Heart Disease

The heart beats about 2.5 billion times over the average lifetime, pushing millions of gallons of blood to every part of the body. This steady flow carries with it oxygen, fuel, hormones, other compounds, and a host of essential cells. It also whisks away the waste products of metabolism. When the heart stops, essential functions fail, some almost instantly.

Given the heart's never-ending workload, it's a wonder it performs so well, for so long, for so many people. But it can also fail, brought down by a poor diet and lack of exercise, smoking, infection, unlucky genes, and more.

A key problem is atherosclerosis. This is the accumulation of pockets of cholesterol-rich gunk inside the arteries. These pockets, called plaque, can limit blood flow through arteries that nourish the heart — the coronary arteries — and other arteries throughout the body. When a plaque breaks apart, it can cause a heart attack or stroke.

Although many people develop some form of cardiovascular disease (a catch-all term for all of the diseases affecting the heart and blood vessels) as they get older, it isn't inevitable. A healthy lifestyle, especially when started at a young age, goes a long way to preventing cardiovascular disease. Lifestyle changes and medications can nip heart-harming trends, like high blood pressure or high cholesterol, in the bud before they cause damage. And a variety of medications, operations, and devices can help support the heart if damage occurs.

Heart diseases include:

  • coronary artery disease: the accumulation of cholesterol-filled plaque in the arteries that nourish heart muscle
  • heart attack (myocardial infarction): the sudden stopping of blood flow to part of the heart muscle
  • heart failure: the inability of the heart to pump as forcefully or efficiently as needed to supply the body with oxygenated blood
  • heart rhythm disorders: heartbeats that are too fast, too slow, or irregular
  • heart valve disorders: problems with the valves that control blood flow from one part of the heart to another part of the heart or to the body.
  • sudden cardiac arrest: the sudden cessation of the heartbeat
  • cardiomyopathy: a disease of the heart muscle that causes the heart to become abnormally enlarged, thickened, and/or stiffened
  • pericarditis: inflammation of the pericardium, a thin sac that surrounds the heart
  • myocarditis: inflammation of the myocardium, the middle layer of the heart wall
  • congenital heart disease: heart diseases or abnormalities in the heart's structure that occur before birth

Heart Disease Articles

Implantable Cardioverter Defibrillator (ICD)

An implantable cardioverter defibrillator (ICD) is a potentially lifesaving medical device that is placed inside the body. An ICD treats life-threatening abnormal heart rhythms (called arrhythmias), including ventricular fibrillation, which makes the heart's large muscular chambers (the ventricles) quiver without actually squeezing and pumping. When this happens, there is no real heartbeat and not enough blood flows to the brain or other organs, including the heart. As a result, a person with ventricular fibrillation passes out and can die within minutes. An ICD is made of two parts. The pulse generator looks like a small box. It is implanted under the skin below the collarbone. The box contains a lithium oxide battery (which lasts about five to nine years) and electrical components that analyze the heart's electrical activity. Connected to the pulse generator are one or more electrodes, which travel to the heart. When the ICD senses an abnormal heart rhythm, it administers a brief, intense electrical shock to the heart, correcting the abnormal rhythm. Many people say that the shock feels like being punched in the chest, although the amount of discomfort varies. In addition to "zapping" the heart back to a normal rhythm, ICDs also can generate milder electrical impulses. These impulses can artificially regulate or "pace" the heartbeat if the heart develops other types of arrhythmias. For example, ICD impulses can help to slow down the heart when a person has ventricular tachycardia, an abnormally fast heartbeat. ICD impulses also can speed up the heartbeat in cases of bradycardia, an abnormally slow heartbeat. (Locked) More »

Advice about taking aspirin and statins after age 75

Low-dose aspirin and statins are mainstays for preventing heart disease. But for people ages 75 and older, there is less information about the safety and efficacy of these drugs than there is for younger people. According to estimates, nearly half of people ages 70 and older without heart disease take daily aspirin. But as people age, they may be more prone to bleeding, a potentially dangerous side effect of aspirin. Statins are associated with fewer and less serious complications than aspirin, yet people tend to worry more about statin side effects, especially muscle aches. For avoiding heart attacks, taking a statin is probably a safer and more effective approach than taking aspirin. But older people should consult with a doctor about whether to start, stay on, or stop either of these medications. (Locked) More »

Are the new blood thinners better than warfarin (Coumadin)?

For 50 years, warfarin was the only choice for people who needed to take an oral anticoagulant (blood thinner). New drugs called direct oral anticoagulants (DOACs) are just as effective as warfarin in preventing strokes in people with atrial fibrillation and normal heart valves. (Locked) More »

Are you getting enough sleep?

People who consistently get less than six hours of sleep nightly face a higher risk of heart disease, as well as other, often co-occurring conditions such as diabetes and obesity. Strategies such as avoiding bright lights at night and only getting into bed when drowsy may help. People with insomnia (difficulty falling or staying asleep) may benefit from cognitive behavioral therapy for insomnia, which teaches people to change the unproductive thinking patterns and habits that get in the way of a good night’s sleep. More »

Dealing with the discomfort of angina

Angina pectoris is often defined as chest pain due to an inadequate supply of oxygen to the heart muscle. But most people describe the feeling as a sense of heaviness or pressure. It can also cause discomfort in the neck, jaw, and shoulders. Anything that increases blood flow to the heart, including exercise or periods of intense emotion, can trigger angina. Unstable angina (which is a medical emergency) occurs during rest or slight exertion. A number of medications can help ease angina. (Locked) More »

Target heart rate on a beta blocker

People who take beta blockers (which lower the heart rate and blood pressure) may not be able to reach their target heart rate during exercise. Instead, they can use the perceived exertion scale to assess how hard they’re exercising. (Locked) More »

When the heart beats too slowly

Bradycardia, defined as a heart rate is below 60 beats per minute, is common in older adults, usually after age 70. Most people don’t experience symptoms, but those who do may feel dizzy, lightheaded, fatigued, breathless, or confused, and may faint. The condition may result from normal, age-related degeneration of the sinoatrial node, the heart’s natural pacemaker. Another underlying cause is a problem with the atrioventricular node, located in the center of the heart. (Locked) More »