Heart Disease

Heart disease is a general term for a wide variety of diseases and conditions that affect the function of the heart.

What is going on in the body?

The main job of the heart is to pump blood to the rest of the body. The primary concern with most heart conditions is how much they affect the heart's ability to pump blood. When people use the term heart disease, they are often referring to atherosclerosis, or clogged arteries. Clogged heart arteries cause coronary artery disease, or CAD. In turn, coronary artery disease can lead to:

But heart disease can also refer to many other conditions. This is important for people to remember when they see or hear the term heart disease. Heart disease is the leading cause of death in the United States and in many other countries.

What are the causes and risks of the disease?

There are many causes of heart disease.

Atherosclerosis, or clogging of the arteries, is partly or fully responsible for many diseases that affect the heart, including:

Factors that increase a person's risk of developing atherosclerosis include:

High blood pressure can cause heart disease even when arteries are not clogged. The increased blood pressure can cause heart enlargement, called hypertrophy, and congestive heart failure. It also increases the risk of clogged arteries, which can further damage the heart.

Congenital heart disease, which means heart disease that is present at birth, can result in a heart that has an abnormal structure or function. For example, a baby with Down syndrome may have an atrial septal defect and/or ventricular septal defect. Heart valve conditions, such as pulmonary stenosis, may be present at birth as well.

Other causes of heart disease include:

Many other conditions can also affect the heart.

What are the signs and symptoms of the disease?

Symptoms depend on the cause, severity, and type of heart disease. Common signs and symptoms in heart disease include:

Other signs and symptoms are also possible.

How is the disease diagnosed?

Heart disease is often suspected after a medical history is taken and a physical exam is performed. Further tests may be done to determine the type, severity, and cause of the heart condition. These may include:

What can be done to prevent the disease?

Prevention of heart disease is related to its cause. Heart disease caused by atherosclerosis can be prevented by not smoking and by controlling high blood pressure, diabetes, and cholesterol. Avoidance of alcohol could prevent cases due to this cause. Maintaining a healthy body weight, including physical activity in everyday life, and eating a diet designed to minimize heart disease can help decrease heart disease risk.

The American Heart Association recently issued recommendations about hormone replacement therapy (HRT) in women. For women who have already had a heart attack or have heart disease, it appears that HRT does not protect against having another heart attack or dying from heart disease. The studies that support this information were done with women over 65 years of age. It is unclear if this information also holds true for younger postmenopausal women who take HRT.

For women who have not already had a heart attack or who do not have heart disease, HRT should not be started for the sole purpose of preventing heart disease. The research is not strong enough to support doing that at this time. Also, it is not necessary for a woman to stop HRT if she is doing well on it.

Overall, the decision to use HRT should be based upon the proven benefits and risks of HRT. Women should discuss the benefits and risks with their healthcare provider. Together, they can choose the most appropriate course of action.

What are the long-term effects of the disease?

Long-term effects depend on the type, severity, and cause of heart disease. Heart attacks and congestive heart failure are common causes of death in the United States. Heart infections may go away completely after treatment and have no long-term effects. In other cases, they may cause permanent damage to the heart or even death.

What are the risks to others?

Heart disease is not contagious. Some inherited causes of heart disease can be passed on to one's children. If the underlying cause is an infection, the infection may be contagious.

What are the treatments for the disease?

There are many possible treatments for heart disease. Medicines are commonly used to:

Surgery or other procedures may also be used to treat heart disease. These procedures include:

Many other medicines and surgery techniques are used to treat heart disease. Cardiac rehabilitation and other forms of exercise can also help to improve the person's ability to function.

What are the side effects of the treatments?

All medicines and surgeries have possible side effects. Medicines may cause allergic reactions or stomach upset. Surgery carries a risk of bleeding, infection, and allergic reaction to anesthesia.

What happens after treatment for the disease?

Most individuals with coronary artery disease are encouraged to begin a regular exercise program. A person with CAD should make every effort to reduce coronary risk factors. This may include smoking cessation, control of other diseases such as diabetes and high blood pressure, and eating a healthy diet for prevention of heart disease.

Many people with heart disease need lifelong treatment and monitoring. Death may occur, even with the best treatment.

How is the disease monitored?

A person with heart disease will have regular visits to the healthcare provider, along with periodic EKGs and blood tests. Any new or worsening symptoms should be reported to the healthcare provider.

Author:Adam Brochert, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:08/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:08/08/01

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