Heart Disease

Heart Disease
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Heart disease begins when cholesterol, fatty material, and calcium build up in the arteries, a process known as atherosclerosis.


Blockage of the coronary arteries by plaque may cause a heart attack (myocardial infarction) or a fatal rhythm disturbance (sudden cardiac arrest).
The link between heart disease and heart attack
When plaque builds up to the point that it ruptures, it causes a blood clot to form in the coronary artery. The blood clot blocks blood from flowing to the heart muscle, leading to a heart attack. In a worst-case scenario, sudden cardiac arrest or fatal rhythm disturbance can occur.
Heart disease: the number-one killer
Heart disease affects about 14 million men and women in the United States, and it has a high mortality rate. In fact, it takes more lives than the next seven leading causes of death combined.
What are the risk factors for heart disease?
Some of the common risk factors for heart disease include
• smoking,
• high blood pressure (hypertension),
• high cholesterol,
• diabetes,
• family history of heart disease
What are lifestyle risk factors for heart disease?
Lifestyle risk factors that contribute to heart disease include
• lack of exercise,
• high-fat diet,
• emotional stress, and
• having a "type A" personality (aggressive, impatient, competitive).
Sudden cardiac death - a fatal consequence of heart disease
Everyone's experience with heart disease is different. Some people experience shortness of breath or chest pain and make it to the hospital in time to be treated. Others are not as lucky. For some people, sudden cardiac arrest can be the first symptom they experience, and it is often deadly unless treated immediately.
Besides chest pain (angina) and shortness of breath, some other common symptoms of heart disease include jaw pain, back pain, and heart palpitations.

What are other symptoms of heart disease?
Other symptoms of heart disease may include
• dizziness or light-headedness,
• weakness when at rest,
• irregular heartbeat,
• nausea, and
• abdominal pain.
What are the heart disease symptoms in women, seniors, and people with diabetes?
For many women, seniors, and people with diabetes, pain is not a symptom of heart disease at all. Instead of experiencing discomfort, they often have symptoms of malaise or fatigue.
Doctors use a variety of tests to detect heart disease. One common test is the electrocardiogram (ECG or EKG).

What is an electrocardiogram (EKG)?
A healthy heart works as an "electrical pump" and needs a strong blood supply to conduct electricity. People with heart disease, however, have a weak blood supply, so their hearts conduct electricity poorly. An electrocardiogram (EKG) is a noninvasive test that measures the electrical activity of the heart. An EKG takes approximately five minutes and is painless. Many other heart conditions can be diagnosed with an EKG, for example
• abnormal heart rhythms,
• evidence of prior heart attack,
• evidence of an evolving heart attack,
• unstable angina,
• congenital heart abnormalities,
• evidence of abnormal blood electrolytes, and
• evidence of inflammation of the heart (myocarditis, pericarditis).
• oronary angiography via cardiac catheterization is considered the "gold standard" of heart disease tests.
What makes coronary angiography a superior test compared to the others?
During coronary angiography, doctors guide a catheter into the coronary arteries. Next, a small amount of radiographic contrast (a solution containing iodine, which is easily visualized with X-ray images) is injected into each coronary artery. X-ray images are then taken, which are called the angiogram. Angiographic images accurately reveal the extent and severity of all coronary arterial blockages.
What are some common medications used to treat heart disease?
Common heart disease medications can include:
• beta blockers which reduce heart rate and blood pressure;
• nitroglycerin, which dilates the coronary arteries, making it easier for blood to flow;
• calcium channel blockers, which help slow the heart rate, allowing the heart to beat more efficiently;
• ACE Inhibitors, which dilate blood vessels to increase blood flow and relieve stress on the heart; and
• statins, which reduce the number of lipids (found in cholesterol) in the blood to reduce the likelihood of plaque forming on the arteries.
What are some of the procedures performed to treat heart disease?
The following are common procedures used to treat heart disease.
• Coronary (balloon) angioplasty: A thin catheter is inserted into the blocked artery with a tiny balloon on the end. When the balloon is in the spot of the blockage, it is expanded to keep the artery open so blood can flow more freely, and the catheter is removed.
• Stents: The insertion of a stent is similar to coronary angioplasty except that over the balloon is a small metallic tube (a stent) that stays in place to keep the artery open while the catheter and the balloon are removed.
• Atherectomy: A drill-like device or laser cuts away the plaque covering the arteries.
• Brachytherapy: Radiation is applied to the blockages to remove them from recurring after angioplasty.
• Heart disease is a highly preventable and reversible disease. A healthy diet is a major factor in controlling heart disease.
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The key to preventing heart disease is through a healthy lifestyle, starting with a healthy diet.
Although heredity is a risk factor for heart disease, and an individual cannot control this factor, other factors can be modified to decrease the risk of heart disease. What you eat can reduce your chances of developing heart disease. A heart-healthy diet includes lots of whole grains, vegetables, and fruits. Chickpeas, beans, and soy products can help lower your cholesterol as well as olive oil, garlic, and avocados. Nuts, such as almonds, walnuts, and pecans, can boost "good" cholesterol (nuts are high in calories, so limit the amount you eat). Incorporate fish and seafood into your meals a few times a week. Also, try to avoid sweets.
Other lifestyle changes that can be made to help prevent heart disease include drinking alcohol in moderation and quitting smoking.

Lifestyle changes: using alcohol in moderation and quitting smoking
To raise good cholesterol levels (HDL), it is recommended that women have only one drink per day, while men should have no more than two. In addition, smoking has been linked to heart disease, so the sooner you quit, the better. In fact, after just three years of not smoking, your risk of developing heart disease becomes equal to that of a nonsmoker.
Exercise, controlling high blood pressure and diabetes, and taking daily aspirin are more ways to reduce your chances of developing heart disease.

Lower the risk of heart disease with exercise, aspirin, and by controlling high blood pressure and diabetes.
The following steps may help reduce your risk of heart disease.
• Regular exercise strengthens the heart, lowers bad cholesterol (LDL), raises good cholesterol (HDL), and lowers blood pressure, The AHA recommends exercising at least 30 minutes of exercise at least three to five days a week.
• Control high blood pressure and diabetes: If you have diabetes, keep blood sugars under control.
• Take a low-dose aspirin daily; This can reduce your risk of heart attack.
Talk with your doctor before taking any new medications or starting an exercise program.

http://www.mayoclinic.com/health/heart-disease-prevention/wo00041
Preventive Methods
1) Don't smoke or use tobacco products
Smoking or using other tobacco products is one of the most significant risk factors for developing heart disease. When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.
In addition, the nicotine in cigarette smoke makes your heart work harder by narrowing your blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — only smoking while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.
2. Get active
Regularly participating in moderately vigorous physical activity can reduce your risk of fatal heart disease. And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.
Physical activity helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may also be a factor in heart disease.
Guidelines recommend that you get at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can't meet those guidelines, don't give up. You can even break up your workout time into 10-minute sessions and still get the same benefits.
3. Eat a heart-healthy diet
Eating a special diet called the Dietary Approaches to Stop Hypertension (DASH) eating plan also can help protect your heart. Following the DASH diet means eating foods that are low in fat, cholesterol and salt. The diet is rich in fruits, vegetables, whole grains and low-fat dairy products that can help protect your heart. Legumes, low-fat sources of protein and certain types of fish also can reduce your risk of heart disease.
Heart-healthy eating isn't all about cutting back, though. Most people, for instance, need to add more fruits and vegetables to their diet — with a goal of five to 10 servings a day. Eating that many fruits and vegetables can not only help prevent heart disease but also may help prevent cancer.
Omega-3 fatty acids, a type of polyunsaturated fat, may decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure. Some fish are a good natural source of omega-3s. However, pregnant women and women of childbearing age should avoid shark, swordfish, king mackerel and tilefish because they contain levels of mercury high enough to pose a danger to a developing fetus. But for most others, the health benefits of fish outweigh any risks associated with mercury. Omega-3s are present in smaller amounts in flaxseed oil, walnut oil, soybean oil and canola oil, and they can also be found in supplements.
4. Maintain a healthy weight
As you put on weight in adulthood, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.
4. Maintain a healthy weight
As you put on weight in adulthood, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.

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What is coronary artery disease?
Coronary arteries are the blood vessels that carry blood to the heart muscle. Coronary artery disease (also called CAD) is caused by a thickening of the inside walls of the coronary arteries. This thickening is called atherosclerosis (say “ath-uh-roe-skluh-roe-suhs”). A fatty substance called plaque builds up inside the thickened walls of the arteries, blocking or slowing the flow of blood. If your heart muscle doesn't get enough blood to work properly, you may have angina or a heart attack. Angina (say "ann-jye-na") is a squeezing pain or pressing feeling in your chest.
What is a heart attack?
A heart attack (also called myocardial infarction) is when part of the heart muscle is damaged or dies because it isn't getting enough blood from the coronary arteries. Heart attacks usually result from a blockage in the coronary arteries. This blockage is most likely to be caused by a blood clot that forms from plaque inside the artery that has cracked or ruptured.
What is a stroke?
A stroke is caused by a blockage in an artery that carries blood to the brain. When blood flow to a part of your brain is cut off, that part of the brain can become damaged. You may lose the ability to perform activities that are controlled by that part of the brain, such as the ability to speak or to move your arm or leg.

http://www.everydayhealth.com/heart-health/how-your-heart-works.aspx
Everyone's heart beats around 70 times per minute, or 100,000 times per day, or about 2.5 billion times in the average lifetime. This vital organ is programmed to work automatically for every second of every day for as long as you live, no matter what else you're doing mentally or physically. In other words, your heart never rests.
Calculate your Heart Disease Risk
Calculate Your Heart Disease Risk
This is the information you need to calculate your risk:
• Your age. As you get older, your overall increase for heart disease and heart attack goes up. For men this means being over age 45 and for women, over 55.
• Cholesterol. You need to know about your total cholesterol as well as both the “bad” low-density lipoprotein (LDL) cholesterol and the “good” high-density lipoprotein (HDL) cholesterol. If your LDL is too high or your HDL is too low (less than 40 mg/dL), you are at risk. Get a blood test to find out what your cholesterol levels are if you do not already know.
• Blood pressure. It should be 140/90 or lower. If you are taking medication to control blood pressure, you are still considered to be at risk even if your blood pressure is under control.
• Chronic diseases. There are other health conditions, such as diabetes, that are closely tied to heart disease risk.
• Family history. If you have close male relatives who had heart disease before age 55 or close female relatives with heart disease before age 65, you are at increased risk. However, Levy points out that many people do not know all the details of their family’s history with heart disease. Make the best guess you can if you don’t have someone to ask.
• Smoking cigarettes. Bad news for people who are smokers — this is a strong independent risk factor for heart disease.
Women's Heart Attack Calculator
Men's Heart Attack Calculator

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What Your Waistline Says About Your Heart
Carrying excess weight around your middle could have a profound impact on your heart.

The ailment has many names, including metabolic syndrome, insulin resistance, Syndrome X, and the name I will use, prediabetes. Why is it so easy to diagnose? There's one clue that's a dead giveaway: It's your waistline. One of my colleagues says that when a patient's belly is the first body part to enter his office, the diagnosis is made. If you have gained weight in middle age and most of it is in your belly, you are likely part of the American epidemic of prediabetes. And if you don't start eating better and exercising, full-blown diabetes will almost certainly be in your future.
Why would a cardiologist be so concerned with your waistline? The reason has less to do with how you look on the outside than it does with how you look on the inside. I'm worried about what prediabetes and diabetes are doing to your arteries. Both conditions can injure the lining of your vessels and accelerate the production of plaque, greatly increasing your risk of having a heart attack or stroke.
After a meal, it is the job of insulin to help transport fats as well as sugar from the blood into the tissues. As you develop insulin resistance, fats accumulate in your bloodstream and hang around much longer than usual. During this time, changes in your blood fats occur — your LDL particles and your HDL particles become smaller and your total HDL is reduced. These changes favor the movement of cholesterol from your bloodstream into your artery walls. The smaller and denser the LDLs are, the more likely they are to move into your vessel walls. And the smaller and denser the HDLs are, the less efficient they are at removing the cholesterol from those vessel walls. These changes are also associated with high blood fat levels measured in the form of triglycerides. The fact that these fats are in your bloodstream longer also favors their accumulation in the vessel walls.
So, if you have gained predominantly belly fat as an adult and there is diabetes in your family (even if it occurred in a parent or grandparent late in life), you probably are insulin resistant and have prediabetes. The diagnosis of prediabetes is made if you meet three of the five following criteria:
• Central obesity: A waist circumference of greater than 40 inches for men and 35 inches for women
• Elevated triglycerides: Greater than or equal to 150 mg/dL
• Low total HDL: Less than or equal to 40 mg/dL for men and less than or equal to 50 mg/dL for women
• Elevated blood pressure: Systolic blood pressure of greater than or equal to 130 mm Hg and diastolic blood pressure of greater than or equal to 85 mm Hg
• Elevated fasting glucose: Greater than or equal to 100 mg/dL
Learn more in the Everyday Health Heart Health Center.