The heart is a vital organ made up of a complex combination of muscles, blood vessels, heart valves, and nerves.
The perfect interplay of each of these components will lead to the proper functioning of the heart – pumping blood rich in oxygen and nutrients to all parts of the body. The blood exits the heart and enters the main artery of the body, called the Aorta, which subsequently gives off branches to supply the various parts of the body (e.g. organs and muscles).
The blood vessels (arteries) supplying the heart are also known as the Coronary Arteries. There are usually 3 main arteries supplying the heart – the Left Anterior Descending Artery (LAD), the Left Circumflex Artery (LCX), and the Right Coronary Artery (RCA). These arteries bring oxygen and nutrient-rich blood to ensure the normal functioning of heart muscles. Blockages in any of these arteries will result in damage to the heart muscles that it supplies.
The heart muscle contracts and relaxes to push blood out of the heart into a major artery called the Aorta. Damage to the heart muscle will impact the ability of the heart to supply blood to the rest of the body.
The Conduction System of the heart also called the “nervous system” or “electrical system”, coordinates the pumping function of the heart muscle. A diseased conduction system results in arrhythmias, which can cause the heart to beat irregularly, too slowly or too quickly.
The four valves of the heart open and close to ensure that blood flow forward, rather than backward, when the heart contracts and relaxes. If there is an incomplete opening of a valve due to a disease, it will result in the inadequate forward flow of blood. On the other hand, if a valve does not close completely, it will result in a leakage of blood against the direction of the normal flow.
The Aorta and the Peripheral blood vessels of the body also act as important conduits to bring blood to the rest of the body. Diseases of these vessels (most commonly blockages or abnormal enlargements (aneurysms)) can result in damage to that particular body part that it supplies.
Coronary artery disease, also called coronary heart disease, is a result of cholesterol-laden plaque build-up in the coronary arteries — a condition called atherosclerosis.
The arteries become narrow and rigid, restricting blood flow to the heart. The heart becomes starved of oxygen and the vital nutrients it needs to pump properly. Coronary Artery Disease is the No. 1 killer in many developed countries.
Atherosclerosis normally begins in the second or third decade of life. The rate that it progresses depends on the dietary and lifestyle habits (such as smoking or sedentary lifestyle) as well as cardiovascular risk factors (such as Diabetes Mellitus, Hyperlipidaemia, Hypertension).
Cardiac ischemia occurs when the inside of an artery narrows to a point where it cannot supply enough oxygen-rich blood to meet your heart’s needs. This results in symptoms such as chest pain and shortness of breath on exertion.
What are the symptoms of Coronary Artery Disease?
Typical symptoms of Coronary Artery Disease include:
Less typical symptoms of Coronary Artery Disease include:
Atypical symptoms of Coronary Artery Disease are more common in the elderly, females, and diabetic patients.
How is Coronary Artery Disease diagnosed?
Common tests used to diagnose Coronary Artery Disease include:
How is Coronary Artery Disease treated?
The main evidence-based treatment available include:
Medical treatment is necessary even if one undergoes coronary angioplasty or bypass surgery.
Also known as Percutaneous Coronary Intervention or Stenting.
This is a minimally invasive procedure that usually involves the ballooning of the artery to first open up the blocked artery, followed by the implantation of a Stent to act as a “scaffolding” to keep the artery open.
Coronary Artery Bypass Graft surgery
If multiple arteries are blocked, especially in diabetic patients or if heart function is impaired, open heart bypass surgery may be recommended as the preferred treatment for Coronary Artery Disease.
A Heart Attack, also known as Acute Myocardial Infarction or Acute Coronary Syndrome, occurs in a patient with Coronary Artery Disease.
It occurs when the surface of a cholesterol plaque in a coronary artery suddenly tears or ruptures. This leads to the formation of a blood clot, which can lead to a critical blockage of the artery. Consequently, the blood supply to that particular portion of the heart is affected, leading to damage of the heart muscle.
If not treated in time, one in two people can die within one hour of a heart attack.
What are the symptoms of a Heart Attack?
Typical symptoms of Heart Attack include:
How is Heart Attack diagnosed?
Common tests used to diagnose Heart Attack include:
How is Heart Attack treated?
Every minute counts in a heart attack. Call 995 for the emergency ambulance or seek help immediately at the nearest Emergency Department if you suspect you have a heart attack.
The main treatment available include:
Heart Failure occurs when the heart becomes too weak or too stiff to pump blood efficiently around the body. The chambers of the heart may respond by enlarging to hold more blood to pump through the body or by becoming thickened.
This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently, causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and “Congestive Heart Failure” is the term used to describe the condition.
Heart failure is one of the leading causes of recurrent hospitalisation and reduced life expectancy in the world. Quality of life is also reduced in a heart failure patient.
Some common causes of heart failure include:
What are the symptoms of Heart Failure?
Typical symptoms of heart failure include:
How is Heart Failure diagnosed?
Common tests used to diagnose Heart Failure include:
How is Heart Failure treated?
Treating the underlying cause
Some causes of Arrhythmia include:
Types of arrhythmias include:
What are the symptoms of Arrhythmia?
Typical symptoms of Arrhythmia include:
How is Arrhythmia diagnosed?
How is Arrhythmia treated?
Treatment depends on the type of Arrhythmia detected:
Heart valve disease occurs when the heart valves do not work the way they should. Your heart valves lie at the exit of each of your four heart chambers and maintain one-way blood flow through your heart.
The four heart valves (aortic valve, mitral valve, tricuspid valve, and pulmonary valve) make sure that blood always flows freely in a forward direction and that there is no backward leakage.
There are several types of heart valve disease:
Common causes of Heart Valve Disease include:
What are the symptoms of Heart Valve Disease?
Symptoms of Heart Valve Disease include:
How is Heart Valve Disease diagnosed?
Common tests used to diagnose Heart Valve Disease include:
How is Heart Valve Disease treated?
Most patients with mild or moderate Heart Valve Disease do not need treatment. They will instead need routine surveillance scans to monitor the severity of the Heart Valve Disease. Patients with severe Heart Valve Disease may have to consider open heart surgery to have his/her heart valve repaired or replaced. For patients who are at increased risk for open-heart surgery, they may also opt for a minimally invasive valve procedure called Transcatheter Aortic Valve Implantation (also known as TAVI / TAVR), Percutaneous Mitral Valvuloplasty (ballooning of the mitral valve), or Mitraclip.
If there is associated heart failure, the appropriate medication can also help improve survival and quality of life.
Peripheral Artery Disease, also called peripheral vascular disease, is a result of cholesterol-laden plaque build-up in the arteries supplying the body, such as the brain, kidney or limbs — a condition called atherosclerosis. Diseases of these vessels (most commonly blockages or abnormal enlargements (aneurysms) can result in damage to that particular body part that it supplies.
The Carotid Arteries are blood vessels supplying blood to the brain. Blockages in the Carotid Artery can increase the risk of stroke. Femoral, popliteal, and tibial arteries supply the lower limbs. Blockages of these arteries can result in pain in the calves when walking (claudication), painful ulcers, and gangrene. Renal arteries supplying the kidneys can impact on kidney function.
What are the symptoms of Peripheral Artery Disease?
Symptoms of Peripheral Artery Disease depend on which blood vessel is blocked. They include:
How is Peripheral Artery Disease diagnosed?
Common tests used to diagnose Peripheral Artery Disease include:
How is Peripheral Artery Disease treated?
Peripheral Artery Disease can often be controlled with medication. It is important to treat concomitant risk factors like Diabetes, Hypertension, and High Cholesterol. The patient must stop smoking.
Peripheral Angioplasty (or stenting) to unblock the affected arteries may help alleviate persistent symptoms. This procedure helps improve blood flow to the affected body part.
In more severe diseases, open surgery may be required. In the worst-case scenario, the affected limb may have to be amputated.
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