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

Are erectile dysfunction pills safe for men with heart disease?

In men without cardiovascular disease, erectile dysfunction (ED) pills are safe. The three rivals -- Viagra, Cialis, Levitra and Stendra-- have similar side effects, including headache, facial flushing, nasal congestion, diarrhea, backache, and, in a few Viagra or Levitra users, temporary impaired color vision (men with retinitis pigmentosa, a rare eye disease, should check with their ophthalmologists before using these medications). Headaches and blue vision are one thing, cardiac abnormalities, quite another. Are ED pills safe for the heart? More »

Heart disease and erectile function

Men: Don't be surprised if a discussion with your doctor about erection problems veers into a talk about your heart, or vice versa. Problems getting or keeping an erection may be a red flag for heart trouble down the road, and many men with heart disease have sexual concerns they aren't talking about. The connection between heart disease and erection problems (doctors call it erectile dysfunction) isn't far-fetched at all. Both follow the same age-related trajectory and become increasingly common from age 45 onward. They even share common causes. A study of middle-aged California men begun many years ago shows that smoking, overweight, and high cholesterol or high triglycerides — all risk factors for heart disease — were also linked with erection problems 25 years later.  More »

When You Visit Your Doctor - Mitral Valve Prolapse

Have you had an echocardiogram? What did it show? Does your mitral valve leak? Do you get chest pain? What brings it on? How long does it last? What relieves it? Do you ever get a rapid or pounding heartbeat (palpitations) for no reason? How long does it last? Do you feel faint or develop chest pain or shortness of breath? Have you ever fainted? Do you get short of breath when you lie down or exert yourself? Have you ever taken any medications for your heart? Did you develop any side effects from these medications? Heart rate, blood pressure, and weight Heart (sometimes while you are standing, squatting, or performing other maneuvers) Lungs Electrocardiogram Echocardiogram Holter monitor or event monitor   More »

When You Visit Your Doctor - Peripheral Artery Disease

Do you develop pain, cramps, aches, fatigue, or numbness in your leg muscles when you walk? At what distance do you develop symptoms? Do they go away when you stop walking? Do you ever develop these symptoms at rest? Do you have decreased sensation in your feet? If you are a man, do you have erectile dysfunction? Are you doing everything possible to modify the risk factors that can worsen this disease (smoking cessation, treating elevated blood pressure and cholesterol, and controlling diabetes)? Are you exercising regularly and at progressively more strenuous levels? Are you taking an aspirin every day? If you have diabetes, do you practice meticulous foot care (cleaning, applying moisturizing lotions, and wearing well-fitting protective shoes)? Do you know when to seek emergency medical care for peripheral artery disease (if your leg becomes suddenly painful, pale, cold and numb)? Do you get chest pain or pressure with exertion or at rest? If so, you may have coronary artery disease. Do you have sudden brief episodes of blindness (like a shade being pulled over your eyes) or sudden episodes of weakness in an arm or leg, or difficulty speaking? These could be warning symptoms of stroke. Heart rate, blood pressure, and weight Pulses in your feet and groin, and behind your knees Listen with the stethoscope over your carotid arteries in your neck Heart and lungs Neurologic exam (reflexes and sensation in your legs) Muscles (looking for atrophy in leg muscles) Skin, looking for changes related to reduced circulation Blood tests, including glucose and cholesterol levels Ultrasound of your carotid arteries Doppler Ankle-Arm Indices Exercise Stress Test MRI/MRA Angiography   More »

Alternatives to Vioxx if Heart Disease Present — TheFamily HealthGuide

Although the sudden decision to withdraw Vioxx came as a surprise, it wasn't entirely unexpected. Concerns about the cardiovascular safety of this medication were raised soon after it was approved for sale in the United States . As of this early October 2004 article, hard and fast guidelines for replacing Vioxx haven't yet been published. What many doctors are telling their patients with heart disease is to first try one of the older, more established anti-inflammatory drugs. Many people turned to the new drugs, called COX-2 inhibitors, because they thought they were superior for relieving pain or easing inflammation. In reality, Vioxx, Celebrex, or Bextra aren't any better at this than older and much less expensive nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, others), and naproxen (Aleve, Naprosyn, others). Like the older drugs, the COX-2 inhibitors can also irritate the stomach. Their main advantage is that they aren't as likely to cause bleeding ulcers. Keep in mind, though, that this "advantage" is small and far from complete - about 1%-2% of people who use an older NSAID develop serious stomach bleeding, compared to 0.5%-1% of those using a COX-2 inhibitor. More »

Heart attacks in women

Although hard-to-read heart attacks happen to both men and women, they are more common in women. One reason for this is that men's symptoms initially set the standard for recognizing heart trouble. Now a growing body of research shows that women can experience heart attacks differently than men. Understanding sex differences in heart disease is important. Heart disease is the leading cause of death for women. Although it mostly affects older women, it isn't rare in younger women. One in 10 of all women who die from heart disease or a stroke are under age 65, and this age group accounts for one-third of heart- or stroke-related hospitalizations. Even so, younger women and their doctors don't necessarily suspect a heart attack even when all the signs are there. In a survey of more than 500 women who survived heart attacks, 95% of them said they noticed that something wasn't right in the month or so before their heart attacks. Two most common early warning signs were fatigue and disturbed sleep. Some women, for example, said they were so tired they couldn't make a bed without resting. More »

Diabetes Update: 2002

Type 2 diabetes affects approximately 8% of adults in the United States. An additional 10 million Americans are at high risk for the disease. This type of diabetes begins gradually, later in life. Most people with type 2 diabetes produce plenty of insulin, but their tissues resist the action of the hormone, so their blood sugar levels rise; some people develop the disease as their insulin production gradually slows down. Although treatment may prevent some complications of type 2 diabetes, which can include atherosclerosis, vision impairment, and nerve damage, it cannot eliminate the condition altogether. As a result, prevention of type 2 diabetes remains preferable. In a recent study in the New England Journal of Medicine (NEJM), researchers from the Diabetes Prevention Program Research Group sought to determine whether lifestyle intervention or drug treatment could be used to prevent or delay the onset of type 2 diabetes. The researchers gathered 3,234 subjects who they determined to be at high risk for diabetes based on elevated blood sugar levels. They assigned the subjects to one of three interventions: twice-daily treatment with 850 mg of metformin (a drug commonly used to lower blood sugar in people with type 2 diabetes), lifestyle intervention, or placebo. The goal of the lifestyle intervention was to achieve a weight reduction of at least 7% of initial body weight through a low-fat, low-calorie diet, and to complete at least 150 minutes of moderate-intensity physical activity per week. As measured by the researchers, the lifestyle intervention group achieved much greater weight loss and increased their physical activity level more than the metformin or placebo groups. More »

Aspirin and heart disease

The study, published in the May 9, 2002, issue of the New England Journal of Medicine, analyzes the major trials on the subject. Four out of five of the randomized trials show a reduction in cardiovascular events (especially heart attacks) with aspirin use. (In randomized trials, researchers randomly assign patients to one of the treatments being tested.) But the studies' statistics vary wildly. For example, risk reduction ranged from 4%–44%, depending on the study. All but one trial showed that aspirin use increased the risk of bleeding, most commonly in the stomach. Two large observational studies also showed that aspirin use decreased coronary events in both people with and without heart disease. (In observational studies, researchers simply monitor subjects' behaviors and health, they do not test a specific treatment on them.) Subjects' ages had an impact in both studies, with aspirin's benefit on the heart kicking in when subjects hit 50 years old in one, 60 years old in the other. Other trials have found that aspirin has the greatest effect on patients with high risk for heart disease. So what should you do? That depends a lot on your heart disease risk. To calculate your risk go to this downloadable scoring system on the National Institutes of Health Web site. More »