Introduction to Heart Disease

What is Heart Disease?

The term heart disease actually applies to a number of illnesses that affect the circulatory system, which consists of heart and blood vessels. It is intended to deal here only with the condition commonly called "Heart Attack" and the factors, which lead to such condition.

Heart attack is the popular term for sudden pain in chest with breathing difficulty arising out of certain heart conditions. Heart attacks can be suddenly fatal, but the great majority- an estimated 85 percent are not. The patient recovers under proper treatment and goes on to live many useful years.

Like all muscles and organs of the body, the heart also needs nourishment and food which it gets thorough its own arterial system. The arteries, which supply blood to the heart muscle, may lead to impairment of its function. The sudden narrowing of the artery may result in the sudden stoppage of blood supply to the heart muscle. Such attacks of narrowing of arteries are called angina. If the damage takes place it is called infarction.

Infarction can also occur because of a blood clot, big enough to interfere with blood supply, is formed in the coronary artery. This formation of blood clot is called trombosis and the clot itself is known a thrombus. The term coronary heart disease is usually applied to diseases of the heart secondary to defective or interrupted supply of blood to the heart muscles through the coronary arteries.

Besides the sudden narrowing of coronary arteries such as in anginal attacks or thrombosis the blood supply to heart muscle could also be impaired by certain long term and (chronic) conditions like arteriosclerosis and atherosclerosis.

Arteriosclerosis is a condition when certain arteries (may be all) start losing their elasticity and their walls, due to some unknown factors, become thickened and hardened. When this happens. Blood pressure inside the arteries tends to become high and which in its wake puts more stress and strain on heart.

Recent researches in connection with heart diseases have demonstrated a high correlation between fats in the diet, cholesterol level and atherosclerosis. Cholesterol is fat like substance found in animal fats, oils and some tissues of the human body.


Some Early Signs Of The Heart Trouble


It has been said earlier that any disturbance in the supply of blood to heart muscle leads to its functional impairment.

It will be useful to discuss here such factors, which may lead to disturbances in the supply of blood to heart muscles. Certain conditions increase the strains on the heart. Among these are lack of rest, over exertion or prolonged hard labor which create an excessive body demand for oxygen that the heart, muscle must supply through pumping more blood. If the blood vessels are inelastic on account of arteriosclerosis fibrous thickening or narrowing of passage (atherosclerosis) additional work on the part of the heart will be needed to push blood through these vessels. Other indirect factors that may result in causing disturbance in blood supply are indigestion of food, anger and other emotional excitements.

There are some early symptoms, which may be important to watch for. Their appearance calls for a visit to the doctor for a check up. The symptoms are:


1. Dizzy spell or fainting fits
2. Discomfort following meals, especially if long continued.
3. Shortness of breath, after slight exertion.
4. Fatigue with out otherwise explained origin.
5. Pain or tightness in the chest a common sign of coronary insufficiency is usually constrictive in nature and is located behind the chest bone with radiation into the arms or a sense of numbness or a severe pain in the center of the chest
6. Palpitation

Some causative factors of heart trouble

Heart disease has been more frequently found in certain persons who show peculiar personality physical and mental traits. It will therefore, be worthwhile to discuss these factors. Coronary heart disease is considered to have multiple causative factors i.e., no one single factor perhaps could be identified as one causing a heart attack.


Heredity - There is ample evidence to show that incidence of heart disease is more in persons whose direct predecessors like fathers, grandfathers, mothers, brothers have suffered from similar disease. Coronary artery disease is found to run mainly in families. A strong family history of the disease is important in diagnosis.


Stress- Heart disease has often been identified with certain personality patterns. It is labelled as personality disease or a high executive disease, that is, it strikes persons with a certain personality. A certain study has shown that there was four times as much coronary disease among aggressive type of individuals.

In addition to this other factors such as family responsibilities, interpersonal relationship, financial worries, leisure interests, habits of eating drinking and smoking etc. may play a part that may effect one's heart.


Smoking - It has been found by some workers that death rate among those who had heart attack was 50-150 percent higher in those who were heavy cigarette smoker than non-smokers.

Physical Exercise - There is a fairly general trend towards encouraging regular physical effort of a kind suited to age and condition of the person concerned. As a preventive as well as a remedial measure exercise is of great importance. There is abundant evidence to suggest that a stressful sedentary life without much exercise provides a situation fraught with coronary danger. Death rate from coronary heart disease is lower among those who do strenuous physical work.

Even for patients, who have survived coronary attacks, there has lately been a change in the thinking in marked contrast in earlier ideas. The doctors are now a day advocating, after the initial prescribed rest, walking up the stairs, going on hikes, bicycles and other forms of exercise. The quantum of exercise in each case must of course be decided by the attending physician.


Diet and obesity - Certain studies have shown 50 percent increase in heart attacks in employees who were over weight similarly diet and amount of fat are matter of vital importance in incidence of heart disease. The sound advice which could be given is to lead a life of moderation in matter of diet and activity an also to avoid obesity. Large fatty meals and strenuous exercise after them is not conducive to a healthy heart.

Saturated fats are likely of animal origin like whole milk, cream, butter, cheese meat, fat, etc. They raise blood cholesterol level. On the other hand unsaturated fats are of vegetable origin and they tend to lower blood cholesterol levels like maize oil, cottonseed oil sunflower oil and fat of fish.

Heart Attack
(Myocardial Infarction)
What is a heart attack?
A heart attack (myocardial infarction) is the death of heart muscle due to the loss of blood supply. Usually, the loss of blood supply is caused by a complete blockage of a coronary artery(an artery that supplies blood to the heart muscle) by a blood clot.

What are the features of a heart attack?
Pain: is the cardinal symptom of a heart attack. The pain is often described as a tightness or heaviness in the chest. It is often severe enough to be the worst pain that can be experienced. the usual location of the pain is in the center of the chest but it frequently radiates to the left arm or the jaw.

Some heart attacks though can pass unrecognized; these painless attacks are called as ‘silent infarcts’ and are particularly common in diabetics.

Anxiety: fear of impending death.
Breathlessness,
Nausea and vomiting,
Sweating, pallor and a fast pulse.

Sudden death: loss of blood supply disturbs the orderly transmission of electrical impulses in the heart and as a result the heart stops to effectively pump blood. Permanent brain damage and death can occur unless oxygenated blood flow is restored within five minutes. Approximately 40% of people suffering a heart attack die before reaching to the hospital.

What causes a heart attack?
A heart attack is almost always caused by the formation of a blood clot on a cholesterol plaque located on the inner wall of an artery to the heart (coronary artery). It is believed that the process of formation of these plaques starts in the late teens. Over a period of time the accumulation of cholesterol plaque causes thickening of the artery walls and narrowing of the arteries; a process called atherosclerosis.

Ultimately, the arteries narrow to an extent where they are unable to supply enough blood to the heart muscle during periods of increased demand like during exercise or excitement. This results in a condition called ischemia which leads to chest pain called as angina.

Occasionally, however, for unknown reasons, the surface of the cholesterol plaque can become sticky, causing blood clotting. When a blood clot forms on top of this plaque, the artery becomes completely blocked, causing death of the heart muscle (heart attack).

Many factors have been found to influence this plaque formation. It can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. Whereas, factors like exercise, low fat diet, avoiding stress seem to help in retarding this process.