Heart Disease

Though being the size of a fist, the heart is the most vital organ in the body. Basically, it is a muscular pump whose pumping keeps us alive. However, a number of complications could hinder this pumping or beating of the heart. These are known as Heart diseases or cardiovascular diseases. A number of factors can cause these complications but modern lifestyle changes have aced the hierarchy. According to a survey recorded in AHA Journals, one in 4 deaths in India is now due to CVD with ischemic heart disease. It is because of the risk factors that are increasing day by day in India.

Types of Heart Diseases:

There are several types of heart diseases depending upon how and what they affect. Some of them are:

1. Coronary Artery Disease: It is the most common one, caused by the hardening and narrowing of the arteries that supply blood to the heart due to the deposition of cholesterol or other substances. The plaque clogs the arteries, resulting in a low or no supply of blood to the heart, and can lead to heart failure or heart attack.
2. Congenital Heart Defects: It is a situation when a person is born with heart defects or problems such as atypical heart valves, septal defects, missing heart valves or Atresia, etc. Generally, many congenital heart diseases do not show any noticeable symptoms and therefore, are only diagnosed accidently. It is most common in children.
3. Arrhythmia: In this, the electrical signals and impulses that monitor the heartbeat don’t work properly, leading to irregular heartbeats. Tachycardia, Bradycardia & Atrial Fibrillation are some of its types.
4. Dilated Cardiomyopathy: In this the muscles of the heart become thinner thus, making the heart weaker due to which it cannot pump blood properly.
5. Myocardial Infarction: Popularly known as Heart Attack, it occurs due to an interruption of the blood flow to the heart which damages the parts of the heart muscles.
6. Heart Failure: In the case of heart failure the heart doesn’t work as it should be. Thus, tampering with the heart’s ability to pump or relax properly.
7. Hypertrophic Cardiomyopathy: It is an inherited condition in which the heart muscles become thick thus making contraction and relaxation harder.
8. Mitral Valve Regurgitation: In this condition, the mitral valve doesn’t close tightly due to which blood flows back to the heart. This can put pressure on the heart and can cause heart failure.
9. Mitral Valve Prolapse: This happens when the valve flaps don’t close properly instead they bulge into the left atrium.
10. Aortic Stenosis: In this, the pulmonary valve doesn’t open correctly thus making it harder for the heart to pump blood from the left ventricle into the aorta.

Signs & Symptoms

Though the symptoms depend on the type of heart disease a person has, some are common in all. These include:

• Angina or Chest Pain
• Breathlessness
• Fatigue & light-headedness
• Heart palpitations
• Stomach pain & Nausea
• Swelling in limbs
• Irregular heartbeat

On diagnosis of any of these symptoms, one should immediately consult the cardiologist & go for a heart check-up.

Risk Factors

A number of factors are likely to increase one’s chance of developing heart disease. These include aging, sex, family history, smoking, poor diet, high blood pressure, high blood cholesterol level, diabetes, obesity, physical inactivity stress, etc. Therefore, one should work on these factors for reducing their chances of developing complications.

Diagnosis

On detection of any signs and symptoms doctors run a number of physical tests and exams to know the exact cause of the discomfort or problem. Some tests include:

• Electrocardiogram (ECG or EKG)
• Echocardiogram
• Stress test
• Carotid ultrasound
• Holter monitor
• Tilt table test
• CT scan
• Heart MRI

If a physical exam, blood tests, and non-invasive tests aren’t conclusive, some invasive tests are done which may include:

• Cardiac catheterization and coronary angiography.
• Electrophysiology study.

Treatments:

Depending upon the diagnostic results, type, and severity of the disease, doctors decide whether the medications and lifestyle changes would work or whether the patient has to undergo surgery.

• Various medications such as anticoagulants, blood thinners, blood pressure controllers, beta-blockers, calcium channel blockers, etc. are advised at the primary or early stages. However, if the medications are ineffective then surgery is required.
  

  Types of Surgery Required by Various Heart Diseases:

  Different diseases require different surgeries. They are:

  • Coronary Artery Bypass Grafting (CABG). It is done in the case of Coronary Artery Disease. In this, the surgeon takes a healthy artery or vein from any limb or portion of the body and connects it to supply blood past the blocked coronary artery thus, bypassing the blocked portion and creating a new path for blood to flow to the heart muscle.
  • Heart Valve Repair or Replacement. It is performed in the cases of Mitral Valve Regurgitation and Prolapse. In this, the damaged or defective valve is either repaired or replaced with an artificial one.
  • Insertion of a pacemaker or an implantable Cardioverter Defibrillator (ICD). Though medication is generally the first option for Arrhythmia, surgical implantation of a pacemaker or ICD is required in case the medicines become ineffective. The devices use electrical pulses to control the heart rhythm when a sensor detects that it is abnormal.
  • Maze surgery. In this, scar tissue is created within the upper chambers of the heart to block stray electrical signals that cause Atrial Fibrillation — the most common type of serious Arrhythmia.
  • Aneurysm repair. A weak section of the artery or heart wall is replaced with a patch or graft to repair a balloon-like bulge in the artery or wall of the heart muscle. It is used for the correction of Dilated Cardiomyopathy.
  • Heart transplant. The diseased heart is removed and replaced with a healthy heart from a deceased donor. It is usually done in case of Heart Failure.
  • Insertion of a ventricular assist device (VAD) or total artificial heart (TAH). A VAD is a mechanical pump that supports heart function and blood flow. A TAH replaces the two lower chambers of the heart.

  In addition to these surgeries, a minimally invasive alternative to open-heart surgery that is becoming more common is transcatheter structural heart surgery. This type of surgery is used to replace a faulty aortic valve.