Cardiovascular Disease Types

Overview  

Cardiovascular diseases affect many people worldwide. It is estimated that around 60 million people develop a heart or circulatory disease each year.¹

Fortunately, most cardiovascular diseases can be prevented by maintaining a healthy lifestyle. There are many treatment options available, and early detection of these conditions is supported by screening and diagnosis tools that are widely available. 

Read on to learn more about the signs of cardiovascular disease, and find out how you can keep your heart and blood vessels healthy to prevent cardiovascular disease. 

About cardiovascular disease

Cardiovascular diseases are a group of conditions that affect the heart (“cardio”) and blood vessels (“vascular”). These can range from structural changes to blood vessels, changes to the movement of the heart muscles, inflammation, as well as many other factors. 

While not all cardiovascular diseases are life-threatening, they are still a leading cause of death, accounting for around 32% of all global deaths in 2019, according to the World Health Organization (WHO). Hence, it is important to detect signs of cardiovascular disease at its early stages to manage the conditions appropriately. 

Types of cardiovascular disease

There are several different types of cardiovascular diseases. Some of these include: 

• Coronary artery disease

Coronary arteries are blood vessels that supply the heart muscles with oxygen-rich blood. In coronary artery disease, the arteries are partially or completely blocked and thus are unable to provide  enough oxygen to the heart. This is often caused by a build-up of cholesterol: a waxy, fatty substance that can accumulate in the lining of the blood vessels, and can eventually form a plaque (this process is known as “atherosclerosis”). Coronary artery disease is the most common type of heart disease in the US, with about 18.2 million adults experiencing this condition. 

• Congenital heart disease

Heart conditions that are present since birth are known as congenital heart diseases (CHD); they affect approximately one in every hundred newborns worldwide.¹ The severity of the symptoms depends on the specific type of disease. Some CHD can be detected even before birth (via an ultrasound scan), but some may not be detected until later in life. 

CHD can be passed down genetically, but may also be caused by exposure to harmful substances before birth (for example, through the mother’s diet or medication use during pregnancy).⁵ 

• Heart attack (myocardial infarction)

Heart attacks are most often caused by reduced or stopped blood flow to a part of the heart. Atherosclerosis (the development of plaques in the lining of blood vessels) can lead to the formation of blood clots - heart attacks are most often caused by a blood clot that blocks blood flow to the affected heart muscle.²

Those experiencing a heart attack may feel chest pain, as well as having difficulty in breathing (shortness of breath). Nausea, vomiting, faintness, cold sweat, and back or jaw pain are also often observed.²

• Cardiomyopathy

Cardiomyopathy is a general term for diseases affecting muscles in the heart. Signs of cardiomyopathy can include stretched, thickened, or stiff heart muscles - in rare cases, scar tissue on the heart muscles can also be present. Due to adverse changes to the heart muscle in cardiomyopathy, the heart can become weaker and less able to maintain its rhythm and ability to pump blood around the body correctly. Cardiomyopathy can be a congenital disease (present at birth), or may develop over time. 

• Heart valve disease

The heart contains four valves that control the direction of blood flow through the heart - the valves open and shut as the heart beats. Heart valve disease affects one or more of the heart valves. It may develop over time (for example, due to age or infection), but may also be present at birth.

In heart valve disease, the valves may be too narrow (this is known as “stenosis”), or may not have a proper opening (this is a congenital condition called “atresia”). The valves may also be leaky, letting blood flow through when they should be shut. 

• Pericardial disease

The pericardium is a thin covering that separates the heart from other surrounding organs and structures; it reduces friction between the surrounding tissue and the heart as it beats. Diseases affecting the pericardium are known as pericardial disease - some common examples of these diseases include pericarditis (inflammation of the pericardium) and pericardial effusion (build-up of fluid in the pericardium).³  

• Peripheral vascular disease

Peripheral vascular disease (PVD) can affect any blood vessel outside of the heart. It is caused by thickening and hardening of the artery walls due to a build-up of plaque (atherosclerosis). As atherosclerosis develops, the space inside the arteries narrows, and blood flow is reduced. 

It is estimated that around 2% of adults over 65 years of age experience peripheral vascular disease.⁴ A common symptom of PVD is claudication: a pain in the arms or legs while you move them, caused by insufficient blood supply. Other symptoms can include bruising, abnormal skin colour, or a cool skin temperature.⁴

• Rheumatic heart disease

Rheumatic heart disease is a rare chronic condition in which the heart valves have been damaged due to recurring acute rheumatic fever (ARF).⁵

ARF is caused by an infection with Streptococcus pyogenes bacteria. The infection causes inflammation in the upper part of the throat, joint pain and swelling, fever, and damage to the valves in the heart. Most other clinical symptoms often resolve after 2 or 3 weeks in the hospital, but damage to the heart valves can persist - each recurrence of ARF can cause this damage to accumulate, leading to chronic rheumatic heart disease. 

Causes, symptoms and treatment

Causes of cardiovascular disease

Although some cardiovascular diseases are passed down genetically, many are caused by lifestyle factors. An unhealthy diet and lack of physical activity can eventually lead to thickening and hardening of the arteries (atherosclerosis), which can lead to the development of several types of heart and vascular diseases. 

Cardiovascular disease risk also increases with stress, high salt intake, harmful use of alcohol, and smoking cigarettes. 

Symptoms of cardiovascular disease

In many cases, a person with cardiovascular disease may not experience symptoms of their condition until its later stages.¹ It is important to have regular check-ups of your cardiovascular health, particularly if you are at risk of heart disease (for example, if you are over 65 years of age, or if you are overweight or obese). If raised blood pressure or high blood glucose levels are detected, further medical tests to screen for cardiovascular disease may be needed. 

Treatment for cardiovascular disease

Treatment for cardiovascular disease will depend on the type of disease the patient is experiencing and may be influenced by some other medical conditions they may have. 

Medications may be prescribed to ease symptoms or to slow the progress of cardiovascular diseases. Some types of drugs prescribed include aspirin, statins, and beta-blockers.

Medical devices can help to support patients with various heart conditions. For example, to help to control the rhythm of their heart, some patients may have a device called a pacemaker implanted inside the heart. 

Certain types of heart disease may also be treated with surgical operations, such as heart valve surgery or coronary bypass surgery. 

Diagnosis and Prevention

How is cardiovascular disease diagnosed?

Cardiovascular disease is usually diagnosed using a combination of blood tests (for example, blood pressure and blood glucose level tests) and heart monitoring or imaging tests. 

Some heart monitoring and imaging tests include:

• Electrocardiograms 

An electrocardiogram also commonly known as an ECG - it is one of the fastest and simplest ways to assess heart health. The movements of the heart muscles during each heartbeat are controlled by electrical impulses that travel through the heart. By performing an ECG, your doctor is able to see if the electrical impulses in your heart have a healthy pattern and intensity. This information can help in the diagnosis of arrhythmias (abnormal heart rhythms), coronary artery blockage, inflammation of the pericardium (the sac which surrounds the heart), and many other diseases and symptoms. To perform an ECG, small patches (electrodes) are attached to the skin on the chest, arms and legs of the patient. The patches are also connected to an ECG machine, which can measure and record the electrical activity of your heart. 

• Angiograms

An angiogram is a special type of scan used to visualise blood vessels. Since blood vessels and heart tissue do not show up clearly in regular X-ray scans, a special type of dye is injected into the patient’s blood vessels in the area which is to be examined. The contrast dye will appear on the X-ray image, and will show the shape of the blood vessel that it is flowing through. An angiogram can be used in the diagnosis of several cardiovascular conditions, including blood vessel blockages and aortic aneurysms (bulges in the artery walls). 

• Echocardiogram

An echocardiogram is a type of ultrasound scan of the heart. To perform  echocardiography, the healthcare professional will place a device called a transducer on various areas of the chest of the patient. The transducer emits ultrasound waves that bounce off of structures in the body - some of these waves return back, and are detected by a machine that can use information on the intensity and frequency of the waves recorded to create moving images of the heart walls and valves.⁶

The moving images obtained (echocardiographs) can be used to diagnose conditions such as cardiomyopathy (disease of the heart muscles), pericarditis (inflammation of the sac surrounding the heart), or aneurysms (bulges in blood vessel walls).

Can I prevent cardiovascular disease? If so, how?

Most cardiovascular diseases can be prevented by maintaining a healthy lifestyle. Some proven indications include:

• Eating a healthy diet rich in fruit and vegetables, whole grains, and lean proteins Avoiding red meat, refined carbohydrates, and sweetened beverages is also advised 
• Quitting smoking
• Exercising weekly. At least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week is recommended for most adults⁷

Summary

Cardiovascular disease is highly prevalent around the world, but many of us can avoid it by maintaining a healthy diet and exercising frequently. If you think you may be at risk of developing cardiovascular disease, seek guidance from your healthcare provider.