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Cardiology
Heart disease describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases and heart defects you're born with
The term "heart disease" is often used interchangeably with the term "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease.
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Common Cardiovascular Diseases
- Abnormal heart rhythms, or arrhythmias
- Aorta disease and Marfan syndrome
- Congenital heart disease
- Coronary artery disease (narrowing of the arteries)
- Deep vein thrombosis and pulmonary embolism
- Heart attack
- Heart failure
- Heart muscle disease (cardiomyopathy)
- Heart valve disease
- Pericardial disease
- Peripheral vascular disease
- Rheumatic heart disease
- Stroke
- Vascular disease (blood vessel disease)
Diagnosis
Besides blood tests and a chest X-ray, tests to diagnose heart disease can include: Electrocardiogram (ECG). Holter monitoring. Echocardiogram. Stress test. Cardiac catheterization. Cardiac computerized tomography (CT) scan. Cardiac magnetic resonance imaging (MRI).
Treatment
Heart disease treatments vary by condition. For instance, if you have a heart infection, you’ll likely be given antibiotics. In general, treatment for heart disease usually includes: Lifestyle changes. These include eating a low-fat and low-sodium diet, getting at least 30 minutes of moderate exercise on most days of the week, quitting smoking, and limiting alcohol intake. Medications. If lifestyle changes alone aren’t enough, your doctor may prescribe medications to control your heart disease. The type of medication will depend on the type of heart disease. Medical procedures or surgery. If medications aren’t enough, it’s possible your doctor will recommend specific procedures or surgery. The type of procedure will depend on the type of heart disease and the extent of the damage to your heart.On an extreme case when other treatments fail heart transplant is performed.
Coronary artery disease is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis (sometimes called “hardening” or “clogging” of the arteries) is the buildup of cholesterol and fatty deposits (called plaques) on the inner walls of the arteries.
A congenital heart defect is a problem with the structure of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart.
Early signs of heart disease
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes – or it may go away and then return. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath. This can occur with or without chest discomfort.
- Other signs. Other possible signs include breaking out in a cold sweat, nausea or lightheadedness.
what are the 4 stages of congestive heart failure?
Stage A
Stage A is considered pre-heart failure. It means you are at high risk of developing heart failure because you have a family history of heart failure or you have one of more of these medical conditions:
- Hypertension
- Diabetes
- Coronary artery disease
- Metabolic syndrome
- History of alcohol abuse
- History of rheumatic fever
- Family history of cardiomyopathy
- History of taking drugs that can damage the heart muscle, such as some cancer drugs
Stage A treatment
The usual treatment plan for patients with Stage A heart failure includes:
- Regular exercise, being active, walking every day
- Quitting smoking
- Treatment for high blood pressure (medication, low-sodium diet, active lifestyle)
- Treatment for high cholesterol
- Not drinking alcohol or using recreational drugs
- Medications:
- Angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB) if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions
- Beta-blocker if you have high blood pressure
Stage B
Stage B is considered a pre-heart failure. It means you have been diagnosed with systolic left ventricular dysfunction but have never had symptoms of heart failure. Most people with Stage B heart failure have an echocardiogram (echo) that shows an ejection fraction (EF) of 40% or less. This category includes people who have heart failure and reduced EF (HF rEF) due to any cause.
Stage B treatment
The usual treatment plan for patients with Stage B heart failure includes:
- Treatments listed in Stage A
- Angiotensin converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) (if you aren’t taking one as part of your Stage A treatment plan)
- Beta-blocker if you have had a heart attack and your EF is 40% or lower (if you aren’t taking one as part of your Stage A treatment plan)
- Aldosterone antagonist if you have had a heart attack or if you have diabetes and an EF of 35% or less (to reduce the risk of your heart muscle getting bigger and pumping poorly)
- Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease (you may need valve repair or replacement surgery) or congenital heart disease
Stage C
Patients with Stage C heart failure have been diagnosed with heart failure and have (currently) or had (previously) signs and symptoms of the condition.
There are many possible symptoms of heart failure. The most common are:
- Shortness of breath
- Feeling tired (fatigue)
- Less able to exercise
- Weak legs
- Waking up to urinate
- Swollen feet, ankles, lower legs and abdomen (edema)
Stage C treatment
The usual treatment plan for patients with Stage C HF-rEF includes:
- Treatments listed in Stages A and B
- Beta-blocker (if you aren’t taking one) to help your heart muscle pump stronger
- Aldosterone antagonist (if you aren’t taking one) if a vasodilator medicine (ACE-I, ARB or angiotensin receptor/neprilysin inhibitor combination) and beta-blocker don’t relieve your symptoms
- Hydralazine/nitrate combination if other treatments don’t stop your symptoms. Patients who are African-American should take this medication (even if they are taking other vasodilator medications) if they have moderate to-severe symptoms.
- Medications that slow the heart rate if your heart rate is faster than 70 beats per minute and you still have symptoms
- Diuretic (“water pill”) may be prescribed if symptoms continue
- Restrict sodium (salt) in your diet. Ask your doctor or nurse what your daily limit is.
- Keep track of your weight every day. Tell your healthcare provider if you gain or lose more than 4 pounds from your “dry” weight.
- Possible fluid restriction. Ask your doctor or nurse what your daily fluid limit is.
- Possible cardiac resynchronization therapy (biventricular pacemaker)
- Possible implantable cardiac defibrillator (lCD) therapy
If the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression to Stage D.
Stage D and reduced E
Patients with Stage D HF-rEF have advanced symptoms that do not get better with treatment. This is the final stage of heart failure.
Stage D treatment
The usual treatment plan for patients with Stage D heart failure includes:
- Treatments listed in Stages A, B and C
- Evaluation for more advanced treatment options, including:
- Heart transplant
- Ventricular assist devices
- Heart surgery
- Continuous infusion of intravenous inotropic drugs
- Palliative or hospice care
- Research therapies
Stages C and D with preserved EF
Treatment for patients with Stage C and Stage D heart failure and reserved EF (HF-pEF) includes:
- Treatments listed in Stages A and B
- Medications for the treatment of medical conditions that can cause heart failure or make the condition worse, such as atrial fibrillation, high blood pressure, diabetes, obesity, coronary artery disease, chronic lung disease, high cholesterol, and kidney disease
- Diuretic (“water pill”) to reduce or relieve symptoms