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Know Your Heart

Richard Keating, MDBy: Richard Keating, MD FACC | Cardiology & Nuclear Cardiology, CareMount Medical

Despite the significant progress that has been made in reducing the impact of cardiovascular (or heart) disease, heart problems remain the leading cause of death among Americans.  As February is American Heart Month, the cardiologists here at CareMount Medical encourage you to know about the heart conditions that we can help you manage and simple strategies to avoid heart trouble.

Heart Disease:  An Overview

The heart and blood vessels provide oxygen-rich blood to all tissues in the body.
Without a strong pump to help the blood go where it is needed, organs will not function properly. For this reason, a healthy heart can be considered the foundation of good health.

Heart disease can occur from several sources.  In the U.S., coronary artery blockage and heart attacks remain the most common form of heart problems; however, coronary artery disease , heart valve disease, congestive heart failure, arrhythmia, peripheral artery disease and stroke are also important contributors to our patients’ troubles.  These are all serious problems; they rarely can be cured. Fortunately, scientists and clinicians have made tremendous strides in improving outcomes related to these illnesses. These advances have translated into improved quality of life for our heart patients.

Types of Heart Disease

Coronary artery disease occurs when plaque (fatty substances) is deposited along the walls of the arteries, blocking blood flow to the heart.  Coronary plaques are very common and can be seen in the majority of “healthy” young adults. When plaque blocks more than 70% of the artery., the heart fails to get enough oxygen and can cause symptoms such as chest pain, shortness of breath, or nausea/abdominal discomfort.  This condition, known as angina, is serious and requires immediate medical attention.  Risk factors for developing coronary artery disease include: high cholesterol, high blood pressure, diabetes, obesity and a sedentary lifestyle.  Some people have a genetic predisposition to premature (early) coronary artery disease. If your parent or close relative has had heart trouble, you may want to talk to your doctor and get screened for this condition.  These days, a variety of medical and surgical treatments can improve blood flow to the heart and significantly improve the lives of patients with coronary artery disease.

Heart valve disease occurs if one or more of your heart valves do not function well. The heart muscle has four chambers that are separated by flaps of connective tissue called valves, which serve to ensure that blood flow occurs in only one direction when traveling through the heart. Sometimes, due to a congenital malformation (a defect that is present at birth), infection or degenerative wear and tear, these valves fail to open or close correctly, resulting in valve disease. Tight or leaky valves can reduce the heart’s efficiency and result in symptoms that are similar to angina.  Valve disease can also result in syncope (unexplained fainting).  While there are no medical treatments to correct heart valve problems, there are several surgical options to repair or replace damaged valves, including minimally invasive valve procedures that do not require traditional surgery, thereby reducing recovery time compared to traditional surgery.

Congestive heart failure occurs when there is inadequate blood flow to the heart due to either a weak heart pump or hardening of the arteries that hinders normal blood flow throughout the body.  Patients with this condition often notice swelling (usually of the lower extremities – the hip, leg, ankle or foot) and shortness of breath.  The most common causes of heart failure are: heart attack, valve disease, the toxic effects of some medications, uncontrolled hypertension (high blood pressure) and genetic conditions.  Several medications can be helpful in managing heart failure. In general, a low salt diet and diuretic medications are very helpful to reduce symptoms.

Arrhythmia is a general term used to describe disorders of the heart’s electrical system, which is responsible for coordinating the contraction and relaxation of the heart muscle.  Types of arrhythmias include fast arrhythmias, slow arrhythmias and combined fast/slow arrhythmias.  Symptoms of these conditions include palpitations (rapid heart beat), fainting, lethargy or breathing troubles. Diagnosing arrhythmias can be difficult because arrhythmias can come and go and may not be apparent unless you are being evaluated while you are experiencing an arrhythmia. A variety of medications, procedures and implantable devices can help to manage arrhythmias. Consult your primary care physician if you are experiencing any of these symptoms.

Peripheral artery disease (PAD) and stroke occur when plaque obstructs the arteries that lead from the heart to other organs in the body. The symptoms of PAD can vary widely and depend on which arteries become blocked.  Common places include the arteries to the legs, manifesting as claudication (muscle cramps with activity) or ulceration of the skin.  Internal organs such as the kidney, spleen, and intestine can also be affected.  Stroke specifically refers to blocked blood flow to the brain. Strokes result in neurologic changes, speech difficulty, sensory problems, visual changes or movement disorders.  Treatments can include medications to lower cholesterol and to prevent platelet aggregation (clumping).  There are several revascularization procedures to restore blood supply to peripheral arteries, thereby reducing your risk for PAD and stroke and alleviating symptoms.  Your doctor will evaluate you to determine the best treatment plan for you.

Heart Disease Prevention

Prevention of heart disease begins with maintaining a healthy body and lifestyle.  Careful monitoring of cholesterol and blood pressure are key.  Early evaluation with a cardiologist can also be invaluable.  CareMount Medical has 11 cardiologists spread out throughout our patient service area.  Please talk with your primary care physician or give one of us a call.