What is heart disease?
There are a lot of different names for heart disease but some describe the causes and others the symptoms. Essentially heart disease covers any breakdown of normal heart function that affects its performance as a pump, supplying oxygen-rich blood to all parts of the body including the heart muscle itself.
Causes of heart disease
The heart’s own oxygen needs (as a pump made of muscle) is supplied via the coronary arteries which are narrow arteries branching off the main blood vessel out of the heart, the aorta. These small arteries run over the surface of the heart supplying the heart muscle; if they become narrowed or blocked the heart muscle cannot get enough oxygen and thus cannot work properly. This narrowing is called coronary heart disease (CHD) or ischemic heart disease and is caused by fatty deposits (mainly cholesterol) in the artery walls which clog up the arteries, narrowing and hardening them so that blood flow is restricted (atherosclerosis).
This fatty deposit (plaque) can also cause a blood clot to form, which may then block the blood flow completely; this may result in a heart attack because the muscle beyond the clot can’t get oxygen and dies.
This can be life-threatening by causing:
What are the symptoms of ischaemic heart disease?
Chest pain from narrowing of the arteries is called angina and is often the first sign that something is wrong. This is felt as tightness in the chest or pain that can spread from the chest to the arm. Exercise and exertion commonly cause angina to come on. Breathlessness on exertion can sometimes be the only symptom of angina. The pain will usually dissipate with rest or after a few minutes.
Chest pain of a heart attack is similar but usually more severe, described as a severe crushing pain across the chest that does not subside.
Other symptoms of heart disease, especially in persons over age 50 may be:
Heart disease is more common in people who:
Many people will often have a combination of these risk factors which greatly increases the risk.
Prevention and treatment
Although you can’t do much about some of the above risks such as getting older or your ethnicity, there are plenty of measures you can take at any age to reduce your risk.
1. Lifestyle changes
2. Risk assessment
There are a number of accurate ways (computerised) to assess your risk which your general practice nurse or doctor can administer. If your 5-year risk is high (greater than 15%) then you will need to consider medications for blood pressure, cholesterol or to prevent clotting.
If you suspect you have a heart condition go to your medical practitioner who will ensure that you have the appropriate risk assessment and diagnostic tests.
Angioplasty (PCTA or PCI) – A balloon is inserted into the coronary arteries (via an artery in your groin) and then inflated to widen them and prevent blockage. A stent (fine metal mesh tube) will usually be inserted into the artery to hold it open.
Coronary artery bypass surgery (CABG) – After opening up the chest under general anaesthetic, a blood vein is taken from another part of the body (usually the leg) and attached to the aorta at one end and the blocked coronary artery at the other, so that blood flow can bypass the blockage and get to the heart muscle.
5. Living with a heart problem
(if you have known ischaemic heart disease)
For more about Heart Disease visit heartfoundation.org.nz
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