What Is Heart Disease?

• Heart disease /cardiovascular disease is a class

of diseases that affects the heart and blood vessel

many of which are related to a process called

atherosclerosis.

• Cardio –relates to the heart

• Vascular –relates to the veins and arteries

• Atherosclerosis is a condition that develops when

a substance called plaque builds up in the walls of

the arteries This buildup narrows the arteries,

making it harder for blood to flow through. If a

blood clot forms, it can stop the blood flow.

COMMON TYPES OF HEART DISEASE

Preventable –

• Heart disease can affect the structure of the heart –valves ,muscles ,fibers and

blood supply e.g. coronary heart disease – disease of the blood vessels supplying

the heart muscle.

• The common cause of coronary heart disease result from - Atherosclerosis –this is

a condition that develops when a substance called plaque builds up in the walls of

the arteries. Coronary arteries that supply the heart muscle become blocked And as

a result can cause:

• Hypertension (increased pressure )

• Angina /Ischemic heart disease (partially blocked)

• Heart attack /M.I(Fully blocked )

• Heart failure (damaged valves and enlargement),arrythmias (damaged heart fibers)

COMMON TYPES OF HEART DISEASE • Heart disease can also result from infection –rheumatic

heart disease – damage to the heart muscle and heart valves

from rheumatic fever, caused by streptococcal bacteria ,and

endocarditis .

Non-preventable –

• Heart disease can also be congenital -congenital heart

disease - malformations of heart structure existing at birth

Risk Factors

Modifiable risk factors-Some risk factors can be avoided or altered, potentially

slowing the disease process or even reversing it. These factors include:

• elevated serum lipid levels

• hypertension

• cigarette smoking

• diabetes mellitus

• sedentary lifestyle

• stress

• obesity—especially abdominal (waist measurement greater than 40″ [101.6 cm] in

men and greater than 35″ [88.9 cm] in women)

• excessive intake of saturated fats, carbohydrates, and salt.

Risk Factors Con’t

Non-modifiable risk factors- there are four non-modifiable

factors increase a person's risk of cardiovascular disease:

• age

• male gender

• family history

• race.

Common signs and symptoms

Heart disease Signs and symptoms

Hypertension -A sustained blood pressure above 140/90mmhg .

Dizziness ,or may be ASYMPTOMATICComplications- Cardiac complications include CAD, angina, MI, heart failure, arrhythmias, and sudden death,stroke,blindness,kidney failure

Hypertrophic cardiomyopathy—primary disease of the heart muscle that's characterized by a thickened, inflexible heart muscle-results from extensively damaged myocardial muscle fibers

shortness of breath,fatiguedry cough at night,palpitations,nauseaEdema of the legs , chest pain

Common signs and symptoms

Heart disease Signs and symptoms

Heart attack /MI

Angina /ischemic heart disease

Symptoms: chest /thumb /back pains that is not relieved by rest or medications .(nitrates)light headednessAnxiety/nervousnessPalenessIncreased, irregular heart rate

Chest pain is relieved by medications and rest.

Heart failure -When the heart can't pump effectively enough to meet the body's metabolic needs, heart failure occurs

Fatigue, Difficulty breathing,dependent edema, unexplained, steady weight gain,nausea,chest tightnessslowed mental response, anorexia

How is heart disease

diagnosed? LABORATORY TESTING –measures heart enzymes/proteins and reveals the

extent of damage and monitor healing.

• Creatine kinase (CK)-Elevated levels indicate death to heart muscles.

• Ischemia-modified albumin (IMA)-indicates lack of oxygen supply to

the heart .

• Myoglobin- indicates damage to the heart muscle

• Troponin I and T-indicates heart damage

• Cholesterol levels-detects cholesterol levels-LDL/HDL

GRAPHIC RECORDING STUDIES –used to detect heart disorders .

• ECG- graphically records electrical current generated by the heart.

• Exercise ECG(stress test)-assess heart response to an increased

workload.

How is heart disease diagnosed? Imaging studies –

• Chest X-ray-may detect enlargement or structural

changes of the heart

• Echo- visualize heart size and shape, heart wall thickness

and motion, and cardiac valve structure and function

• CT /MRI-detect changes in the structure of the heart

Interventional studies –

• Cardiac catheterization and coronary angiography-

determines location of blockage ,pressure and oxygen

levels of the heart.

How is heart disease

treated ?Treatment of heart disease depends on the causative

factor or the disorder present;

• Pharmacological –medications may be used to reduce

blood pressure(anti –hypertensives),control heart

rate(ant-arrythmias) ,reduce pain(anti –anginal) ,lower

cholesterol(anti –lipidemics),dissolve or prevent blood

clots (anti –platelet /thrombolytics)and reduce fluid

accumulation(diuretics)

How is heart disease treated ?• Non –pharmacological -lifestyle changes-education,diet (DASH

diet ),exercise

• Invasive interventions (surgery)

• Coronary artery with an autogenous graft-restores blood flow to

the heart

• Bypass grafting -bypasses the obstruction resulting from

arteriosclerosis

• Embolectomy- removes the blockage (blood clot)

Valve repair

HOW CAN HEART DISEASE BE

PREVENTED ?DIETARY MEASURES-These are based on the DASH (Dietary

Approaches to Stop Hypertension)• • Limiting use of salt to less than 2.4 grams of sodium (6

gm salt) per day i.e. no added salt in cooking or at table); avoid canned foods, salted meat, etc.

• • Reducing excessive dietary fat (especially saturated fat and trans-fatty acids) to no more than 30% of calories. Saturated fat should not exceed 10% of total calories.

• • Ensuring intake of fibre of at least 30-40 gm/day.• • Ensuring intake of potassium between 70-80 mmol/l

daily. This can be achieved by a good selection of fruits and vegetables especially bananas,tomatoes and oranges as well as coconut water.

• Avoiding red meat .

HOW CAN HEART DISEASE BE PREVENTED ?

Physical Exercise

• This should be undertaken for 30-60 minutes at least five times

each week,but preferably daily. Walking is the easiest form of

exercise for most people.

Weight Management

• This aims at the attainment and maintenance of desirable body

weight i.e.

• BMI <25 or at least a significant reduction, if overweight or

obese. There is a possibility of 5-20 mmHg decrease in systolic

pressure for every 10kg (22lb) weight loss.

HOW CAN HEART DISEASE BE PREVENTED ?

Reduction of Alcohol Intake

• Alcohol use should not exceed 2 drinks/day for men and 1

drink/day for women. (1 drink = one ounce of spirits or 1 bottle

of beer or 1 glass of wine)

Cessation of Tobacco Use

• Tobacco should be avoided.

Education

• Every opportunity should be taken for education of the patient,

with partner and relatives. The education should include diet,

exercise and other lifestyle advice(stress reduction)