What Is Heart Disease?

Overview

Diseases of the heart are a leading cause of death worldwide. The World Health Organisation has estimated that each year, approximately 17.9 million people die due to heart disease. A third of these deaths occur in individuals under the age of 70 years. 

So, what is heart disease?

Heart disease, also called cardiovascular disease, refers to any condition that negatively affects the function and/or structure of your heart and its associated blood vessels. Your heart is a vital muscular organ responsible for pumping blood around your body via veins and arteries, delivering oxygen, nutrients, and protective factors for your immune system. When this becomes impaired it can have serious implications for your organs and overall health. There are many different types of heart diseases that have varying symptoms and treatments. Heart disease can affect everyone, no matter your gender or age. Preventative measures and early diagnosis are key to enhancing patient outcomes. This article will inform you of the types of heart diseases, risk factors, symptoms, diagnosis, and treatment options. 

Types of heart disease

The cardiovascular system includes your heart and its associated blood vessels. There are different types of heart disease that impair different parts of your cardiovascular system. Below are some of the most common types of heart disease. 

Coronary heart disease

Coronary Heart Disease (CHD) is also referred to as Coronary Artery Disease (CAD) or ischaemic heart disease. This occurs when the arteries that supply blood to your heart become impaired or blocked. The most common cause of this is atherosclerosis, which refers to a build-up of fatty deposits in the wall of the arteries, causing them to narrow. This can lead to your heart becoming oxygen-deprived and can even cause heart attacks. CHD is the most common type of heart disease, accounting for nearly half of all heart disease cases.¹ 

Peripheral arterial disease 

Peripheral Arterial Disease (PAD), also called Peripheral Vascular Disease (PVD), refers to a narrowing or blockage of the arteries that transport blood to your legs and lower limbs.¹ Similar to CHD, this occurs through a process of atherosclerosis.  

Aortic atherosclerosis 

Aortic atherosclerosis describes a build-up of fatty deposits in your aorta, the main artery that pumps blood from your heart to the rest of your body.¹ This can lead to a thoracic or abdominal aortic aneurysm. 

Arrhythmia

Arrhythmias refer to an atypical heartbeat. This occurs when the electrical impulses that control your heartbeat are interrupted or impaired.² This can lead to a heart rate that is faster than normal, slower than normal, or irregular. 

Cardiomyopathy

Cardiomyopathy refers to disease of the heart muscle.³ The muscular walls of your heart are vital for creating enough pressure to pump blood into your arteries to be transported around your body. When the muscle is affected, so is blood transport, leading to heart failure and other health issues. This can occur when the muscular walls of the heart become stretched and thinner (dilated cardiomyopathy), enlarged and thicker (hypertrophic cardiomyopathy), or stiff (restrictive cardiomyopathy).          

Heart infections

Heart infections can be caused by bacteria, viruses, or even fungi.³ The main types of heart infection include: 

• Endocarditis: An infection of the inner lining of the heart (called the endocardium), commonly caused by bacteria
• Myocarditis: An infection of your heart muscle (called the myocardium)
• Pericarditis: An infection of the outer lining of your heart (called the pericardium)

Causes of heart disease

The most common cause of heart disease is atherosclerosis.¹ This occurs when fatty deposits build up on the walls of your arteries, forming plaques over time. These deposits accumulate and narrow the lumen of your blood vessels, increasing your blood pressure and impairing blood transport around your body. There is also a risk of these plaques breaking off and blocking your blood vessels completely, which can have detrimental outcomes, such as a heart attack or stroke. 

Blood cholesterol levels have been shown to play an important role in atherosclerosis.⁴ Increased “bad” cholesterol levels, known as your low-density lipoprotein (LDL) levels, are associated with cardiovascular disease incidence. This dyslipidaemia (lipid abnormality), alongside inflammation, endothelial dysfunction (abnormality in the inner layer of blood vessels),¹³ and activation of your immune system are key processes involved in atherosclerosis.^1,4 Importantly, atherosclerosis is a progressive process that might have been initiated in childhood.⁵

Altered heart rates can be caused by anything that impairs the conduction of electrical impulses responsible for determining your heart rate. The most common causes of this are heart attack, heart failure, cardiomyopathy, or CHD. It can also be caused by genetic conditions, including Long QT syndrome or PCCD (Progressive Cardiac Conduction Defect). 

In cardiomyopathy, the size, shape, and thickness of the heart muscle can be affected by several different causes.³ These include high blood pressure, heart attack, arrhythmias, hemochromatosis (too much iron), amyloidosis (a build-up of abnormal protein molecules in your heart), and alcoholism. Cardiomyopathy can also be inherited. 

Heart infections are caused by bacterial, viral, or fungal infections of the heart tissue. Bacteria, viruses, or fungi are often present in the blood and are transported to the heart, where they can then infect the various tissues.³ The most common causes are adenovirus, staphylococci (staph), streptococci (strep), candida, and Aspergillus. 

Signs and symptoms of heart disease

If you have heart disease, you may not realise immediately because you can be asymptomatic. Different heart diseases can also lead to different symptoms. Most commonly, patients will experience chest pain (angina), breathlessness, nausea, feeling faint, and heart palpitations. PAD is associated with pain in the lower limbs during exercise, which can be intermittent.¹

Men and women can experience different symptoms.⁶ For example, women are more likely to report vomiting, breathlessness, dizziness, or no symptoms. 

Management and treatment for heart disease

If heart disease is diagnosed early, treatment can help individuals to live a relatively normal life. Research suggests that the input from various specialists from cardiologists to dieticians, offers the best outcomes.^1,6 There are various forms of treatment that range from lifestyle changes to medication and surgery.^7,8

Lifestyle changes 

• Regular exercise
• Diet changes to reduce the amount of saturated fats and sugars in your diet 
• Stopping smoking

Medication 

• Medications such as ACE inhibitors, anticoagulant medications, beta-blockers, and statins can be used to help manage the symptoms and prevent the worsening of the condition

Surgical Procedures 

• Coronary angioplasty is a surgical procedure that involves inserting a stent (a metal mesh tube) into your arteries to reopen them and keep them open.⁸ It is a painless procedure that generally only takes a few weeks to recover
• Heart bypass surgery is a more invasive surgical procedure that treats CHD
• Electrical cardioversion or having a pacemaker inserted can be used to treat arrhythmias

Diagnosis

Heart disease is generally diagnosed through a series of checks and risk assessments. This includes a physical examination where your doctor will look for any signs of distress or skin changes (for example, those that can result from PAD).¹ Your doctor may also ask about your medical and family history to establish your risk of heart disease. They may also check your blood pressure and carry out a blood test to assess your blood cholesterol levels. Further tests including an electrocardiogram, CT scan, MRI scan, and coronary angiography may be used to confirm if you have heart disease.

Risk factors

Research has identified many risk factors that can make you more susceptible to developing heart disease.^7,9 Some of these are modifiable factors that you can change to help reduce your risk.^1.10 Below is a list of factors that can increase your risk of developing heart disease.^11,12 

• Physical inactivity
• A high-calorie diet, or a diet high in saturated fats and sugars
• Dyslipidemia
• Diabetes
• Smoking
• Hypertension
• Family history of CVD
• Older age
• COVID-19
• HIV

There is also a gender difference when it comes to the risk of heart disease. Pre-menopause, men appear to have a greater risk of developing a heart disease than women, however, post-menopause this difference decreases.¹ 

Complications

Heart disease can lead to a number of complications including:

• Heart failure (occurs when the heart cannot pump sufficient blood around your body) 
• Heart attack (occurs when your arteries that supply blood to the heart become blocked) 
• Stroke (if your arteries that supply blood to the brain become blocked, it can lead to a stroke)
• Aneurysm (heart diseases can cause bulges to form in your artery walls, called an aneurysm; if an aneurysm bursts it can cause internal bleeding that can be fatal)
• Death (heart disease is a leading cause of death globally) 

FAQs

How can I prevent heart disease?

Regular exercise, a healthy diet low in saturated fats and sugars, and quitting smoking are the best ways to help prevent heart disease.¹

How common is heart disease?

It is estimated that around 1 in 13 people suffer from heart disease around the world. Heart disease is a leading cause of death globally. The World Health Organisation estimates that 17.9 million people die from heart disease yearly. 

When should I see a doctor?

If you have any symptoms of heart disease or a family history of heart disease, you should speak to your doctor. 

Summary

Heart disease refers to any condition that affects your heart and its associated blood vessels. Your heart is a vital organ, and if heart disease is left untreated it can have serious consequences. There are various risk factors, some of which are modifiable such as smoking, diet, and exercise. Many proven effective treatment forms are there for this condition. It is important that you consider lifestyle changes and seek medical attention if you think you are at risk of heart disease or are experiencing any symptoms.