What Is Heart Disease?

Heart Disease (aka Cardiovascular Disease) results from narrowing and hardening of blood vessels.

Heart Disease, also known as Cardiovascular Disease refers to a condition that results from the buildup of plaques in blood vessels. While Cardiovascular Disease is commonly referred to as “Heart Disease”, the disease does not just affect the blood vessels of the heart. Heart Disease can and often does affect blood vessels anywhere in the body. High blood pressure, diabetes and high blood cholesterol have all been linked to the formation of the blood vessel plaques that cause heart disease. As plaques in blood vessels grow, they cause blood vessels to become narrow, harden and become more weak. As blood vessels narrow, harden and become more weak, less blood can flow through them. When blood flow through narrow, harden, weak blood vessels is diminished, less of the oxygen and nutrients carried in blood is able to get to the body’s organs. Over time, diminished oxygen and nutrients can damage and injure organs.

Why Is Heart Disease Dangerous?

When blood flow to the heart is blocked, a “heart attack” results and heart muscle dies.

Heart disease is dangerous simply because it damages the body’s blood vessels. Blood vessels are the “roadways” used by the body to deliver oxygen and nutrients to the various organs. When these “roadways” become damaged, one of two things can occur. Damaged blood vessels can either become too narrow to effectively deliver blood to the body’s organs. Or, damaged blood vessels can become too weak and fragile to properly do their job. When damaged blood vessels become too narrow to effectively deliver blood to the body’s organs, all or part of the organs supplied by the damaged blood vessels can die. On the other hand, when damaged blood vessels become too weak or fragile, they can rupture or burst under the force of the blood flowing through them. Ruptured blood vessels, just like narrow blood vessels, are no longer able to effectively deliver blood to the body’s organs. This again can cause all or part of the organs supplied by the ruptured blood vessel to die.

When blood flow to a portion of the brain is not adequate, a “brain attack” or stroke results.

The two organs most susceptible to heart disease are the heart and the brain. This is because the heart and the brain never rest. They are working constantly. This constant work means that the heart and the brain need lots of oxygen and nutrients. When blood vessels supplying the heart have either narrowed or ruptured, the heart does not get enough oxygen and nutrients. This leads to a “heart attack”. A heart attack simply means that parts of the heart muscle have died due to oxygen and nutrient “starvation”. When blood vessels supplying the brain have either narrowed or ruptured, the brain does not get enough oxygen and nutrients. This leads to a “brain attack” also known as a stroke. A stroke simply means that parts of the brain have been damaged due to oxygen and nutrient “starvation”.

What Are Symptoms of Heart Disease?

Common symptoms of heart disease can include chest pain (angina), shortness of breath and pain in the neck, jaw, throat, upper abdomen and back. Heart disease can also present with pain, numbness, weakness or coldness in the arms or legs or just with simple fatigue.

How Is Heart Disease Diagnosed?

There are a number of different tests that can be used to diagnose heart disease.

ECG

• Electrocardiogram (ECG) : ECG’s measure the electrical signals flowing through the heart. When heart disease has caused damage to heart muscle, the flow of electricity through the damaged part of the heart may be compromised. This will cause abnormal ECG readings that help diagnose heart disease.
• Holter Monitoring: Like ECG’s, Holter monitors measure the electrical signals flowing through the heart. Holter monitors however are portable, and can be worn so that a continuous ECG reading is obtained, usually over a 24 to 72 hour period.
• Catheterization: During a cauterization procedure, a catheter tube is inserted through a blood vessel and then guided through the circulation until it reaches whatever blood vessel(s) there is concern maybe damaged by plaques. A dye is then passed through this catheter, and the flow of blood through the blood vessel(s) being examined can be assessed. If the blood vessel is damaged by plaques, the flow of blood through it will not be normal. Catheterization can be used to determine whether or not the blood flow through blood vessels supplying the heart or the brain has been compromised.
• Computerized Tomography (CT) Angiography Scan: During a CT Angiography scan, a dye material is placed in the circulation. CT scan pictures of the dye flowing through the blood vessels supplying either the heart or the brain can taken. These pictures can help to determine whether or not these blood vessels are narrowed or damaged.
  

  Heart Ultrasound (Echo)

• Ultrasound: Ultrasound of the heart is called echocardiogram. Echocardiograms can be used to assess both the structure and the function of the heart. When heart muscle tissue has been damaged by heart disease, the muscle may either look or function differently. Ultrasound will pick this up. Ultrasound can also be used to visualize the flow of blood through the carotid arteries. The carotid arteries are the blood vessels in the neck that lead from the heart to the brain. If these blood vessels have been damaged and narrowed, this can be seen on a “Carotid Artery Ultrasound”.
• Magnetic Resonance Imaging (MRI): Like a CT scan, an MRI of the brain and heart can provide detailed images of the brain, the heart and the blood vessels of the brain and the heart. If these blood vessels have been narrowed by heart disease, this can be easily seen on MRI.

How Can Heart Disease Be Prevented?

The most common causes of cardiovascular disease/heart disease include high blood pressure, high blood sugar (diabetes), high blood cholesterol and triglyceride levels and smoking. Heart disease can therefore be prevented by maintaining healthy blood pressure, healthy blood sugar and both healthy blood cholesterol and blood triglyceride levels. Avoiding the use of tobacco can also help to prevent heart disease.

Healthy blood pressures can be maintained by doing the following;

Exercising can lower blood pressure significantly.

• Eating a diet that is low in salt (i.e. no more than 1500-2300mg of sodium per day).
• Avoiding tobacco.
• Consuming no more than a moderate amount of alcohol each day. Moderate alcohol use for healthy adult women of all ages means no more than one drink per day. Moderate alcohol use for healthy adult men older than 65 also means no more than one drink per day. For healthy adult men younger than 65 however, moderate alcohol use means no more than two drinks per day. And if you are wondering what exactly “one drink” means? For beer, one drink means 12 fluid ounces. For wine, one drink means 5 fluid ounces. For distilled spirits (80 proof), one drink means 1.5 fluid ounces.
• Maintaining a healthy weight with a Body Mass Index (BMI) of 18.5-24.9.
• Exercising regularly by getting at least 150 minutes of moderate aerobic activity every week, 75 minutes of vigorous aerobic activity every week or a combination of the two.
• Taking medications to treat high blood pressure when it does not respond to the above lifestyle modifications.

Eating the ideal diabetic diet can prevent high blood sugar

Healthy blood sugars can be maintained by doing the following

• Exercising regularly. This means getting at least 150 minutes of moderate aerobic activity every week, 75 minutes of vigorous aerobic activity every week or a combination of the two.
• Maintaining a healthy weight with a Body Mass Index of 18.5-24.9
• Eating a healthy “Ideal Diabetic Diet”. A good rule of thumb when trying to eat a healthy diet is to properly portion your meals. 50% of your plate should have non-starchy vegetable. These vegetables include things like asparagus, Brussel Sprouts, carrots, mushrooms, beans and baby corn. 25% of your plate should have starchy vegetable like potatoes or peas. The remaining 25% of your plate should have proteins like fish and poultry.
• Getting 7-8 hours of sleep a night.
• Taking medications to treat high blood sugar when it does not respond to the above lifestyle modifications.

Healthy blood cholesterol and triglyceride levels can be maintained by doing the following;

Eating a high fiber diet can prevent high cholesterol.

• Limiting in-take of foods rich in saturated fats.
• Limiting in-take of foods rich in trans fats.
• Limiting in-take of foods rich in cholesterol.
• Eating foods rich in fiber.
• Eating foods rich in unsaturated fats.
• Maintaining a healthy weight with a Body Mass Index (BMI) of 18.5-24.9.
• Exercising regularly. This means getting at least 150 minutes of moderate aerobic activity every week; 75 minutes of vigorous aerobic activity every week or a combination of the two.
• Testing and appropriately treating both high blood cholesterol and high blood triglyceride levels if present.
  1. 1. Men at high risk for heart disease should start having their blood cholesterol checked regularly as early as age 20.
     2. Women at high risk for heart disease should start having their blood cholesterol checked regularly as early as age 30.
     3. Men at low risk for heart disease should start having their blood cholesterol checked regularly at age 35.
     4. Women at low risk for heart disease should start having their blood cholesterol checked regularly at age 45.
• Eating a moderately low fat diet that includes no more than 25%-30% of daily calories coming from fat.
• Limiting the daily in-take of sugar to no more than 100 grams for women and 150 grams for men.
• Eating foods that are rich in omega-3 fatty acids.
• Eating foods rich in unsaturated fats.
• Drinking alcohol in moderation can help to prevent high blood triglycerides. Moderate alcohol use for healthy adult women of all ages means no more than one drink per day. Moderate alcohol use for healthy adult men older than 65 also means no more than one drink per day. For healthy adult men younger than 65 however, moderate alcohol use means no more than two drinks per day. And if you are wondering what exactly “one drink” means? For beer, one drink means 12 fluid ounces. For wine, one drink means 5 fluid ounces. For distilled spirits (80 proof), one drink means 1.5 fluid ounces.
• Taking medications to treat high cholesterol and/or high triglycerides when they do not respond to the above lifestyle modifications.

How Is Heart Disease Treated?

Heart disease can be treated using both medications and surgical procedures. Medications used to treated heart disease typically include those medications that are used to treat the common underlying causes of heart disease (i.e. high blood pressure, diabetes, high blood cholesterol and high blood triglycerides).

Medications to treat high blood pressure, high cholesterol and diabetes can all treat heart disease.

Medications used to treat high blood pressure can include Diuretics, Beta-Blockers, Calcium Channel Blockers, Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Vasodilators. More about these medications can be found HERE.

Medications used to treat diabetes include Metformin, Sulfonylureas, Meglitinides, Thiazolidinediones, DPP-4 Inhibitors, SGLT2 Inhibitors and GLP-1 Receptor Agonists. More about these medications can be found HERE.

Medications used to treat high cholesterol and high triglycerides include Statins, Bile-Acid-Binding Resins, Cholesterol Absorption Inhibitors and certain injectable medications. More about these medications can be found HERE.

Surgical procedures used to treat heart disease include Angioplasty, Coronary Artery Bypass Grafting (CABG) and Carotid Artery Endarterectomy (CEA).

Catheter with balloon used to perform angioplasty.

• Angioplasty: Angioplasty utilizes a thin, flexible catheter tube with a balloon on the end of it. This tube is threaded through the circulation until it reaches the narrowed or blocked blood vessel that the angioplasty is targeting. Once in the narrowed blood vessel, the balloon on the end of the catheter tube is inflated. Inflating the balloon compresses the plaque that is narrowing the targeted blood vessel. This restores the flow of blood through the previously diseased blood vessel.
• Coronary Artery Bypass Grafting (CABG): CABG is a major surgical procedure that is used to replace damaged blood vessels leading to the heart. During a CABG, healthy blood vessels are taken from other areas of the body. They are then used to replace diseased blood vessels in the heart. This helps to restore good blood flow to the heart.

Carotid artery providing primary blood supply to the brain.

• Carotid Endarterectomy (CEA): CEA is a major surgical procedure that is used to replace damaged blood vessels leading to the brain. The main blood supply to the brain travels from the heart to the brain by way of the Carotid Artery. The Carotid Artery runs through the neck. When plaques form in the Carotid Artery, blood flow to the brain can be compromised and strokes can result. During a CAE, a diseased Carotid Artery is cut open and any damaging plaques that have formed within it are removed.

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