Factors for Heart Disease
What is a heart attack?
A heart attack is an event that results in permanent heart damage
or death. It is also known as a myocardial infarction, because
part of the heart muscle (myocardium) may literally die (infarction).
A heart attack occurs when one of the coronary arteries becomes
severely or totally blocked, usually by a blood clot. When the
heart muscle does not obtain the oxygen-rich blood that it needs,
it will begin to die. The severity of a heart attack usually depends
on how much of the heart muscle is injured or dies during the
What are possible consequences of a heart
Depending upon the severity of both the attack and of the subsequent
scarring, a heart attack can lead to any the following: heart
failure, irregular heart rhythms (arrhythmias), cardiac arrest
(which could lead to sudden cardiac death), cardiogenic shock
(an often-fatal shock-like state) or death.
How is cardiac arrest different from a heart
Each year approximately one million Americans experience a heart
attack, making it the number-one cause of unexpected or sudden
death among otherwise healthy adults. While many people use the
two terms interchangeably, cardiac arrest is not the same as a
heart attack. Cardiac arrest occurs when the heart actually stops
beating and pumping blood, usually due to a malfunction in the
heart's electrical system (ventricular fibrillation). The term
"massive heart attack" is also mistakenly used to describe
cardiac arrest, but they are not the same thing. A heart attack
may lead to cardiac arrest, but these are separate events.
What are the common symptoms of a heart attack?
The classic symptom of a heart attack is chest pain that is unrelieved
by rest and often spreads or radiates through the upper body to
the arms, neck, shoulders or jaw. However, some patients may only
experience chest pressure/discomfort, with or without other symptoms
such as the following: shortness of breath, palpitations, fainting,
fatigue, sweating or nausea. In contrast with men, women are more
likely to feel fatigue or nausea prior to a heart attack. They
also feel pain high in the abdomen and chest, and even in the
back, neck or jaw. Whatever the nature of the pain, it does not
have to be jarring or obvious for it to signal an impending heart
attack. In fact, obvious pain is a better signal of an impending
heart attack than discomfort or heartburn-like symptoms, which
can be easily ignored or mistaken for indigestion.
What should you do if you think they might
be having a heart attack?
As a general rule, it is better to be safe than sorry. If a heart
attack is suspected and any of these symptoms are present, this
may indeed be a sign of a serious lack of oxygen-rich blood supply
to the heart. Emergency medical help should be sought immediately.
What are the risk factors for heart disease?
Risk factors for heart disease include: hypertension (high blood
pressure), hyperlipidemia (high cholesterol), a family history
of heart disease (particularly premature coronary artery disease),
cigarette smoking, sedentary lifestyle and diabetes.
Risk Factors You Cannot Modify:
Your risk is higher if immediate family members have had coronary
artery disease. Your risk is even higher if you are a man with
a relative who died of a heart attack at an early age (under 70).
The risk of developing coronary disease increases as you age.
Men under 50 have two to three times greater risk of heart attack
than women of the same age. After menopause, however, women have
the same risk as men.
Factors You Can Modify:
Smoking increases your risk of heart attack three to four times
over non-smokers. Smoking can cause artery muscles to spasm, or
contract, reducing blood flow to your heart.
High Blood Pressure
High blood pressure causes blood to press too hard against the
walls of your arteries, damaging the arteries and promoting the
development of atherosclerosis of the coronary arteries.
High Blood Cholesterol
Cholesterol is a fat substance found in foods of animal origin.
High levels of cholesterol contribute to the formation of fatty
buildup along the inside lining of the arteries, blocking the
flow of blood.
Triglycerides are a fat found in the blood and are the end products
of sugar breakdown that contributes to plaque formation. Limit
your intake of sugars, starches and alcohol.
If you have diabetes, you are more than twice as likely to develop
heart disease. Diabetes damages the artery walls and increases
the risk of plaque formation. You can reduce, but not eliminate
the risk of coronary artery disease by keeping your blood sugar
levels normal and by controlling your cholesterol and triglycerides.
Excessive Alcohol and Caffeine Intake
Alcohol and caffeine can raise your cholesterol by raising the
fat level in your blood. Try to limit your alcohol consumption.
Small amounts of alcohol on a regular basis have been shown to
decrease the risk of coronary disease. Limit caffeine beverages
to two cups per day.
Being overweight puts a direct strain on the heart. When you are
overweight, your heart has to work harder to supply the extra
tissues with blood. Many times, losing weight will decrease your
cholesterol and lower your blood pressure.
Lack of Proper Exercise
A balance of rest, relaxation and activity are needed for a healthy
body. A balanced exercise program is best with some exercise each
day rather than a lot one day and none the next.
What causes coronary heart disease?
Coronary heart disease is caused when fatty plaques accumulate
along the walls of the coronary arteries, narrowing them and thereby
reducing blood flow to the heart. This process is referred to
as atherosclerosis. Over time, the heart muscle, which is "starved"
of oxygen and nutrients carried by the blood, begins to weaken,
and parts of it may even die.
What is a stroke?
When brain cells are deprived of their blood supply, a stroke
or "brain attack" occurs. Without access to vital nutrients
and oxygen, brain cells die. The effects of a stroke can vary
widely depending on where it occurs in the brain, the severity
of the attack, and the general health of the person. A minor stroke
may not even be noticed, while a major one can cause crippling
mental and physical disabilities or even death.
What are some of the high risk factors for
There is an increased risk if you have a family history of stroke
or transient ischemic attacks (mini-strokes - also called TIA's).
Also, more strokes occur in men. African-Americans have an increased
risk of stroke, which in part is thought to be related to genetic
factors. A high-fat diet, high blood pressure, exessive alcohol
consumption, and being overweight all increase one's risk of having
What is heart failure?
Heart failure occurs when the heart loses the ability to pump
blood efficiently through the body. The seriousness of the condition
depends on how much of the pumping capacity has been lost. Mild
heart failure may have little effect on one's life, while severe
heart failure interferes with even simple activities and often
What does a heart-healthy diet mean?
Heart-healthy means eating a diet that is low in sodium, cholesterol,
and fat. Foods that best meet this requirement are whole grains,
fruits, and vegetables. A diet high in sodium, fat and cholesterol
is associated with higher blood pressure, increased weight, and
elevated blood cholesterol levels, all of which increase the chances
that atherosclerosis will occur. Atherosclerosis is the hallmark
of coronary artery disease and consists of the build-up of fatty
deposits on the inside of the artery walls.
If your doctor suspects that you have peripheral vascular disease
or if you have symptoms of the disease, several tests are used
to make a diagnosis. The following are diagnostic tests that your
doctor may order:
Ankle Brachial Index (ABI)
The ABI is a simple non-invasive test that measures the ratio
of the blood pressure in your ankle to that in your arm. This
ratio may indicate a potential vascular problem.
Ultrasound Doppler Test
This non-invasive test uses sound waves to provide animage of
the inside of the blood vessel to determine if a specific artery
has plaque build-up.
Before a final diagnosis is made, you may be asked to undergo
an angiogram. A special dye is injected into the arteries under
local anesthetic and x-rays are taken. The dye shows up on the
x-rays, revealing the arteries and the presence of any narrowing
or blockages. Your doctor will explain the risks and benefits
of your treatment options and answer any questions you or your
family may have.
Treatment options for atherosclerotic disease include: medication,
surgery and minimally invasive interventional procedures such
as percutaneous transluminal coronary angioplasty (PTCA), percutaneous
transluminal angioplasty (PTA), atherectomy, stent implantation
and intravascular radiotherapy. The purpose of these treatments
is to eliminate or reduce the symptoms you may have and, in the
case of coronary artery disease, decrease your risk of heart attack.
Medications can be used alone or in combination with one of the
treatments. While medications do not eliminate the narrowing of
arteries, they can help improve the efficiency of the heart and
reduce symptoms such as chest pain (angina), leg pain/ claudication
In the case of coronary artery disease, Coronary Artery Bypass
Graft Surgery (CABG), is performed by removing a portion of a
small blood vessel from the leg or chest and sewing or “grafting”
one end of the bypass to the aorta and the other end to the coronary
artery beyond the narrowed area. Blood flows through the new grafted
vessel to the heart muscle, “bypassing” or avoiding
the blockage in the coronary artery.
Angioplasty or percutaneous transluminal angioplasty (PTA) and
percutaneous transluminal coronary angioplasty (PTCA) are techniques
used to widen the narrowing in your artery without surgery. The
basic idea of angioplasty is to position a catheter with a small
inflatable balloon on the end within the narrowed section of the
artery. Inflation of the balloon catheter causes the balloon to
push outward against the narrowing and surrounding wall of the
artery. This process reduces the narrowing until it no longer
interferes with blood flow. The balloon is then deflated and removed
from the artery.
A stent is a small, latticed, metal scaffold that is introduced
into your blood vessel on a balloon catheter. Stents are used
for treatment of new lesions or blockages and in areas where restenosis
(plaque build-up after treatment) has occurred. The doctor maneuvers
the catheter into the blocked artery and inflates the balloon.
The stent expands against the vessel wall as the balloon is inflated.
Once the balloon has been deflated and withdrawn, the stent stays
in place permanently, holding the blood vessel open and improving
Stent placement may reduce the possibility of restenosis but does
not prevent its occurrence. Intravascular Radiotherapy is a recent
advancement in the treatment of coronary artery disease that has
been shown to reduce the occurrence of restenosis. Both beta and
gamma radiation are therapeutic options that have shown positive
results in clinical trials.
Directional Coronary Atherectomy (DCA) is a technique by which
a catheter with a small mechanically-driven cutter shaves the
plaque and stores it in a collection chamber. The plaque is then
removed from the artery when the device is withdrawn. Mechanical
rotational atherectomy is a technique that uses a diamond-shaped
burr that rotates and shaves the plaque into tiny particles, which
then pass through the circulatory system.
What is cardiac rehabilitation?
Cardiac rehabilitation is a comprehensive program consisting of
monitored exercise, health education and support. It helps people
who are recovering from or experiencing a heart problem return
to an active life.