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Understanding different Heart Problems

 

   Understanding different Heart Problems 

 

Globally there are around millions people living with CVD . CVD ( Cardiovascular Disease ) is one of the leading causes of death worldwide . In India too CVD is one of the leading causes of death . Behaviors which can affect our risk of developing health issues that can lead to coronary artery disease, including:- Obesity , high cholesterol , high blood pressure , diabetes and  smoking .We often hear about the death of people by  Angina , Heart attacks , heart failures and cardiac arrest .  They are all serious and need immediate attention but often we treat them interchangeably . 


Angina Vs Cardiac Arrest vs Heart Attack vs Heart Failure 


In short a heart attack is when blood can’t reach the heart , heart failure is when the heart fails to circulate adequate blood properly and cardiac arrest is when the heart stops beating suddenly . Let us try to understand - 


Angina - Angina Pectoris commonly called Angina -  It is a Type of chest pain caused by reduction of blood to the heart . Angina is a CAD ( coronary artery disease ) mainly due to blockage of Artery / arteries supplying blood to heart . It is also felt like squeezing , pressure , tightness , heaviness in the chest . Sometimes it’s confused with heart attack or chest pain due to indigestion . It can come and go with medications or  sometimes itself on rest . Types of Angina -


Stable Angina - This is the most common angina problem which happens due to activities or exertion like exercise or walking uphill . This can go off by rest or after taking angina medicines .


Unstable Angina - This is the unpredictable type of angina - it can happen with nominal efforts or even while resting . It’s more severe than stable angina and lasts longer also , say 20 minutes . It’s dangerous and does not go away on rest or even with usual angina medicines . If the blood flow remains reduced it can cause heart attack also . It needs emergent treatment . 


Variant Angina or Prinzmetal Angina - Severe chest pain happens in this type of angina . It’s not due to CAD . It’s caused by spasms in the heart’s arteries which tentatively reduces blood flow to heart . This usually happens in the night , particularly in the wee hours . It may go away with angina drugs . 


Refractory Angina - This type of angina happens frequently despite medications .


Symptoms -  Besides Chest pain or tightness it can be - dizziness , fatigue , sweating ,nausea and shortness of breath . Sometimes it might be accompanied with abdominal pains , neck and jaw pains ,  particularly in women . 


Risk Factors - Old age , family history , tobacco , high B.P. , diabetes , high cholesterol , obesity , inactivity . stress , drug misuse , too cold  .


Diagnosis - Blood test , X- ray , ECG , CT scan  MRI , Stress Test , Angiography . 


Treatment - Medications , Angioplasty or stenting , Lifestyle changes , Bypass surgery 


Cardiac Arrest -It results from electrical disturbances that cause the heart to suddenly stop beating the way it should . What is CARDIAC ARREST - Abnormal heartbeats are called Arrhythmia . Heart beats can be too fast or too slow . Either of them can cause the heart to stop beating . We all know our normal heart rate is 72 beats per minute.  When Arrhythmia happens the heart stops beating entirely and causes death . This is called Cardiac Arrest . Cardiac arrest basically happens due to electrical disturbances that cause the heart to suddenly stop  beating  in the manner it should do . 

Symptoms of Cardiac Arrest - The good thing about  Cardiac arrest is that it’s reversible , if attended in time . The moment it happens the person becomes unresponsive and unable to breathe . If anyone knows CPR  ( cardiopulmonary resuscitation) , the person can be saved or if a defibrillator is available use it immediately . Cause - CAD , physical stress , hereditary and may be for unknown reasons too . But Arrhythmia can happen even without CAD . In  80 % of cases of Arrhythmia they are detected by ECG . So the moment you feel such a problem, get screened for it . 

 Diagnosis - Most cases can be detected by ECG . Other tests as per doctor’s advice may be Echocardiogram (  sometimes called Echo in short ) , Nuclear scan , X ray ( can tell about size of heart and lungs ) , Blood tests  and catheterisation .

Treatment for Arrhythmia - 


Catheter ablation. ...

Pacemaker. ...

Implantable cardioverter-defibrillator (ICD). ...

Maze procedure. ...

Coronary bypass surgery.

 
Heart Attack - Heart attack happens when blood flow to heart is blocked .Blood clots, cholesterol deposits and atherosclerosis all can cause blood clots in arteries and heart attacks  . In a heart attack the heart keeps beating but oxygen rich blood can’t reach the organ . The more damage to the heart will happen the longer  it's  left unattended . Heart attacks are almost always caused by narrowing of arteries which subsequently results in plaque buildup . This is known as Atherosclerosis . 

 
Symptoms of Heart Attack - The common signs of heart attack are - chest pain which may radiate to the left arm and might be in the right arm also , sweating , nausea or vomiting , jaw pain and shortness of breath . These signs might develop slowly in hours , days or weeks also . Symptoms of heart attacks among men and women may differ .

 
Risk factors - Main Risk factors  of heart diseases  are high blood pressure, high low-density lipoprotein (LDL) cholesterol, diabetes, smoking and secondhand smoke exposure, obesity, unhealthy diet, and physical inactivity.
Diagnosis - Electrocardiogram (ECG)

Blood tests.

Chest X-ray.

Echocardiogram.

Angiogram ( Coronary catheterization )

Cardiac CT 

  MRI .

Treatment - Medications , stents , ballooning ,  bypass surgeries depending on medical conditions 

Heart Failure - Heart failure happens when the heart fails to circulate enough blood throughout our body .  Failure to supply oxygen rich blood causes severe damage to heart muscles . This might also adversely affect heart rhythms and cause Cardiac arrest .  CAD , diabetes , high BP, obesity , can lead to heart failures.  People of  Old age  ( 65 + ) and previous history of heart attack are more at risk  .  Women are less prone to heart failures than men . Depending on the extent of heart failures it is categorized in stages i to iv ( iv being the  worst stage ).

Symptoms of Heart Failure - When the heart's capacity to pump blood reduces blood and fluid may back up into lungs causing swelling of ankles , feet or legs . And the affected person will feel tiredness and shortness of breath . The doctor will try to figure out the underlying reasons for it .irregular heart beats , swelling in abdomen , nausea , lack of appetite , chest pain ( if failure is by heart attack ) 

Diagnosis - Blood tests , ECG , Echo , Stress test , CT scan , MRI , myocardial biopsy and angiogram . 

Treatment - there are several medicines for it depending on condition .

 
Last but not the least is Panic attack 

 
What is a Panic Attack - Many cases of angina / heart attack which come to Emergency turn out to be a Panic attack . Most symptoms of  Panic attack are the same as angina / heart attack . Actually it’s very tricky for a doctor to differentiate between them . Moreover different people often feel differently during such attacks . There can be other reasons for similar symptoms of heart attack  like in case of Pancreatitis , Pneumonia , Panic attack , Pulmonary Embolism ( a blood clot in lungs ) and Aortic Dissection which means a tear in the inner layer of Aorta ( the largest Artery of body which carries blood from heart to our circulatory system .  

Panic attack is an episode of sudden and big fear that triggers some serious  physical reactions  while there is no real cause or real danger . It’s too frightening and one feels like dying like in a heart attack .Main reasons are - genetic , huge stress or emotions , environment and some functions of the brain .   There are effective treatments for it . 

Diagnosis - Physical exam. , blood tests ,ECG , Psychological evaluation . 
Treatment - Psychotherapy and Medications as decided by your doctor . 


Bottom Line  - This is not medical advice . All heart diseases are not the same . It can affect differently - blood vessels to the heart or brain , Valves and muscles of heart , or any other area / organ of blood . CVD might need long term treatment or can come suddenly which can be serious . The bottom line is that whenever you feel any discomfort in your chest and /or breathing problem , you must seek medical advice sooner .

But a healthy lifestyle - regular consumption of a well balanced diet , regular  exercise , maintaining a regular weight is your own tool to protect your heart . Often such episodes might happen in our life on a couple of occasions due to stressful situations but they are not life threatening but they affect quality of life . In some cases there might be repeated episodes which are known as Panic disorder .