All You Need to Know About the Most Common Cardiovascular Diseases

Cardiovascular diseases are the leading cause of death among young people (aged 25 to 64 years) in the United States. The main insidiousness of this group of diseases is that they are often asymptomatic, and a person learns that he or she has heart problems when he or she can no longer be helped. We talked with the cardiologist of the American Heart Association about what cardiac diseases are most common, how to diagnose them, and what symptoms you should pay attention to.

The heart is a muscular organ that pumps blood around the body. The heart muscle is called the myocardium, and it is constantly working – on average, at rest, the heart “pumps” 5 liters of blood per minute, and during intense exercise – more than 15 liters per minute! In order to perform this work effectively, the coordinated work of the entire system is important: the main muscle (myocardium), atria, ventricles, blood vessels. The myocardium must be constantly well supplied with nutrients and oxygen. If the work of one of the elements of the system is disrupted or the vessels supplying the heart with blood are clogged with cholesterol plaques, cardiac diseases develop.

Most common diseases of the cardiovascular system

The most common conditions requiring the help of a cardiologist:

• hypertonic disease;
• cardiac ischemia;
• heart failure;
• atrial fibrillation.

Let’s talk about each disease in more detail.

Hypertension

Essential hypertension or arterial hypertension (AH) is a very common condition associated with a chronic increase in blood pressure. This disease can develop as a consequence of some other conditions (secondary hypertension), or by itself (primary hypertension).

Blood pressure is the pressure inside the blood vessels – arteries. The blood expelled from the heart (about 60 ml) with one contraction stretches the aorta and large arterial vessels from the inside. The walls of blood vessels expand under the pressure of blood and then narrow again. The strongest pressure on the blood vessels is recorded during the contraction of the heart (systole) – this pressure is called systolic. When the heart relaxes (diastole), blood pressure in the arteries decreases. This pressure is called diastolic.

In a healthy person, systolic blood pressure ranges from 100-140 mm Hg. Art., and diastolic about 70-80 mm Hg. Art. Normally, pressure figures can fluctuate depending on the state of the person: increase during physical or psycho-emotional stress, decrease during sleep.

The reasons why normal blood pressure is disturbed, in most cases, cannot be established. Certain factors are known to increase a person’s risk of developing hypertension. They can be divided into non-modifiable (which we cannot change) and modifiable.

Non-modifiable causes:

• Age. With age, the walls of large arteries become more rigid. Because of this, the resistance of blood vessels to blood flow increases, therefore, blood pressure rises.
• Hereditary predisposition. The genetic factor is considered to be the main one in the development of essential hypertension. However, the genes responsible for the occurrence of this disease have not yet been found.
• Sex. Men are more likely to suffer from arterial hypertension.

Modifiable Causes:

• Smoking;
• Excess salt in the diet;
• Excessive alcohol consumption;
• Abdominal obesity (deposition of fat in the abdomen, “beer” belly);
• Low physical activity;
• Chronic stress;
• Increased blood sugar;
• Snoring, especially when breathing stops;
• Changes in the lipid (fatty) composition of the blood.

The eradication of these “vices” of modern life is the basis for the prevention of not only hypertension but all cardiovascular diseases in general.

Symptoms of arterial hypertension

• Headache;
• Dizziness;
• Flashing “flies” before the eyes.

Most often, hypertension is not accompanied by any symptoms and is detected incidentally when measuring blood pressure or after the development of its complications, the most dangerous of which is a stroke. Therefore, to prevent hypertension, doctors recommend regularly measuring blood pressure. If something bothers you, immediately consult a doctor.

A sudden increase in blood pressure can provoke a hypertensive crisis accompanied by pathological changes in the brain and cardiovascular system against the background of vegetative disorders (chills, trembling, sweating, a feeling of a rush of blood to the head, a feeling of lack of air, etc.) If the patient is hypotensive, even a slight increase in blood pressure can cause a clinical picture of a hypertensive crisis.

If a hypertensive crisis is accompanied by intense pain in the chest, shortness of breath, loss of vision, impaired coordination of movements, vomiting – call an ambulance immediately! Such crises pose a danger to the life of the patient and require an immediate decrease in blood pressure in a hospital setting. Complications of the crisis can be myocardial infarction, cardiac arrhythmias, bleeding, strokes, acute encephalopathy, acute renal failure, etc.

Ischemic heart disease (IHD), or coronary heart disease (CHD)

IHD is a disease in which the blood supply to the heart muscle is disrupted, as a result of which it lacks oxygen and nutrients. This is usually due to blockage of the main arteries of the heart by atherosclerotic plaques. Over time, there are more and more of them, and when the lumen of the vessel is blocked by 60% or more, there is a difficulty in blood flow, oxygen starvation (hypoxia) develops, which leads to myocardial ischemia and the onset of an angina attack, as well as to the most dangerous complication of coronary artery disease – acute myocardial infarction.

Angina pectoris is a temporary, transient lack of blood supply to the heart muscle (myocardium). An attack of angina pectoris occurs when the lumen of the coronary artery narrows, through which the heart muscle is supplied with oxygen. With an attack of angina pectoris, pain occurs that has a pressing, squeezing or burning character, it is localized in the middle of the chest, behind the sternum. Most often, pain occurs during physical or emotional stress, at rest it disappears.

An attack of angina pectoris is a signal that the heart muscle is lacking blood supply, the first “bell” that says that you need to see a doctor urgently to prevent a more dangerous complication, such as acute myocardial infarction.

Acute myocardial infarction is the death of a section of the heart muscle due to a violation of its blood supply. This can happen due to blockage of the vessel by a thrombus – a blood clot that forms at the site of damage to an atherosclerotic plaque. As a result, blood stops flowing to the heart muscle, and this leads to myocardial infarction – necrosis, tissue necrosis. Subsequently, a scar is formed at this place.

Most often, with a myocardial infarction, a person experiences acute pain (burning, pressing) behind the sternum or on both sides of the chest, often the pain radiates to the jaw, neck, back under the shoulder blades, to the upper abdomen. The pain can come in waves – either intensifying or weakening. Pain may be accompanied by palpitations, weakness, cold sweat, low blood pressure, feeling short of breath, dizziness, fainting, nausea. This state lasts from 20 minutes to several hours. The above symptoms may appear in different combinations, it is not necessary that all signs be present. In some cases, myocardial infarction can occur without a pronounced pain syndrome, with atypical pain sensations (similar to osteochondrosis or gastric ulcer, for example), and it can also occur without any symptoms at all.

One must remember that acute myocardial infarction is the most dangerous disease with a high level of deaths. Therefore, if you suspect that you or your close person has a myocardial infarction, call an ambulance urgently.

Heart failure

Heart failure is a pathology in which the heart cannot fully cope with its function, as a result of which other organs and tissues of the body receive less nutrients and oxygen.

Heart failure is expressed in the discrepancy between the needs of the body and the capabilities of the heart. Normally, the heart muscle contracts with a certain intensity and “pumps” a large amount of blood. In heart failure, the body cannot cope with its function. Most often, this is expressed by shortness of breath, weakness, swelling. At the initial stage of the disease, heart failure manifests itself only during physical exertion – when the heart is forced to work more intensively. At this stage, the disease can still be completely cured, so do not ignore even the slightest hint of symptoms and consult a doctor!

The more advanced the disease, the greater the disturbances in all organs and systems can lead to a long-term lack of blood supply and nutrients.

Atrial fibrillation

Atrial fibrillation is a disease in which the rhythm of heart contractions is disturbed. Normally, the conduction system of the heart generates an impulse that causes the heart to contract at a certain frequency, in sinus rhythm. With atrial fibrillation, the sinus node stops working, the muscle fibers of the two upper chambers of the heart stop rhythmically contracting, and tremble or contract uncoordinated. This leads to an irregular heartbeat, and as a result, blood enters the chambers of the heart unevenly, can accumulate in them, resulting in the formation of blood clots (thrombi). A blood clot can travel through the bloodstream to the brain and cause a stroke. Uncontrolled atrial fibrillation increases the risk of stroke by about 5 times!

Symptoms of atrial fibrillation: change in heart rate, shortness of breath, chest pain, weakness, dizziness, fainting. Often, with atrial fibrillation, a person does not feel any changes, and the disease is detected by chance – during a preventive examination.

The number of diagnosed cases of atrial fibrillation is constantly growing. At the same time, new, modern drugs have now appeared that effectively fight this disease. The main thing is to contact a cardiologist in time.

Methods for diagnosing cardiovascular diseases

Electrocardiogram (ECG) at rest. ECG measures the heart rate, allows you to assess the condition of the heart muscle and the general condition of the heart. This is usually the so-called screening examination – that is, one that is recommended to be carried out regularly as a preventive measure, even in the absence of complaints. Unfortunately, it is not very informative due to its short duration, but we can “catch” the most serious pathological changes with the help of an ECG.

If there are complaints, suspicion of the diseases, it is recommended to perform more detailed tests.

ECG with physical activity (treadmill test). This procedure is continuous ECG recording and blood pressure monitoring under conditions of a step-increasing dosed load on a treadmill until a submaximal heart rate (200 minus age) is reached. This makes it possible to identify possible ischemia (oxygen starvation) of the heart muscle, which is not detected at rest.

The study is carried out on a specially equipped treadmill. During the treadmill test, walking is actually simulated – a familiar form of exercise for any person. That is why most researchers consider the treadmill test to be a more physiological method of stress testing. Adhesive electrodes are attached to the chest and distal extremities for ECG recording. With the help of a computer program, the slope of the track is adjusted, due to which the patient is given a certain physical load with a gradual further increase.

During the treadmill test, the patient should report pain and other discomfort. The study ends when a certain heart rate is reached or due to a deterioration in the patient’s well-being. After the procedure is terminated, the cardiogram and blood pressure readings continue to be recorded for about 10 minutes.

The value of any examination is characterized by the sensitivity and specificity of the method, which are quite high for the load treadmill test: according to various authors, the sensitivity of the treadmill test is 80–85%, the specificity is 83–88%.

The results of the treadmill test allow choosing the most optimal method of treatment – conservative or surgical, evaluating the effectiveness of therapy, giving recommendations on household and professional physical activity, and drawing up rehabilitation and training programs.

Holter ECG monitoring

This examination is a continuous recording of the work of the heart on the ECG during the day – using a special portable device that is attached to the patient. During the study, the patient is recommended to lead a normal life – for the most accurate result.

Holter is a small device that is attached to the patient’s belt, sensors are attached to the chest. The procedure itself is automated, the patient does not have to do anything with the device. During Holter monitoring, the patient keeps a diary of activity and rest, notes his/her well-being. After the device is removed, the data from the device and from the patient’s diary are entered into a special program in which this information is analyzed and a daily cardiogram is displayed.

Daily monitoring allows you to track the dynamics of the human heart for a longer time than with a conventional ECG or measuring blood pressure. As a result, we get a much more complete and reliable picture.

Ambulatory blood pressure monitoring (ABPM)

ABPM is an automatic measurement of blood pressure for a day or more (if necessary) at certain intervals, according to a given program (usually every 15 minutes during the day and 30 minutes at night). A blood pressure cuff is put on the patient’s upper arm and connected to a portable monitor of small size and weight (about 200 grams), which the patient wears on his/her belt. Measurements are carried out on an outpatient basis, under the conditions of the patient’s normal activity. The system provides automatic measurement of heart rate, systolic and diastolic blood pressure at set intervals, on the basis of which the average daily blood pressure and heart rate are calculated during the day and night, the degree of nighttime decrease and morning increase in blood pressure, the reaction to physical exertion and psycho-emotional stress are determined, degree and duration of hypertensive load on target organs, variability of pressure and pulse during the day, episodes of hypotension are detected. For a more accurate assessment, the patient is asked to keep a diary in which he or she describes his/her well-being and complaints during the examination, his/her activities, physical activity, indicates the time of taking medications, notes the time of sleep and awakening. The only limitation for the patient during ABPM is the need to relax the arm on which the measurement is taken in order to more accurately record.

The technique is simple, painless and very informative. It improves the accuracy of assessing the true level of blood pressure, especially when you suspect the presence of initial, unstable arterial hypertension.

Ultrasound of the heart. During the examination, the doctor can assess the structural features of the heart, the condition of the chambers and valves of the heart, the aorta, the size of the heart cavities and the pressure in them, the thickness of the walls of the heart, the thickness of the myocardium, the contractility of the heart muscle, the speed of intracardiac blood flow.

Ultrasound of the vessels of the head and neck is a screening examination for the presence of atherosclerotic changes in the walls of arterial vessels. Ultrasound allows clarifying the state of the arteries and veins that feed the brain, which will allow drawing conclusions about the risk of developing cardiovascular accidents, as well as detecting problems in the blood supply to the brain, neck, head and spine.

Vascular ultrasound is recommended for men over 40 years of age – unfortunately, in this category of patients, changes in the state of the vessels are not uncommon, which can be determined thanks to this study.

Blood tests

A cardiologist may recommend taking tests for cholesterol, glucose, and uric acid.

These indicators reflect the state of metabolism in the body: fat, protein, carbohydrate. A deviation from the norm in these indicators may indicate an increased risk of stroke, heart attack.

Symptoms you should pay attention to

• Level of pressure. An increase in pressure is always a sign that you need to see a doctor. Signs such as headaches, redness of the skin, tinnitus, and dizziness can indirectly indicate high blood pressure.
• Pain in the chest, especially associated with walking and physical activity. Also, chest pain can appear with increased pressure and stress. Such pain is likely to indicate heart disease. The pain syndrome can be either constant or appear only with exertion, and subside at rest.
• Shortness of breath is another fairly common symptom of heart problems.

It is important to understand that heart disease is often asymptomatic or comes with mild symptoms. With age, the risk of their development increases significantly. Therefore, any man over 40 years of age and a woman over 50 years of age should regularly visit a cardiologist for preventive care. An ECG should be performed at least once a year – to check if everything is in order.

Most of the heart diseases “caught” at the initial stage are successfully treated.

Why is it necessary to visit a cardiologist and do an ECG during pregnancy?

Pregnant women are sent for an ECG several times during pregnancy, and it is also often recommended to consult a cardiologist. In addition, blood pressure is monitored at each visit to the doctor. What is it connected with?

Pregnancy is always stressful for the body. During pregnancy, the load on the whole body and, in particular, on the heart increases. The volume of circulating blood increases, the heart rate increases. This can provoke hypertension, heart defects, rhythm disturbances. Therefore, it is important to constantly monitor the condition of a woman in order to stop the disease in time and prevent serious complications.

It often happens that these conditions appear during pregnancy and disappear after childbirth.

“Working pressure” is a harmful myth

There is an officially permitted maximum upper limit for blood pressure: 140/90 mm Hg. Art. – this is the border, after which hypertension is already placed.

But there is a common myth among the people that there is a so-called working pressure – it can be above this limit, but it is believed that if a person feels well, then it’s okay, there is no need to be treated. This is a dangerous delusion!

The risk of complications with hypertension is equally high, regardless of whether you feel unpleasant symptoms or not! Yes, hypertension is often asymptomatic. But the risks of a hypertensive crisis, stroke, heart attack, etc. remain. Therefore, the main indicator for prescribing treatment is the results of measuring blood pressure, and not the patient’s well-being. High blood pressure must always be reduced – this is the only way to avoid complications and serious consequences of hypertension.

Another common misconception is that blood pressure medications can be taken not constantly but only during episodes of high pressure. This is not true. Arterial hypertension is a chronic disease. And in order for the patient’s condition to remain stable, medications must be taken as prescribed by the doctor – regularly. Agree, this is not such a big price for good health and reduced risk of stroke and other complications – take a pill once a day!

Extrasystole – what is it?

Extrasystole is one of the types of heart rhythm disturbance. Quite often, extrasystole is detected with the help of the ECG. This violation is quite common. Only a doctor can determine how serious it is. Most likely, if you have been diagnosed with extrasystole, this is not a reason to panic – even an absolutely healthy heart can give such a rhythm disturbance. But it is important that such an arrhythmia can be provoked by serious heart diseases, that is, in this case, extrasystole will be one of the symptoms. That is why one should not ignore such symptoms and be sure to undergo an examination by a cardiologist.

Category: Heart Health

Tags: cardiology, cardiovascular disease, heart, heart disease, heart diseases, heart disorders