FIGHTING HEART DISEASE TOGETHER
You are not alone. Over 70 million people nationwide are fighting heart disease1. The National Center for Disease Control reports that Heart Disease remains the leading cause of death in the United States2. But, together we are making progress. Health care companies, medical professionals, and patients nationwide are contributing in the fight against heart disease.
1Statement for the Record of the House Appropriations Subcommittee on Labor, Health and Human Services Regarding Fiscal Year 2007 Funding for Cardiovascular Research and Public Health Education.
American College of Cardiology, 31 March 2006
2Health, United States, 2007
U.S. Department of Health and Human Services
Centers for Disease Control
National Center for Health Statistics
November 2007, DHHS Publication No. 2007-1232
Coronary Heart Disease
LIVING WITH HEART DISEASE
Millions of Americans are living with heart disease. The most common form of heart disease is Coronary Artery Disease, or CAD. In the United States, CAD is the leading cause of death for both men and women. According to recent trends, half of healthy 40 year old males and one in three healthy 40 year old females will develop CAD1.
What is Coronary Artery Disease?
Coronary Artery Disease is a condition in which the arteries that supply oxygen rich blood to your heart build up plaque over time. This plaque causes blockages to form in the arteries. Eventually, this reduces the blood flow to the heart muscle, a condition known as ischemia. Ischemia simply means there is not enough oxygen supplied to the heart to keep up with the needs of this hard working muscle. The body may react to this reduced blood flow by causing angina or even a heart attack.
What is Angina?
Angina, or chest pain, may feel like pressure, tightness or squeezing in your chest. This discomfort may occur at rest, when walking or climbing stairs, after a heavy meal, or under conditions of extreme stress or cold weather. This pain may also radiate to your shoulders, arms, neck, jaw, or back. If the blood flow to the heart is improved, it may be possible to reverse ischemia.
It is important to remember that many people do not display any symptoms at all. This is known as silent CAD. Often times, CAD is not diagnosed until a heart attack or heart failure occurs. Heart attacks occur when, overtime, an area of the heart muscle is unable to receive oxygen rich blood. This causes permanent damage to the heart muscle. A heart attack is serious should be treated immediately.
What Happens if CAD Remains Untreated?
If left untreated, Coronary Artery Disease can weaken the heart muscle and lead to arrhythmias, heart failure, or a heart attack. Arrhythmias are disturbances with your heart’s rhythm. Many arrhythmias can be treated and controlled with medication. Heart Failure is a condition in which the heart is unable to efficiently pump blood to your body. A heart attack causes permanent damage to the heart muscle or even death.
Risk Factors for Coronary Artery Disease
There are many risk factors that may increase the likelihood of developing Coronary Artery Disease. Cholesterol levels, blood pressure, smoking, insulin resistance, diabetes, obesity, exercise, age and family history are all taken into account. Physicians base their diagnosis on the above factors as well as the results of diagnostic tests. These tests may include baseline electrocardiogram (EKG), exercise stress test, echocardiogram (ultrasound), and/or nuclear stress test.
Treatment for CAD
When it comes to your health always consider your options. Understand what treatments are available. Together with your physician, assess what is the best option for you.
Treatments for CAD may include lifestyle changes such as exercise, stress reduction, or diet modifications. Physicians often prescribe pharmacological agents, or perform bypass surgery (CABG), angioplasty or stenting when necessary and appropriate. ECP therapy is often prescribed for those unable or unwilling to undergo surgical intervention. The goal of these treatments may be any of the following: relieving symptoms (chest pain, shortness of breath), reducing risk factors in an effort to stop plaque build up and eventually occlusions, lower the risk of clots, widen or bypass clogged arteries, form or grow collateral circulation, and/or prevent complications associated with CAD.
1 Rosamond w, Flegal K, Friday G, et al (February 2007). “Heart Disease and Stroke Statistics- 2007 Update: A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.” Circulation 115(5): e69-171.
LIVING WITH ANGINA PECTORIS
If you suffer regularly from the pains of angina, you are not alone. According to the American Heart Association, approximately 9,100,000 people in the United States also suffer from angina pectoris. Nearly 500,000 new cases will be diagnosed each year.1
Simply put, angina (pronounced an-jahy-nuh) is the symptom commonly known as chest pain. Angina can occur for different reasons, many of which are related to heart disease.
There are two classifications for angina pectoris: Stable angina and unstable angina. Stable angina is the most common type of angina and tends to occur on a frequent basis. Stable angina is often predictable and occurs with physical activity, such as walking or climbing stairs. Stable angina tends to go away with rest or medication (nitroglycerin).
Unstable angina, on the other hand, is not as common but can be a more serious condition. Unstable angina causes severe, gripping chest pain that is often less predictable. This type of angina can occur with no physical activity (at rest). If you suspect that you may have unstable angina contact your doctor or even the hospital immediately. This could be a sign of a serious heart condition and could lead to a heart attack or stroke.
What Causes Angina?
The causes for angina are often heart related. One of the most common causes of angina is Coronary Artery Disease (CAD). Coronary Artery Disease is a condition in which the arteries that supply oxygen rich blood to your heart build up plaque over time. This progressive condition is known as atherosclerosis (pronounced ath-uh-roh-skluh-roh-sis).
Atherosclerosis is the leading cause of Coronary Artery Disease. As plaque accumulates over time, the arteries begin to narrow. Eventually, these blockages sreduce blood flow to the heart muscle, a condition known as ischemia. Ischemia simply means there is not enough oxygen supplied to the heart to keep up with the needs of this hard working muscle. The body may react to this reduced blood flow by causing angina or even a heart attack.
What does Angina typically feel like?
When people describe angina, they often use terms like “constricting,” “suffocating,” “crushing,” “tightness,” or “squeezing” in their chests. Sometimes this pain may also radiate to your shoulders, arms, neck, jaw, or back. Other severe symptoms may include: weakness, heavy sweating, nausea, indigestion, cramping, or shortness of breath.
It is important to remember that many people do not display any symptoms at all. This is known as “silent” ischemia. Often times, CAD is not diagnosed until a heart attack or heart failure occurs. Heart attacks occur when, overtime, an area of the heart muscle is unable to receive oxygen rich blood. This causes permanent damage to the heart muscle. A heart attack is serious should be treated immediately.
How Long Does Angina last?
Angina attacks tend to begin gradually and reach the maximum intensity within a few minutes, and then it dissipates. The pain usually lasts from 1 to 15 minutes. Non-anginal chest pain typically lasts less than 5 seconds or may last more than 20-30 minutes (unless experiencing a heart attack).2 These non-coronary causes of chest pain may cause sharp, stabbing or burning sensations that tend to come and go within a few seconds.
When does Angina Occur?
The pains of angina can come and go at any time. Many people say they experience discomfort during rest, when walking or climbing stairs, after a heavy meal, or under conditions of extreme stress or cold weather. If you experience chest pain or discomfort with daily activities or when you are resting, contact your doctor immediately. This could be a sign of a serious condition.
What treatments are available for Angina?
The treatments for angina can vary. It is first necessary to determine what is causing the angina. If it is a heart condition, such as Coronary Artery Disease, physicians often prescribe pharmacological agents, perform bypass surgery (CABG), angioplasty or stenting when necessary and appropriate. ECP therapy is often prescribed for those unable or unwilling to undergo surgical intervention. Physicians commonly suggest lifestyle changes such as exercise, stress reduction, or diet modifications to help fight heart disease.
1 “Heart Attack and Angina Statistics.” American Heart Association. 15 Oct 2008.
Heart Attack and Angina Statistics
2 Rutherford, John D., M.D., Eugene Braunwald, M.D. and Peter Cohn, M.D. “Chronic Ischemic Heart Disease.” Ed. Braunwald, Eugene, M.D. Heart Disease – A Textbook of Cardiovascular Medicine. Philadelphia: W.B. Saunders Company, 1988. 1316-1318
LIVING WITH HEART FAILURE
Heart Failure is a serious condition that afflicts over 5 million people a year in the Unites States alone1. It is important to understand that Heart Failure does not mean the heart stops working. Heart Failure is actually a condition that develops overtime. Simply put, in patient’s who have Heart Failure their heart can not pump blood effectively. The pump is in a slump, so to speak. Taking measures to prevent Coronary Artery Disease (CAD) is one way to help prevent Heart Failure. Diseases that damage the heart are the main cause of Heart Failure. These may include CAD, high blood pressure, and diabetes.
Understanding the Heart
First, let’s review the way the heart works. This will help you better understand the way that Heart Failure affects the heart.
The heart muscle has four chambers. The two upper chambers are known as the atria. There is a right atrium and a left atrium. The two bottom chambers are known as the ventricles. There is a right ventricle and a left ventricle.
Each of these chambers has a different job. The right atrium receives used blood from the body. As pressure builds up in the heart, the right atrium passes blood to the right ventricle. The right ventricle eventually pumps blood out to the lungs. The used blood is re-oxygenated in the lungs. As soon as this process occurs, oxygenated blood travels back to the left atrium. As the pressure builds, the left atrium passes blood to the left ventricle. The left ventricle is the biggest chamber, as it has the biggest job. It is responsible for pumping freshly oxygenated blood to all vital organs in the body.
Diagnosing Heart Failure
Heart Failure can affect both sides of the heart, or the right side alone. Right and left sided heart failure is the most common, and is referred to as left sided heart failure. Left sided heart failure is diagnosed when the heart can’t properly pump oxygen rich blood to the body.
When the heart can’t properly pump blood to the lungs, right side heart failure is diagnosed. This can be dangerous as fluid may build up in the feet, ankles, legs, liver or abdomen. Both right and left sided heart failure may cause fatigue and shortness of breath, or trouble breathing. All of these are symptoms of Heart Failure, as well as swelling in the ankles, feet, legs and abdomen.
Before a diagnosis of Heart Failure can be made, physicians must rule out other causes for these symptoms. It is also important for physicians to determine what disease or condition is causing the heart failure (CAD, hypertension, diabetes). Once a diagnosis has been made, physicians must determine how efficiently your heart is pumping blood, and how much it has been damaged.
Heart Failure doesn’t have to Mean Life Failure
Just because you have been diagnosed with heart failure, it does not necessarily mean your quality of life will fail. There has been great progress made in the treatment of Heart Failure. However, there is no cure for Heart Failure at this time. External Counterpulsation (ECP) therapy, implantable defibrillators, various medications, and lifestyle changes are often used to combat and treat Heart Failure.
1 National Library of Medicine and the National Institute of Health. http://www.nlm.nih.gov/medlineplus/heartfailure.html