When you say the word heart disease or cardiac disease, the first thing that comes to mind is blocked arteries and reduced blood flow to the heart. People know this more commonly as a heart attack, and in medical terms it is called a myocardial infarction. Although a myocardial is the most common cardiac condition which affects the population world over, there are other heart conditions which equally important because even they can be life threatening if not detected early and treated or brought under control. And it is important that people are aware that these conditions exist and how it can manifest and affect their lives. All of these conditions, collectively are known as cardiovascular diseases.
Coronary Artery Disease
Coronary artery refers to the vessels which supply blood top the heart muscle. Our heart is basically a muscular pump, which enables oxygenated blood to flow out with increased pressure and velocity to all the vessels in our body, thereby supplying all the tissue in our body with oxygen. In order to function well, the heart muscle itself requires oxygen, and the coronary vessels only help with delivering oxygenated blood to the heart muscle. With age and our diet, there may be buildup of cholesterol within these vessels causing them to become narrowed, thereby reducing the flow of blood within them and to the part of the heart which they supply. This buildup of fatty plaques is known as Atherosclerosis. With continuous buildup of cholesterol, it might end up with complete occlusion of the vessel, thereby cutting off the blood supply to the tissue also completely. Causing that part of the heart muscle to die due to lack of oxygen. This is known as a myocardial infarction.When you experience this blockage only in one vessel, it affects only a small area of your heart, and this means that your heart will be able to compensate for this lost tissue and continue to function normally. But if it occurs in multiple vessels at the same time, then the heart cannot compensate, and it can end up being fatal. Therefore it is important, that you bring in changes to your lifestyle and diet, following your first myocardial infarction, so that we can further prevent buildup of fatty plaques.
Heart Failure
Is a condition, where the heart cannot meet the demand for oxygen in other parts of the body as it cannot pump out blood at the needed rate, with the necessary amount of force. As a result, even though the heart continues to beat and pump out blood, it cannot do so to meet the requirements of the body. And as it continues to try to keep up and work harder, it only further regresses in its functionas a pump, until one day it stops working altogether. This continuous process of deterioration in function is called heart failure, and it can develop following a myocardial infarction, where some part of the heart muscle has died and the rest of the tissue is working twice as hard to compensate for this tissue loss and maintain the same function, or even in instances where the heart has to pump blood into vessels which have high resistance for prolonged periods of time, such as in people with poorly controlled high blood pressure. All this will cause the heart muscle to work under great stress, until one day it gives in and starts to fail.
Cardiac Arrhythmia
A normally functioning heart has a regular rhythm, which is important to maintain the filling time of the heart as well as the output of blood from the heart. The rhythm determines how much of time is given for the heart to fill up with enough blood and how much of time the heart takes to contract and pump out the necessary amount of blood. When this rhythm becomes too fast or too slow then the efficiency of the heart is affected, as it cannot meet the demands of the body as required. The irregularity of the beating heart will affect its output and reduce the amount of blood and oxygen reaching all parts of the body.
Problems with heart valves
The heart consists of four chambers and two outflow tracts, and at the entrance of each of this there are one way valves, which make sure that blood flows only in one direction. But when these valves fail to function properly it can lead to the following conditions:
Valve stenosis – where the valves do not open up completely causing the blood to flow through a narrowed space, limiting the amount of blood that can flow through. This can be caused by stiffening or thickening of the valve leaflets.
Valve regurgitation – in this condition the valves fail to close properly, as a result of which there is backflow of blood when the heart muscle is contracting, and this commonly occurs when there is deposition of various substances on the valve leaflets.
Congenital Heart Disease
The term Congenital refers to the time of birth. Certain disease conditions of the heart are present at the time of birth itself, even though they fail to manifest at that time. Most congenital heart conditions only start to show symptoms when the child is a little older, or only when they grow up to be adults. Such conditions include septal defects commonly called ‘’hole in the heart’’. If they are very small and not causing any difficulty to the baby, then they can be left alone and will most probably close up on their own. If they don’t or I they too large and threatening the life of the baby, then surgical intervention to close the defect may be required.
Cardiomyopathy
This is condition where there is an abnormality in the structure of the heart muscle itself, causing the heart to function poorly. The muscle can be abnormally thick and stiffened, making it unable for the muscle to contract and relax efficiently thereby weakening it, even though it appears bulky. If this condition goes on for long periods of time, then it may lead to rhythm abnormalities and even a myocardial infarction.
Pericarditis
The heart is surrounded by a thin serosal lining called the pericardium, and this condition is related to the inflammation and irritation of this lining, which can again lead to problems with the contraction and relaxation of the heart. It is a very rare condition.
All of these constitute the diseases which can affect the heart. And all of the above mentioned conditions if not treated in the correct manner at the correct time, will be fatal. This is the reason that we should work towards maintaining healthy heart. And this can be achieved with incorporating brisk exercises as well as a well-balanced diet into our lifestyle.
Dr. Rajneesh Malhotra is the Chief of Cardiac Surgery at Max super Speciality Hospital, New Delhi. He also offers consultation at Dharm Clinic, Kalkaji, New Delhi. He is an expert in Minimally Invasive Cardiac Surgery, Minimally Invasive Mitral Valve Replacement, and repairs, Coronary Artery Bypass Grafting (CABG), Aortic Valve Replacement and Repair, Atrial Septal Defects (ASD's), Robotic Cardiac Surgery.