Every minute of every day, your heart is working hard for you. It’s the lifeline to your body. Your heart is essentially a pump that delivers blood to the rest of your body.
By beating an impressive 60 to 100 times each minute, it sends oxygen-rich blood to all the cells in your body. The blood comes back to your heart, then goes to your lungs to pick up more oxygen. When you have heart disease, your heart is unable to do its job effectively.
Because we put so much of a workload on our hearts, it can be very serious when things don’t work as they should. This is what we refer to as heart disease.
- Heart disease is the leading cause of death for both men and women in the US.
- 1 in 4 deaths in the US is caused by heart disease.
- ½ of all Americans have at least 1 of the top 3 risks factors for heart disease (high blood pressure, high cholesterol, and smoking).
- Heart disease can often be prevented through healthy lifestyle choices and managing risk factors, such as high blood pressure, high cholesterol, and smoking.
What Is Heart Disease, Really?
The term “heart disease” includes many problems, such as:
- Coronary artery disease (CAD), which is the buildup of plaque in your arteries
- Valvular heart disease, which is when the valves that let blood through or out of your heart do not work as they should.
- Congenital heart disease, which is a heart defect that develops before a person is born
- Heart failure, which is when the heart isn’t pumping enough blood to the body
Each of these conditions affects the heart a little differently, but they all put your heart at risk of heart attack. Here’s a breakdown on what each condition really means, what the risk factors are, and what you can do about lowering your risk.
Coronary Artery Disease (CAD)
CAD is the most common type of heart disease in the US. Unfortunately, the first sign of it for some people is a heart attack.
There are two main arteries that supply oxygen-rich blood to your heart. Sometimes, a waxy substance called plaque starts to build up in these arteries. This takes many years and can start as early as childhood. Plaque limits the amount of blood that makes it to your heart, which can be life-threatening.
Plaque can do two things — harden or rupture. If it hardens, it keeps blood from getting to your heart, which can cause a heart attack. If it ruptures, the fragments can clump together and form a clot, which can cause a heart attack or stroke.
Who is at risk for CAD?
There are a number of factors in your control that can put you at risk for CAD, including:
- Smoking, which can damage and tighten your blood vessels, increase your cholesterol levels, and raise your blood pressure
- An unhealthy diet, which can lead to obesity and high levels of bad cholesterol
- Lack of physical activity, which can cause high blood pressure, high cholesterol, diabetes, and obesity
- Insulin resistance or diabetes, which causes you to have too much sugar in your blood, damaging the arteries
Additionally, there are some factors that are not in your control:
- Older age, allowing plaque to build up in your arteries over time — for men, the risk of CAD increases at age 45, and for women, it increases at age 55
- Genetic history, especially if a father or brother was diagnosed before age 55, or a mother or sister was diagnosed before age 65
However, managing other parts of your life can help lower your risk.
How is CAD treated?
The goal of CAD treatment is to either slow, stop, or reverse the buildup of plaque and to prevent complications because of those already-blocked arteries.
Treatments for CAD include:
- Heart-healthy lifestyle changes, such as quitting smoking, getting more exercise, and managing stress
- A healthier diet, including foods such as fish, fruits, vegetables, and whole grains, and avoiding foods such as red meat, alcohol, and foods high in sugar or sodium
- Medications to lower your cholesterol or blood pressure, or prevent blood clots
- Medical procedures, such as stents placed to open blocked arteries, or surgery to provide another pathway for blood to travel around a blocked artery
Valvular Heart Disease
There are four valves in your heart. Their job is very important — to let blood flow through or out of your heart. Then, they close to make sure blood does not flow back into the heart.
Much like a one-way street, these valves only allow blood to flow in one direction, and much like driving the wrong way on a one-way street, if the blood goes the wrong way, it can cause serious problems. If the valves allow blood to go in the wrong direction or do not open enough to allow blood flow out, that means oxygen-rich blood is not getting to your other organs and tissues.
This can cause chest pain, fatigue, lightheadedness, and shortness of breath, which can worsen over time. Heart valve disease can put you at risk for problems in and around the heart that may be life threatening if not treated.
Who is at risk for valvular heart disease?
The number of people affected by valvular heart disease is smaller than other heart conditions, but that number is growing because of increasing life expectancy. Some factors that put you at risk for valvular heart disease are:
- Older age, which can cause heart valves to become thickened with calcium deposits, causing them to become stiff over time
- Related health conditions, such as rheumatic fever or endocarditis, which damages the heart valves through bacteria and infection
- Previous heart attacks, heart failure, arrhythmia, and heart valve conditions at birth
- Radiation in the chest because of treatment for cancers
There is good news: valvular heart disease is treatable if it is monitored. If you’re at risk, you should closely monitor symptoms, such as how easy it is for you to do routine activities like taking the stairs or walking faster. If they get worse, take them seriously.
How is valvular heart disease treated?
Though there isn’t currently medication to cure valvular heart disease, lifestyle changes and medication can treat symptoms and help you avoid complications. Treatments include:
- Medicines to lower blood pressure, prevent irregular heartbeats (called arrhythmias), and thin the blood to prevent clots
- Heart-healthy lifestyle changes — such as eating fish, fruits, vegetables, and whole grains — as well as exercising regularly and quitting smoking
- Surgery to replace heart valves by removing or replacing the valve
You can significantly lower your risk of complications from valvular heart disease with close monitoring and regular follow-up appointments with your provider.
Congenital Heart Disease
“Congenital” means that a problem exists at birth. Congenital heart defects — the most common kind of heart defect — are problems with the heart’s structure. Health care providers usually find severe defects at birth, but some milder defects might go undiagnosed until children are older — or even into adulthood.
Defects can involve abnormalities in the heart walls, valves, arteries, or veins — which may affect normal blood flow by slowing it down, allowing it to go in the wrong direction, or stopping it completely. This can keep the heart from getting blood to the rest of your body, causing irregular heartbeats, limited blood supply to vital organs, blood clots, heart attack, or stroke.
Who is at risk for congenital heart disease?
The causes of congenital heart disease, which all occur before birth, include:
- Genetic conditions that can be passed down from parent to child
- Uncontrolled diabetes during pregnancy
- Smoking during pregnancy
- Exposure to an infection or certain medications during pregnancy
Regular follow-ups with your health care provider can help you diagnose congenital heart disease early and get treatment to avoid complications. Often, diagnosis occurs as a child. If you’re a parent, make sure your child has all of their recommended well-child visits and yearly physicals.
How is valvular congenital disease treated?
Treatment may not be needed if you have a congenital heart defect, and your provider may just monitor the condition. However, depending on the type of defect and severity of symptoms, treatment may include:
- Surgery or a minimally invasive procedure to repair or reduce the defect
- Lifestyle changes, such as a special diet or exercise program
Heart failure is when your heart cannot pump enough blood out to the rest of your body to get the necessary amount of oxygen to the rest of your organs. This is a serious condition, but it does not mean that your heart has completely stopped beating.
Heart failure is chronic and progressive, meaning it lasts for many years and gets worse over time. If your heart cannot handle its workload, it may enlarge, develop a thicker muscle mass, or pump faster to try to keep up.
Another way your heart might try to compensate is by constricting and making your blood vessels get smaller to try to keep blood pressure higher to direct more blood to important organs, such as your brain — meaning it’s not getting to other organs.
These temporary measures are like putting on a bandage when you need stitches — they mask the problem, but they will not solve it. Eventually, the heart will not be able to keep up, which can be fatal if not treated.
Who is at risk for heart failure?
Over 6 million Americans are living with heart failure, and by knowing the risk factors, having regular follow-ups in addition to getting treatment, it is very manageable. Many conditions that affect your heart can cause heart failure, including:
- Coronary artery disease, which is the buildup of plaque in your arteries, affecting blood flow to and from the heart
- High blood pressure, which causes strain against your arteries, damaging your heart
- Diabetes, which can lead to high blood pressure, high cholesterol, and obesity
- Unhealthy behaviors such as smoking, lack of physical activity, or eating foods high in fat, cholesterol, and sodium.
How is heart failure treated?
By diagnosing heart failure early, you can improve the quality and length of your life with treatment. Treatments include:
- Lifestyle changes, such as quitting smoking, losing weight, avoiding or limiting caffeine and alcohol, increasing physical activity, and eating a heart-healthy diet full of fruits, vegetables, and whole grains
- Medications to reduce the heart rate can decrease the heart’s strain, lower cholesterol, or thin the blood
- Devices to assist your heart, like an implantable defibrillator or a pacemaker
- Surgeries to open up blocked or narrowed arteries or to create another route for blood to travel
- Heart transplant
Keeping a regular log of symptoms is essential in managing heart failure. You should be sure to discuss any changes in symptoms with your provider during your regular follow-up appointments.
Lowering Your Risk of Heart Disease
If you think you may be at risk for heart disease, a visit with your primary care provider is a good place to start. They can help monitor your health and manage existing conditions to keep you living a long and heart-healthy life.
Your primary care provider may recommend you see a cardiologist for further monitoring, testing, and treatment.
Heart disease can be very manageable with the help of your medical team. Through the choices you make each and every day, you have the ability the help prevent and manage the health of your heart.