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Heart Disease Explained—The Many Risk Factors, Causes, and Treatment

Medically Reviewed by

Heart Disease Statistics, Heart Disease Facts

According to the American Heart Association, heart disease, which includes coronary heart disease, hypertension, and stroke, kills more Americans every year than any other medical condition. In fact, coronary heart disease is responsible for 1 in 4 U.S. deaths annually, and more than 610,000 lives.[2]

What is heart disease?

Heart Disease Definition

The term, “heart disease” actually refers to a whole host of conditions affecting the heart. These include diseases such as, blood vessel disease, coronary artery disease, congenital heart defects, and heart arrhythmias. Sometimes “heart disease” is used interchangeably with the term, “cardiovascular disease” that involves narrowing or blocked blood vessels that could lead to a heart attack, angina, or stroke.[1]

Heart Diseases Beyond Cardiovascular Diseases

Other conditions that are also considered heart disease may affect the actual heart muscle, valves of the heart, or heart rhythms including:

  • Abnormal heart rhythms, or arrhythmias
  • Heart failure
  • Heart valve disease
  • Congenital heart disease
  • Heart muscle disease (cardiomyopathy)

Types of Heart Disease

Graphic showing types of heart disease

Coronary Artery Disease—Coronary Heart Disease Explained

Coronary artery disease is one of the cardiovascular diseases and the most common type of heart disease in the United States, caused from the build up of sticky plaque in the arteries of the heart that can restrict blood flow through the muscle. It is also known as ischemia. This may occur over time and become chronic, affecting one area of the heart, or happen suddenly with a plaque rupture that results in a clot or thrombus.[2]

Symptoms of Heart Disease

Signs of Heart Disease—Coronary artery disease symptoms may include the following:

  • Chest pain (angina)
  • Shortness of breath
  • Heart attack

What Causes Heart Disease?

Coronary artery disease may begin as early as childhood when the inner layer of the arteries become damaged possibly from:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes or insulin resistance
  • Sedentary lifestyle

Plaque caused by cholesterol deposits and other waste substances then forms in damaged areas. This is known as the development of atherosclerosis. There is evidence that by the teenage years, those plaques that will be with us for the rest of our lives may already be present. Cholesterol is necessary for every cell in the body. Too much bad (low density lipoprotein or LDL) cholesterol creates sticky plaque, however.

Risk Factors For Heart Disease—Coronary Artery Disease

Heart disease risk factors for coronary artery disease include:

  • High LDL cholesterol
  • Low HDL cholesterol
  • High blood pressure
  • Heredity/family history
  • Diabetes
  • Smoking
  • Post-menopausal for women
  • Over 45 for men
  • Obesity in men or women
  • Stress
  • Physical inactivity

Heart Arrhythmia, Heart Disease

Heart rhythm dysfunction or “heart arrhythmia” is also classified as heart disease and caused by malfunctioning electrical impulses, necessary to properly coordinate the beats of the heart. Heart arrhythmia causes the heart to beat either too fast, too slow, or irregularly.

Symptoms of Heart Disease—Symptoms of Arrhythmia

It is possible that patients with heart arrhythmias exhibit no outward signs or symptoms of a heart condition at all.

Noticeable symptoms of arrhythmia may however, include:

  • Fluttering in the chest
  • Racing heart (tachycardia)
  • Slow heartbeat (bradycardia)
  • Pain in chest
  • Shortness of breath
  • Dizziness or Lightheadedness
  • Sweating
  • Fainting (syncope) or feeling faint
  • Feeling pauses between beats of the heart[1]

Causes of Heart Disease—Arrhythmia

Many factors can contribute to arrhythmia. These include:

  • Congenital heart defects
  • Coronary artery disease
  • High blood pressure
  • Diabetes
  • Smoking
  • Overuse of alcohol or caffeine
  • Drug abuse
  • Stress
  • Certain medications, whether prescription or non-prescription, some nutritional supplements
  • Valvular heart disease

An arrhythmia that is fatal is very unlikely to ever develop in a normal healthy heart, free from disease or deformity. Without some serious outside trigger such as, electrical shock or drug abuse that damages or scars the heart tissue, electrical impulses can travel properly through the heart.

Risk Factors For Heart Disease—Heart Arrhythmias

Individuals with specific medical conditions that weaken the heart are at risk for heart arrhythmias.

Heart disease risk factors include:

  • Heart attack
  • Heart failure or cardiomyopathy
  • Leaking or narrowed heart valves
  • Congenital heart defects
  • High blood pressure
  • Infections around the heart
  • Diabetes
  • Sleep apnea
  • Overactive or underactive thyroid gland[9]

Congenital Heart Defects

Congenital heart defects are the most common birth defects, affecting 8 out of every 1,000 newborns. These heart defects affect the normal flow of blood through the heart and are present at birth. They affect the structure of the heart and may involve the interior heart walls, the heart valves, or the veins and arteries carrying blood to and from the heart. Some congenital heart defects are mild, creating no symptoms, while others are more serious, even life-threatening, requiring medical intervention immediately after birth. Common congenital heart defects include septal defects, or holes in the heart, patent ductus arteriosus, causing abnormal blood flow between the aorta and the pulmonary artery, heart murmur, and narrowed heart valves.[6]

Heart Disease Symptoms—Congenital Heart Defects

While symptoms may never present in some individuals with congenital heart defects, common signs may also include:

  • Rapid breathing
  • Cyanosis (blue lips, skin, fingernails)
  • Fatigue
  • Poor circulation[7]

Causes of Congenital Heart Defects

Heart defects generally develop as a baby grows within the womb, about one month after conception. Medications and genetics may play a role in congenital heart defects. Adults can also develop heart defects as the heart’s structure changes with aging.

Risk Factors for Heart Disease—Congenital Heart Defects

  • Rubella
  • Diabetes
  • Medications
  • Alcohol consumption during pregnancy
  • Smoking
  • Heredity[1]

Valvular Heart Disease

Valvular heart disease refers to damage or a defect to one of the heart’s four valves, mitral, aortic, tricuspid, or pulmonary.

Symptoms of Heart Disease—Valvular Heart Disease

Signs of valvular heart disease may include the following:

  • Chest pain
  • Heart palpitations
  • Shortness of breath
  • Fatigue
  • Lightheadedness
  • Loss of consciousness
  • Swollen feet/ankles/abdomen[5]

Causes of Valvular Heart Disease

Heart valve disease may be caused by a number of conditions including rheumatic fever, infections, and connective tissue disorders.

Risk Factors for Heart Disease—Valvular Heart Disease

Individuals at risk for valvular heart disease include those who currently have/had, or may be at risk for, the following conditions or diseases:

  • Infective endocarditis (IE)
  • Rheumatic fever
  • Heart attack
  • Heart failure
  • Coronary heart disease
  • High blood cholesterol
  • High blood pressure
  • Smoking
  • Insulin resistance
  • Diabetes
  • Overweight or obesity,
  • Lack of physical activity
  • Family history of early heart disease
  • Bicommissural aortic valve[10]

Cardiomyopathy—Heart Muscle Disease

Cardiomyopathy includes diseases of the actual heart muscle causing it to become enlarged, rigid, thick, and sometimes scarred. As the disease progresses the heart loses its ability to efficiently pump blood through the body and maintain a normal electrical rhythm. As a result, heart valve problems, arrhythmias, and heart failure can occur.

Symptoms of Heart Disease—Cardiomyopathy

Signs of heart disease include:

  • Shortness of breath
  • Difficulty breathing with physical exertion
  • Fatigue
  • Swelling of ankles/feet/legs/abdomen/neck veins
  • Dizziness
  • Lightheadedness
  • Fainting
  • Chest pain
  • Heart murmurs
  • Arrhythmias[8]

Causes of Cardiomyopathy

There are three main types of cardiomyopathy that can occur, each causing the heart muscle to become thickened or enlarged. The cause for heart muscle disease is dependent on whether it is diagnosed, “Dilated”, “Hypertrophic”, or “Restrictive” cardiomyopathy.

Dilated cardiomyopathy—Cause may be unknown, but can be related to reduced blood flow to heart, infections, toxins, certain drugs, or heredity. The condition usually dilates the left ventricle.

Hypertrophic cardiomyopathy—Condition is usually inherited, but can also develop as a result of high blood pressure or aging. This condition usually causes the heart muscle to become very thick.

Restrictive cardiomyopathy—Cause may be unknown, but may also be due to connective tissue diseases, excessive iron build up, or cancer treatments. This type of cardiomyopathy causes the heart muscle to become rigid or less elastic.

Risk Factors for Heart Disease—Heart Muscle Disease

Heart disease risk factors for cardiomyopathy include:

  • Family history of heart failure or sudden cardiac arrest
  • Coronary heart disease, heart attack, infection affecting the heart
  • Diabetes
  • Obesity
  • Hemochromatosis, sarcoidosis, or amyloidosis
  • Alcoholism (long-term)
  • High blood pressure (long-term)

Heart Disease Prevention

Preventing heart disease involves reducing risk factors that make individuals vulnerable such as, high blood pressure, smoking, excessive alcohol use, stress, diabetes, obesity, poor diet high in fat/LDL cholesterol, and inactivity.

Heart Disease Treatment

Treatment for heart disease may include lifestyle changes, medicines, surgery, medical procedures, or cardiac rehabilitation. By relieving symptoms, widening or bypassing clogged arteries, reducing risk factors for plaque build up, and lowering the risk for blood clots, physicians and surgeons may help slow, stop, or manage heart disease for patients.[3]

Reversing Heart Disease

Research studies indicate that intensive lifestyle changes maintained over a significant period of time can actually reverse heart disease, especially in patients with coronary artery disease. Individuals participated in a 5-year study, ate a reduced fat, whole food diet, engaged in aerobic exercise, quit smoking, underwent stress management training, and attended a support group. These patients experienced greater regression of coronary atherosclerosis and had fewer cardiac events than the control group (who made only moderate lifestyle changes) studied.[4]

Heart disease affects all of us, and while it’s the most common medical condition in the United States, it’s also the most preventable. Taking steps now to make and maintain positive lifestyle changes, is an investment in a healthy heart for the future.

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