Archive For November, 2012
Heart disease or cardiac disease is an outcome of deposition of plaque in the coronary arteries; this condition is called atherosclerosis, which causes blockages. The arteries which were elastic and smooth become rigid and narrow, limiting the blood supply to the cardiac system.
The heart is deprived of the vital nutrients and oxygen, which are required for its functioning (pumping). Coronary arteries are the main blood vessels that supply blood, nutrients, and oxygen to the heart; when these vessels get diseased or damaged due to the continuous build up of plaque (deposits of cholesterol), a person may develop coronary artery disease.
The accumulation of plaque narrows the arteries, which causes the cardiac system to receive lesser amount of blood. The decreased blood flow ultimately develops symptoms like shortness of breath, angina (chest pain) or other signs and symptoms of coronary heart disease. A complete clogging may cause a heart attack (cardiac arrest). Since the process of plaque accumulation often occurs gradually, it can remain unnoticed until a person undergoes a cardiac attack. But there are plenty of options to opt for preventing and treating this medical emergency. You can initiate by commending a healthy lifestyle.
About the Cardiac System
The heart is a muscle, which is similar to the size of a fist in an adult human. Normally, it beats nearly 70 times in a minute and provides oxygen rich blood throughout the body. From the heart, the blood travels toward the lungs for collecting oxygen. This oxygenated blood returns from the lungs to the cardiac system and is then pumped to other body organs through the arteries. The blood again returns to the cardiac system through the veins and is then pumped back to the lungs. This entire process in which the blood flows towards the lungs to receive oxygen and then return to the heart and from there gets distributed to the other body parts and then again back to the lungs is called circulation. Heart muscles receive oxygen through the network of blood vessels or coronary artery.
Coronary Artery Disease: How Does it Develop?
The process of cholesterol or plaque buildup in the walls of the blood vessels may begin when a person is young. As the person gets older, the burden of plaque deposits increases, inflaming the blood vessel and elevating the risk of formation of blood clots and thus heart attack. The cholesterol deposits release chemicals that encourage the healing process, but make the inner area of the blood vessel sticky. This stickiness attracts other substances such as calcium, lipoproteins and inflammatory cells that move into the bloodstream towards itself (inside the walls of the blood vessel).
Ultimately, a narrowed artery may produce new blood vessels for supplying blood to the cardiac system. However, in some cases, due to stress and overexertion, the new developed arteries may become unable to supply adequate amount of oxygenated blood to the muscle of the heart. During such times, a blood clot may completely stop the blood flow towards the heart muscle, causing cardiac arrest. If a blood vessel that supplies blood to the heart gets blocked due to the clot, an ischemic stroke may occur. If the arteries within the brain rupture, usually as an outcome of high blood pressure or uncontrolled hypertension, a hemorrhagic stroke may occur.
Facts Related to Coronary Heart Disease
Coronary artery disease can also be called Coronary Heart Disease (CHD), which affects almost 14 million Americans. This disorder develops when many substances such as the plaque (scar tissue), calcium and fatty material accumulate inclusively in the arteries that supply blood to the myocardium (heart muscle). These arteries are responsible for providing oxygen and other nutrients to the myocardium required for pumping blood. Here are a few facts related to the coronary heart disease:
- The plaque starts accumulating over the time and eventually narrows the artery which interrupts the blood supply to the cardiac system.
- This plaque may sometimes completely obstruct blood flow, which may lead a person to myocardial infarction (heart attack) or a sudden cardiac arrest (a fatal disturbance in rhythm).
- Interruption and slowing of blood supply may cause angina or chest pain.
- Coronary heart disease is considered as the major cause of disability and death in Americans. It is one of the seven leading causes of death.
- The heart is divided into four chambers: a ventricle and an atrium on the left and a ventricle and an atrium on the right.
- Blood returning to the cardiac system through the veins from all over the body moves into the right atrium.
- From the right atrium, the blood travels into the right ventricle, which is then pumped again to the lungs for collecting oxygen.
- The oxygenated blood moves into the left atrium and from there it travels into the left ventricle, which is then pumped into the arteries throughout the body with higher pressure.
- This complete procedure generates one heartbeat.
- The process of contraction or pumping of the left ventricle should be very powerful because it is required for keeping the blood moving throughout the body and thus maintaining the normal heart beat.
- The strength and capacity of the heart muscle depends on the nutrients and oxygen supply coming through the coronary arteries.
- Coronary arteries are generally elastic, quite flexible and strong. The cardiac system has three major and prime coronary arteries.
- Among the three major arteries, two arise or are attached with a common stem, which is known as the left main coronary artery.
- The left side of the heart receives blood from the left main coronary artery.
- The back and the left lateral side of the heart receives blood from the LCX (left circumflex).
- The front part of the cardiac system receives blood from the LAD (left anterior descending).
- Ultimately, the RCA (right coronary artery) is separate, and it provides the bottom and the right parts of the cardiac system.
- During childhood, the inner wall of the coronary arteries is smooth, which allows easy blood flow. As a person ages, the accumulation of calcium and cholesterol content in the walls of the arteries increases, which narrows them and makes them less elastic as well as thicker.
- Unhealthy eating habits such as consumption of fats and high cholesterol diet and certain pattern of lifestyle such as lack of exercise, drinking alcohol and smoking can accelerate the fat and calcium deposit within the inner wall of the arteries.
The process of plaque deposition is called hardening of the arteries or atherosclerosis. These deposits eventually clog the blood vessel and obstruct the flow of blood through the arteries. Plaque deposits are like a rigid shell which has a soft inner core comprising cholesterol. During each heartbeat, as the blood hits these deposits, they may rupture and the inner cholesterol core gets exposed, which results into clotting of blood. Clots may create interruption in the smooth blood supply, causing angina (severe chest pain) or even completely blocking the artery.
Ultimately, it can be said that coronary artery disease or coronary heart disease is caused due to the narrowing of the arteries, which is a result of plaque deposition. Avoiding cholesterol rich and fatty foods can help to prevent this fatal medical condition.
Are the symptoms of heart attack the same for men and women? Previously, it was considered that men and women had different symptoms of heart disease; however, this may not be the fact. Both men and women may undergo non typical or typical warning signs such as sweating, pain in the throat, arm, jaw, nausea, unusual pain and severe pain in the center of the chest.
However, women may often describe these signs differently than men. Yet, the most common warning sign in men and women is still chest pain. Here we have shared a few facts about women and heart attack.
Cardiovascular disease or coronary artery disease (stroke and heart disease) ranks second in the list of life threatening diseases in women. Some of the heart diseases may errupt suddenly, while few may develop gradually. Women tend to protect themselves from heart disease before their menopause because of the conservative or preventive effect of estrogen (hormone). However, few cases may have a different scenario. For instance, a diabetic woman in her pre-menopausal period is at the same risk as men of the similar age, since diabetes eradicates the protective or preventive effect of estrogen.
Unique Conditions in Women Related to Stroke and Heart Disease
While majority signs and risk factors of heart disease are same for men and women, there are a few unique factors that develop the risk of cardiac disease in women. The factors that affect women’s health include:
- Pregnancy
- Triglycerides
- Cholesterol
- Oral contraceptives or birth control pills
- The role of estrogen
- Hormone therapy and menopause
Warning Signs of Heart Attack
Every year, thousands of people die from cardiac arrest because they do not receive the required medical assistance immediately. Learn to identify the symptoms of cardiac arrest, so you can immediately get the medical aid and save your life. It is significant to understand that the alarming signs may differ for each individual and they may not essentially be severe or sudden.
Although discomfort or pain in the chest is the most common sign of a cardiac failure in both women and men, some patients will not undergo pain in chest at all, while others will suffer only gentle discomfort or chest pain. Few may experience a single symptom, while others may suffer a combination of signs. The common symptoms of heart attack include:
- Shortness of breath
- Nausea
- Chest pain or discomfort (squeezing, uncomfortable chest pressure, heaviness or burning, pain or fullness)
- Light headedness
- Discomfort due to pain in other upper body areas (back, jaw, arms, shoulder, neck)
If you observe any of these indications even in their gentle form, you must:
- Call your local emergency number or 911 immediately or ask someone to call for you. Make sure that you keep a list of emergency phone numbers all the time near your phone.
- If your doctor has prescribed you nitroglycerine, take it in your regular dosage.
- Stop all your activities and lie down or sit in your most comfortable position.
- Rest comfortably till the ambulance with medical personnel arrives
- In case of severe chest pain, take 2 aspirins of 80 mg each. It is also called acetylsalicylic acid (ASA). Other pain medicines such as Advil or Tylenol do not work as the ASA does, and hence they cannot be used in emergency situations.
Steps to Prevent Heart Attack
It is a fact that heart attack is more prominent than breast cancer among women. It has three times more possibilities of developing in women. In the duration following menopause, the risk of heart disease significantly rises. But it can be prevented by taking certain steps or by making certain changes in the lifestyle.
- Be Active: Being active means doing physical workout regularly for protecting the heart. You can try various workout styles, including regular aerobic as well as swimming and walking. Take stairs instead of an elevator or perform aerobic activity (fast walking or cycling) with moderate intensity for around one to two hours. Cycling helps a lot in burning extra fats and thus helps to control cholesterol.
- Lose Weight if You are Overweight: Obesity can be called a disorder which is present in every five women among ten. Carrying extra pounds increases strain on the heart and a person tends to increase her chances of developing high cholesterol and high blood pressure, which also elevate the risk of heart attack. Try to avoid being overweight and maintain your weight.
- Regular Medical Checkup: If you are above 40 years, ask your doctor for health checkup in order to assess your risk of getting heart disease. Your regular medical checkup should include cholesterol level test and blood pressure checkup. If the level of cholesterol or blood pressure is high, this means you are at a higher risk of developing cardiac disease. Your health care practitioner will prescribe few medications and will recommend certain lifestyle changes to reduce the blood pressure as well as the level of cholesterol.
- Change your Body Shape: As your weight, your shape also matters a lot. Most women in the age group of 40 to 60 become apple shaped due to the deposition of excess fat around the waist portion. Women with apple shape body are at more risk compared to the women with pear shape body, where extra fat is concentrated on the hip portion. Having a waistline around 80 cm can reduce your risk.
- Drink Occasionally: Drinking a little amount of alcohol can be good for the cardiac system, but assure that you follow the limits wisely. Excessive consumption of alcohol may increase your risk. Heart healthy drinking (one to two units per day) is ok, but if you drink beyond this, you may increase your risk. Binge-drinking or excess alcohol may impair the muscles of the heart to cardiac failure or abnormal heart rhythms.
- Quit Smoking: If you are a smoker, then you are at higher risk of getting heart attack. For the past few decades, even women have started smoking, which has increased their risk of getting a cardiac arrest early. Actually, young women are more into smoking as compared to young men. Restricting cigarette smoking will reduce your prospects of developing cardiac arrest.
- Don’t Rely on Hormone Replacement Therapy: It was considered that HRT (hormonal replacement therapy) for treating menopausal symptoms can work as a preventive solution for heart disease. But recent studies state that this therapy is not protective, instead it has some side effects with certain drug treatments. You can prefer to take HRT if you require it for getting relief from the night sweats and hot flushes during menopausal duration, but don’t expect that this will protect your cardiac system.
- Maintain Your Diet: Eat healthy and balanced diet always. Avoid intake of excessive saturated fat and salt; recommended quantity for per day is less than 6g.
- Cope with Your Stress: Many studies have revealed that stress increases one’s prospect of heart disease. Learn to deal with stress and try to relax if you often remain under stress. Your doctor can suggest you certain simple techniques that are helpful to cope with stress and anxiety that affect you in your daily life.
These are the facts that connect women and heart attack. Your prospects of getting a cardiac disease can be reduced by following the above mentioned preventive tips wisely.
Congestive heart failure diagnosis is based on certain aspects such as the relevant medical history of a patient, risk factors, selected medical test and a prudent physical examination.
A thorough history of the patient may divulge the presence of one or more warning signs of cardiac failure. Additionally, a history of prior cardiac arrest, significant use of alcohol, diabetes, hypertension or coronary heart disease can be clues. The physical evaluation focuses on detecting the quantity of the fluid accumulated in the body (neck veins, leg swelling, or breath sounds) as well as cautiously characterizing the heart’s condition (murmurs, heart sounds, pulse and heart size).
The doctors who deal with the heart related issues are called cardiologists. Some doctors have training in advanced and additional areas which involve non-invasive studies where they use radioactive drugs or dyes for studying the function and structure of the heart (nuclear cardiology), echocardiography, cardiac rhythm disorders or abnormal heart beats (electrophysiology), cardiac catheterization and radiologic heart imaging.
Why Tests and Exams ?
Once the patient visits the cardiac center, the doctor will examine his/her signs and symptoms of cardiac failure:
- Edema (swelling on the leg)
- Breathing problems or fast breathing
- Veins in the neck are distended
- Swelling on the abdomen or liver
- Abnormal heart sounds with fast, irregular or uneven heart beat
- Doctors use their stethoscope to listen the sound that develops during the build up of fluid (crackles) into the lungs.
Many tests are performed to find the cause, monitor the cardiac failure and diagnose the exact condition.
An X-ray, echocardiogram, electrocardiogram and MRI are best for having a visual idea about the cardiac system. The cardiologists often use these images as a guide for opting the right treatment.
Various blood tests are helpful in:
- Diagnosing and monitoring heart failure
- Finding out possible causes and other disorders that may lead to this medical condition
- Identifying the risk factors
- Monitoring the side effects of drugs that a patient might be taking
Medical Tests for Diagnosing Congestive Cardiac Failure
Cardiac specialists use various medical tests for diagnosing the cardiac failure. The most preferred tests are as below:
Chest X-ray: This technique helps to get an x ray image that shows the shape and size of the heart and lungs. In cardiac failure, the accumulated fluid in the lungs can be seen and the enlarged shape of the heart is also visible. An X ray is also used to detect other medical conditions.
Blood Tests: This test may indicate the presence of other disorders that impair the cardiac system. A blood test is helpful in checking the levels of B-type natriuretic peptide or BNP (hormone). When your heart overworks, it tends to secrete B-type natriuretic peptide in excess or at greater level, and this levels indicates that a patient is undergoing heart failure.
Electrocardiogram (ECG): Electrocardiogram is used to measure the electrical impulses produced by your heart. In this process, doctors locate electrodes or sensor patches attached with wires on your skin. Electrocardiogram helps to reveal any damage to the cardiac system and heart rhythm disorder due to a previous attack.
Angiogram or Coronary Catheterization: This test uses a catheter (a thin, elastic tube), which is inserted into a blood vessel of the elbow or groin (upper thigh) and guided to the heart. A dye that makes the arteries visible under the x-ray is injected into the arteries that move towards the heart. Angiogram helps to identify the narrowed arteries moving towards the heart (coronary heart disease), which may develop congestive cardiac failure. This test is also beneficial to know the health of the heart valves and the strength of the left ventricle (main pumping chamber of the cardiac system).
Myocardial Biopsy: In this test, a tiny flexible biopsy cord is inserted into a vein in your groin or neck to take off some tiny pieces of the cardiac muscle. Myocardial biopsy is performed to detect certain forms of cardiac muscle diseases that may result into cardiac failure.
Magnetic Resonance Imaging or MRI: In this technique, radio waves and magnetic field are used to develop detailed and clear visuals of the cardiac system.
Echocardiogram: This technique uses sound waves to create a clear and detailed picture of certain factors such as the size, function and stricture of the cardiac system. These images allow doctors to determine the pumping capacity of the heart and differentiate between various forms of heart failure. An echocardiogram also measures the ejection fraction (how much percentage of blood is pumped by the major blood supplying chamber of the heart).
Right Heart Catheterization: This technique requires a catheter (a thin elastic tube) to be inserted into a vein (blood vessel) in the groin or neck of the patient. They direct the catheter to the cardiac system and thus measure the pressure within the chambers of the heart. This process helps to opt for heart failure treatment.
Multiple-gated Acquisition Scanning(MUGA) or Radionuclide ventriculography: This is a nuclear medicine test in which a small amount of radioactive dye is injected into the vein and a special camera is used to see the percentage of blood pumped by your heart with each beat. Outcome of these tests allows the doctors to determine the causes of the symptoms and schedule a treatment plan. Cardiologists categorize or measure the cardiac failure on the basis of a standard scale that ranges between I to IV. A cardiac failure of class I type is considered as the moderate form, in which the patient is able to perform the routine activities normally without feeling stressed, fatigued or winded, whereas the patients at class IV level are considered to be in the extreme severe condition in which they experience shortness in breathing even while resting.
Stress Tests: This is an exercise test in which the patient is asked to workout on a stationary bicycle or a treadmill or take a dose of drug that will boost the activity of the heart during the workout. An electrocardiogram is used to monitor each activity of the heart when a person in performing activities. 
The stress test allows your doctor to judge the effectiveness of your therapy and plan for more advanced therapies. Various form of stress examinations measure the response of the cardiac system to workout in various manners and situations. Few cardiac centers throughout the world have the advanced equipment to measure the relaxation effect of the cardiac system to the exercise. They perform a test to analyze diastolic cardiac failure.
The above mentioned medical techniques require expertise and specialization for appropriate diagnosis. All the methods are commonly used for congestive heart failure diagnosis. The symptoms of this medical condition develop with build up of plaque deposits and the process of deposition is gradual. If the patient observes the symptoms in the early stages and gets it diagnosed immediately, his/her chances of recovering from this medical condition increases.