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heart disease

Alternative Names
cardiac disease, coronary 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 arteriosclerosis, or clogged arteries. Clogged heart arteries cause coronary artery disease. 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 Australia and in many other countries.

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.

What are the causes and risks of the disease?
There are many causes of heart disease.

Arteriosclerosis, 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 arteriosclerosis 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, also may be present at birth.

Other causes of heart disease include:
  • heart valve infections, known as endocarditis, which can damage the valves and cause conditions such as aortic regurgitation or mitral stenosis
  • infections of the heart muscle, known as myocarditis
  • infection of the lining around the heart, a condition called bacterial pericarditis
  • toxins, such as alcohol and some chemotherapy medications used to treat cancer. Both of these can cause a condition called cardiomyopathy, a disease of the heart muscle.
  • kidney failure, which can cause pericarditis, an inflammation of the lining around the heart. Kidney failure may also cause an abnormal collection of fluid around the heart, called pericardial effusion.
  • autoimmune disorders, in which the body, even specifically the heart, is attacked by its own immune system
Many other conditions can also affect the heart.

What can be done to prevent the disease?
Prevention of heart disease is related to its cause. Heart disease caused by arteriosclerosis 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 minimise heart disease can help decrease heart disease risk. However, many cases cannot be prevented.

How is the disease diagnosed?
Heart disease is often suspected after a medical history is taken and a physical examination is performed. Further tests may be done to determine the type, severity, and cause of the heart condition. These may include:
  • blood and urine tests
  • electrocardiogram, or ECG, which shows the electrical activity of the heart
  • chest X-ray
  • echocardiogram, which uses sound waves to view the beating heart
  • stress tests in which the person either walks on a treadmill or receives a medication and the effects on the heart are examined with an ECG or imaging test
  • cardiac catheterisation, a special X-ray done with a contrast agent to look at the heart and its blood supply
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 Australia. 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. Medications are commonly used to:
  • control high blood pressure, such as atenolol, hydrochlorothiazide, amlodipine, or enalapril
  • control high cholesterol, such as pravastatin, simvastatin, and lovastatin
  • act as diuretics, or water pills, such as frusemide and hydrochlorothiazide
  • help the heart pump better, such as digoxin or dobutamine
  • stop or control irregular heartbeats, such as amiodarone or procainamide
  • help the heart relax and rebuild itself, such as carvedilol and captopril
  • prevent blood clots in the heart, such as warfarin
Surgery or other procedures may also be used to treat heart disease. These procedures include: Many other medications 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 medications and surgeries have possible side effects. Medications may cause allergic reactions or stomach upset. Surgery carries a risk of bleeding, infection, and allergic reaction to anaesthesia.

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 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 doctor, along with periodic ECGs and blood tests. Any new or worsening symptoms should be reported to the doctor.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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