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Heart Diseases & Prevention 


Angina (Chest Pain)

Angina is chest pain or discomfort caused when the heart muscle doesn't get enough oxygen-rich blood. Angina is a symptom of heart disease that is often triggered by physical activity or stress, but can also occur when you are at rest or inactive.

Symptoms
Pressure or squeezing in the chest, shoulders, arms, neck, jaw or back.

Treatment
Generally, mild angina can be controlled with lifestyle changes and medications such as aspirin (to prevent blood clots), nitrates (to relax and widen blood vessels and increase blood flow), beta blockers (to make the heart beat slower and reduce its work), statins (to reduce cholesterol), calcium channel blockers (to widen blood vessels and reduce workload) or ACE inhibitors (to relax blood vessels).

Lifestyle changes include eating healthy, stopping tobacco use, losing weight, reducing cholesterol and high blood pressure, managing diabetes, exercising regularly and decreasing stress.

If lifestyle changes and medications are not effective at reducing the symptoms of angina, your doctor may recommend angioplasty or coronary bypass surgery.


Arrhythmia

An arrhythmia is an abnormal heart beat in which the heart beats too fast, too slow or too irregular. When the heart doesn’t beat properly, it doesn’t pump blood effectively which can result in damage to the lungs, brain and other organs. There are several types of arrhythmia, the most common include:

•  Atrial Fibrillation (also called A-Fib) – the upper heart chambers contract irregularly
•  Ventricular Fibrillation – a disorganized contraction of the lower chambers of the heart
•  Bradycardia – a very slow heart rate (less than 60 beats per minute in adults)
•  Tachycardia – a very fast heart rate (more than 100 beats per minute in adults)
•  Premature contraction – an early heart beat
•  Conduction disorders -- the heard does not beat normally

Symptoms

Symptoms of arrhythmia range from very mild to severe and include:
•  Mild – a skipped heart beat or fluttering sensation in the chest.
•  Severe – fatigue, dizziness, light headedness, fainting, very rapid or very slow heart beat, shortness of breath, chest pain.

Treatment
In some cases, medicine may be enough to keep arrhythmia under control. In other cases, minimally invasive options include cardioversion (shocking the heart back into rhythm) or ablations (destroying small areas of the heart that are causing the abnormal rhythm). In still other cases, patients may need surgery to implant a pacemaker or defibrillator. 


Atrial Septal Defect (ASD)
Atrial septal defects (ASD) are often present at birth and are characterized by an opening, or hole, in the dividing wall of the heart's upper chambers (atria).

Symptoms
M​any people with ASD do not have any symptoms and may not be diagnosed until adulthood. In most cases that are diagnosed, a heart murmur is detected. 

Treatment
​Typically, ASD does not require treatment. In some cases, medication may be prescribed to treat symptoms, or - if the hole is large enough - surgery may be performed to correct the defect. 


Heart Attack

A heart attack occurs when the flow of blood to a part of the heart is blocked by a blood clot. If the blood flow is cut off completely, the part of the heart muscle supplied by the blocked artery begins to die. That’s why it’s important to act fast and get medical help right away. If you think you are having a heart attack, take an aspirin and call 9-1-1 immediately -- do not drive to the hospital yourself.

Symptoms
No two heart attacks are the same – even in a repeat heart attack in the same person, symptoms can be very different. It is also important to know that women’s symptoms are often less dramatic than men and are often overlooked. Some people may have minor symptoms that go unnoticed for up to six weeks before they actually have a heart attack. Things to look out for include:
•  Chest discomfort – including pain, tightness, squeezing or pressure. While some people experience severe stabbing pains, other people (especially women) may just have a sense of pressure or tightness that can be in the center of the chest but may also be on the left or right side of the chest or in the lower abdomen. The important thing to remember is that if there is discomfort above the waist, it could be a heart attack.
•  Pain, discomfort or tingling in one or both arms, back, shoulder, neck or jaw.
•  Shortness of breath, especially if it is new and without an obvious reason.
•  Unusual sweating that comes on suddenly, is particularly extreme, doesn’t go away in a few minutes or keeps you awake at night. Women may confuse this symptom with night sweats or hot flashes, but if it lasts more than a few minutes, it could be a sign of a heart attack.
•  Nausea or vomiting, especially in women. Many women often confuse heart attack symptoms with food poisoning or a gastrointestinal issue.
•  Unusual tiredness or a profound sense of fatigue without an explanation.
•  Feeling faint, lighthearted or dizzy.
If you experience these symptoms, especially if they wake you up or they happen when you are sitting down, dial 9-1-1 immediately. Do not attempt to drive yourself or a family member to the hospital.

Treatment

Treatment for a heart attacks varies depending on the severity but includes:  
•  Medication -- treatment for a heart attack may initially include medications to open arteries such as aspirin, thrombolytics (clot busters), heparin
(blood thinner) or clot preventing drugs.

•  Angioplasty – performed in a cardiac catheterization lab, a catheter with a balloon is inserted into blocked the blocked artery and inflated to open the artery.
•  Stent – also performed in the catheterization lab, sometimes in conjunction with angioplasty, a small wire mesh coil is inserted into an artery to
hold it open.

•  Open heart surgery – also called coronary bypass surgery, an alternate route around the blocked artery is created to restore blood flow to the
heart.



Heart Failure

Heart failure is a chronic condition in which the heart’s ability to pump blood is reduced. As a result, patients often feel tired and weak and simple activities may seem exhausting. Heart failure can get worse if it is not treated and heart failure is the leading cause of hospitalization today.

Symptoms

People with heart failure typically experience:
•  Tiredness or weakness during activity
•  Shortness of breath
•  Swelling in the legs, stomach and lungs 

Treatment

While heart failure is a lifelong condition and does not go away, it can be managed through medication and lifestyle changes.
•  Medication – heart failure is treated with medications to make the heart beat slower and reduce its work (beta blockers) and to relax and widen
blood vessels and increase blood flow (nitrates).

•  Lifestyle changes – to live as long and healthy a life as possible, heart failure patients should avoid alcohol and tobacco, exercise moderately,
reduce salt intake and take all medicines prescribed by their physician to keep other conditions such as diabetes, high blood pressure or thyroid
issues under control.



Heart Valve Disease

The heart has four valves (aortic, mitral, tricuspid and pulmonary) that keep blood flowing efficiently and in the right direction. Valve disease occurs when one or more of these valves don’t open or close correctly, resulting in a disruption of blood flow to the body and an increased workload for the heart. While some people are born with valve disease, it also may occur as a result of the natural aging process, infections (such as rheumatic fever) or other heart conditions. Some forms of valve disease do not require medical intervention while others may cause serious or even life-threatening complications if left untreated. There are several types of valve disease, including:

•  Valvular stenosis - occurs when a valve doesn't open fully. In turn, the narrowed opening causes the heart to work harder in order to pump blood to the rest of the body. Without treatment, stenosis can lead to heart failure. Stenosis can occur in any of the four valves, but it is most common (and most dangerous) when it occurs in the aortic valve.
•  Valvular regurgitation or insufficiency - occurs when a valve doesn't close tightly and blood leaks backward across the valve. As the "leak" worsens, the heart has to work harder to supply blood to the body. Valvular regurgitation may simply be referred to as "leaky valve disease" and is most common in the mitral valve.
•  Congenital valve disease - occurs when a valve develops incorrectly before birth. The affected valve may be the wrong size or shape, or there may be a problem with the leaflets (the flaps that open and close with each heartbeat) of the valve. Mitral valve prolapse is a common congenital valve disease that usually doesn’t cause any problems or require treatment.

Symptoms
People with valve disease may not have symptoms for many years. Symptoms may include:
•  Abnormal sound (heart murmur) when a doctor is listening to the heart beating with a stethoscope
•  Fatigue 
•  Shortness of breath, particularly after physical activity or when lying down

•  Swelling of ankles and feet
•  Dizziness
•  Fainting
•  Irregular heartbeat

Treatment
The treatment of valve disease depends on which valve is affected and how severe the disease is. In some cases, treatment might include surgery to repair or replace the valve.


Hypertension (High Blood Pressure)

High blood pressure is when the force of the blood flowing through vessels is consistently high. Nearly half of American adults have high blood pressure but many are not aware of it because most of the time there are no symptoms. Left untreated, high blood pressure damages blood vessels and can lead to heart attack, stroke, kidney disease and vision problems. The best way to know if you have high blood pressure is to have your blood pressure checked regularly. A normal blood pressure is when the systolic pressure (upper number) is less than 120 and the diastolic pressure (lower number) is less than 80.

Symptoms
Often there are no symptoms of high blood pressure. 

Treatment
Treatment for high blood pressure includes medications and lifestyle changes:
•  Medication – many patients are started off with a diuretic to increase the amount of water and salt output in the urine. Other medications include ACE inhibitors, ARBs, beta blockers, calcium channel blockers, alpha blockers, alpha-agonists and renin inhibitors.
•  Lifestyle changes – lifestyle changes can be very effective in managing high blood pressure and include: exercising regularly, eating a healthy diet, losing weight, reducing salt intake and avoiding alcohol, tobacco and caffeine.


Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy occurs when the heart muscle becomes abnormally thick, making it difficult for the heart to pump blood efficiently.

Symptoms
Most people with hypertrophic cardiomyopathy have few symptoms and lead a normal life. Very rarely, they may die from sudden cardiac arrest. When symptoms do occur, they may include shortness of breath, chest pain, arrhythmia (irregular heartbeat), fainting, heart palpitations or heart murmur.

Treatment  
In severe cases that are identified, medications may be given to help the heart pump blood more effectively, reduce the risk of blood clots, restore normal heart rhythm or destroy defective tissue.


Left Atrial Appendage (LAA)
The left atrial appendage (LAA) is a pocket-like structure in the top left chamber of the heart. The LAA does not serve a significant purpose and is rarely a cause for concern. People with atrial fibrillation, however, are prone to blood clots in the left atrial appendage, so sometimes the structure is removed or destroyed to reduce the risk of stroke.


Patent Foramen Ovale (PFO)
The foramen ovale is a normal “hole” in the hearts of all developing babies. Patent foramen ovale (PFO) is a birth defect that results when the foramen ovale (located in the upper chambers of the heart) does not close properly. PFO is very common, occurring in about 25% of people.

Symptoms
​Most individuals do not have symptoms, although a physician may investigate for PFO if a patient has severe migraines with aura, a stroke or a mini stroke of unknown origin. 

Treatment
Oftentimes, treatment for PFO is not necessary. In more severe cases, treatment may include medication to thin the blood to help prevent the formation of blood clots. Closure of the PFO using a catheter-based procedure or surgery may also be discussed. PFO closure has a high success rate and carries with it a low risk of complications.


Structural Heart Disease
Structural heart disease is a broad term that refers to a variety of diseases related to the valves, walls or muscle of the heart. Some of the most common types of structural heart disease include aortic stenosis (the aortic valve does not open fully), mitral regurgitation (the mitral valve does not close fully) and patent foramen ovale, or PFO, an opening between the upper chambers of the heart.


Ventricular Septal Defect
A ventricular septal defect is an opening between the left and right ventricles of the heart, which may be present at birth or occur later in life following a heart attack. The gap allows oxygen-rich blood to flow into the right ventricle of the heart instead of out to the rest of the body, causing the heart to pump harder to make up for the lost blood.

Symptoms
​Most people do not have any symptoms or they may not have symptoms until adulthood. Symptoms in adults include shortness of breath or a heart murmur, while symptoms in babies may include poor eating, failure to thrive, fast breathing, shortness of breath or getting tired easily.

Treatment
The majority of people with small ventricular septal defects go on to live normal lives. When treatment is necessary, the opening may be plugged or patched using surgery or a catheter-based approach.