Heart Disease

Heart Disease 

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Although most people think of heart disease and stroke as two different diseases, they’re really part of the same basic problem. That’s why health professionals call this prob lem cardiovascular disease. If we break this medical term down, the first part, “cardio” means heart, and the second part, “vascular” means blood vessels, or the pipelines which carry the blood from the heart to all the other parts of the body.

There are also very important blood vessels which carry blood to the heart, itself, called coronary blood vessels. Since the heart can’t do its job of supplying blood to the body without the blood vessels, and since the blood vessels can’t do their job of carrying nourishment throughout the body unless the heart pumps the blood out, they’re clearly part of the same system. That’s why it’s called the cardiovascular system.
Two of the most important machines in the body are the heart and the brain. They are called vital organs because they are absolutely necessary for normal living. In other words, when the heart or the brain stop working, normal living stops. Heart attacks and heart failure occur when either not enough blood gets through the coronary blood vessels, or one of them breaks or ruptures. Stroke occurs when not enough blood gets through the blood vessels that feed the brain or one of them breaks.

The most common diseases associated with cardiovascular disease, the leading overall cause of death in the U.S. are:

We discuss coronary artery disease, hypertension and strokeseparately because each of them is a serious killer and disabler of many people. Therefore, in this section we will focus on coronary heart disease. We will discuss the other big heart disease killer and disabler, namely hypertensive heart disease, in the section on hypertension.

Congestive heart failure is a frequent major complication of both coronary heart disease and hypertensive heart disease. It is discussed in this section although it is also a complication of hypertensive heart disease. We also provide information in this section about cholesterol and its relationship to arteriosclerosis because of their close relationships to cardiovascular disease.


  • Key Risk Factors for Heart Disease and Stroke hypertension
    high blood cholesterol/high fat and cholesterol intake
    too little exercise or physical activity
    smoking – Want to Quit Smoking? View Health Power’sSmoking Tip Sheet
    overweight and obesity

Coronary Artery Disease-

Coronary artery disease is the most common type of heart disease in the United States, and the leading cause of death in African-Americans/Blacks, Hispanics/Latinos, Asian Pacific Islanders, and Caucasians. In addition, heart disease is the leading cause of death in both men and women.

Coronary artery disease occurs when the coronary arteries, which supply blood to the heart muscle, become hardened and narrowed. This process occurs when a material called plaque (sounds like plak) builds up on the inner walls of the coronary arteries. The buildup of plaque is known as atherosclerosis (ATH-er-o-skler-O-sis), and is more likely to occur in people with high blood cholesterol levels because cholesterol accumulates in the plaques. As the plaques increase in size, the coronary arteries get narrower on the inside, and less blood flows through them. As a result, less blood flows to the heart muscle. Since blood carries oxygen to the heart muscle, the muscle doesn’t get enough.

Major complications of the heart muscle not getting enough oxygen are:

  • Angina – Chest pains or discomfort (See Warning Signs of Heart Attacks).
  • Heart attack – Occurs when a blood clot develops where there’s a plaque in a coronary artery and suddenly cuts off most or all of the blood supply to that part of the heart muscle.

Over time, coronary heart disease can weaken the heart muscle enough to cause one or both of the following:

  • Congestive Heart failure – Coronary heart disease can eventually weaken the heart muscle enough to cause heart failure. When this happens, the heart muscle doesn’t pump blood as well as it should.
  • Arrhythmias – Arrhythmias occur when the heart doesn’t beat with its normal rhythm. They can occur when the heart muscle has too little oxygen for too long a period of time.

Heart Attack or Acute Myocardial Infarction (or MI)

Heart attack or myocardial infarct occurs when blood flow to part of the heart is blocked. The blockage is usually caused by either a blood clot, or a plaque (sounds like plak) in a coronary artery. The coronary arteries supply blood and oxygen to the heart muscle. Plaques are collections of fatty and hardened or calcified materials in the wall of an artery associated with a condition called arteriosclerosis or atherosclerosis. When the blood and oxygen supply to the heart is restricted too long without treatment, the result is damage or death (infarction) of heart muscle (myocardium).That’s why the term myocardial infarction is also used for a heart attack.

Common symptoms of heart attack include:

Squeezing chest pain or pressure
Chest pain that radiates to the arm, neck, or shoulder, usually on the left side
Tightness in the chest
Shortness of breath
Feeling of heartburn, nausea and/or vomiting

Women tend to have fewer of the above common symptoms of a heart attack than men. More likely symptoms in women include:

Indigestion or gas-like pain
Nausea or vomiting
Unexplained weakness or fatigue
Pain between the shoulder blades
Repeated chest discomfort

A heart attack is always a medical emergency. Therefore, people who have real chest pain should call 911 because getting treatment at once is very important.

Heart attacks are the leading cause of death for both men and women, worldwide.
Key risk factors for heart attack are:

Previous cardiovascular disease, such as angina, a previous heart attack or stroke
Tobacco smoking
Hypertension or high blood pressure
High blood levels of bad cholesterol and low levels of good cholesterol
Inactive physical activity
Congestive heart failure

Health Power Tip Sheets on the Warning signals of a Heart Attack, and the Warning Signals of a Stroke, both of which are based on American Heart Association recommendations, provide additional information on both conditions.

  • Cholesterol and Cholesterol Levels – A soft fat-like substance found in all body cells. It is important in the healthy body because it helps to build certain body tissues. However, when a person has too much cholesterol in the blood, it increases a person’s risk of having a heart attack by building up in the arteries, calcifying, and leading to arteriosclerosis, also called atherosclerosis or hardening of the arteries. Cholesterol is mostly produced in the human liver, and is found in animal foods, especially egg yolks, organ meats (like liver and kidney) fatty meats and whole milk and other dairy products. Vegetables do not contain cholesterol.Because cholesterol cannot dissolve in the blood, it is carried, or transported, by other substances called lipoproteins. Low density lipoprotein (or LDL-cholesterol) is also called the “bad” cholesterol. When the LDL level is too high, it can slowly build up in the arteries and combine with other substances to form plaques (hard coatings) that can block the arteries feeding the heart and brain. This process is known as arteriosclerosis or atherosclerosis, and can lead to a heart attack or stroke.High-density lipoprotein or HDL is known as “good” cholesterol because a high level seems to protect against having a heart attack. The reverse is also true. In other words, a low HDL level increases the risk of heart attack.Know Your Blood (Serum) Cholesterol Numbers
    Number What it Means
    Below 200mg/dl Desirable
    200 mg to 239mg/dl Normal to high normal
    240 mg/dl and over High


  • Congestive Heart Failure – Inability of the heart to pump enough blood to adequately supply the rest of the body. It is associated with weakening of the heart muscles. The sluggish (slowed) blood flow causes a “backup” of blood in other vital organs, such as the lungs and kidneys, resulting in the build up of fluid. Persons with congestive heart failure may have one or more of the following symptoms: shortness of breath from lung congestion
    difficulty breathing when lying flat because the of lung congestion, which may be relieved by sitting or elevating the head and shoulders
    abdominal fullness because of congestion in abdominal organs
    swelling of the feet and ankles during the day because of fluid retention that leaves a temporary dent after finger pressure is applied to the swollen areaThe most common causes of congestive heart failure, namely hypertension, coronary heart disease and heart attack, are often preventable, such as:Congestive heart failure is not necessarily fatal, but requires regular medical care.
  • Hypertension and StrokeAlthough hypertension and stroke are both closely associated with heart disease or cardiovascular disease, they are also each major diseases.The American Heart Association, Tel. (800) AHA-USA1, is another good source of information on heart disease. Its web site can be reached directly from our Relevant Resourcessection.Visit Aetna Women’s Health Online for important information about the unique risk factors for heart disease for women of color.