flow or pressure for the normal functioning of the body. One of the causes for heart failure is cardiomyopathy, where the heart muscles enlarge and/or stiffen, impairing function.
  • Rheumatic heart disease: Characterized by permanent damage to heart valves and muscles due to rheumatic fever, an acute bacterial infection.
  • Peripheral vascular disease: Loss of blood to the peripheral regions of the body such as the hands, legs and feet due to blockages in the arteries that supply the extremities.
  • Congenital heart disease: Abnormalities of the heart or blood vessels present at birth. Symptoms may appear immediately or in the next few years of life.
  • Arrhythmia: Irregular heart rate (pulse) or heart rhythm

Anatomy

The heart is an organ that pumps blood throughout your body. It is located between the lungs in your chest. Your heart consists of 4 chambers: 2 atria and 2 ventricles, each separated by 4 valves, which regulate the unidirectional flow of blood in and out of the heart. The sinoatrial (SA) node, located near the right atrium, generates electrical impulses that initiate the heart muscles to contract rhythmically.

Blood is pumped continuously to and from the heart to the other parts of the body with the help of a complex network of blood vessels (arteries, veins and capillaries). Arteries carry oxygenated blood from the heart to the various parts of the body, while veins carry impure (deoxygenated) blood towards the heart for purification. The heart consists of two important arteries and veins: the pulmonary veins and pulmonary artery transport blood to and from the lungs for purification, while the aorta, and superior and inferior vena cava transport blood to and from different parts of the body.

Causes

Heart diseases are usually caused due to damage to the blood vessels or muscles of the heart walls. This occurs due to abnormalities in the heart’s structures or blockage and weakening of the arteries. Blockages occur due to the accumulation of plaque (cholesterol, fat, calcium and other substances) in the blood vessels, which may cause hardening or narrowing of the blood vessels. This obstructs the flow of blood causing chest pain, heart attacks and various other cardiovascular diseases.

There are several factors that may increase your chances of developing CVD. Some of them include:

  • Smoking
  • High amounts of fat/cholesterol in blood
  • High blood pressure
  • Inflammation of blood vessels
  • Diabetes

Impact

Cardiovascular diseases have a huge impact on your daily life and may be associated with severe complications such as disability, sudden cardiac arrest and death.

Symptoms

Cardiovascular diseases have a wide range of symptoms. However, some heart diseases may not show any signs or symptoms. The most common symptom includes pain and discomfort in the chest region. Pain may also present in the neck, back, arms and stomach. Other symptoms may include vomiting, tiredness, shortness of breath, feeling light-headed or dizzy, and swelling of the feet and ankles, abdomen and veins of the neck.

Diagnosis

Cardiovascular diseases are diagnosed on the basis of your medical history, physical examination, risk factors and confirmatory tests. Some of the tests used for the diagnosis of cardiovascular diseases include:

  • Electrocardiogram (ECG): test performed to record the electrical activity of your heart during rest or activity (stress ECG), and diagnose any damage to the heart or detect any previous or current heart attacks.
  • Holter monitoring: portable ECG monitoring for 24 to 72 hours to detect irregular heart rhythms.
  • Echocardiography: uses sound waves to produce moving images of the heart to detect damage or changes in shape and size of the heart.
  • Chest X-ray: X-rays of the chest taken to produce images of the heart
  • Angiography: dye injected into arteries and imaged using X-rays to diagnose any blockages
  • Cardiac catheterization: catheter or hollow flexible tube inserted into an artery is guided to the heart to measure pressures in the chambers. A dye may also be inserted and X-rays taken to detect abnormalities.
  • Blood tests: checks the levels of sugar, cholesterol and proteins in blood
  • Cardiac computerized tomography (CT) scan and cardiac magnetic resonance imaging (MRI) use X-rays and magnetic fields to produce pictures of the heart.

Treatment Options

Treatment for heart diseases is targeted at relieving your symptoms, reducing and preventing the build-up of plaque in the blood vessels, lowering the risk of blood clotting or widening of the clogged blood vessels. Treatment includes medications to treat risk factors such as high blood pressure and high cholesterol. When your symptoms cannot be relieved with medications and to avoid further complications, your doctor usually suggests various surgical procedures depending on the severity of your condition and the type of heart disease.

Others

Other methods that help prevent, control and manage CVDs include bringing about changes in your lifestyle:

  • Avoid a high cholesterol diet
  • Stop smoking
  • Limit alcohol intake
  • Regular exercise, keeping yourself physically fit and maintaining a healthy body weight
  • Learning to cope with stress and depression
  • Eating low-sodium foods

Procedures and Surgeries

The type of procedure can be decided by talking to your doctor regarding your symptoms and the severity of your condition.

Invasive surgical treatments

  • Balloon angioplasty:In this procedure, a catheter attached with a balloon at its tip is guided through an artery in the groin to the narrowed artery. The balloon is then inflated at this point to compress the blockage against the walls of the artery and make room for blood to flow.
  • Angioplasty and stenting:It is a surgical procedure in which a catheter is inserted into an artery in the groin, and a dye injected to detect blockages in the vessels using X-rays. A stent (a metal mesh tube) is then inserted through the catheter and positioned at the blocked artery to keep it open and ensure that it does not collapse.
  • Bypass surgery:This is a surgical procedure in which a blood vessel from the leg or arm is redirected or removed and placed in such a way that the blockage in the affected blood vessel is bypassed. This procedure is mostly performed in cases of coronary artery damage.
  • Pacemaker:A pacemaker is a device that sends electrical impulses to your heart in order to maintain its rhythm. It consists of the pulse generator, which is inserted beneath the skin of your chest, and lead wires, which are connected to your heart muscles.
  • Heart valve surgery:Surgery of the heart valves involves repair or replacement with a normal functioning valve. Repair may involve decalcification, where calcium deposits in the valve are removed or commissurotomy, where fused valves are separated. If a valve leaflet is floppy, a part of the leaflet is cut and the valve is stitched back together. In case of tears or holes, a patch of tissue can be used to repair these tears.
  • Heart transplantation:Heart transplantation is the last option for severe heart failure, when you do not respond to any other treatment measures. In this procedure, your diseased heart is replaced with a healthy donor heart.