Cardiology Common Diseases & Conditions MCMC Cardiology offers the expertise and technology to diagnose and treat a vast range of heart-related diseases and conditions such as, but not limited to: Chest Pain Chest pain is one of the most common reasons people call for emergency medical help. Fortunately, chest pain doesn’t always signal a heart attack. Often chest pain is unrelated to any heart problem. Even so it is important not to ignore it, and to seek a medical evaluation as quickly as possible. There are many possible causes of chest pain. Some causes are mildly inconvenient, while other causes are serious, even life-threatening. Any organ or tissue in your chest can be the source of pain, including your heart, lungs, esophagus, muscles, ribs, tendons or nerves. Angina is one type of heart-related chest pain. This pain occurs because your heart is not getting enough blood and oxygen. Angina pain can be similar to the pain of a heart attack. Other causes of chest pain include: Asthma, which is generally accompanied by shortness of breath, wheezing, or cough. Pneumonia, a blood clot to the lung (pulmonary embolism), the collapse of a small area of a lung (pneumothorax), or inflammation of the lining around the lung (pleurisy). In these cases, the chest pain often worsens when you take a deep breath or cough and usually feels sharp. Strain or inflammation of the muscles and tendons between the ribs. Anxiety and rapid breathing. Chest pain can also be related to problems with your digestive system. These include stomach ulcer, gallbladder disease, gallstones, indigestion, heartburn, or gastroesophageal reflux (when acid from your stomach backs up into your esophagus). Ulcer pain burns if your stomach is empty and feels better with food. Gallbladder pain often gets worse after a meal, especially a fatty meal. Hypertension (High Blood Pressure) Hypertension, or high blood pressure, is defined as a repeatedly elevated blood pressure exceeding 130 over 80 mmHg - a systolic pressure above 130 with a diastolic pressure above 80. When you have high blood pressure, or hypertension, the force of blood against your artery walls is too strong. High blood pressure can damage your arteries, heart, and kidneys and lead to atherosclerosis and stroke. Hypertension is called a “silent killer” because it does not cause symptoms unless it is severely high and, without your knowing it, causes major organ damage if not treated. In most cases, a doctor may not be able to pinpoint the exact cause of your high blood pressure. But several factors are known to increase blood pressure, including obesity, heavy alcohol use, family history of high blood pressure, high salt intake and aging. A sedentary lifestyle, stress, low potassium intake, low calcium intake and resistance to insulin may also cause your blood pressure to rise. Hypertension is treated with regular aerobic exercise, weight reduction (if overweight), salt restriction and medications. Heart Attack Heart attacks result from blood vessel disease in the heart. Coronary heart disease (CHD), sometimes referred to as coronary artery disease (CAD), is a more general name for heart attack (and angina). A heart attack (or myocardial infarction) occurs when the blood supply to part of the heart muscle itself (the myocardium) is severely reduced or stopped. This occurs when one of the coronary arteries (the arteries that supply blood to the heart muscle) is blocked by an obstruction, often plaque due to atherosclerosis. A heart attack also can be caused by a blood clot lodged in a coronary artery. Such an event is sometimes called a coronary thrombosis or coronary occlusion. If the blood supply is cut off drastically or for a long time, muscle cells suffer irreversible injury and die. Disability or death can result, depending on how much heart muscle is damaged. Sometimes a coronary artery temporarily contracts or goes into spasm. When this happens, the artery narrows and blood flow to part of the heart muscle decreases or even stops. What causes a spasm is unclear, but it can occur in normal blood vessels as well as vessels partially blocked by atherosclerosis. If a spasm is severe, a heart attack may result. Arrhythmia An arrhythmia occurs when the heart’s regular rhythm changes - it may speed up or slow down, and it may beat irregularly. In North America, about 5 million people get arrhythmias, most over the age of 50. Some also have heart disease, but many don’t. In the vast majority of cases, the arrhythmia by itself isn’t life threatening, but may predispose someone to a number of problems such as a stroke. There are many different types of arrhythmias and their significance and consequences are varied. The normal beating of the heart is controlled by electrical signals sent from a particular segment of heart muscle tissue called the sinus node. This natural pacemaker is located near the top of the right atrium. The heart is divided into four chambers: two atria on top, and two ventricles underneath. The job of the atria is to fill the ventricles with blood, which then do the heavy work of pumping it through the rest of the body. In a normal heartbeat, an electrical pulse travels down the muscle tissue, activating the ventricles a split-second after the atria. In arrhythmias, there’s a problem with this signal. There are many different kinds of arrhythmias, but those that affect the ventricles are generally more serious than arrhythmias of the atria. High Cholesterol High blood cholesterol is one of the four major risk factors for coronary heart disease (along with cigarette smoking, high blood pressure and sedentary lifestyle). Your cholesterol level is determined partly by your genetic makeup and the saturated fat and cholesterol in the foods you eat. Even if you didn’t eat any cholesterol, your body would manufacture enough for its needs. The risk of developing coronary heart disease increases as your blood cholesterol level rises. This is why it is so important that everyone over age 20 should have their blood cholesterol level measured every five years. The following breakdown can help you see how the results of your total blood cholesterol tests relate to your risk of developing coronary heart disease: Total Cholesterol: Desirable: Less than 200 mg/dl Borderline High: 200 to 239 mg/dl High: 240 mg/dl and above If your blood cholesterol is 240 mg/dl or greater, you have more than twice the risk of someone whose cholesterol is 200 mg/dl, and you need medical attention and further testing. Self-Care Lowering your total cholesterol levels will reduce your chance of suffering a heart attack or stroke, or dying of heart disease. If you have had a heart attack, keeping your cholesterol under control is especially important. Managing your diet and weight, and increasing your physical activity can help bring low-density lipoprotein (LDL) cholesterol down to normal levels. Heart Failure Heart failure affects nearly 5 million Americans, including approximately 550,000 newly diagnosed heart failure patients each year. It is the leading cause of hospitalization in people older than 65. Heart failure does not mean the heart has stopped working; rather, it means that the heart’s pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body’s needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This helps to keep the blood moving for a short while, but in time, the heart muscle walls weaken and are unable to pump as strongly. As a result, the kidneys often respond by causing the body to retain water and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested, a condition called congestive heart failure. Heart failure is caused by many conditions that damage the heart muscle, including coronary artery disease, heart attack, cardiomyopathy and conditions that overwork the heart, such as valve disease, kidney disease and congenital heart defects. Stroke Most strokes are caused by a blockage in an artery that carries blood to the brain. Within minutes, brain cells begin to die. This can cause that part of the brain to be damaged, and you may lose control of a function that is controlled by that part of the brain. For example, you could lose the use of an arm or leg, or the ability to speak. The damage can be temporary or permanent, partial or complete. Doctors have found that if you get treatment right away after symptoms start, there is a better chance of getting the blood moving to your brain, and less chance of damage. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. “Mini-strokes,” or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted. Stroke symptoms Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) Sudden confusion, trouble speaking or understanding speech Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause If you have any of these symptoms, you must get to a hospital quickly to begin treatment. Risk factors Arteriosclerosis (hardening of the arteries) Uncontrolled diabetes High blood pressure High cholesterol level Smoking Previous transient ischemic attack (TIA) Heart disease Carotid artery disease (the artery that carries blood to your brain) Preventive measures Control your blood pressure Avoid foods that are high in fat and cholesterol, and eat less sodium to lower your cholesterol and blood pressure If you have diabetes, keep your blood sugar level under control Limit how much alcohol you drink. Quit smoking. If you don’t smoke, don’t start.