Cardiovascular disease (CVD) refers to any disease condition affecting the vascular system (blood vessels) and the heart. Cardiovascular diseases can be broadly classified into various types depending on the cause and specific location of the disease, such as coronary heart disease, cardiomyopathy, atherosclerosis, congestive heart failure, hypertensive heart disease, inflammatory heart disease, and valvular heart disease.
Cardiovascular diseases are life threatening and require intervention. CVDs are a leading cause of death worldwide, affecting both men and women. Over six million deaths were reported in the US in 2006 and statistics show that someone has a heart attack every 34 seconds.
Symptoms of Cardiovascular diseases are marked and numerous. Primary symptoms include chest pain, cyanosis, dyspnea, edema, fatigue, palpitations, and syncope. Chest pain is the most common symptom. The term Cyanosis indicates a bluish discoloration of the skin and mucous membranes caused by inadequate oxygen supply during an adverse cardiovascular event. Dyspnea involves the shortness of breath or difficulty breathing. Edema denotes swelling around the ankles, legs, eyes, chest wall, or abdominal wall. Palpitations are abnormally fast and irregular heartbeats. Fatigue describes an abnormal weakness. Syncope is fainting and loss of consciousness.
According to the American Heart Association, 1 in every 9 deaths reported in the United States is due to heart failure. This statistic shows that traditional risk factors like smoking, alcohol, hypertension, cholesterol, and diabetes remains an issue for many Americans. The 2012 statistics clearly points out the relationship between the obesity epidemic and CVD prevalence.
The risk factors for cardiovascular diseases can be classified as:
- Behavioral risk factors
- Metabolic risk factors
- General risk factors
Behavioral risk factors include tobacco and alcohol abuse, sedentary life style, and high cholesterol and high calorie diet. Metabolic risk factors include persistent high blood pressure, diabetes, high LDL cholesterol, obesity, and excess homocysteine in blood. General risk factors include poverty, illiteracy, aging, family or genetic disposition, stress and other psycho-sociological factors.
These risk factors are related and one can lead to the other. For example, alcohol and high fat diet coupled with sedentary life style causes hypertension, high cholesterol, and diabetes. These risk factors are further aggravated by poverty, illiteracy, aging, stress, and anxiety. These risk factors contribute to CVDs not only as a single entity but also in synergy. Thus, cardiovascular diseases have multiple risk factors, especially in older adults.
Common Cardiovascular diseases (CVDs)
1. Coronary Heart Disease
Coronary heart disease (CHD) is the most common cardiovascular disease that occurs due to blocked or congested coronary arteries. Reduced blood supply to the heart muscles distresses the heart, leading to various heart diseases.
Symptoms. Chest pain and the sensation of pressure or squeezing in the chest, extending to shoulders, arms, neck, jaw and back, shortness of breath with gasping and difficulties breathing are all symptomatic of coronary heart disease.
Treatment. Treatment options for CHD include drug and surgical interventions. Drug intervention includes statins that reduce LDLcholesterol, nitroglycerin, ACE inhibitors, calcium channel blockers, and aspirin. Surgical interventions include angioplasty, stent placement, coronary artery bypass, and heart transplant.
Heart muscles are referred to as the myocardium. Cardiomyopathy is the disease of the heart muscles. It is most often caused by external factors, rather than problems related to the structure and function of the heart muscle. These factors include alcohol addiction, hypertension, and fat deposits.
Symptoms. Breathlessness during normal activity, abnormal non-injury related swelling in the legs, ankles and feet, abdominal bloating with fluid, abnormal fatigue, irregular heart rhythms, and sudden fainting are marked symptoms of cardiomyopathy.
Treatment. Common medications include ACE inhibitors, beta-blockers, digoxin, and diuretics. Surgical interventions include septal myectomy, septal ablation, pacemaker implantation, and implantable cardioverter-defibrillator.
Atherosclerosis is a type of arteriosclerosis that causes the formation of plaques due to fat or lipid deposits in the inner walls of blood vessels. These atherosclerotic plaques in the blood vessels rupture, forming blood clots that block the blood vessels supplying blood to the heart muscles.
Symptoms. Atherosclerosis of the major arteries that supply blood to heart shows symptoms such as chest pain and pressure in the chest region. Breathlessness during normal activity, abnormal non-injury swelling in the legs, ankles and feet, abdominal bloating with fluid, abnormal fatigue, irregular heart rhythms, and sudden fainting are also common symptoms.
Treatment. Drugs for the treatment of atherosclerosis include statins or fibrates that lower LDL cholesterol, anti-platelet drugs like aspirin, beta-blockers, ACE inhibitors, calcium channel blockers, and diuretics. Surgical interventions include angioplasty, stent placement, endarterectomy, thrombolytic intervention, and bypass surgery.
4. Congestive Heart Failure
Any structural or functional disability of the heart to pump adequate blood throughout the body leads to congestive heart failure.
Symptoms. Acute symptoms include chest pain, shortness of breath, pink foamy mucus from coughing, and palpitations. Chronic symptoms include shortness of breath from normal activity, abnormal fatigue, edema in legs, palpitations, abdominal swelling, weight gain, and pinkish blood stained phlegm from coughing.
Treatment. Treatment includes ACE inhibitors, angiotensin II receptor blockers, digoxin, beta blockers, aldosterone antagonists, and diuretics. Coronary bypass surgery, heart valve repair or replacement, implantable cardioverter-defibrillators, cardiac resynchronization therapy or biventricular pacing, heart pumps including left ventricular assist devices or LVADs, and heart transplant are the recent surgical interventions available for congestive heart failure.
5. Valvular Heart Disease
There are four valves in the human heart that regulate the flow of blood into and out of the heart chambers, these include the aortic and mitral valves on the left side of the heart and the pulmonary and tricuspid valves on the right. These valves open and close during normal pumping cycles of the heart. Any dysfunction in one of these valves leads to heart valve diseases.
Symptoms. Heart valve disease symptoms include shortness of breath during normal daily activity, abnormal fatigue or weakness with or without dizziness; chest discomfort, pressure in the chest region, irregular heartbeats, edema or swelling in the lower limbs and abdomen, and sudden weight gain.
Treatment. Treatment for heart valve diseases includes medications that regulate heart rhythms and heart load. Balloon Valvotomy is a common medical procedure used to treat valve stenosis. Surgical heart valve repair procedures include ring annuloplasty and valve repair by surgical trimming. Valve replacement surgery is performed when the heart valve is damaged beyond repair.
Other Cardiovascular diseases (CVDs)
The Cor pulmonale is a condition in which complications in the lungs like COPD cause failure of the right side of the heart.
Hypertensive heart disease is caused by chronic high blood pressure. Hypertensive heart disease often leads to other cardiovascular complications, such as left ventricular hypertrophy, cardiomyopathy, and arrhythmias.
Inflammatory heart disease refers to the inflammation of the heart muscles and tissues. Endocarditis refers to the inflammation of the endocardium, especially the heart valves. Myocarditis denotes the inflammation of heart muscles.
Maintaining a Healthy Heart
Life style changes, stress management strategies, and adherence to medical guidance can all help to prevent cardiovascular diseases. A low-fat, fiber-rich diet with green vegetables and fruits can help maintain a healthy heart. Dietary fiber is effective in flushing unwanted cholesterol deposits in the colon and blood vessels. Daily intake of dietary vitamins like folate helps in the regulation of homocysteine levels in blood, thereby promoting cardiovascular health. Moderate physical exertion and exercise helps support preventive heart care.