Know the basics on symptoms, diagnosis and treatment to help as you battle the disease.

For an aging population such as that found in America, chronic diseases like cancer, diabetes and heart disease take a massive toll. While these diseases might not garner the headlines awarded to acute killers like the latest flu outbreak or an exotic tropical disease, the Centers for Disease Control and Prevention reports that about 610,000 people die of heart disease in the United States every year.

That accounts for some 25 percent of all American deaths, making heart disease the No. 1 killer of both men and women in the U.S. today.

"It's the biggest killer in America and most westernized societies," says Dr. Steven M. Goldberg, head of cardiology at ProHEALTH Care in New York. "It's been around for a long time, but it's gotten much worse in the past century. Since society built cities, we started gaining weight, eating processed foods and smoking a lot more. A lot of those things have been attributed to atherosclerosis (hardening of the arteries) and weight gain," which have caused many people in Western society to develop heart health issues.

An Umbrella Term

The phrase "heart disease" is an umbrella term that refers to a number of diseases and conditions that negatively impact the cardiovascular system, which controls the flow of blood throughout the body. Some of these specific conditions include:

Coronary artery disease – a disease of the blood vessels. Aside from the heart defects some people are born with, most cases of heart disease are related to a buildup of plaque in the arteries – the blood vessels that carry oxygen-rich blood around the body. This condition, known as atherosclerosis, is also known as hardening of the arteries. The National Heart, Lung and Blood Institute reports this problematic plaque is "made up of fat, cholesterol, calcium, and other substances found in the blood." The American Heart Association website likens this buildup to a plumbing problem. "Think of sludge forming on the inside of pipes. That's not a perfect comparison because buildups don't just form on artery walls but inside them. Still, you get the idea." Over time, plaque hardens and narrows your arteries. This limits the flow of blood to your organs and other parts of your body. Ultimately, this narrowing of the passageways can lead to a heart attack, stroke or even death.
Hypertension – high blood pressure. Often called the "silent killer" because it is the source of so many health problems and may not offer many signs of its presence, high blood pressure forces your heart to work much harder than it should to move blood through the body. Over time, this pressure can cause heart attacks or a weakening or enlargement of the heart muscle.
Congestive heart failure – a progressive disease where the heart muscle doesn't pump blood as well as it should and eventually fails altogether. Heart failure affects about 6 million people in the U.S. Dr. Ayehsa Hasan medical director of the cardiac transplant program and director of the heart failure devices clinic at The Ohio State University Wexner Medical Center says heart failure can take a few different forms, depending on how the heart struggles to pump blood. "With systolic heart failure, the pumping function or the squeeze of the heart is weakened." The systolic function is the beat of the heart – the squeeze phase of the pump that's represented by the top number of a blood pressure reading. Heart failure can also be the result of "a relaxation issue," during the diastolic phase, or the moment of rest between pumps of the heart. Diastolic pressure is represented as the bottom number in a blood pressure reading.
Arrhythmias – irregular heart rhythms like atrial fibrillation.These issues can take a number of forms and occur when the electrical activity that regulates your heartbeat is disrupted. This can be caused by an imbalance of hormones, a heart attack, damage to the heart tissue from a previous heart attack, enlargement of the heart, blocked arteries, high blood pressure, smoking, medications, drug abuse, stress, sleep apnea, diabetes and structural issues in the heart.
Congenital heart defects – genetic problems that result in leaky valves, holes in the heart and other structural issues that impact the heart's ability to pump blood through the body. These defects are usually found early – sometimes even before a baby is born – but some people are adults before a structural deformity becomes known.

Signs and Symptoms

Some people with heart disease have no signs or symptoms. Often, the first sign is a heart attack or stroke. But even then, some people still don't know they've had a heart attack. A May 2016 study in the journal Circulation found that more than 45 percent of all heart attacks are "silent," meaning the symptoms were so subtle, the person doesn't even know it happened. Regardless, a silent heart attack is still a heart attack, says Dr. Evelina Grayver, director of the coronary care unit at North Shore University Hospital in Manhasset, New York. "As a critical care cardiologist, to me silent heart attacks are actually scarier, because when people have symptoms, they know to seek care right away."

Any heart attack, including one you might not even know you had, can inflict damage on the heart because the flow of blood is blocked to the muscle tissue, potentially starving it of oxygen. Damage sustained during a heart attack may be difficult or impossible to repair later, so it's important to stay aware of your health and talk to your doctor about any changes. "The most important thing an individual can do is to know yourself and understand risk factors," says Dr. Ali Rahimi, a cardiologist with Kaiser Permanente Atlanta. "Never let a symptom get old. If something is different, let your doctor know. If you used to be able to go up and down stairs easily and now you can't, let your doctor know. If you have new shortness of breath or chest pain with exertion, you should let your doctor know."

Other early warning signs that may show up in routine tests your doctor should perform as part of your annual physical include elevated levels of cholesterol and triglycerides (building blocks of fat) in the blood and high blood pressure. In some cases, people with heart disease may experience pain or pressure in the chest and shortness of breath. Others may feel unusually fatigued or have difficulty sleeping.

In the case of a heart attack, jaw pain, upper back pain, pain in the left arm, sudden onset of sweating, discomfort and nausea or indigestion are common symptoms. Many patients who've had a heart attack report feeling like there's an elephant on their chest – a weighty pressure, squeezing, or fullness and an inability to catch their breath. If these symptoms last just a few seconds, it's probably not a heart attack. But if they last longer than a few minutes, you should seek emergency care. The quicker you can get help, the less damage the heart attack will do to your heart muscle and the healthier you'll be in the long run.

All of these symptoms need to be checked out by your doctor or a cardiologist.

Risk Factors

The NHLBI reports the exact cause of atherosclerosis isn't known, but "certain traits, conditions or habits may raise your risk for the disease." These risk factors include:

- A sedentary lifestyle and a lack of physical activity.
- Smoking.
- Being overweight.
- Eating an unhealthy diet.
- Family history of heart disease.
- Age.

"I would say smoking, hypertension and the diabetes epidemic have been the biggest sources of increases in heart disease that we've seen in recent decades," Goldberg says.

Diagnosis

The first thing that happens anytime you visit a doctor – having your blood pressure measurement taken – is an easy, ongoing way to monitor your cardiac health. An elevated blood pressure reading can mean a number of things, but if your doctor suspects heart disease, that will often be followed up with bloodwork to check your cholesterol and triglyceride levels and possibly a chest X-ray. Your doctor will also likely perform a physical exam and ask about your personal and family medical history before doing additional tests.

According to the Mayo Clinic, depending on the specific condition you're suspected of having, you may undergo one or more of these additional tests:

Electrocardiogram. An ECG records electrical signals that show irregularities in your heart rhythm and structure. This can be performed while you're resting or during exercise, which is called a stress electrocardiogram.
Holter monitoring. The Holter monitor is a portable device that continually records your heart's electrical activity, usually for 24 to 72 hours, to detect heart rhythm problems that might not show up during a shorter ECG.

Echocardiogram. An echocardiogram is an ultrasound of the chest that gives your doctor a detailed picture of your heart's structure and function.
Stress test. During a stress test, sometimes also called a treadmill test or an exercise test, your doctor will elevate your heart rate with exercise or medication and watch what happens with imaging and other diagnostic devices.

Cardiac catheterization. Using X-ray images, your doctor threads a catheter through an artery in your groin or arm and into your heart where the catheter measures pressure in the heart chamber. Your doctor may also inject a dye that shows up on X-ray to see how blood flows through the heart and blood vessels.
Cardiac computerized tomography scan, or CT scan. With this test, your doctor uses CT images created by X-rays to get a good look at your heart and chest.
Cardiac magnetic resonance imaging, or MRI. Similar to CT scanning, in this test, the MRI machine uses magnets to create detailed images of your heart and chest.
Treatment

Depending on the specific heart disease you have, your doctor may recommend several means of treating your illness. Chief among them are medications and surgical interventions.

Medications:

Aspirin or other anticoagulants. These drugs prevent blood clots and can help keep things moving in your arteries and veins.
Beta blockers. These drugs lower blood pressure and can be useful for treating arrhythmias, angina (chest pain) and preventing future heart attacks.
Statins. These drugs lower your cholesterol levels to prevent plaque buildup in the arteries.
Diuretics. Also known as water pills, these medications help the body rid itself of excess fluids, which brings down blood pressure and reduces swelling (edema).
Vasodilators. Also known as nitrates, these drugs relax blood vessels and increase the supply of blood and oxygen to the heart, thereby reducing its workload. They can help ease angina.
Surgery:

Angioplasty. A catheter with a small balloon on the end is threaded into a clogged artery. At the site of the blockage, the balloon is inflated, which pushes the plaque against the artery walls, creating more room for blood to flow through. The balloon and catheter are removed after the procedure concludes.
Stent placement. Stents are small, flexible tubes inserted into a blocked artery to prop it open. They make the blood vessel bigger so that blood can flow through more easily. Stents are left in the artery after the surgery concludes.
Coronary artery bypass grafting. The NHLBI reports that CABG is the most common type of heart surgery. During CABG, a healthy vein or artery is grafted (surgically connected) to a blocked coronary artery to create a bypass of the blocked portion of the artery. This allows the blood to circumvent the problem area and reach the heart.
Heart valve repair or replacement. If you have problems with your heart valves, that can allow blood to leak into places it shouldn't be or prevent it from going to places it should. To fix these problems, your doctor may replace or repair the faulty valve with a man-made or biological valve.
Pacemaker placement. A pacemaker is used to fix arrhythmias. It's a small device implanted into the chest that sends electrical current to the heart to control its rhythm.
Heart transplant. Transplanting the heart is a measure of last resort available to certain qualified patients with end-stage congestive heart failure. It's a massive surgery that removes the old, diseased heart and replaces it with a healthy one from a donor.

Managing Risk

Most any doctor will tell you that stopping a disease before it starts is always preferable to treating it after the fact. Therefore, it's important to know your risk factors for heart disease and seek to control the ones you can. While things like age and family history can't be altered, there are many lifestyle interventions you can employ to help yourself, including:

Eating right. Eating a healthy diet should be a primary focus for everyone, not just patients with heart disease. A diet that's low in sodium and saturated fat and high in whole grains, healthy fats, lean proteins and vegetables is generally considered a good option for people looking after their heart health. Avoiding high-fat and processed foods is usually advised for cardiac patients.

Losing weight. Obesity puts an added strain on the heart as it struggles to supply a too-large body with oxygenated blood. Over time, this can take a toll on the heart, so it's important to manage your weight, especially if you have other risk factors for heart disease.

Managing other health problems. Certain chronic diseases, such as diabetes, are associated with a higher risk of heart disease. Therefore, if you have another comorbidity, or ongoing health problem, it's important to manage it appropriately. For diabetes, that means keeping tight control of your blood sugars.

Stopping smoking. The NHLBI reports that "the chemicals in tobacco smoke harm your blood cells. They also can damage the function of your heart and the structure and function of your blood vessels. This damage increases your risk of atherosclerosis," or the buildup of plaques that can lead to heart attacks or strokes. Therefore, quitting smoking is one of the very best ways you can improve your heart health. In addition, Goldberg says that although the technology is still too new to know for sure how it will impact heart health long-term, e-cigarettes shouldn't be considered a heart-healthy alternative to cigarettes. "You should only use e-cigarettes as a substitute to wean off cigarettes," he says. They shouldn't be considered a safe, long-term replacement to conventional tobacco cigarettes.

Limiting alcohol intake. Although some studies have found certain heart health benefits associated with drinking red wine, by and large, drinking alcohol isn't healthy. If you do drink, seek to do so in moderation, which the American Heart Association reports means "an average of one to two drinks per day for men and one drink per day for women. (A drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.)"

Exercising. Being physically active is important for helping your heart stay healthy across your lifetime. Even after a heart attack, it's important to move as much as your doctor advises to help build your strength back up and boost your cardiac health. Low-impact exercises such as brisk walking, swimming and cycling can all help boost cardiac health when you engage in them for at least 30 minutes a day, five or more times a week, the American Heart Association reports. "You don't have to run the New York City Marathon," Goldberg says. Simply meeting that AHA level of activity is enough to gain a benefit. The key is to elevate your heart rate to between 50 and 85 percent of your maximum heart rate during that time. You can calculate your maximum heart rate with the American Cancer Society's online heart rate calculator.

Improving sleep. The Centers for Disease Control and Prevention reports that "adults who sleep less than 7 hours each night are more likely to say they have had health problems, including heart attack, asthma, and depression. Some of these health problems raise the risk for heart disease, heart attack and stroke." While you're sleeping, your body is busy repairing itself, so seek to get 7 to 8 hours of shuteye each night to improve your overall health picture and help preserve your heart's well-being for as long as possible.

Stressing less. We're a stressed-out society, and that constant sense of urgency can be harmful to your health. "Although the link between stress and heart disease isn't clear, chronic stress may cause some people to drink too much alcohol, which can increase your blood pressure and may damage the artery walls," the AHA reports. Stress can also trigger some people to overeat, which may lead to obesity, which also has heart health consequences.
All of these factors are controllable to some extent, and focusing on hitting your targets – be they lowered blood pressure numbers, increased minutes of exercise a week or reduced pounds on the scale – can help improve your heart health."Big picture – society needs to be aware that they need to help themselves," Goldberg says.

 

 

By: U.S. News Staff
Source: https://health.usnews.com/conditions/heart-disease