Heart Disease

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Summary

The heart is one of the body’s most essential organs. It is the center of the cardiovascular or circulatory system and is responsible for delivering blood, oxygen, and nutrients to various parts of the body. Without the heart, body parts like the brain, kidneys, liver, and lungs, among many others, would not be able to receive oxygen, would slowly weaken, and eventually deteriorate.

The heart works 24/7. It never stops beating. It is a robust type of muscle that is divided into right and left sections. The right side of the heart is composed of the right atrium and right ventricle. These chambers are responsible for carrying blood to the lungs. On the left side, there’s the left atrium and left ventricle. These transport blood to the rest of the body.

Though the heart is a very durable organ, it doesn’t mean it’s immune to diseases. If parts of the heart have problems or are damaged, a person might develop heart disease. Apart from the heart, problems can also arise in other parts of the cardiovascular or circulatory system, like the blood vessels. In the Philippines alone, heart disease is one of the leading causes of death.

When someone has heart disease, they might experience various symptoms such as chest pain, difficulty breathing, irregular heartbeat, dizziness, headaches, paleness, bluish skin discoloration, swelling of the stomach, legs, and feet, fatigue, and more. Depending on the type of heart disease, some of the mentioned symptoms might not be present, like bluish skin and swelling.

Anyone can get heart disease, regardless of their gender or age. Even a baby can be affected by a heart condition if they are born with a heart problem or congenital heart defect. A person can also develop heart disease due to an unhealthy lifestyle. Common causes of heart disease include consuming salty and fatty foods, lack of exercise, obesity, smoking, excessive alcohol consumption, and others. Sometimes, heart disease arises as a complication from other illnesses.

Having heart disease can pose a risk to a person’s life, especially if not detected early. If diagnosed and treated in time, the symptoms can be controlled or alleviated to make the patient feel better. Some types of heart diseases can be treated with medications, while others might require surgery.

History of Heart Disease

Currently, heart disease is one of the primary causes of death, not only in the Philippines but also around the world. However, this disease has claimed many lives even in the distant past. Even some of the famed kings of ancient Egypt were not spared from it.

Take, for instance, Pharaoh Merneptah (1213-04 BC), known as a valiant defender of Egypt against Libyan invaders. He didn’t die in battle or war. Rather, he passed away from a type of heart disease called atherosclerosis or arterial blockage (a type of blood vessel).

Studies on some remains of ancient Egyptians suggest that those in higher social strata were often affected by heart disease. This was because they had the means to consume whatever they desired, such as cattle, ducks, and geese—animals that are rich in fat.

Aside from atherosclerosis, other heart conditions like coronary artery disease and angina were discovered over different periods. The study of coronary artery disease or the constriction of blood vessels was first investigated by Leonardo da Vinci (1452-1519). Meanwhile, angina or chest tightness was later found to be an indicator of a heart condition called ischemic heart disease.

Among the various types of heart diseases, another crucial historical note is the contribution of William Harvey (1578-1657). Harvey was the personal physician to England’s King Charles I. Among the many who attempted to understand the heart’s function and blood flow, only Harvey was able to accurately describe it.

Harvey’s discoveries paved the way for a better understanding of the cardiovascular or circulatory system. This served as a guide for developing appropriate treatments for heart diseases.

Characteristics

Different types of heart diseases or heart conditions often have similar symptoms because they affect the cardiovascular or circulatory system.

That said, aside from the cardiovascular system, heart diseases can also affect various parts of the body because they are all interconnected. Every part of the body has blood vessels that transport blood.

Some of the most common characteristics or symptoms of heart disease include the following:

• Chest pain
• Difficulty in breathing
• Irregular heartbeat
• Dizziness
• Headaches
• Paleness
• Bluish tinge or darkening of the skin
• Swelling of the stomach, legs, and feet
• Getting tired easily

Some of the above-mentioned symptoms, like the bluish tinge or darkening of the skin, might not be experienced by the patient. Often, these are only felt when the patient has a hole in their heart. A patient might also not experience swelling if their kidneys are in good condition.

The kind or level of chest pain can also vary. The patient might feel like they are being poked, crushed, weighed down upon, or squeezed. When it comes to irregular heartbeat, the heart rate might slow down or speed up; a different sound may also be heard when the heart is listened to using a stethoscope.

Causes

Heart disease is usually a lifestyle disease or diseases acquired through an unhealthy lifestyle. The common causes include:

• Excessive consumption of salty and fatty foods. Eating too much salty and fatty foods can cause hypertension. When blood pressure rises, the heart is forced to work harder than usual. As a result, the heart might thicken and stiffen; fats or blood clots may also block the heart’s vessels and blood pathways.
• Lack of exercise. If a person doesn’t exercise, they may become overweight. Fats might also accumulate and block the heart’s blood vessels if a person doesn’t get enough exercise. This can lead to hypertension and the heart can struggle with pumping blood.
• Being overweight. Being overweight isn’t good for health because it increases vulnerability to diseases like heart disease. If one is overweight, it’s easier to develop hypertension and this can lead to heart conditions.
• Smoking. The harmful chemicals in cigarettes, like nicotine and carbon monoxide, can thicken and clot the blood. This can block the heart’s vessels and blood pathways.
• Excessive alcohol consumption. Consuming too much alcohol can cause hypertension. If the condition isn’t treated, it might worsen and cause heart disease.

Aside from an unhealthy lifestyle, heart disease may also be due to the following:

• Congenital heart defect. In a congenital heart defect, a baby is born with problems in different parts of the heart. This happens when the baby was not able to receive enough nutrition during the mother’s early months of pregnancy. As a result, the heart might not fully form, have missing parts, or have holes.
• Complications from other diseases. Heart disease can also develop if other conditions aren’t adequately treated, like diabetes.

Risk Factors

Heart disease can affect anyone, but the likelihood of acquiring it is higher if one falls into any of the following groups or categories:

• Being older. As one ages, the heart and blood vessels become more fragile. Therefore, older people are more susceptible to heart disease.
• Gender. More men tend to have heart diseases. For women, their risk of heart disease increases once they reach menopause.
• Family history. If close family members have a history of heart disease, it’s possible to inherit the condition.
• Hypertension. When someone has hypertension, the blood vessels and arteries typically constrict. Because of this, the heart works harder to pump blood to adjust to this change.
• Having an unhealthy lifestyle. If one leads an unhealthy lifestyle, there’s a high likelihood of heart disease. Those usually affected are those who are overweight, fond of salty and fatty foods, smokers, heavy alcohol drinkers, and those who don’t exercise.

Treatment and Prevention

Heart disease is a dangerous condition, but it can be treated. To do this, doctors may prescribe medication recommend surgery.

Treatments for Heart Disease

Here are common medications prescribed for heart disease patients:

• Blood thinners. To prevent blood clotting and possible obstructions, doctors often prescribe blood thinners like aspirin.
• Anti-platelet. If aspirin isn’t suitable for the patient, the doctor may prescribe anti-platelet medicine to prevent blood clotting. Some examples of this medication are clopidogrel and prasugrel.
• Anti-coagulant. Apart from blood thinners and anti-platelets, doctors can also prescribe anti-coagulants. They function similarly to the aforementioned medicines. However, they can also dissolve existing blood clots in the heart’s vessels and arteries. Well-known anti-coagulants include warfarin and NOAC.
• Blood pressure medicine. These are medications to lower blood pressure. The most prescribed ones are ACE inhibitors, angiotensin II receptor blockers, and beta blockers.
• Cholesterol medicine. To reduce cholesterol in the body, doctors may prescribe cholesterol medication like statins.
• Anti-anginal medicine. To reduce chest pain or tightness, doctors give anti-anginal medicines like nitrates.

If medications don’t alleviate heart disease, patients may undergo the following procedures and surgeries:

• Open-heart surgery. In this surgical procedure, the patient’s chest is opened to view and fix the heart. It can be done for any heart disease but if there’s a more suitable method, open-heart surgery is avoided.
• Angioplasty. This procedure isn’t a surgery. Rather, in angioplasty, a doctor inserts a balloon catheter (a small tube with a balloon) through the patient’s groin artery to push aside blockages in the heart’s artery.
• Coronary artery bypass surgery. In this operation, the surgeon creates a new artery or blood pathway to bypass or circumvent the problematic artery.
• Valve repair surgery and valve replacement surgery. If the heart’s valves are problematic, the patient might undergo valve repair or replacement surgery. If the valves can still be salvaged, only valve repair is needed. Otherwise, valve replacement is conducted to give the heart a new valve. Surgeons might craft a new valve from animals like cows or pigs.
• Pacemaker. A pacemaker is a device implanted near the patient’s heart or stomach. This device is used when the patient’s heartbeat is irregular. When the pacemaker detects a too-rapid heartbeat, it sends an electric shock to slow it down.

Preventing Heart Disease

To prevent heart disease, a person must do the following:

• Eat a balanced and nutritious diet.
• Exercise daily.
• Maintain a healthy weight.
• Stop smoking.
• Limit alcohol consumption.
• Have regular check-ups with your doctor.

If you experience any symptoms, consult your doctor immediately. Initially, consult with general practitioners or internists to identify the illness. If it’s confirmed as heart disease, the doctor will refer you to a heart specialist or cardiologist.

Types of Diseases

Various types of heart diseases can affect a person. One can develop heart disease due to defects in the muscle itself, its arteries, or blood vessels. Here are different types of heart diseases:

Cardiovascular diseases. Diseases in this category affect different parts of the cardiovascular system, such as the heart, heart veins, and blood vessels.

• Angina
• Acute coronary syndrome
• Anomic aphasia
• Aortic aneurysm
• Aortic dissection
• Aortic regurgitation
• Aortic stenosis
• Apoplexy
• Apraxia
• Arrhythmia
• Asymmetric septal hypertrophy
• Atherosclerosis
• Atrial flutter
• Atrial septal defect
• Atrioventricular canal defect
• Atrioventricular septal defect
• Avascular necrosis
• Dilated cardiomyopathy (and related diseases)
• Hypertrophic cardiomyopathy
• Heart failure (heart failure)

Cardiac electrophysiology. This type of heart disease involves the heart’s electrical activity. Diseases in this category relate to defective cardiac electrophysiology:

• Atrioventricular block (AV Block)
• AV nodal reentrant tachycardia
• Accelerated idioventricular rhythm
• Andersen-Tawil syndrome
• Ashman phenomenon
• Atrial fibrillation
• Atrial fibrillation with rapid ventricular response
• Atrial flutter
• Atrial tachycardia
• Bifascicular block
• Brugada syndrome
• Bundle branch block
• Cardiac dysrhythmia
• Catecholaminergic polymorphic ventricular tachycardia
• Ectopic beat
• Ectopic pacemaker
• Heart block
• Inappropriate sinus tachycardia
• Jervell and Lange-Nielsen syndrome
• Junctional escape beat
• Junctional rhythm
• Left bundle branch block
• Left anterior fascicular block
• Left axis deviation
• Lev’s disease
• Long QT syndrome
• Lown-Ganong-Levine syndrome
• Multifocal atrial tachycardia
• Wolff-Parkinson-White syndrome

Congenital heart disease. This type of heart disease involves a baby born with a defective heart. Various types include:

• Aortic coarctation
• Acyanotic heart defect
• Atrial septal defect
• Cor triatriatum
• Dextro-Transposition of the great arteries
• Double aortic arch
• Double inlet left ventricle
• Double outlet right ventricle
• Ebstein’s anomaly
• GUCH
• Tetralogy of Fallot
• Total anomalous pulmonary venous connection
• Hypoplastic left heart syndrome
• Transposition of the great arteries
• Truncus arteriosus
• Tricuspid atresia
• Interrupted aortic arch
• Coarctation of aorta
• Pulmonary atresia
• Pulmonary stenosis
• Ventricular septal defect
• Patent ductus arteriosus

Ischemic heart disease. In this type of heart disease, the heart no longer receives an adequate amount of oxygen. Included diseases are:

• Angina pectoris
• Acute coronary syndrome
• Heart attack (acute myocardial infarction)

Valvular heart disease. This heart disease affects the heart valves, such as the aortic valve, bicuspid valve, pulmonary valve, and tricuspid valve. Diseases in this category include:

• Aortic insufficiency
• Mitral stenosis
• Tricuspid valve stenosis
• Pulmonary valve stenosis
• Mitral regurgitation
• Mitral valve prolapse
• Tricuspid regurgitation
• Pulmonary regurgitation

Even though heart disease is one of the leading causes of death globally, this condition can be treated. However, for treatments to be effective, patients need to maintain close communication with doctors and follow their advice.