CARDIOVASCULAR DISEASE AND TREATMENTS
ETIOLOGY OF CARDIOVASCULAR DISEASE
Heart or cardiovascular disease is the leading cause of death in the World 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 (A chest pain or shortness of breath). 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.
TYPES OF CARDIOVASCULAR DISEASE
Myocardial infarction (MI), also known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat or feeling tired.
Coronary heart disease Coronary artery disease (CAD), also known as coronary heart disease (CHD) or ischemic heart disease (IHD), involves the reduction of blood flow to the heart muscle due to build-up of plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn.
Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat.
Ventricular fibrillation (V-fib or VF) is an abnormal heart rhythm in which the ventricles of the heart quiver instead of pumping normally. It is due to disorganized electrical activity. Ventricular fibrillation results in cardiac arrest with loss of consciousness and no pulse. This is followed by death in the absence of treatment. Ventricular fibrillation is initially found in about 10% of people with cardiac arrest.
Congenital heart disease Malformations of heart structures existing at birth may be caused by genetic factors or by adverse exposures during gestation. Examples are holes in the heart, abnormal valves, and abnormal heart chambers. Risk factors Maternal alcohol use, medicines (for example thalidomide, warfarin) used by the expectant mother.
SIGNS AND SYMPTOMS OF 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 nitro-glycerine or rest.
Not all pain from heart disease has 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.
TREATMENT OF CARDIOVASCULAR DISEASE.
The treatment option that is best for a person will depend on their specific type of CVD.
However, some options include:
medication, such as to reduce low density lipoprotein cholesterol, improve blood flow, or regulate heart rhythm surgery, such as coronary artery bypass grafting or valve repair or replacement surgery cardiac rehabilitation, including exercise prescriptions and lifestyle counseling
Treatment aims to:
- relieve symptoms
- reduce the risk of the condition or disease recurring or getting worse
- prevent complications, such as hospital admission, heart failure, stroke, heart attack, or death
Depending on the condition, a healthcare provider may also seek to stabilize heart rhythms, reduce blockages, and relax the arteries to enable a better flow of blood.
STATISTICS ON CARDIOVASCULAR DISEASE
According to the World Health Organization (WHO), CVD is the leading cause of death worldwide.
In 2016, around 17.9 million people died from CVD, accounting for 31% of all registered premature deaths.
Of these, 85% resulted from a heart attack or stroke. These conditions affect equal numbers of men and women.
The WHO estimate that by 2030, 23.6 million people will die from CVD conditions annually — mostly due to stroke and heart disease.
Although these conditions remain prevalent in global mortality rates, people can start taking steps to prevent them.
People can take the following steps to prevent some of the conditions within CVD:
Manage body weight: The National Institute of Diabetes and Digestive and Kidney Disorders advise that if a person loses 5-10% of their body weight, they may reduce their risk of developing CVD.
Get regular exercise: The American Heart Association (AHA) recommend doing 150 minutes of moderate-to-intense physical activity every week.
Follow a heart-healthy diet: Eating foods that contain polyunsaturated fats and omega-3, such as oily fish, alongside fruits and vegetables can support heart health and reduce the risk of CVD. Reducing the intake of processed food, salt, saturated fat, and added sugar has a similar effect.
Quit smoking: Smoking is a key risk factor for almost all forms of CVD. Although quitting can be difficult, taking steps to do so can drastically reduce its damaging effects on the heart.
CARDIOVASCULAR DISEASE TERMS INTERPRETED
Cardiovascular disease is the broad term for problems with the heart and blood vessels. These problems are often due to atherosclerosis. This condition occurs when fat and cholesterol build up in blood vessel (artery) walls. This build-up is called plaque. Over time, plaque can narrow blood vessels and cause problems throughout the body. If an artery becomes blocked, it can lead to heart attack or stroke.
Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they include:
coronary heart disease – disease of the blood vessels supplying the heart muscle;
cerebrovascular disease – disease of the blood vessels supplying the brain;
peripheral arterial disease – disease of blood vessels supplying the arms and legs;
rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
congenital heart disease – malformations of heart structure existing at birth;
deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.