To be able to function, our heart needs to be supplied with blood and oxygen, which are provided by the coronary arteries. When fatty deposits form on the vessel walls, the walls narrow or may even be blocked, and blood can no longer flow to the heart normally. This is called heart disease.
Symptoms of Heart Disease
The main symptoms of heart disease are breathing difficulties, breathlessness or significant fatigue upon exertion, and a feeling of heaviness or pulling in the chest that sometimes radiates to the shoulder or arm. They may also be accompanied by palpitations, heavy sweating, nausea, and/or fainting. The intensity of the pain in the chest depends on the type and severity of the heart disease. In the early stages of the disease, this pain may only appear during physical exertion requiring the person to stop and rest.
It is important to note that because women have smaller arteries than men, they do not always experience the same symptoms traditionally associated with heart disease. Women more often report nausea and/or pain between the shoulder blades.
Causes of Heart Disease
In most cases, heart disease is caused by atherosclerosis*Atherosclerosis is a buildup of fats, cholesterol, and other substances on the artery walls., which is a narrowing of the interior diameter of the arteries. It is caused by a buildup of fatty deposits inside the vessels that gradually form plaque that prevent normal blood flow to the heart.
Although some heart diseases can be caused by genetics, others have environmental causes, and some have both.
The risk factors, which are now well known, include:
- a lack of physical activity,
- a bad diet (eating food that is too high in fat, sugar, or salt),
- being overweight,
- high blood pressure,
- excess harmful lipids in the blood (cholesterol*Cholesterol is a type of fat.),
- excess sugar in the blood (hyperglycemia*Hyperglycemia is an abnormally high concentration of glucose in the blood. and diabetes*Diabetes is a disease that affects the way the body regulates blood sugar levels.),
- anxiety and/or depression.
These risk factors are referred to as controllable, as you can reduce their impact by changing your lifestyle. Inversely, some risk factors are referred to as uncontrollable, as is the case with heredity for example. That means that the person is more likely to develop heart disease.
Treating Heart Disease
The treatment strategy for heart disease requires the patient to change their lifestyle to relieve the symptoms, slow the progression of the disease, and prevent a heart attack*Heart attacks occur when there is a partial or complete obstruction of a coronary artery. The part of the heart connected to this artery stops receiving oxygen, and so can necrotize and die. Heart attacks are also known as myocardial infarctions.. The advice includes in particular:
- exercising regularly,
- reducing the amount of processed, fatty, high-sugar, or high-salt foods you eat,
- stopping smoking,
- limiting exposure to stressful situations.
The medication prescribed varies depending on the stage of the heart disease and the patient's risk factors, which include high blood pressure, hyperlipidemia*Hyperlipidemia is when there are abnormally high levels of fat (lipids) in the blood. (cholesterol), and hyperglycemia (diabetes). However, medication does not replace the need to live a healthier lifestyle.
In terms of surgery, an operation can also be performed to enlarge the segments of the arteries that have narrowed. The type of procedure chosen nevertheless depends on the severity and/or extent of the circulatory problems in the myocardium*Myocardium is the technical name for the muscle tissue of the heart. This comes from the Greek myo- for muscle and carde for heart. The rhythmic contraction of the heart is controlled by the autonomic nervous system. Therefore, the contractions do not depend on a conscious effort on the part of the human being..
One option is to dilate the affected artery using an inflatable balloon inserted using a catheter. A stent*A stent is a medical device used to keep arteries open. is then fixed to the inside of the wall, which is a small prosthesis often made out of metal that keeps the artery open and prevents it narrowing again.
The other option is a coronary bypass*A bypass is a technique used in heart surgery to bypass an obstructed blood vessel by implanting another blood vessel. an operation that re-establishes blood flow and the supply of oxygen to the heart by connecting a healthy artery to the blocked segment of artery.
Progression and Possible Complications
Although people with heart disease do not always experience symptoms, the condition can progress to chest pains (angina), a cardiac arrhythmia*Cardiac arrhythmia is when the heart beats too quickly, too slowly, or in an irregular way., heart failure, or a heart attack (myocardial infarction).
If an artery is completely blocked, the part of the heart supplied by this artery stops receiving blood and oxygen, and is therefore at risk of dying quickly. That is when a heart attack happens.
Preventing Heart Disease
You can reduce your risk of heart disease considerably by living a healthier lifestyle. Moving enough, eating a healthy diet, stopping smoking, and limiting your exposure to stress are all integral to preventing the disease.
When Should You See the Doctor?
Some symptoms can be a sign of heart disease. Be alert if you feel weakness or an unusual breathlessness on exertion and/or a pulling, burning, or heaviness in the chest for example. Loss of consciousness (fainting) and nausea or vomiting can also be a sign of heart disease.
More generally, intense chest pain that lasts for longer than five minutes and radiates into the left arm, shoulder blades, neck, jaw, or upper part of the abdomen for example are clearly associated with heart disease and a heart attack in particular.
Care at Hôpital de La Tour
If a patient has heart disease, examinations must be performed to identify circulation issues in their heart. An electrocardiogram*A test that uses electrodes and studies the electrical activity of the heart, can detect whether the patient has had a heart attack, and if there is insufficient blood supply to the heart. (ECG) is normally performed, which records the very low intensity electric current generated during each heart contraction using electrodes placed on the skin of the chest. The line produced is used to detect previous heart attacks and/or heart arrhythmia.
In certain cases, the characteristic signs of heart disease only occur during strenuous physical activity, so exercise stress tests may also be needed. An exercise electrocardiogram*A test used to observe variations in heart activity, heart rate, and blood pressure while the patient exercises on a treadmill or bike. is the most common type, which is performed with the patient on a treadmill or an exercise bike. This test can be combined with a medical imaging technique (echocardiogram*A medical imaging technique that uses ultrasound to perform a scan of the heart., scintigraphy scan*An examination during which a small quantity of radioactive product is administered to the patient to obtain images of their body and observe how an organ functions., magnetic resonance imaging*A medical imaging technique used to obtain 2D or 3D images of the inside of the body., cardiovascular magnetic resonance*A medical imaging technique used to observe the structures and functioning of the heart, its valves, and its main veins and arteries. or computed tomography*A medical imaging technique used to obtain a 3D reconstruction of the different organs of the body. in particular).