Heart Disease (Coronary Artery Disease) (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Heart (cardiovascular) disease definition and facts
- What is heart (cardiovascular) disease?
- Who is at risk for heart (cardiovascular) disease?
- What are the signs and symptoms of heart (cardiovascular) disease?
- What causes heart (cardiovascular) disease?
- How is heart (cardiovascular) disease diagnosed?
- What is the treatment for heart (cardiovascular) disease?
- What lifestyle changes can a person make to prevent further heart disease or heart attack?
- What is the medical treatment for heart (cardiovascular) disease?
- How many people have heart (cardiovascular) disease, and what is the prognosis?
- Can cardiovascular disease be prevented?
- Heart Disease FAQs
- Find a local Cardiologist in your town
What are the signs and symptoms of heart (cardiovascular) disease?
- The classic symptoms of angina, or pain from the heart, are described as a crushing pain or heaviness in the center of the chest with radiation of the pain to the arm (usually the left) or jaw. There can be associated shortness of breath sweating and nausea.
- The symptoms tend to be brought on by activity and get better with rest.
- Some people may have indigestion and nausea while others may have upper abdominal, shoulder, or back pain.
- Unstable angina is the term used to describe symptoms that occur at rest, waken the patient from sleep, and do not respond quickly to nitroglycerin or rest.
Other heart (cardiovascular) disease symptoms and signs
Not all pain from heart disease have the same signs and symptoms. The more we learn about heart disease, the more we realize that symptoms can be markedly different in different groups of people. Women, people who have diabetes, and the elderly may have different pain perceptions and may complain of overwhelming fatigue and weakness or a change in their ability to perform routine daily activities like walking, climbing steps, or doing household chores. Some patients may have no discomfort at all.
Most often, the symptoms of cardiovascular disease become worse over time, as the narrowing of the affected coronary artery progresses over time and blood flow to that part of the heart decreases. It may take less activity to cause symptoms to occur and it may take longer for those symptoms to get better with rest. This change in exercise tolerance is helpful in making the diagnosis.
Often the first signs and symptoms of heart disease may be a heart attack. This can lead to crushing chest pressure, shortness of breath, sweating, and perhaps sudden cardiac death.
What causes heart (cardiovascular) disease?
Heart or cardiovascular disease is the leading cause of death in the United States and often can be attributed to the lifestyle factors that increase the risk of atherosclerosis or narrowing of arteries. Smoking, along with poorly controlled hypertension (high blood pressure), and diabetes, causes inflammation and irritation of the inner lining of the coronary arteries. Over time, cholesterol in the bloodstream can collect in the inflamed areas and begin the formation of a plaque. This plaque can grow and as it does, the diameter of the artery narrows. If the artery narrows by 40% to 50%, blood flow is decreased enough to potentially cause the symptoms of angina.
In some circumstances, the plaque can rupture or break open, leading to the formation of a blood clot in the coronary artery. This clot can completely occlude or block the artery. This prevents oxygen-rich blood from being delivered to the heart muscle beyond that blockage and that part of the heart muscle begins to die. This is a myocardial infarction or heart attack. If the situation is not recognized and treated quickly, the affected part of the muscle cannot be revived. It dies and is replaced by scar tissue. Long term, this scar tissue decreases the heart's ability to pump effectively and efficiently and may lead to ischemic cardiomyopathy (ischemic=decreased blood supply + cardio=heart + myo=muscle + pathy=disease).
Heart muscle that lacks adequate blood supply also becomes irritable and may not conduct electrical impulses normally. This can lead to abnormal electrical heart rhythms including ventricular tachycardia and ventricular fibrillation. These are the heart arrhythmias associated with sudden cardiac death.
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