Heart Disease

Heart Disease describes a range of conditions and diseases that affect the health of your heart. The term "heart disease" is often used interchangeable with "cardiovascular disease" and can refer to conditions that involve blood vessel diseases (including conditions that involve narrowed or blocked blood vessels) that could lead to a heart attack or stroke, congenital heart defects that you're born with, heart rhythm problems (such as arrhythmias), and other conditions that affect your heart's rhythm, muscle, or valves.

Coronary Heart Disease

“Coronary heart disease, also called coronary artery disease, occurs when plaque builds up on the inner walls of the coronary arteries,” says David Portugal, MD, medical director of the catheterization lab at Memorial Hermann Heart & Vascular Institute–Southwest. “The arteries are important because they carry oxygen-rich blood to the heart. Problems occur when the plaque hardens, causing the coronary arteries to narrow, thus reducing the flow of this oxygen-rich blood to the heart. The result may be chest pain or discomfort.”

Plaque is composed of fat, cholesterol, calcium and other substances found in the blood. If plaque ruptures, a blood clot can form on its surface. A large blood clot can block the blood flow through a coronary artery. This is the most common cause of heart attacks in both men and women.

Congenital Heart Disease

Congenital heart disease (also called congenital heart defect) refers to an abnormality in the structure of the heart that occurs while the fetus is developing in the uterus. The word “congenital” means the defect exists at birth. The most common type of birth defect, congenital heart defect may affect approximately one in 100 children. Symptoms may appear at birth, during childhood, or not until adulthood.

Arrhythmia

An arrhythmia is a heart rhythm abnormality that may indicate a serious problem and can lead to heart disease, stroke or even death. An arrhythmia may be suspected when a physician hears a fast or irregular heartbeat while listening to the heart with a stethoscope.

Heart Attack

A heart attack, also known as a myocardial infarction, generally occurs when the blood flow to the heart is blocked. When blood flow is blocked, the heart can't receive the oxygen and nutrients it needs and can suffer permanent damage or death.

Heart Failure

Heart failure is a serious, life-threatening condition that develops gradually over time as the heart’s pumping action grows weaker. Eventually, the heart can’t pump enough blood to meet the body’s needs. Heart failure can involve the right side of the heart only, or it can affect both sides of the heart.

Mitral Regurgitation

Mitral regurgitation (MR) is a condition in which the heart's mitral valve (dual-flap valve between the left atrium and the left ventricle) doesn't close tightly, allowing blood to flow backward, or regurgitate, into the atrium, each time the left ventricle contracts. This reduces the amount of blood that flows to the rest of the body. As a result, the heart may try to pump harder, which may lead to congestive heart failure.

Peripheral Artery Disease (PAD)

Peripheral arterial disease (PAD) of the legs is also called atherosclerosis. It occurs when the long arteries in the legs harden and narrow, limiting blood flow to muscles. The most common symptom is pain or nagging muscle aches in the legs.

“The body’s circulatory system is interconnected,” says Amilcar Avendano, MD, an interventional cardiologist affiliated with Memorial Hermann The Woodlands Medical Center. “Individuals with atherosclerosis of the legs commonly have atherosclerosis in other parts of the body, putting these patients at increased risk for heart attack or stroke.“

PAD and coronary heart disease are related; individuals who have one are likely to have the other.

Broken Heart Syndrome

Broken Heart Syndrome is also referred to as stress-induced cardiomyopathy. The most common symptoms are chest pain and shortness of breath and the symptoms tend to occur suddenly in people who have no prior history of heart disease.

“Extreme emotional stress can lead to severe heart muscle failure,” explains Marco Campos, MD, a cardiologist affiliated with the Memorial Hermann Heart & Vascular Institute–Memorial City. “The symptoms and test results for broken heart syndrome are similar to a heart attack but the patient will show no evidence of blocked heart arteries. The good news is that most people have a full recovery.”

Additional Types of Heart Disease

These other types of heart disease pose a serious risk for women and are not as well known:

• Coronary microvascular disease (MVD)
• Peripheral arterial disease (PAD) of the legs
• Pulmonary stenosis
• Mitral valve prolapse
• Hypertrophic cardiomyopathy

Risk Factors You Can't Control

Risk factors are conditions or habits that make a person more likely to develop a disease and some cannot be controlled. According to the National Heart, Lung, and Blood Institute, having just one of these risk factors can double your chance of developing heart disease.

Gender: In general, men are at greater risk for heart attack than women and have attacks earlier in life. But after age 65, the risk is about the same for both men and women.

Age: Your chance of having cardiovascular disease doubles for each decade after you turn 55. More than 80% of people who die of a heart attack are over 65.

Family History: Heart disease tends to run in families. Your risk increases if you have an immediate family member with cardiovascular disease. Risk factors like high blood pressure, diabetes and obesity can also be passed from one generation to another.

Race and Ethnicity: As a group, African-Americans are more likely to develop high blood pressure; racial and ethnic minorities are generally more likely to develop heart disease.

Blood Pressure: Blood pressure measures the how hard your heart has to work to pump blood into the arteries and through the circulatory system.

High blood pressure, also known as hypertension, increases the heart's workload. Blood pressure level of less than 120/80 mmHG is normal. The higher number (systolic) represents the pressure when the heart is beating. The lower number (diastolic) represents the pressure when the heart is resting between beats.

Diabetes: According to the American Heart Association, approximately three-quarters of people with diabetes dies of some form of cardiovascular disease. Diabetics have an abnormal amount of lipoprotein, which speeds plaque build-up. Even if blood sugar levels are under control, diabetes sill increases the risk of heart attack and stroke.

Heart Disease and Women

Risk Factors You Can Control

The good news is that there are lifestyle changes you can make at any age to reduce your risk of heart disease. Among the most important are following a heart-healthy diet low in saturated fat, cholesterol and salt and getting regular exercise almost daily.

Cholesterol: High cholesterol is a major risk factor for cardiovascular disease. High levels of cholesterol, a fatty wax-like substance, in the blood increase the amount of plaque that forms on the walls of the arteries.

A total cholesterol level under 200 mg/DL is ideal. The risk of heart attack increases two times with cholesterol level of 240 and four times at a level of 300. The individual ideal level of LDL (bad cholesterol) is lower than 100 mg/dL, and of HDL (good cholesterol, carries extra fat away from the arteries) is higher than 40 mg/dL.

Smoking: Smokers are twice as likely to have a heart attack than non-smokers. Nicotine narrows the blood vessels, causing an increase in blood pressure and heart rate. Smoking also leads to the buildup of fatty plaque in the arteries and increases the risk of blood clots.

Obesity: Excess body fat can increase your risk for cardiovascular disease, even if you have no other risk factors. Extra weight makes the heart work harder to supply the body with needed oxygen, and it raises cholesterol, blood pressure and the risk for diabetes.

Activity Level: Physical activity can help strengthen the heart muscle and control blood pressure, diabetes and weight. Regular moderate-to-vigorous activity helps prevent cardiovascular disease.

Stress: During stressful situations, the nervous system releases adrenaline, which can raise heart rate and blood pressure, increasing your heart's need for oxygen. This need for oxygen can bring or chest pain in people who already have heart disease.

Increased blood pressure can injure the lining of the arteries. When the arteries heal, the walls may harden or thicken, making is easier for plaque to build up. Stress may also cause people to overeat, start smoking, or smoke more than they normally would.

While nothing guarantees that you don't develop heart disease, you can do several things to reduce your risk and stay healthy.

• Exercise regularly. Exercise improves your heart's pumping efficiency, benefits circulation and increases overall strength and endurance. According to the latest joint American Heart Association/American College of Sports Medicine guidelines on physical activity, all healthy adults ages 18-65 should get least 30 minutes of moderate intensity activity five days a week. You can also break up those 30 minutes into three 10-minute sessions.
• Make healthy food choices.
  • Replace foods high in fat with healthier foodsEat more fruits, vegetables and whole grains.
  • Choose lean meats and poultry without skin and prepare them without added saturated and trans fat.
  • Select fat-free, 1% fat, and low-fat dairy products.
  • Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
  • Cut back on foods high in cholesterol. Aim to eat less than 300 milligrams of cholesterol each day.
  • Limit beverages and processed foods with added sugars.
  • Choose and prepare foods with little or no salt - at you should aim to eat less than 2,300 milligrams of sodium per day.
  • Don't overeat. Watch portion size and calories.
• Know your levels. Know your cholesterol, LDL, HDL and triglyceride levels - the higher your cholesterol level, the greater your risk of heart disease
• Watch your weight. Diet and exercise should help you lower and maintain your weight.
• Talk to your family. Family history of cardiovascular disease, high blood pressure, heart attack, obesity or diabetes increases your risk.
• Lower your stress level. People who experience costant stress are more prone to cardiovascular disease. If you cannot avoid stressful situations, learn how to respond in a way that is not stressful for you.
• Don't smoke.
• Limit alcohol consumption.
• Get regular check-ups.

Treatment for heart disease varies by condition. Your physician may recommend:

• Lifestyle changes, such as changes to your diet, getting more exercise, quitting smoking, and reducing your alcohol intake
• Medications
• Medical procedures or surgery

Are you at risk for heart disease? If you answer yes to any of the questions below, talk to your doctor about getting a complete heart disease risk assessment.

• Age and Sex. I am a man or woman over 50 years of age.
• Family History. My father or brother had a heart attack before age 55, OR my mother or sister had one before age 65, OR my mother, father, sister, brother or grandparent had a stroke.
• Blood Pressure. My blood pressure is 130/80 mm Hg or higher (high blood pressure), OR a health care professional has said my blood pressure is high, OR my blood pressure is 120/80 - 129/80 mm Hg (prehypertension), OR I don't know what my blood pressure is.
• Tobacco Smoke. I smoke, OR I live or work with people who smoke regularly.
• Total Cholesterol. My total cholesterol is 200 mg/dL or higher, OR I don't know my level.
• HDL Cholesterol. My HDL ("good") cholesterol is less than 40 mg/dL, OR I don't know my HDL cholesterol level.
• Physical Activity. I get less than a total of 30 minutes of physical activity on most days.
• Overweight. I am 20 pounds or more overweight for my height and build.
• Diabetes. I have diabetes (a fasting blood sugar reading of 126 mg/dL or higher), OR I need medicine to control my blood sugar, OR I have been told I have an impaired ability to control my blood sugar (a fasting blood sugar reading greater than 100 mg/dL).
• Heart Disease Medical History. I have coronary heart disease, atrial fibrillation or other heart condition(s), OR I've had a heart attack.
• Stroke Medical History. I've been told that I have carotid artery disease, OR I have a disease of the leg arteries, a high red blood cell count or sickle cell anemia.