Heart Disease
19/06/2011 15:46
Heart disease is the nation's number one cause
of death among older adults. The disease takes
many forms in its effect on the human body,
such as heart attack, heart failure and sudden
death. Although the risk of dying from many of
these conditions has been reduced, it is
necessary for older adults to be aware of the
heart disease and its warning signs.
As I get older, what is my risk of heart
disease?
On average, men age 65 and over have a 25%
chance of developing heart disease over ten
years. However, if no additional risk factors are
present, such as diabetes, high blood pressure,
high cholesterol, or smoking (or if these
conditions are controlled by medications), the
chance of developing heart disease is 11% over
ten years. Women of the same age, on average,
have a 13% chance of developing heart disease
over ten years. The risk is only 8% over ten
years if no other risk factors are present.
What is cholesterol? Should I be
concerned if my cholesterol level is
high?
Cholesterol is a soft, waxy substance found
among the fats in the bloodstream and in all
your body's cells. Cholesterol is produced by
the body, but also comes to us from animal
products we eat, such as meats, fish, eggs,
butter, cheese and whole milk. Low-density
lipoprotien, or LDL, is known as the "bad"
cholesterol. Too much LDL cholesterol can clog
the arteries to your heart and increase your risk
of heart attack. High -density lipoprotein, or
HDL, is known as the "good" cholesterol. There
is strong evidence that we should reduce our
LDL cholesterol when it is abnormally high.
What is coronary artery disease?
Coronary artery disease is the hardening of the
vessels that supply blood to the muscles of the
heart. The hardening is the most often caused
by a buildup of plague (deposits of the fat-like
substances) in the arteries. This condition
reduces the blood supply to the heart and cause
a heart attack. When permanent damage occurs
to the heart muscle it is called a myocardial
infarction (MI).
Are any groups of people more likely
to develop coronary artery disease?
Yes. There are certain risk factors for the
development of atherosclerotic coronary artery
disease. However, since the peak occurence of
the coronary artery disease in the 1960s, deaths
due to ischemic heart disease have been
decreasing. This decrease has occurred most
likely because of the identification and
reduction of the specific risk factors. The risk
factors for the development of atherosclerotic
coronary artery disease include:
· Family history
· Male sex
· High level of lipids(fats) in blood
· Diabetes mellitus
· Hypertension
· No physical activity
· Cigarette smoking
· Personality type or behavior pattern
· Ending of Menstrual cycle
· Pills preventing pregnancy
· Obesity
· Excessive alcohol intake
What are the symptoms of a heart
attack?
Common warning signs of a heart attack
include:
· An uncomfortable pressure, fullness.
squeezing or pain in the center of the chest
that lasts for more than a few minutes, or
goes away and comes back;
· Pain that spreads to the shoulders, neck or
arms
· Chest discomfort with light head ness,
fainting, sweating, nausea or shortness of
breath.
Less common warning signs of heart attack
include: back or shoulder pain; stomach or
abdominal pain; nausea or dizziness(without
chest pain); shortness of breath and difficulty
breathing(without chest pain); unexplained
anxiety, weakness or fatigue; and palpitations,
cold sweat or paleness. Chest pain associated
with the heart is often called angina or angina
pectoris.
What are the risk factors for coronary
artery disease?
Risk factors for CAD often include:
· High blood cholesterol
· High blood pressure (hypertension)
· Physical inactivity
· Smoking
· Obesity
How is coronary artery disease
diagnosed?
In addition to a complete medical history and
physical examination, diagnostic procedures
for coronary artery disease may include any, or
a combination of, the following:
· Electrocardiogram (ECG) - a test that
records the electrical activity of the heart,
shows abnormal rhythms (arrhythmias or
dysrhythmias), and detects heart muscle
damage.
· Stress test (usually with ECG; also called
treadmill or exercise ECG)- a test that is
given while a patient walks on a treadmill
to monitor the heart during exercise.
Breathing and blood pressure rates are also
monitored. A stress test may be used to
detect coronary artery disease, and/or to
determine safe levels of exercise following
a heart attack or heart surgery.
· Coronary arteriogram (or angiogram) -
with this procedure, x-rays are taken after a
contrast agent is injected into an artery - to
locate the narrowing, occlusions, and other
abnormalities of specific arteries.
· Nuclear scanning - radioactive material is
injected into a vein and then is observed
using a camera as it is taken up by the
heart muscle. This indicates the healthy
and damaged areas of the heart.
Treatment for Coronary Artery
Disease
Treatment of Coronary Artery Disease is not
simple. A patient's heart and life depend upon
its successful treatment. For some people,
careful lifestyle changes and medications can
control the disease. In more serious cases,
surgery may be required. In any case, the
disease requires lifelong management.
Lifestyle changes
One of the best ways to treat coronary artery
disease is to change one's habit. The most
beneficial changes include the following:
· Diet change: Many foods that taste good
are not necessarily good for healthy bodies,
especially bodies predisposed to
developing atherosclerosis. fats,
particularly saturated fats, cause high
levels of blood cholesterol, a primary
ingredient of the deposits that clog arteries.
· Being overweight also leads to high blood
cholesterol; therefore, losing weight is a
major step to a healthier heart and blood
vessels. Patients should concentrate on
adding fruits and vegetables to their diet.
One or two servings of fish per week are
beneficial.
· Exercise: In the calories in - calories out
equation, exercise helps to take off excess
body weight. More importantly, moderate
amounts of physical exercise help build a
stronger circulatory system and decrease
the risk of death from coronary artery
disease. Patients with advanced forms of
the disease may need to limit their exercise,
and should check with their doctor for
special advice.
· Quit smoking
Medications
Medications can also help prevent the
progression of coronary artery disease. Other
drugs can improve blood flow to the heart if
the disease is already present. Some of the
more common medications include:
· Cholesterol lowering drugs: By decreasing
the amount of cholesterol, especially LDL
(the "bad" form of cholesterol), these drugs
decrease the primary material that make
up deposits that narrow or plug coronary
arteries. Examples of the these drugs are
niacin, statins, fibrates, and bile acid
sequestrants. And now a novel drugezetimibe
which you have been prescribed.
Some foods and butter are now available
with special cholesterol-lowering
ingredients.
· Aspirin: This common medication, and
other blood thinners, can reduce the
tendency of blood to clot, and the
likelihood of a blocked coronary artery and
heart attack. Other antiplatelet agents or
antioagulants may be prescribed as well.
· Beta-blockers: These drugs help to slow
heart rates and decrease blood pressure,
which lowers the heart's demand for
oxygen.
· Nitroglycerin: This medication, as a tablet,
spray, or skin patch, controls chest pain
(angina) by opening coronary arteries and
reducing heart's demand for oxygen .
· Calcium channel blockers: These drugs
also help to open coronary arteries to
increase blood flow to the heart muscle.
They also control high blood pressure.
Angiotension-converting enzyme (ACE)
these drugs allow blood to flow from the
heart more easily, decreasing the workload
on the heart.
Procedures involving opening or
cutting of skin
In specific situations, there are other dietary
supplements that may be prescribed such as Larginine
and Omega-3 fatty acids. Coronary
angioplasty - with this procedure, a catheter is
used to create a bigger opening in th vessel to
increase blood flow. Although angioplasty is
performed in other blood vessels. Percutaneous
Transluminal Coronary Angioplasty (PTCA)
refers to angioplasty in the coronary arteries to
permit more blood flow into the heart. There
are several types of PTCA procedures,
including:
· Balloon Angioplasty: a small balloon is
inflated inside the blocked artery to open
the blocked area.
· Atherectomy: the blocked area inside the
artery is "shaved " away by a tiny device on
the end of the catheter.
· Laser angioplasty: a laser used to
"vaporize" the blockage in the artery.
· Coronary Artery Stent: a tiny coil is
expanded inside the blocked artery to open
the blocked area ans is left in place to keep
the artery open.
· Gene therapy: Genes and growth factor
proteins may be injected directly into the
heart or through a catheter-delivery
system. These material may stimulate new
vessels to grow (angiogenesis) to restore
blood flow to the heart.
· Brachytherapy: prevent restenosis,
radiation may be directed to the lining of
the artery to eliminate the regrowth of
deposits that would clog the artery.
· Coronary artery bypass grafting (CABG):
Another way to manage a coronary
blockage is to create an alternative route for
the blood to go around the blockage. This
is the principal of coronary artery bypass
grafting (CABG). In this procedure, a short
piece of blood vessel is taken from some
other location in the body and placed onto
the heart muscle, around the obstructed
artery. Blood flows through the new vessel
to nourish the heart. If more then one
artery is blocked, a bypass can be
performed on each. This type of operation
was first done in 1969; it is now a common
procedure the world-over.
· Laser revascularization: In this new type of
surgery, the surgeon uses a laser beam to
make tiny new channels in the wall of the
heart muscle. New vessels may grow
through these channels and into the heart
to provide additional blood flow paths.
This procedure is considered only for
people in whom standard treatments are
no longer effective
What is heart failure ?
Heart Failure is a condition in which the heart
cannot pump enough blood to meet the body's
needs. This condition occurs when the heart
muscle has been damaged by a past heart
attack or other conditions, such as high blood
pressure or diseased heart valves. People with
heart failure cannot extra themselves because
they become short of breath and tired. Other
common signs of heart failure are swollen leg
or ankles and weight gain due to a buildup of
fluid in the body.
Doctor tells me I have High blood
pressure. What steps can I take to
reduce it ?
To help control mild to moderate high blood
pressure, your doctor may prescribe dietary
and lifestyle change such as : reducing your
salt intake ; eating more fruit, vegetables, and
fat-free and low-fat dairy products; reducing
alcohol consumption; incorporating exercise
into your daily activates; and maintaining a
healthy weight. in some cases, lifestyle changes
are not enough to bring blood pressure down
and your doctor must prescribe medication to
help control your blood pressure.
What dose it mean if I get lightheaded
when I stand up in the morning?
Having low pressure can cause a dizzy feeling
upon rising. As we age, blood vessels becomes
less responsive to change in position and the
body takes longer to adjust to gravity. To help
alleviate this feeling and to avoid a possible
fall, take your time when getting up so that
your system can adjust to an upright position.
Certain medications can also cause a
lightheaded feeling. You should speak with
your doctor to determine the exact cause of
your feeling.
Why does my heart occasional skip a
beat and sometimes beat really fast?
Occasional missed heartbeats are fairly
common, even in young people. When the
heart takes up a persistent irregular rhythm it
may be a sign of atrial fibrillation or another
more serious abnormality. If the rhythm
disturbance is accompanied by symptoms of
weakness, fatigue, dizziness, chest pain or
tightness, fainting or shortness of breath, seek
medical attention immediately.