Angina
What is it?
Also known as angina pectoris, angina refers to pain originating from the heart. The painful condition occurs when the heart muscle tissue does not receive enough oxygen, especially during exercise or excitement. An attack of angina pectoris is not a heart attack. However, it signals the presence of conditions that could lead to a heart attack.
What causes it?
Coronary heart disease and coronary spasms are usually the cause of angina because these conditions restrict the heart's blood flow, resulting in an oxygen deficit for the heart muscle tissue.
What are the symptoms?
The angina attack sensation may be felt as chest pain or pressure in the chest. Most often, there is a feeling of tightness in the chest, which may spread to the neck, jaw, shoulders, and occasionally one or both arms (sometimes spreading as far as the hands). Some conditions even involve the upper abdomen. The sensation of suffocation and even impending death frequently accompanies an attack of angina.
What is the treatment?
Lifestyle changes provide the greatest improvement. For example, weight loss helps to reduce the strain on the heart. In addition, stopping smoking and controlling hypertension (high blood pressure) combined with a moderate exercise routine are highly effective. All these modifications improve heart circulation, which reduces the incidence and/or severity of angina episodes.
In conjunction with lifestyle changes, medications may be prescribed for optimal benefit. Nitroglycerine may help to ease the pain during an angina attack. Beta-blocker medications also reduce chest pain by reducing the amount of oxygen the heart muscle requires and regulating the heart rate. Calcium channel blocker medications are also helpful in controlling angina.
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Arteriosclerosis/Atherosclerosis
What is it?
Arteriosclerosis is a disorder characterized by a progressive thickening and hardening of the walls of the arteries, often called "hardening of the arteries." The hardening and thickening of the arteries causes a decrease in the blood circulation through the affected vessel and adversely impacts the organs.
Atherosclerosis is the accumulation of fatty deposits (plaque) on the interior lining of the arterial walls. This plaque accumulation iinterferes with blood flow. If the accumulation becomes too great, it may cause a complete blockage through the artery, in turn, leading to tissue damage to the areas served by the affected blood vessel.
What causes it?
Although atherosclerosis is known to be part of the normal aging process, other factors increase its likelihood and severity. These conditions include hypertension, smoking, obesity, diabetes, high cholesterol, inactivity, and genetics (family predisposition).
What is the treatment?
There is no known cure for atherosclerosis. Making positive lifestyle changes to reduce the impact of cardiac risk factors (obesity, smoking, inactivity and diet) to reduce high cholesterol levels are the best ways to minimize the effects.
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Congestive Heart Failure (Chf)
What is it?
Congestive heart failure refers to the condition of the heart when it can no longer maintain the normal body blood flows. In congestive heart failure, the heart becomes progressively inefficient as the volume of blood in the veins increases, causing the veins to become dilated (expanded). As a result, the lungs, liver, and intestines become congested with blood.
What causes it?
Causes include weakness of the heart muscle, hypertension (high blood pressure), heart attack, chronic lung disease (emphysema), heart valve disease, hyperthyroidism, certain viral illnesses, arrhythmias, severe anemia or pulmonary embolism.
What are the symptoms?
Symptoms include shortness of breath, weakness and swollen ankles (a type of edema).
What is the treatment?
Treatment focuses on reducing the fluid volume in the circulatory system. Diuretics (to promote urination to run off these fluids) may be prescribed. A salt-free diet is often ordered because salt causes fluid retention (bloating). Additionally, digitalis may be prescribed to strengthen the heartbeat. Other drugs that dilate the arteries may be taken to ease the heart's ability to pump blood. More severe or acute cases of congestive heart failure may require bed rest or hospitalization. Oxygen may be required in some cases to facilitate breathing.
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Fibrillation
What is it?
A rapid, irregular twitching of the heart muscle tissue.
What causes it?
In order to function as a pump, the muscle tissue of the heart must contract and relax in an even, coordinated manner. When the nervous tissue controlling the rate of contraction and relaxation of the heart muscle tissue is compromised through disease, age or trauma, the coordination is lost.
This loss of coordination may affect either of the two sets of chambers of the heart.
- Atrial fibrillation is the extremely rapid twitching of the upper chambers (atria) of the heart. When the atria cease to contract rhythmically, the ventricles do not receive a regular stimulus to trigger their contraction. This results in an inefficient pumping of the blood and in irregular pulse. Causes of this condition include many types of heart disease, such as coronary artery disease, hyperactivity of the thyroid gland or alcohol abuse.
- Ventricular fibrillation is similar to atrial except it affects the lower chambers of the heart (the ventricles). This condition may have fatal results within minutes because the rapid, fluttering of the ventricles pumps little or no blood through the circulatory system of the body. This condition may be caused by coronary thrombosis, drugs such as digitalis, excessive diuretic use, or electric shock.
What is the treatment?
Atrial fibrillation (see above) is typically controlled by digitalis or other medications to control the heart rhythm. If fibrillation is associated with thyroid disease (as a symptom of a thyroid problem as opposed to a condition itself), appropriate treatment of the thyroid is required. Ask your physician for further information.
Ventricular fibrillation is an emergency condition that is treated as a cardiac arrest. Subjecting the heart to a controlled electrical shock with a defibrillator attempts to restore the regular heartbeat.
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Heart Murmur
What is it?
An abnormal sound produced by blood flowing through the valves and chambers of the heart.
What are the symptoms?
Often there are no overt symptoms, but patients may experience a periodic "fluttering" or suddenly become aware of their heart rate, especially in calm states (sitting, laying down at night, etc.), which feels excessive for the activity.
What is the treatment?
Consultation of a cardiologist is recommended when a heart murmur is present. Many cases simply require periodic monitoring. Other cases may be more severe, such as murmurs caused by defective valves inside the heart, which can require surgical intervention.
Any patient diagnosed with a heart murmur should advise their physician or dentist before undergoing surgery or dental work. Antibiotics may be prescribed before the procedure to prevent potential bacterial endocarditis.
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Hypercholesterolemia
What is it?
Hypercholesterolemia (high cholesterol) is a condition by which the serum cholesterol levels in the body are above normal. As a fatty substance found in all animal tissue, cholesterol makes up an important part of cell membranes. The liver uses cholesterol to manufacture bile, and the body uses it to produce certain hormones, including sex hormones.
What causes it?
The body manufactures its own cholesterol, but it also absorbs it through fatty foods. When cholesterol levels become too high, the excess cholesterol is deposited as fatty plaque on the interior walls of the arteries, which can lead to blockages.
What are the symptoms?
There are no outward symptoms, but blood test can detect levels. Total serum cholesterol levels are monitored as well as the amount of specific types of cholesterol transport molecules. In many studies, high-density lipoproteins (HDL, also known as "good cholesterol") may actually provide protection from heart attacks. However, low-density lipoproteins (LDL, or "bad" cholesterol) have been linked to certain diseases, particularly atherosclerosis.
Risk Level LDL ("Bad") Level
Low Risk < 100
High Risk > 160
Risk Level HDL ("Good") Level
Decreased Risk > 60
Increased Risk < 40
What is the treatment?
Lowering total serum cholesterol levels and reducing LDL (the "bad") can be done through lifestyle change (nutrition adjustments) and in some cases, with medication. Most frequently, improvements are reached when patients implement diet adjustments that limit fat to no more 30 percent of calorie. Aerobic exercise also has been shown to reduce serum cholesterol levels and boost HDL ("good cholesterol") levels. According to research, not smoking and limiting alcohol tend to help lower cholesterol levels as well. When these steps are insufficient, medications may be prescribed.
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Hypertension
What is it?
Most commonly known as high blood pressure, hypertension means a person's blood pressure is consistently above normal. Although blood pressure varies from person to person, and from time to time for individuals, readings for a person at rest of 140/90 (diastolic and systolic, respectively) or above are considered abnormal.
What causes it?
High blood pressure doesn't have a specific cause but it's frequently a result of other conditions including kidney disease, diseases of the arteries, and tumors, especially of the adrenal glands. Predisposing factors include genetics (family history), obesity, smoking, high salt intake, high stress levels, and excessive alcohol intake. High blood press is more common for African Americans than Caucasians and its incidents increase with age in all groups.
How dangerous is it?
High blood pressure is an important risk factor for several diseases. As blood pressure rates accelerate, so does the likelihood of developing stroke, heart attack, kidney failure, retinal (eye) damage, and brain tissue dysfunction.
What are the symptoms?
It's often called the "silent killer" because hypertension provides no blatant symptoms. It's typically diagnosed during a routine medical examination, which is another reason physicians encourage annual check-ups even in seemingly healthy individuals.
What is the treatment?
These treatments are simple via daily medications, which usually include diuretics to rid the body of excess salt and fluid retention. This progress is easily monitored through routine pressure readings. However, if left untreated or undetected, episodes of extremely high blood pressure may cause severe headache, heart failure and visual disturbances. Extended periods of hypertension may weaken the walls of the blood vessels, making them prone to bulging (aneurysm) or bursting (internal hemorrhage or stroke).
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Pericarditis
What is it?
An inflammation of the membranous sac that surrounds the heart.
What causes it?
Many different conditions can lead to pericarditis, but the most common cause is a viral infection. Other conditions that can cause it or create environments favorable to it are bacteria, tuberculosis, rheumatoid arthritis, systemic lupus erythematosus and uremia.
In some patients it can be a cancer complication from other organs, such as lungs.
What are the symptoms?
Primarily, pain in the center of the chest, which may vary in intensity and I soften exacerbated by movement or coughing. Additional symptoms can include fever, breathlessness, coughing and rapid pulse.
What is the treatment?
Care options focus on the initial underlying causes. If viral infection is the cause, antibiotics are prescribed. In early stages of Pericarditis, painkillers may provide relief.
What are the complications?
The most serious complication is the accumulation of fluid in the pericardium (pericardial tamponade). This causes pressure on the heart and a rapid heart rate. Another form called constrictive pericarditis causes scarring and thickening of the pericardium. This condition may lead to progressive heart failure with increased shortness of breath, liver enlargement and edema (accumulation of fluids).
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