2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines | Circulation
Heart Disease: Types, Causes, And Symptoms
Heart disease isn't just one thing. It's a number of conditions that can affect how your heart works. Heart disease can also be called cardiovascular disease, though that term covers blood vessels problems as well.
Heart disease is a major killer in the U.S., causing about 1 in 5 deaths, or about 700,000 a year.
Each type of heart disease has its own symptoms and treatment. If you have some kinds, lifestyle changes and medicine can make a huge difference in your health. For others, you may need surgery to make your ticker work well again.
Here are some of the common types of heart disease and how to prevent, recognize, and treat them.
Heart disease can affect different parts of your heart and circulatory system, including arteries that carry blood to and from the heart and valves that open and close to keep blood moving in the right direction at the right time. (Photo Credit: iStock/Getty Images)
CAD is the most common heart problem and the biggest killer.
With CAD, you get blockages in your coronary arteries — the vessels that supply blood to your heart. That can reduce the flow of blood to your heart muscle, keeping it from getting the oxygen it needs. The disease usually starts as a result of atherosclerosis, sometimes called hardening of the arteries. When you have that condition, deposits called plaque build up in your arteries, often over many years.
Coronary heart disease can give you pain in your chest, called angina, or lead to a heart attack. It can also contribute to other heart problems, such as abnormal heart rhythms or heart failure.
Some things that may put you at a higher risk of CAD are:
When you have an arrhythmia, your heart beats too fast, too slow, or in an irregular, uneven pattern.
Some arrhythmias are harmless. But others can put you at a serious risk of problems such as cardiac arrest and stroke. They may also cause symptoms like dizziness and fainting.
Serious arrhythmias often develop from other heart problems but may also happen on their own. You're at higher risk if you smoke, drink alcohol, or have health problems such as obesity, high blood sugar, or sleep apnea.
With heart failure, your heart doesn't pump blood as well as it should to meet your body's needs. It is usually caused by CAD, but it can also happen because you have thyroid disease, high blood pressure, heart muscle disease (cardiomyopathy), or certain other conditions.
Your heart has four valves that open and close to direct blood flow between your heart's four chambers, the lungs, and blood vessels. An abnormality could make it hard for a valve to open and close the right way. When that happens, your blood flow could be blocked or blood can leak.
The causes of heart valve problems include infections such as rheumatic fever, congenital heart disease, high blood pressure, CAD, and damage from a heart attack.
Diseases of the heart valves include:
Endocarditis. This is an infection that's usually caused by bacteria, which may enter the blood and take root in your heart during illness, after surgery, or after using IV drugs. It often happens if you already have valve problems. Antibiotics can usually cure it, but the disease is life threatening without treatment. If your heart valves are seriously damaged as a result of endocarditis, you may need valve replacement surgery.
Rheumatic heart disease. This condition develops when your heart muscle and valves are damaged by rheumatic fever, which is linked to strep throat and scarlet fever. Rheumatic heart disease was more common in the past. But doctors are now able to prevent it by using antibiotics to treat the diseases that lead to it. If you do get it, the symptoms usually show up many years after the infection.
Any disease of the pericardium, the sac that surrounds your heart, is called a pericardial disease. One of the more common diseases is pericarditis or inflammation of the pericardium.
It's usually caused by an infection with a virus, inflammatory diseases such as lupus or rheumatoid arthritis, or injury to your pericardium. Pericarditis often follows open heart surgery.
Cardiomyopathy is a disease of your heart muscle, or myocardium. It gets stretched, thickened, or stiff. Your heart may get too weak to pump well.
There are many possible causes of the disease, including genetic heart conditions, reactions to certain drugs or toxins (such as alcohol), and viral infections. Sometimes, chemotherapy for cancer causes cardiomyopathy. Many times, doctors can't find the exact cause.
Congenital heart disease happens when something goes wrong while the heart is forming before birth. The heart abnormality sometimes leads to problems right after birth, but other times, there aren't any symptoms until adulthood.
Septal abnormalities are among the most common congenital heart problems. These are holes in the wall that separates the left and right sides of your heart. You can get a procedure to patch the hole.
Another type of abnormality is called pulmonary stenosis. A narrow valve reduces the flow of blood to your lungs. A procedure or surgery can open or replace the valve.
In some babies, a small blood vessel known as the ductus arteriosus doesn't close up at birth as it should. When this happens, some blood leaks back into the pulmonary artery, which puts strain on the heart. Doctors can treat this with surgery or a procedure or sometimes with medication.
Heart disease symptoms vary, depending on the kind of heart disease you have. In some cases, symptoms of different conditions overlap; in others, they don't. Here are some symptoms you might see with common types.
CAD
Arrythmias
Heart failure
Heart valve disease
Cardiomyopathy
Congenital heart disease
If you have symptoms of heart disease, your doctor will start with the basics: examining you and listening to your heart with a stethoscope. They'll also want to know about your family and medical history.
From there, you might get some tests, depending on your symptoms and history. They might include:
Blood tests. These include the routine tests you get for cholesterol and blood sugar levels. In some cases, you might get tests for proteins linked to inflamed arteries and heart attacks.
Chest X-ray. This can show if your heart is enlarged.
EKG. This test records the electrical signals in your heart and shows the rate and rhythm of your heartbeats.
Echocardiogram. This test uses sound waves to make detailed images of your heart in motion. It can show how blood moves through the heart and heart valves.
Exercise tests or stress tests. You might use a treadmill or stationary bike while your heart is checked.
Cardiac catheterization. If you might have blockages in your heart arteries, you can get this test, in which a long, thin flexible tube called a catheter is inserted in a blood vessel and guided to your heart. Dye can then be injected to help the arteries show up on X-rays.
Depending on your type of heart disease, your treatment might start with lifestyle changes and include medications, procedures, and rehabilitation.
Medications for heart disease
These include medications to:
Procedures for heart disease
These include:
Cardiac rehabilitation
If you've had a heart attack, angioplasty, or heart surgery or if you have heart failure, you can benefit from this kind of program. Cardiac rehab includes:
Because heart disease is the leading cause of death, taking steps to protect your heart is important, whether you've been diagnosed with heart disease or not.
Here are some ways to keep your heart in the best shape possible:
Don't smoke. Smoking isn't just bad for your lungs. It harms your heart and blood vessels, too. Quitting can quickly improve your heart health.
Get or stay active. Try to get your heart pumping with 150 minutes a week of moderate activity, like brisk walking, or 75 minutes of vigorous activity, like running.
Eat heart-healthy foods. That means lots of fruits and veggies, lean proteins, whole grains, and healthy fats like those found in olive oil and avocados. Limit salt, sugar, alcohol, and highly processed foods.
Get enough sleep. Most adults need at least seven hours a night.
Reduce stress. If you're constantly on edge, try relaxation exercises or meditation. Getting more physical activity can help, too.
Get regular checkups. Make sure you know your blood pressure, cholesterol levels, and blood sugar levels and take steps to improve them if needed.
Having heart disease can have a big impact on your life and keep you from doing the things you'd like to do. The most common form of heart disease, CAD, is a major killer. But you can prevent or limit the damage from most forms of heart diseases. Living a heart-healthy lifestyle and working with your doctor to recognize and treat heart problems can make a big difference.
Can you live a long life with heart disease?
In many cases, the answer is yes. Of course, it depends on the type of heart disease you have and how effectively it's treated, as well as your health habits. For example, people who get treated for CAD can stop artery buildup from getting worse and prevent heart attacks, potentially adding years to their lives. And people with some conditions, including heart failure, are living longer than they did in the past, thanks to advances in medicine.
What are the two warning signs of heart disease?
Heart disease can have many warning signs. For the most common type, CAD, the two most common symptoms are chest pain and shortness of breath.
What happens after you get diagnosed with heart disease?
After the diagnosis, it's important to work with your doctor to get the best care and understand what's going on with your heart. So ask lots of questions — like whether you'll need more tests and treatments and what you should do if you have new symptoms. You may need to have regular visits with a heart doctor and make changes to your diet or other habits. In many cases, you'll need to take medicine for the rest of your life.
17,000-Year-Old Remains Reveal Ancient Baby Likely Had Blue Eyes And Heart Disease
Scientists have discovered new details about an Ice Age baby who lived in southern Italy about 17,000 years ago. The remains, which were discovered by archaeologist Mauro Calattini in the Grotta delle Mura cave in Monopoli in 1998, indicate that the child probably died from congenital heart disease.
DNA analysis determined that the baby, who was male, likely had blue eyes, dark skin, and curly dark brown to nearly black hair. The small remains also manifested symptoms of poor development and inbreeding. No grave goods were found within the child's grave, which was discovered beneath two rock slabs. This burial remains the only one uncovered within the cave.
A paper, published on 20 September in Nature Communications, gives insight into this ancient child's life and appearance, yielding valuable clues about the early human population of southern Europe.
"Genetic analysis highlighted a close relationship between the child's parents, suggesting that they were probably first cousins," explains University of Florence molecular anthropologist Alessandra Modi, "a phenomenon rarely found in the Paleolithic, but more common during the Neolithic."
"Our work is a crucial piece in the understanding of the early stages of life in the Upper Palaeolithic," says Stefano Benazzi, Professor of Physical Anthropology at the University of Bologna. "This pioneering study, which combines different techniques of analysis of skeletal remains, has provided an unprecedented insight into the growth and living conditions of a child who lived in a key period for the settlement of the Italian peninsula, also allowing us to gather information about the mother and the hunter-gatherer groups of the time. Our research represents a significant advance, demonstrating the importance of interdisciplinarity to deepen our knowledge of prehistoric populations."
Anthropological analyses conducted by the University of Siena have provided the basis for understanding the child's physical development. "The combination of these different methodologies has allowed us to reconstruct with unprecedented precision the life and death of this child," says Stefano Ricci of the University of Siena.
AAP Endorses New Algorithm For Critical Congenital Heart Disease Screening
HealthDay News — In a clinical report published online Dec. 16 in Pediatrics, the American Academy of Pediatrics endorses a new algorithm for use in critical congenital heart disease (CCHD) screening, which was added to the U.S. Recommended Uniform Screening Panel in 2011.
Matthew E. Oster, M.D., M.P.H., from Emory University School of Medicine in Atlanta, and colleagues present updated recommendations for CCHD screening since the 2011 AAP endorsement.
The authors note that a new AAP algorithm has been endorsed for use in CCHD screening. This new algorithm has a passing oxygen saturation threshold of ≥95 percent in pre- and post-ductal measurements and has only one retest for infants who do not pass the first screen, instead of two. To aid in surveillance and monitoring of the program and continue to improve screening, state newborn screening programs should collect a recommended minimum uniform dataset. Education on the limitations of screening, the significance of non-CCHD conditions, and the importance of adhering to protocol should be provided to stakeholders. Improving overall sensitivity and implementing methods to reduce health inequities are included as future directions of CCHD screening.
"The recommended changes to the algorithm simplify the screening process, potentially decreasing error rates in the interpretation of the algorithm and reducing the time to conduct a screening," the authors write.
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