Quote from Azizur Munna on March 8, 2019, 11:04 am

Heart disease or cardiovascular diseases is the class of diseases that involve the heart or blood vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH C14), it is usually used to refer to those related to atherosclerosis (arterial disease).

Cardiovascular disease, also known as heart and circulatory disease, covers all diseases that affect the heart and circulation. This includes conditions such as coronary heart disease (angina and heart attack) and stroke.

What is cardiovascular disease?
Cardiovascular disease (CVD) is an abnormal function of the heart or blood vessels. It can cause an increase in risk for heart attack, heart failure, sudden death, stroke and cardiac rhythm problems, thus resulting in decreased quality of life and decreased life expectancy. The causes of cardiovascular disease range from structural defects, to infection, inflammation, environment and genetics. In order to help prevent cardiovascular disease one must adopt a healthy lifestyle and avoid smoking, fattening foods and stress.

Causes:
In his book "The Heart Healthy Program", the cardiologist Dr Richard M. Fleming has identified several key dietary factors that can lower the risk of heart disease, including:

• Lowering of LDL cholesterol by reducing saturated fat intake.
• Lowering of Triglyceride levels by reducing consumption of sugary and processed foods.
• Reduction of Homocysteine levels by supplementation with Vitamins B6 and B12, and folic acid.
• Increased antioxidant activity by higher consumption of fruits and vegetables.
• Lowering of fibrinogen and growth factors by cutting back on foods such as red meat, dairy products, poultry and eggs.

Pathophysiology:
Population based studies in the youth show that the precursors of heart disease start in adolescence. The process of atherosclerosis evolves over decades, and begins as early as childhood. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 7–9 years. However, most adolescents are more concerned about other risks such as HIV, accidents, and cancer than cardiovascular disease.This is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. In order to stem the tide of cardiovascular disease, primary prevention is needed. Primary prevention starts with education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken.

What is coronary heart disease?
Coronary heart disease is caused by a gradual build up of fatty deposits in the walls of your coronary arteries, which can then cause them to narrow. The medical term for this condition is atherosclerosis and the fatty material is known as atheroma.

Over time, the artery may become so narrow that it can’t deliver enough oxygen to your heart, especially when you’re exerting yourself. This can lead to angina – a pain or discomfort in your chest.

If a piece of this fatty material breaks away from the artery wall it can cause a clot to form, which will then starve your heart of blood and oxygen. This is known as a heart attack.

What is a stroke?
Your brain is given blood, containing oxygen and nutrients by the arteries in your neck. If these arteries begin to narrow because of a build up of fatty material, it can affect your blood supply to your brain.

A stroke happens when the artery carrying blood to your brain is blocked. A stroke can also be caused by bleeding from an artery into your brain.
Stroke can affect the way your body works and the way you think.

• Facial weakness - can they smile? Has their mouth or eye drooped?
• Arm weakness - can they raise both arms?
• Speech problems - can they speak clearly and understand what you are saying?

What causes cardiovascular disease?
The following things can increase your risk:
• Smoking
• High blood pressure
• High blood cholesterol
• Physical inactivity
• Being overweight or obese
• Diabetes
• A family history of heart disease
• Age – as you get older, your risk increases
• Ethnic group – some ethnic groups have a higher risk of heart disease. For example, South Asian people living in the UK have a higher risk than the rest of the UK population.
What can I do if I am worried about developing cardiovascular disease?
Your GP or practice nurse will want to:
• talk to you about your lifestyle
• take your weight, height and waist measurements
• take your blood pressure
• have your blood tested for cholesterol
• ask questions about your family history.

How can I help prevent heart disease?
Making small changes to your lifestyle can reduce your risk of developing cardiovascular disease.

• Stopping smoking
• Controlling high blood pressure
• Reducing your cholesterol level
• Being physically active
• Achieving and maintaining a healthy weight
• Controlling your blood glucose if you have diabetes
• Eating a healthy, balanced diet and only drinking moderate amounts of alcohol.

How Your Heart Works

Your heart is a pump, and it keeps blood moving around your body. Your blood delivers oxygen and nutrients to all parts of your body, and carries away unwanted carbon dioxide and waste products.

Your heart has four chambers - two on the left side and two on the right. The two upper chambers are called the atria, and the two lower chambers are called the ventricles. The two sides of the heart are divided by a muscular wall called the septum. Each side of the heart has a ‘one-way valve system’, which means that the blood travels in one direction through the heart – a bit like a one-way system.

The heart and circulatory system
Blood is pushed through the heart by the heart muscle contracting. With each contraction, or heartbeat, the heart pumps blood forward from the left side of the heart through the aorta (the main artery leaving the heart) and into the arteries. The arteries divide off into smaller and smaller branches to supply a microscopic network of capillaries, taking the blood to every part of your body. The blood then travels back to the heart from the capillaries into the veins, back to the heart. The branches of the veins join to form larger veins, which deliver the blood back to the right side of your heart.

As the heart relaxes in between each heartbeat or contraction, blood from your veins fills the right side of your heart and blood from the lungs fills the left side of your heart. The two sides of the heart are separate, but they work together. The right side of the heart receives dark, de-oxygenated blood which has circulated around your body. It pumps this to your lungs, where it picks up a fresh supply of oxygen and becomes bright red again.

The heart wall is made up of special muscle called myocardium. Like every other living tissue, the myocardium itself needs a continuous supply of fresh blood. This supply of blood comes from the coronary arteries which start from the main artery (the aorta) as it leaves the left ventricle. The coronary arteries spread across the outside of the myocardium, feeding it with a supply of blood.

Circulation is the movement of blood around the body, pumped by the heart. This system is called the cardiovascular system. It contains about five litres (eight pints) of blood, which your heart is continuously circulating. Each day, your heart beats about 100,000 times and pumps about 23,000 litres (5,000 gallons) of blood.

Types of Heart Conditions
Sometimes, just understanding the condition - its symptoms, treatment and the recovery process - can help you feel less anxious and more in control.

Cardiovascular Disease
Cardiovascular disease (CVD), also called 'heart and circulatory disease', means all diseases of the heart and circulation, including coronary heart disease (angina and heart attack) and stroke.

Angina
Angina is an uncomfortable feeling or pain in the chest, usually caused by coronary heart disease.

Heart Attack
A heart attack happens when one of the coronary arteries becomes blocked by a blood clot. This cuts off the supply of blood and oxygen to the heart, causing damage to the heart muscle.

Cardiac Arrest
A cardiac arrest happens when the heart suddenly stops pumping blood around the body.

Heart Failure
Heart failure is the term used when the heart becomes less efficient at pumping blood round the body.

Problems with Valves
Heart valve disease happens when one or more of your four heart valves fail to open or close properly.

Cardiomyopathy
Cardiomyopathy is a condition which causes the heart muscle to be abnormally enlarged, thickened or stiff.

Heart Rhythms
Heart rhythm problems occur when there is a disturbance in the electrical activity of the heart

Atrial Fibrillation
An irregular pulse could be a sign that you have atrial fibrillation, which is a major cause of stroke.

Congenital Heart Disease
Congenital heart disease is an abnormality of the heart that you are born with.

Angina
Angina is a pain or discomfort felt in the chest, and usually caused by coronary heart disease. However, in some cases the pain may affect some people in only the arm, neck, stomach or jaw.

What does angina feel like?
Angina often feels like a heaviness or tightness in your chest, but this may spread to your arms, neck, jaw, back or stomach as well. Some people describe the feeling of severe tightness, while others say it’s more of a dull ache. Symptoms of experiencing shortness of breath have been reported too.

Angina is often brought on by physical activity, an emotional upset, cold weather or after a meal. Symptoms usually subside after a few minutes.
If your symptom pattern changes, you should speak to your doctor immediately.

Can I prevent angina?
Unfortunately you can’t reverse coronary heart disease, but you can help prevent your angina and the condition from getting worse by keeping your heart healthy. It is important to:

• stop smoking
• control high blood pressure
• reduce your cholesterol level
• be physically active
• achieve and maintain a healthy weight
• control your blood glucose if you have diabetes
• eat a healthy, balanced diet and only drink moderate amounts of alcohol

Everyday life with angina
Many people with angina have a good quality of life and continue with their normal daily activities. Your doctor or nurse will be able to advise you on your daily activity and any lifestyle changes you may need to make.

Preventing Heart Disease
Prevention is better than cure, and by making small changes to your lifestyle you can reduce your risk of developing coronary heart disease.
Even if you’ve had a heart attack, or been diagnosed with coronary heart disease, you can help your heart to stay healthy and reduce your risk of further problems. Learn more about blood pressure, cholesterol and how reducing your weight and quitting smoking could save your life.

Blood Pressure
Your blood pressure reading might seem like random numbers to you. Let us explain what those numbers mean, and what causes high blood pressure.

Cholesterol
Cholesterol plays an essential role in how every cell in the body works. However, too much cholesterol in the blood can increase your risk of heart problems.

Your Weight
Carrying extra weight can be dangerous to your health. Get our tips on reducing your weight and why it is important.

Smoking
Want to live a long and healthy life? Quit smoking. Find out how to quit here.

Diabetes
Diabetes is a condition where there is too much sugar in the blood. It can lead to cardiovascular disease so it is important to manage it properly. Find out to manage diabetes.

Family History
Your doctor will ask you about your family history to find out your risk of heart disease. Find out why it is important to know about your family medical history.

Stress
We all find different things stressful and can experience different signs and symptoms as a result of feeling stressed.

Counselling
If you or someone you know has health problems which are causing concerns, anxiety or depression, it may be helpful to talk to a trained counsellor.

What is cholesterol?
Cholesterol is a fatty substance which is found in the blood. It is mainly made in the body.

Cholesterol plays an essential role in how every cell in the body works. However, too much cholesterol in the blood can increase your risk of heart problems.

LDL cholesterol and HDL cholesterol
Cholesterol is carried around the body by proteins. These combinations of cholesterol and proteins are called lipoproteins. There are two main types of lipoproteins:

• LDL (low-density lipoprotein) is the harmful type of cholesterol.
• HDL (high-density lipoprotein) is a protective type of cholesterol.

Having too much harmful cholesterol in your blood can increase your risk of getting cardiovascular disease. The risk is particularly high if you have a high level of LDL cholesterol and a low level of HDL cholesterol.

Triglycerides
Triglycerides are another type of fatty substance in the blood. They are found in foods such as dairy products, meat and cooking oils.
They can also be produced in the body, either by the body’s fat stores or in the liver.

People who are very overweight, eat a lot of fatty and sugary foods, or drink too much alcohol are more likely to have a high triglyceride level.
People with high triglyceride levels have a greater risk of developing cardiovascular disease than people with lower levels.

What causes high cholesterol?
One of the causes of high blood cholesterol levels amount people in the UK is eating too much saturated fat.

The cholesterol which is found in some foods such as eggs, liver, kidneys and some types of seafood eg. prawns, does not usually make a great contribution to the level of cholesterol in your blood. It is much more important that you eat foods that are low in saturated fat.

However, some people have high blood cholesterol even though they eat a healthy diet. For example, they may have inherited a condition called familial hyperlipidaemia (FH).

For more information on FH, please download our booklet Reducing your blood cholesterol (see below under further information).

How can I reduce my cholesterol level?
To help reduce your cholesterol level, you need to cut down on saturated fats and trans fats and replace them with monounsaturated fats and polyunsaturated fats. You should also reduce the total amount of fat you eat.

Eat oily fish regularly. Oily fish provides the richest source of a particular type of polyunsaturated fat known as omega-3 fats which can help to lower blood triglyceride levels and also helps prevent the blood from clotting, and help to regulate the heart rhythm.

Eat a high-fibre diet. Foods that are high in 'soluble fibre' such as porridge, beans, pulses, lentils, nuts, fruits and vegetables, can help lower cholesterol. Please see our information on fibre.

Doing regular physical activity can help increase your HDL cholesterol (the 'protective' type of cholesterol).

Will eating sterol-enriched foods help reduce my cholesterol level?
There is evidence to show that substances called ‘plant sterols’ and ‘stanols’ may help reduce cholesterol levels. They are added to certain foods including margarines, spreads, soft cheeses and yoghurts.
I've heard that eating too many eggs can raise your cholesterol - how many can I eat?

The recommendation on how many eggs you can eat has changed over the years and is a common source of confusion. In the past we recommended a restriction on eggs because we thought that foods high in cholesterol (including liver, kidneys and shellfish, as well as eggs) could have an impact on cholesterol levels.

However, as research in this area has developed so has our understanding of how foods that contain cholesterol affect people’s heart health. This means we have changed our recommendation and there is currently no limit on the number of eggs that can be eaten in a week.

For most people, the amount of saturated fat they eat has much more of an impact on their cholesterol than eating foods that contain cholesterol, like eggs and shellfish. So, if you like eggs, they can be included as part of a balanced and varied diet.

Will I need to take medication?
Whether you need to take cholesterol-lowering drugs or not depends not just on your total cholesterol, HDL and LDL levels, but also on your overall risk of coronary heart disease.

Cholesterol-lowering medicines such as statins are prescribed for people who are at greatest overall risk of suffering from coronary heart disease. Please see our information on statins.

Heart Attack
What is a heart attack?
Most heart attacks are caused by coronary heart disease which is when your coronary arteries narrow due to a gradual build-up of atheroma (fatty material) within their walls.

If the atheroma becomes unstable, a piece may break off and lead to a blood clot forming.

This clot can block the coronary artery, starving your heart of blood and oxygen, causing damage to your heart muscle - this is a heart attack. It is also called acute coronary syndrome, myocardial infarction or coronary thrombosis.

A heart attack is a medical emergency. If you think you or anyone else is having a heart attack, you should call 999 immediately.

What is the difference between a heart attack and cardiac arrest?
Cardiac arrest is different from a heart attack - this happens when your heart stops pumping blood around the body. As a result you will be unconscious and won’t be breathing or breathing normally.

However, one of the causes of cardiac arrest is a heart attack. Other causes include electrocution or choking.

What are the symptoms of a heart attack?
The symptoms of a heart attack vary from one person to another. They can range from a severe pain in the centre of the chest, to having mild chest discomfort that makes you feel generally unwell.

The common symptoms of a heart attack include:
• central chest pain.
• pain which may spread to the arms, neck or jaw.
• feeling sick or sweaty as well as having central chest pain.
• feeling short of breath as well as having central chest pain.
The less common symptoms of a heart attack include:
• a dull pain, ache or 'heavy' feeling in your chest.
• a mild discomfort in the chest that makes you feel generally unwell.
• the pain or discomfort may spread to your back or stomach.
• the pain or discomfort may feel like a bad episode of indigestion.
• feeling a bit light-headed or dizzy as well as having chest pain.

How is a heart attack diagnosed?
The ambulance and hospital staff will:
• assess your symptoms and medical history.
• examine you and monitor your heart rate and blood pressure.
• do an electrocardiogram (ECG).
• do blood tests to help check for any damage to the heart muscle.

While you are in hospital, other tests may be carried out as well to assess your heart and decide the best treatment for you.

What treatment will I receive?
You will be given pain relief, oxygen and aspirin, and other medicine which you will need to take after you get sent home.

Other treatment you are likely to have depends on the results of your tests and your condition. The most common types of treatment that are given to people with a heart attack are:
• Thrombolysis - also called a clot buster. This involves injecting a medicine to dissolve the blood clot and restore your blood supply to your heart.
• Coronary angioplasty - a treatment to widen your artery and help to restore or improve your blood supply to your heart muscle.
Some people may also be advised that they need a heart bypass operation.

What about my recovery?
A heart attack can be a frightening experience and it can take time to come to terms with what has happened. It can be natural to be worried about your recovery and future. Many people make a full recovery and within a few months are able to return to their normal activities.

Some people may find that they may not be able to do as much as they previously did, but attending a cardiac rehabilitation course will increase your chances of getting back to normal as quickly as possible.

Can I prevent another heart attack?

Cardiac Arrest
What is a cardiac arrest?
A cardiac arrest is also known as cardiopulmonary arrest or circulatory arrest.

It happens when your heart stops pumping blood around the body. The most common cause of a cardiac arrest is a life threatening abnormal heart rhythm called ventricular fibrillation.

Ventricular fibrillation occurs when the electrical activity of the heart becomes so chaotic that the heart stops pumping and quivers or ‘fibrillates' instead.

This is a cardiac arrest. It can sometimes be corrected by giving an electric shock through the chest wall, using a device called a defibrillator.

Some other reasons why you might have a cardiac arrest are:
•
• if you lose a large amount of blood or fluid
• lack of oxygen
• body being very hot or very cold
• blood clot in the lung or coronary arteries

A cardiac arrest is different from a heart attack
If you have a heart attack, you do not always experience the life threatening rhythms that can lead to a cardiac arrest. A cardiac arrest does not always happen because you have a heart condition.

If you have a cardiac arrest, you lose consciousness almost at once.
There are also no other signs of life such as breathing. This is the most extreme emergency.

Unless someone starts cardiopulmonary resuscitation (CPR) within three to four minutes, the person may suffer permanent damage to the brain and other organs.

CPR means:
• rescue breathing (inflating the lungs by using mouth-to-mouth resuscitation), and
• chest compression (pumping the heart by external cardiac massage), to keep the breathing and circulation going until the ambulance arrives.
Ambulance staff are trained in advanced resuscitation and all emergency ambulances carry a defibrillator.

Heart Failure

You may feel frightened or upset if you hear that you or someone in your family has been told they have heart failure. However, with treatment and drugs many people live full and active lives.

What is heart failure?
Heart failure means that for some reason, your heart is not pumping blood around the body as well as it used to. The most common reason is that your heart muscle has been damaged, for example, after a heart attack.

What causes heart failure?
There are lots of reasons why you might be diagnosed with heart failure. It can be sudden or it can happen slowly over months or even years.

Some causes of heart failure are:
• a previous heart attack
• high blood pressure
• problems with the valves in your heart
• cardiomyopathies diseases of the heart muscle
• too much alcohol
• congenital conditions - ones you are born with

What are the signs and symptoms of heart failure?
Not everyone experiences the same symptoms and everyone copes in different ways. There are four different stages of heart failure and so your symptoms will vary from stage to stage. You might feel out of breath if you are physically active or for some people even at rest. You may also have swollen feet and ankles and feel very tired.

How is heart failure diagnosed?
Your doctor will ask you questions about your medical history and talk to you about what has caused your heart failure. The reason for your condition will make a difference to how your symptoms are controlled. You may need to have tests which include blood tests, an electrocardiogram (ECG) and an echocardiogram.

How is heart failure treated?

While there isn't a cure for heart failure, the treatment to control symptoms has improved dramatically. Your doctor will prescribe drugs that will help control your blood pressure and help the pumping action of your heart.

They will also give you advice about making changes to your lifestyle that will help you do all the things that you enjoy, improve your condition and live a normal life. These include:

• cutting down on salt
• eating a healthy balanced diet
• stop smoking
• keeping active

For more information about living with heart failure, order or download our Heart Failure Plan.

If you are caring for someone with a long-term heart condition like heart failure, it can be physically and emotionally demanding for you too. Therefore, it is important that you look after yourself as well. There are many voluntary organisations that can help and support you.

You may find some of the following booklets helpful too:
• Living with heart failure booklet
• Heart Failure Plan - a self-help guide for people with heart failure, and for their family and friends
• Heart Failure - your questions answered DVD/video
• Caring for someone with a heart condition booklet

Problems with Heart Valves

What is Heart valve disease?
Your heart is a muscle which pumps blood to your lungs and around the rest of your body. There are four chambers to your heart which are separated by valves to make sure that the blood flows in one direction through the heart.
The two large blood vessels that leave the heart also have valves to make sure that the blood does not go back into the heart once it has been pumped out. See our animation for more information.

What causes heart valve disease?
The main causes of heart valve disease are:
• being born with an abnormal valve or valves (congenital heart disease)
• having had rheumatic fever
• cardiomyopathy
• damage to the heart muscle from a heart attack
• getting older
• a previous infection with endocarditis.

What happens to heart valves?
A diseased or damaged valve can affect the flow of blood in two ways:
• If the valve does not open fully, it will obstruct the flow of blood. This is called valve stenosis or narrowing.
• If the valve does not close properly, it will allow blood to leak backwards. This is called valve incompetence or regurgitation or a leaky valve.

Both of these will put extra strain on the heart and if you have stenosis, the valve can restrict the flow of blood making your heart pump harder to force the blood past the narrowing. If you have incompetence, a leaking valve may mean that your heart has to do extra work to pump the required volume of blood through the heart.

What are the symptoms of heart valve disease?
You may not experience any symptoms but if you so some of the common symptoms are:
• being out of breath
• swelling of the ankles and feet
• being unusually tired

How is heart valve disease diagnosed?
You may be visiting your doctor because you are experiencing some of the symptoms listed above. Or you may not have any symptoms but your doctor has said that they can hear a murmur (an unusual sound) when they listen to your heart. A murmur does not always mean that there is a problem with your heart as people with normal hearts may also have murmurs.

Your doctor may suggest that you have further tests to see how well your heart is working. The most common test is an echocardiogram which uses sounds waves to look at the structure of your heart. It is similar to an ultrasound scan used to look at babies before they are born.

How is heart valve disease treated?
Most valve problems can be treated using medicines or by surgery. Your treatment will depend on the cause of your problem and the effect that it is having on your heart.

Cardiomyopathy
What is cardiomyopathy?
Cardiomyopathy is a disease of the heart muscle. It can run in families and can affect more than one member of a family. Some family members may not be affected at all.

There are three main types of cardiomyopathy:
• Hypertrophic cardiomyopathy
• Dilated cardiomyopathy
• Arrhythmogenic right ventricular cardiomyopathy

What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy (HCM) is an inherited (genetic) condition which means it can be passed on through families.

If you have HCM, the cells of your your heart muscle wall are affected and become thickened making the heart muscle stiff. This makes it harder for your heart to pump blood around your body.

What is dilated cardiomyopathy?
When dilated cardiomyopathy (DCM) is diagnosed it might be that there is no-one else in your family has the condition. It can however be inherited too, passed on through families.

In DCM, the heart muscle wall becomes thin and floppy, and is described as being dilated. This makes the heart weak and it is difficult for it to pump blood around the body effficeintly.

DCM can occur in some women in the late stages of pregnancy or shortly after birth. Excessive amounts of alcohol can also cause the condition.

What is arrhythmogenic right ventricular cardiomyopathy?

Arrhythmogenic right ventricular cardiomyopathy (ARVC) usually affects the right side of your heart. It is an inherited condition which means that it can be passed on through families.

In ARVC, the heart muscle cells are gradully replaced with fatty tissue. When this happens, your heart becomes weak and unable to pump blood around the body effectively. It usually takes many years for this to happen so most people are not diagnosed until later in life.

What else do I need to know?
Although cardiomyopathy cannot be cured, there are many effective treatments that can help you to lead a normal life. In a few cases, there is a risk of sudden arrhythmic death (SADS). You should discuss this with your doctor who will be able to advise you about treatments available to you.

Because cardiomyopathies can be inherited, you should speak to your GP about screening for your family. You can also find out more information from the BHF Genetic Information Service on Mon - Fri 0900 - 1800. All calls are charged at a local rate.

Congenital Heart Disease
Congenital heart disease is an abnormality of the heart that a person has had since birth. In some cases, the condition is diagnosed when the baby is still developing in the womb, but in most cases the problem is not discovered until after the baby is born.

There are many different types of congenital heart disease, for example, the heart’s valves may not be properly formed or there could be holes between the chambers of the heart.

The condition occurs in about 7 of every 1,000 pregnancies. For more than half of these children, the condition is a minor problem which either doesn’t need any treatment, or can be successfully corrected with surgery.
Other conditions are more serious and sadly, some children with congenital heart disease do not survive. However, thanks to advances in diagnosis and treatment most children will grow up to become adults and lead full and active lives.

What causes congenital heart disease?
In most cases, something has gone wrong in the early development of the foetus. Often, we don’t understand why the baby’s heart hasn’t developed normally. Some heart conditions in babies are due to faulty genes or chromosomal abnormalities.

How is the condition discovered?
Many heart problems are picked up when the mother has an ultrasound scan during pregnancy, but sometimes the problem is not detected until after the baby has been born. Some conditions may not be discovered until the child is older or even an adult.

What treatment is available?
Treatment depends on the type and severity of the condition. Some children won’t require any treatment, while others may need medication or heart surgery. There are also other new techniques and procedures which can be done to avoid the need for surgery.

What support can I get if my baby is born with a heart condition?
Learning that your child has a congenital heart condition can be very distressing. They will probably be under the care of a specialist centre, where health professionals can offer you support and help to cope with the situation.

What is Endocarditis?
Endocarditis is a rare but serious condition where the inner lining of the heart can become infected. Some people who have congenital heart disease are at a higher risk of endocarditis. See our information sheet on Endocarditis for further information.

Tests
It is normal to feel nervous if you are sent for a test. There are many different tests- from ECGs to blood tests.
Learn more about the most common tests.

Physical assessment
Your doctor will want to examine you and ask questions about your medical history and lifestyle. This will help your doctor to decide if you have a heart problem.

Blood tests
Blood tests are not just used to diagnose, but also to monitor your condition.

Chest X-ray
A chest x-ray allows doctors to examine the heart, lungs and chest wall.

ECG
An ECG is a simple and very useful test that records the electrical activity of the heart. Find out what happens during the test.

Echocardiogram
An ultrasound which looks at the pumping action of the heart, the structure and the valves. Learn more about how the test is carried out.

Angiogram
This procedure looks inside your coronary arteries to find out if you have coronary heart disease. It also helps to decide what treatment you might need.

MRI Scans
MRI can show the structure of your heart and blood vessels. It can also measure the flow of blood through your heart.

Radionuclide Tests
These tests include myocardial perfusion scans and CT scans. Find out what to expect if you having one of these tests.

Electrophysiology Tests
These tests analyse the heart’s electrical activity. Find out more about this procedure.

Treatment

Finding out that you or a loved one has a problem with their heart can be frightening, but there are very effective treatments available which help to get people better and improve their quality of life. Learn more about medication or the different treatments that might be recommended.

Treatment & Care
Treatments for heart disease range from low-tech to high-tech. Read about them here. You'll also find advice for caregivers -- including tips for caregiver care.

Treatment
CPR
Cardiopulmonary Resuscitation -- CPR -- is one link in what the American Heart Association calls the "chain of survival." Learn CPR for a loved one.

Automated External Defribrillators
“AEDs" for short, are devices capable of interpreting a person's heart rhythm and automatically delivering a shock to prevent sudden death. Read more.

Heart Disease Medications
Procedures & Surgeries
Care
Heart Disease Medication

A person with heart disease usually needs several medications. Taking them correctly is as necessary as it is difficult. Here are some tips.

Heart Surgery Recovery
Heart surgery recovery takes a lot of care. Here are some very, very important tips for the aftercare of a heart surgery patient.

Keep Up With Heart Medications
It's critically important to take one's heart disease medication exactly as prescribed. It's by no means an easy thing to do. Here's how to help.

Heart Emergency Preparedness
Don't wait until you've got an unconscious heart patient on your hands. Learn the alphabet of heart emergency preparedness: CPR, AED, and 911. Clicking here may save a life.

Caregiver Burnout
As much as you may love someone with heart disease, you can't help if you've got caregiver burnout. Here's how to avoid it.

Caregiver Stress
Taking care of a heart patient can raise your own blood pressure. Here are some tips for keeping your stress under control.

Religion and the Heart
Not all healing comes from doctors and medicines. Click here for some brief advice on making spirituality part of your caregiving.

Medicines for the Heart
Drugs may be part of your treatment for a heart condition. Find out what to ask your doctor when you get your prescription. The British Heart Foundation raises awareness of heart conditions.

Statins
Statins help to reduce cholesterol and prevent heart disease in people at high risk and those who have already had a heart attacks or stroke. Find out more about these protective drugs.

Angioplasty
Coronary heart disease can reduce the blood flow to the heart. Angioplasty is a technique that improves the blood flow.

Heart Surgery
If you need heart surgery, it's important to understand why and what to expect. You may be anxious, but don't be afraid to ask questions.

Cardioversion
This procedure helps your heart to return to a normal rhythm. Learn more about it.

Ablation
If you’ve been diagnosed with an abnormal heart rhythm, your consultant may have recommended that you have a procedure called an ablation. Find out what this means.

Pacemakers
The pacemaker’s job is to take over from the heart’s natural pacemaker – the sinus node. Modern pacemakers are comfortable and efficient. If you’re about to have a pacemaker fitted, find out what this means for you
ICD

Have you been diagnosed with a dangerous heart rhythm? Your doctor might have recommended that you have an ICD fitted. Learn more about it.

Medicines for your heart

Medication may be a key part of your treatment for a heart condition. Your drugs may be prescribed by your GP or by a heart specialist (cardiologist).

Either way, it’s important to know what you are taking, why you are taking it, when and how to take it and how it will affect you.

Your doctor will advise you on:
• the drugs which will suit you best
• potential benefits and risks of taking the drugs
• how safe it is to use particular drugs if you have any other medical conditions
• possible side effects and what to do if you notice any
• whether it is safe to take other kinds of drug

What do heart medicines do?
There are a number of different drugs to treat heart conditions. The way that each drug works depends on what it is.

Most drugs change how the heart or circulatory system work. Others are given to control high blood pressure or to help lower cholesterol. Some drugs can treat more than one condition.

Some drugs can change how the heart works in more than one way. For example, some beta-blockers can help lower your blood pressure and slow down your heart rate.

Which drug do I need?
You may have heard people talk about different drugs for heart disease and feel confused about all the drugs available. There might be several different drugs available for your heart condition, but not all of them will be right for you. Your doctor will choose the drug that’s most likely to be effective and which they think will suit you best.

Don’t be afraid to ask questions or to tell your doctor how your drugs are making you feel. People’s bodies respond to drugs differently and if your medication doesn’t suit you, your doctor will prescribe something else.

How often will I need to take my drugs?
Most drugs need to be taken regularly, but you should always follow your doctor’s instructions. In most cases, this means taking your drugs once or twice a day, but some drugs need to be taken when you experience a symptom, like angina (chest pain).

Other drugs can be used to prevent a symptom developing. For example, drugs for pain relief can help keep your pain under control before you do exercise.

Drugs come in different forms and you need to take them in different ways. For example, some drugs should be taken when you have an empty stomach, some with food and some after food. You may need to:
• take tablets or capsules
• use a spray under your tongue or
• put a patch on your arm.

It can be dangerous to stop taking your drugs without medical advice so speak to your doctor before you stop taking any medication.

Do heart drugs have side effects?
The drugs used to treat heart conditions are very safe. Although dangerous side effects are rare, all drugs have possible side effects so if you develop any new symptoms, it’s important to tell your doctor.

By law the information leaflet that comes with your drugs must list all its possible side effects. Your pharmacist can also tell you more about your drugs.

Why are there so many different drugs?
Most drugs designed to treat heart conditions belong to a few main types. Drugs of each type are similar, but they may work in slightly different ways.

The same drug may have several different names. Each drug has:
• an official name (also called its generic name)
• one or more trade names, (also called proprietary names) – given to it by its manufacturer

Occasionally, two drugs are combined in one tablet and have a single trade name.

Can I take over-the-counter drugs?
Over-the-counter drugs are drugs you can buy from a pharmacy or supermarket for problems like colds or headaches. You do not need a prescription to buy them.

Check with a pharmacist or your GP whether it is safe to take over-the-counter drugs as well as your prescribed drugs. It may be handy to have the name of your drug with you when you speak to the pharmacist.

Can I take herbal remedies, vitamins or other supplements?
Some people take herbal remedies, vitamins or other supplements which have not been prescribed by their doctor.

Although you may find these products helpful, you should not consider them as substitutes for prescribed drugs. That’s because most of them have not gone through research trials to establish how safe or effective they are.
Herbal remedies, vitamins or other supplements can change the way your prescribed drugs work so check with your doctor before you take a supplement.

CVD prevention and control: missed opportunities
Although many cardiovascular diseases (CVDs) can be treated or prevented, an estimated 17.1 million people die of CVDs each year. A substantial number of these deaths can be attributed to tobacco smoking, which increases the risk of dying from coronary heart disease and cerebrovascular disease 2–3 fold. The risk increases with age and is greater for women than for men. In contrast, cardiac events fall 50% in people who stop smoking and the risk of CVDs, including acute myocardial infarction, stroke and peripheral vascular disease, also decreases significantly over the first two years after stopping smoking.

Continuing to smoke after myocardial infarction or coronary revascularization can have serious clinical consequences. Even eight years after myocardial infarction, the mortality of post-myocardial infarction patients who continue to smoke is double that of quitters. Further, those who do not stop smoking after coronary revascularization also have a two-fold higher risk of re-infarction and death.

Studies indicate that although doctors are knowledgeable about the risks of CVDs associated with tobacco smoking, they are not sufficiently prepared to help their patients stop smoking. Even though physicians identify a substantial number of smokers during consultations, for example, many patients do not receive counseling to help them quit. Smoking cessation is the most cost-effective intervention for patients with documented CVDs, and efficacious programmes have been developed. The challenge is to get these programmes more widely used, and doctors and nurses should seize every opportunity to encourage patients to stop smoking.

The mission of the WHO Cardiovascular Diseases Program is to provide global leadership in the prevention and control of CVDs, and to assist Member States reduce the toll of morbidity, disability and premature mortality due to CVDs.

Plaque build up in arteries.

Symptoms of Heart Disease
Coronary artery disease, heart attack -- each type of heart disease has different symptoms, although many heart problems have similar warning signs. The symptoms you experience depend on the type and severity of your heart condition. Learn to recognize your symptoms and the situations that cause them. Call your doctor if you begin to have new symptoms or if they become more frequent or severe.

Find Out Now If You're at Risk for the 5 Biggest Health Concerns
Symptoms of Coronary Artery Disease

The most common symptom of coronary artery disease is angina, or chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina is usually felt in the chest, but may also be felt in the shoulders, arms, neck, throat, jaw, or back.

Other symptoms of coronary artery disease include:
• Shortness of breath
• Palpitations (irregular heart beats, skipped beats, or a "flip-flop" feeling in your chest)
• A faster heartbeat
• Weakness or dizziness
• Nausea
• Sweating

Symptoms of a Heart Attack (Myocardial Infarction or MI)
Symptoms of a heart attack can include:

• Discomfort, pressure, heaviness, or pain in the chest, arm, or below the breastbone
• Discomfort radiating to the back, jaw, throat, or arm
• Fullness, indigestion, or choking feeling (may feel like heartburn)
• Sweating, nausea, vomiting, or dizziness
• Extreme weakness, anxiety, or shortness of breath
• Rapid or irregular heartbeats

During a heart attack, symptoms typically last 30 minutes or longer and are not relieved by rest or oral medications (medications taken by mouth). Initial symptoms can start as a mild discomfort that progresses to significant pain.

Some people have a heart attack without having any symptoms (a "silent" MI). A silent MI can occur among all people, though it occurs more often among diabetics.

If you think you are having a heart attack, DO NOT DELAY. Call for emergency help (dial 911 in most areas). Immediate treatment of a heart attack is very important to lessen the amount of damage to your heart.
Symptoms of Arrhythmias

When symptoms of arrhythmias, or an abnormal heart rhythm, are present, they may include:

• Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops," or feeling that your heart is "running away").
• Pounding in your chest.
• Dizziness or feeling light-headed.
• Fainting.
• Shortness of breath.
• Chest discomfort.
• Weakness or fatigue (feeling very tired).

Symptoms of Atrial Fibrillation
Atrial fibrillation (AF) is a type of arrhythmia. Most people with AF experience one or more of the following symptoms:
• Heart palpitations (a sudden pounding, fluttering, or racing feeling in the heart).
• Lack of energy; tired.
• Dizziness (feeling faint or light-headed).
• Chest discomfort (pain, pressure, or discomfort in the chest).
• Shortness of breath (difficulty breathing during activities of daily living).

Some patients with atrial fibrillation have no symptoms. Sometimes these episodes are briefer.

Symptoms of Heart Valve Disease
Symptoms of h eart valve disease can include:
• Shortness of breath and/or difficulty catching your breath. You may notice this most when you are active (doing your normal daily activities) or when you lie down flat in bed.
• Weakness or dizziness.
• Discomfort in your chest. You may feel a pressure or weight in your chest with activity or when going out in cold air.
• Palpitations (this may feel like a rapid heart rhythm, irregular heartbeat, skipped beats, or a flip-flop feeling in your chest).
If valve disease causes heart failure, symptoms may include:
• Swelling of your ankles or feet. Swelling may also occur in your abdomen, which may cause you to feel bloated.
• Quick weight gain (a weight gain of two or three pounds in one day is possible).

Symptoms of heart valve disease do not always relate to the seriousness of your condition. You may have no symptoms at all and have severe valve disease, requiring prompt treatment. Or, as with mitral valve prolapse, you may have severe symptoms, yet tests may show minor valve disease.

Symptoms of Heart Failure

Symptoms of heart failure can include:
• Shortness of breath noted during activity (most commonly) or at rest, especially when you lie down flat in bed.
• Cough that is productive of a white mucus.
• Quick weight gain (a weight gain of two or three pounds in one day is possible).
• Swelling in ankles, legs, and abdomen.
• Dizziness.
• Fatigue and weakness.
• Rapid or irregular heartbeats.
• Other symptoms include nausea, palpitations, and chest pain.

Like valve disease, heart failure symptoms may not be related to how weak your heart is. You may have many symptoms, but your heart function may be only mildly weakened. Or you may have a severely damaged heart, with little or no symptoms.

Symptoms of Congenital Heart Defects
Congenital heart defects may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. Sometimes it can be diagnosed because of a heart murmur on physical exam or an abnormal EKG or chest X-ray in someone with no symptoms.

In adults, if symptoms of congenital heart disease are present, they may include:
• Shortness of breath.
• Limited ability to exercise.
• Symptoms of heart failure (see above) or valve disease (see above).

Congenital Heart Defects in Infants and Children
Symptoms of congenital heart defects in infants and children may include:
• Cyanosis (a bluish tint to the skin, fingernails, and lips).
• Fast breathing and poor feeding.
• Poor weight gain.
• Recurrent lung infections.
• Inability to exercise.

Symptoms of Heart Muscle Disease (Cardiomyopathy)
Many people with cardiomyopathy have no symptoms or only minor symptoms, and live a normal life. Other people develop symptoms, which progress and worsen as heart function worsens.

Symptoms of cardiomyopathy can occur at any age and may include:
• Chest pain or pressure (occurs usually with exercise or physical activity, but can also occur with rest or after meals).
• Heart failure symptoms (see above).
• Swelling of the lower extremities.
• Fatigue.
• Fainting.
• Palpitations (fluttering in the chest due to abnormal heart rhythms).

Some people also have arrhythmias. These can lead to sudden death in a small number of people with cardiomyopathy.

Symptoms of Pericarditis
When present, symptoms of pericarditis may include:
• Chest pain. This pain is different from angina (pain caused by coronary artery disease). It may be sharp and located in the center of the chest. The pain may radiate to the neck and occasionally, the arms and back. It is made worse when lying down, taking a deep breath in, coughing, or swallowing and relieved by sitting forward.
• Low-grade fever.
• Increased heart rate.

Prepared by: Md. Azizur Rahman Munna, B.Pharm Mobile: 8801712474778