Cardiovascular disease refers to any disease that affects the cardiovascular system, principally cardiac disease, vascular diseases of the brain and kidney, and peripheral arterial disease. The causes of cardiovascular disease are diverse but atherosclerosis and hypertension are the most common. In addition, with aging come a number of physiological and morphological changes that alter cardiovascular function and lead to increased risk of cardiovascular disease, even in healthy asymptomatic individuals. Cardiovascular disease is the leading cause of deaths worldwide.
Coronary Artery Disease
Coronary artery disease (CAD) also known as atherosclerotic heart disease, atherosclerotic cardiovascular disease, coronary heart disease, or ischemic heart disease (IHD), is the most common type of heart disease and cause of heart attacks. The disease is caused by plaque building up along the inner walls of the arteries of the heart, which narrows the lumen of arteries and reduces blood flow to the heart. The risk of artery narrowing increases with age, smoking, high blood cholesterol, diabetes, high blood pressure, and is more common in men and those who have close relatives with CAD.
Pericarditis is an inflammation of the pericardium (the fibrous sac surrounding the heart). A characteristic chest pain is often present.
Cardiac tamponade, also known as pericardial tamponade, is an acute type of pericardial effusion in which fluid, pus, blood, clots, or gas accumulates in the pericardium (the sac in which the heart is enclosed), resulting in slow or rapid compression of the heart.
Acute Rheumatic Fever
Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as streptococcal pharyngitis. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after a streptococcal infection. Acute rheumatic fever commonly appears in children between the ages of 6 and 15, with only 20% of first-time attacks occurring in adults.
Aortic coarctation is considered when a section of the aorta is narrowed to an abnormal width. Symptoms may be absent with mild narrowings (coarctation). When present, they include: difficulty breathing, poor appetite or trouble feeding, failure to thrive. Later on, children may develop symptoms related to problems with blood flow and an enlarged heart. They may experience dizziness or shortness of breath, faint or near-fainting episodes, chest pain, abnormal tiredness or fatigue, headaches, or nosebleeds. They have cold legs and feet or have pain in their legs with exercise.
Aortic dissection occurs when a tear in the inner wall of the aorta causes blood to flow between the layers of the wall of the aorta, forcing the layers apart. In most cases this is associated with severe characteristic chest or abdominal pain described as “tearing” in character, and often with other symptoms that result from decreased blood supply to other organs.
Aortic Valve Regurgitation
Aortic insufficiency (AI), also known as aortic regurgitation (AR), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. Symptoms of aortic insufficiency are similar to those of heart failure and include dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea. Palpitations and angina pectoris may also be felt.
Mitral Valve Regurgitation
Mitral insufficiency (MI), mitral regurgitation or mitral incompetence is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. The symptoms associated with MI are dependent on which phase of the disease process the individual is in. Individuals with acute MI will have the signs and symptoms of decompensated congestive heart failure (i.e. shortness of breath, pulmonary edema, orthopnea, and paroxysmal nocturnal dyspnea ), as well as symptoms suggestive of a low cardiac output state (i.e., decreased exercise tolerance). Palpitations are also common.
Tricuspid Valve Regurgitation
Tricuspid insufficiency (TI), a valvular heart disease also called tricuspid regurgitation (TR), refers to the failure of the heart’s tricuspid valve to close properly during systole. Tricuspid insufficiency may be asymptomatic, especially if right ventricular function is well preserved. Symptoms are generally those of right-sided heart failure, such as ascites, hepatomegaly, edema and jugular venous distention.
Pulmonary Valve Regurgitation
Pulmonary valve insufficiency (or incompetence, or regurgitation) is a condition where the pulmonary valve is not strong enough to prevent backflow to the right ventricle.
Aortic valve stenosis (AS) is a disease of the heart valves in which the opening of the aortic valve is narrowed. Aortic stenosis is now the most common valvular heart disease in the Western World. Most people with mild to moderate aortic stenosis are asymptomatic. Symptoms usually present in individuals with severe aortic stenosis, though they may occur in those with mild to moderate aortic stenosis as well. The three cardinal symptoms of aortic stenosis are loss of consciousness, anginal chest pain and shortness of breath with activity or other symptoms of heart failure such as shortness of breath while lying flat, paroxysmal nocturnal dyspnea, or pedal edema.
Mitral stenosis is a valvular heart disease characterized by the narrowing of the orifice of the mitral valve of the heart. Symptoms of mitral stenosis include: Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND), Palpitations, Chest pain, Hemoptysis, Thromboembolism, Ascites and edema and hepatomegaly (if right-side heart failure develops) , Fatigue and weakness increase with exercise and pregnancy.
Tricuspid valve stenosis is a valvular heart disease which results in the narrowing of the orifice of the tricuspid valve of the heart.
Pulmonary Valve Stenosis
Pulmonary valve stenosis is a heart valve disorder in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. This results in the reduction of flow of blood to the lungs. Symptoms include jugular vein distension, cyanosis (usually visible in the nailbeds), right ventricular hypertrophy, and general symptoms of lowered oxygenation of the blood. When the stenosis is mild, it can go unnoticed for many years and have no negative symptoms. If stenosis is severe, sudden fainting or dizziness many occur when exercising. An enlarged liver (hepatomegaly) and swelling in the legs (edema) may also be apparent.
Cardiac dysrhythmia (also known as arrhythmia or irregular heartbeat) is any of a group of conditions in which the electrical activity of the heart is irregular or is faster or slower than normal. The most common symptom of arrhythmia is an abnormal awareness of heartbeat, called palpitations.
A ventricular septal defect (VSD), a hole in the heart, is a common heart defect that’s present at birth (congenital). The hole occurs in the wall that separates the heart’s lower chambers (septum) and allows blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder. An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart. The condition is present from birth (congenital). Smaller atrial septal defects may close on their own during infancy or early childhood.
Heart failure (HF), often used to mean chronic heart failure (CHF), occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the needs of the body. The terms congestive heart failure (CHF) or congestive cardiac failure (CCF) are often used interchangeably with chronic heart failure. Symptoms commonly include shortness of breath, excessive tiredness, and leg swelling. The shortness of breath is usually worse with exercise, when lying down, and at night while sleeping. There is often a limitation on the amount of exercise people can perform, even when well treated.
Pulmonary heart disease, also known as Cor pulmonale is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or high blood pressure in the lungs (pulmonary hypertension). The symptoms of pulmonary heart disease depend on the stage of the disorder. In the early stages, one may have no symptoms but as pulmonary heart disease progresses, most individuals will develop the symptoms like Shortness of breath which occurs on exertion but when severe can occur at rest, Wheezing, Chronic wet cough, Swelling of the abdomen with fluid (ascites), Swelling of the ankles and feet (pedal edema), Enlargement or prominent neck and facial veins, Raised jugular venous pressure (JVP), Enlargement of the liver, Bluish discoloration of the skin (cyanosis), Presence of abnormal heart sounds, possible bi-phasic atrial response shown on an EKG due to hypertrophy.
Cardiomyopathy (literally “heart muscle disease”) is the measurable deterioration for any reason of the ability of the myocardium (the heart muscle) to contract, usually leading to heart failure. Common symptoms include dyspnea (breathlessness) and peripheral edema (swelling of the legs).
Hypertension (HTN) or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Hypertension is rarely accompanied by any symptoms, and its identification is usually through screening, or when seeking healthcare for an unrelated problem. A proportion of people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.
Hypertrophic Obstructive Cardiomyopathy (HOCM)
Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle (myocardium) becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood. Signs and symptoms of hypertrophic cardiomyopathy include: Shortness of breath, especially during exercise, Chest pain, especially during exercise, Fainting, especially during exercise or exertion, Dizziness, Fatigue, Sensation of rapid fluttering or pounding heartbeats (palpitations), Heart murmur, which a doctor might detect while listening to your heart.
Congenital heart defect (CHD) or congenital heart anomaly is a defect in the structure of the heart and great vessels that is present at birth. Many types of heart defects exist, most of which either obstruct blood flow in the heart or vessels near it, or cause blood to flow through the heart in an abnormal pattern. Other defects, such as long QT syndrome, affect the heart’s rhythm. Signs and symptoms are related to type and severity of the heart defect. Symptoms frequently present early in life, but it is possible for some CHDs to go undetected throughout life. Some children have no signs while others may exhibit shortness of breath, cyanosis, syncope, heart murmur, under-development of limbs and muscles, poor feeding or growth, or respiratory infections. Congenital heart defects cause abnormal heart structure resulting in production of certain sounds called heart murmur.