The term ‘heart disease’ usually conjures up images of a patient clutching at their chest with a heart attack, but it actually refers to several different types of disease with distinct causes, symptoms, and treatments.
Atherosclerosis and heart attack
The most common issues that arise concerning the heart involve a process called atherosclerosis. This occurs as plaque, a semi-hardened substance that accumulates in the arteries. When that plaque breaks loose it is surrounded by a blood clot, and this clot can obstruct the flow of blood and oxygen, resulting in what we know as a heart attack. The likelihood of full recovery depends on how much damage is done and how much of the heart is affected.
Although massive heart attacks can occur without warning and death can occur, most people do survive their heart attack. Over a period of eight weeks or so, the heart muscle will heal and scar tissue will form at the site of the event. The scarred area of the muscle will not contract as well as the healthy tissue, meaning there will be some decrease in the heart’s ability to pump blood throughout the rest of the body. Heart attack patients are also left with some degree of coronary heart disease which may be corrected with surgery or managed with exercise, diet, and medication.
Heart Failure occurs when the heart is weakened and cannot pump enough blood to meet the body’s need for oxygen. Everyday activities like climbing stairs or even walking a few blocks can become difficult. The heart tries to compensate both by enlarging the affected chamber and by increasing heart muscle mass, resulting in thickened chamber walls and an enlarged heart. Eventually, though, the body cannot compensate any longer. In addition, the heart’s attempts to compensate lead to symptoms that include retained fluid and fluid in the lungs.
Heart failure cannot be cured, but it is manageable with medications.
An Arrhythmia is merely an irregular heartbeat. The heart may not beat normally, may have premature contractions, a very fast or very slow rate. All of these irregularities have their causes and treatments. Probably the best known arrhythmia is atrial fibrillation (AFib). Many people with this condition notice that they have a fluttery heartbeat, but other people notice no symptoms at all; their AFib is found and diagnosed during a routine medical exam.
AFib doubles the risk of heart-related death and is associated with a 4-5 time increase in the likelihood of stroke, yet an American Heart Association survey found that only 33% of AF patients believe that it is a serious condition.
There are a number of commonly prescribed cardiac drugs, and they are used in various combinations to manage the various heart diseases described above. These drugs include:
- Anticoagulants, also known as blood thinners. They don’t actually thin the blood, but they do decrease its ability to clot. The most common anticoagulant is warfarin (Coumadin). Recently a new class of anticoagulant has come on the market, including Xarelto and Pradaxa.
- ACE Inhibitors help to expand the blood vessels and to make the heart pump more easily, creating less work for the muscle. The most common ACE Inhibitors are enalapril (Vasotec) and benazepril (Lotensin).
- Beta blockers can help the heart to beat more slowly and with a lower cardiac output, reducing blood pressure and heart muscle stress. Those commonly prescribed include atenolol (Tenormin) and acebutolol (Sectral).
- Other medications used to treat symptoms of heart disease and heart failure include cholesterol-lowering statin drugs (Lipitor and Crestor) and diuretics.
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