Understanding different Heart Problems
Globally there are around millions people living with CVD . CVD ( Cardiovascular Disease ) is one of the leading causes of death worldwide . In India too CVD is one of the leading causes of death . Behaviors which can affect our risk of developing health issues that can lead to coronary artery disease, including:- Obesity , high cholesterol , high blood pressure , diabetes and smoking .We often hear about the death of people by Angina , Heart attacks , heart failures and cardiac arrest . They are all serious and need immediate attention but often we treat them interchangeably .
Angina Vs Cardiac Arrest vs Heart Attack vs Heart Failure
In short a heart attack is when blood can’t reach the heart , heart failure is when the heart fails to circulate adequate blood properly and cardiac arrest is when the heart stops beating suddenly . Let us try to understand -
Angina - Angina Pectoris commonly called Angina - It is a Type of chest pain caused by reduction of blood to the heart . Angina is a CAD ( coronary artery disease ) mainly due to blockage of Artery / arteries supplying blood to heart . It is also felt like squeezing , pressure , tightness , heaviness in the chest . Sometimes it’s confused with heart attack or chest pain due to indigestion . It can come and go with medications or sometimes itself on rest . Types of Angina -
Stable Angina - This is the most common angina problem which happens due to activities or exertion like exercise or walking uphill . This can go off by rest or after taking angina medicines .
Unstable Angina - This is the unpredictable type of angina - it can happen with nominal efforts or even while resting . It’s more severe than stable angina and lasts longer also , say 20 minutes . It’s dangerous and does not go away on rest or even with usual angina medicines . If the blood flow remains reduced it can cause heart attack also . It needs emergent treatment .
Variant Angina or Prinzmetal Angina - Severe chest pain happens in this type of angina . It’s not due to CAD . It’s caused by spasms in the heart’s arteries which tentatively reduces blood flow to heart . This usually happens in the night , particularly in the wee hours . It may go away with angina drugs .
Refractory Angina - This type of angina happens frequently despite medications .
Symptoms - Besides Chest pain or tightness it can be - dizziness , fatigue , sweating ,nausea and shortness of breath . Sometimes it might be accompanied with abdominal pains , neck and jaw pains , particularly in women .
Risk Factors - Old age , family history , tobacco , high B.P. , diabetes , high cholesterol , obesity , inactivity . stress , drug misuse , too cold .
Diagnosis - Blood test , X- ray , ECG , CT scan MRI , Stress Test , Angiography .
Treatment - Medications , Angioplasty or stenting , Lifestyle changes , Bypass surgery
Cardiac Arrest -It results from electrical disturbances that cause the heart to suddenly stop beating the way it should . What is CARDIAC ARREST - Abnormal heartbeats are called Arrhythmia . Heart beats can be too fast or too slow . Either of them can cause the heart to stop beating . We all know our normal heart rate is 72 beats per minute. When Arrhythmia happens the heart stops beating entirely and causes death . This is called Cardiac Arrest . Cardiac arrest basically happens due to electrical disturbances that cause the heart to suddenly stop beating in the manner it should do .
Symptoms of Cardiac Arrest - The good thing about Cardiac arrest is that it’s reversible , if attended in time . The moment it happens the person becomes unresponsive and unable to breathe . If anyone knows CPR ( cardiopulmonary resuscitation) , the person can be saved or if a defibrillator is available use it immediately . Cause - CAD , physical stress , hereditary and may be for unknown reasons too . But Arrhythmia can happen even without CAD . In 80 % of cases of Arrhythmia they are detected by ECG . So the moment you feel such a problem, get screened for it .
Diagnosis - Most cases can be detected by ECG . Other tests as per doctor’s advice may be Echocardiogram ( sometimes called Echo in short ) , Nuclear scan , X ray ( can tell about size of heart and lungs ) , Blood tests and catheterisation .
Treatment for Arrhythmia -
Catheter ablation. ...
Pacemaker. ...
Implantable cardioverter-defibrillator (ICD). ...
Maze procedure. ...
Coronary bypass surgery.
Heart Attack - Heart attack happens when blood flow to heart is blocked .Blood clots, cholesterol deposits and atherosclerosis all can cause blood clots in arteries and heart attacks . In a heart attack the heart keeps beating but oxygen rich blood can’t reach the organ . The more damage to the heart will happen the longer it's left unattended . Heart attacks are almost always caused by narrowing of arteries which subsequently results in plaque buildup . This is known as Atherosclerosis .
Symptoms of Heart Attack - The common signs of heart attack are - chest pain which may radiate to the left arm and might be in the right arm also , sweating , nausea or vomiting , jaw pain and shortness of breath . These signs might develop slowly in hours , days or weeks also . Symptoms of heart attacks among men and women may differ .
Risk factors - Main Risk factors of heart diseases are high blood pressure, high low-density lipoprotein (LDL) cholesterol, diabetes, smoking and secondhand smoke exposure, obesity, unhealthy diet, and physical inactivity.
Diagnosis - Electrocardiogram (ECG)
Blood tests.
Chest X-ray.
Echocardiogram.
Angiogram ( Coronary catheterization )
Cardiac CT
MRI .
Treatment - Medications , stents , ballooning , bypass surgeries depending on medical conditions
Heart Failure - Heart failure happens when the heart fails to circulate enough blood throughout our body . Failure to supply oxygen rich blood causes severe damage to heart muscles . This might also adversely affect heart rhythms and cause Cardiac arrest . CAD , diabetes , high BP, obesity , can lead to heart failures. People of Old age ( 65 + ) and previous history of heart attack are more at risk . Women are less prone to heart failures than men . Depending on the extent of heart failures it is categorized in stages i to iv ( iv being the worst stage ).
Symptoms of Heart Failure - When the heart's capacity to pump blood reduces blood and fluid may back up into lungs causing swelling of ankles , feet or legs . And the affected person will feel tiredness and shortness of breath . The doctor will try to figure out the underlying reasons for it .irregular heart beats , swelling in abdomen , nausea , lack of appetite , chest pain ( if failure is by heart attack )
Diagnosis - Blood tests , ECG , Echo , Stress test , CT scan , MRI , myocardial biopsy and angiogram .
Treatment - there are several medicines for it depending on condition .
Last but not the least is Panic attack
What is a Panic Attack - Many cases of angina / heart attack which come to Emergency turn out to be a Panic attack . Most symptoms of Panic attack are the same as angina / heart attack . Actually it’s very tricky for a doctor to differentiate between them . Moreover different people often feel differently during such attacks . There can be other reasons for similar symptoms of heart attack like in case of Pancreatitis , Pneumonia , Panic attack , Pulmonary Embolism ( a blood clot in lungs ) and Aortic Dissection which means a tear in the inner layer of Aorta ( the largest Artery of body which carries blood from heart to our circulatory system .
Panic attack is an episode of sudden and big fear that triggers some serious physical reactions while there is no real cause or real danger . It’s too frightening and one feels like dying like in a heart attack .Main reasons are - genetic , huge stress or emotions , environment and some functions of the brain . There are effective treatments for it .
Diagnosis - Physical exam. , blood tests ,ECG , Psychological evaluation .
Treatment - Psychotherapy and Medications as decided by your doctor .
Bottom Line - This is not medical advice . All heart diseases are not the same . It can affect differently - blood vessels to the heart or brain , Valves and muscles of heart , or any other area / organ of blood . CVD might need long term treatment or can come suddenly which can be serious . The bottom line is that whenever you feel any discomfort in your chest and /or breathing problem , you must seek medical advice sooner .
But a healthy lifestyle - regular consumption of a well balanced diet , regular exercise , maintaining a regular weight is your own tool to protect your heart . Often such episodes might happen in our life on a couple of occasions due to stressful situations but they are not life threatening but they affect quality of life . In some cases there might be repeated episodes which are known as Panic disorder .
