Common Heart & Vascular Conditions

Click on a condition below for more information:

For more information on heart and vascular conditions, click here

Atherosclerosis (Hardening of the arteries)

Atherosclerosis is the name of the process in which deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque. Plaques can grow large enough to reduce the blood's ability to flow through an artery. The most severe damage occurs when plaques become unstable and rupture. Ruptured plaques contain material that causes blood to form a clot.  Blood clots can block blood flow or break off and travel to another part of the body. If this process occurs and blood clot blocks an artery that feeds the heart, it causes a heart attack. If it blocks an artery that feeds the brain, it causes a stroke. Heart disease and stroke are the #1 and #4 most common causes of death in this country.

It manifests itself in 3 main forms: (can also involve arteries to other organs)

  1. Coronary Artery Disease – can lead to angina, heart attack, congestive heart failure and arrhythmias.
  2. Cerebrovascular Disease – can lead to stroke.
  3. Peripheral Artery Disease – can lead to leg pain, aneurysms, ulcers, gangrene, non-healing infections and even the need for amputation.

Risk factors include genetics (family history) and the following controllable risk factors:

  • High blood cholesterol (especially LDL or "bad" cholesterol)
  • Cigarette smoking and exposure to tobacco smoke
  • High blood pressure
  • Diabetes mellitus
  • Obesity
  • Physical inactivity

Click for warning signs of heart attack and stroke.

Treatment:

  • Optimal control of risk factors with a combination of medication and healthy lifestyle habits are critical.
  • Medications such as aspirin & cholesterol lowering medication should be taken by all patients with this disease.
  • Blood pressure medication is also usually required to control blood pressure.
  • Treatment with angioplasty and stent or bypass surgery may be necessary to restore normal blood flow.

Heart Attack (Myocardial Infarction)

This is usually caused by rupture of atherosclerotic plaque in a coronary artery (see atherosclerotic heart and vascular disease) which causes a blood clot to form and abruptly stop all blood flow to part of the heart. Symptoms can include chest discomfort, shortness of breath, sweating, nausea and sometimes arm, shoulder or jaw discomfort.  Emergency treatment with heart catheterization and angioplasty with stenting in addition to medication can restore blood flow to the heart, minimizing any permanent heart damage and risk to the patient. Heart attacks can result in serious consequences such as sudden death, heart failure and heart rhythm disorders. Cardiac Rehabilitation after heart attack has shown to improve long term outcomes.

Stroke (Cerebral Infarction)

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it starts to die. The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow can't reach the region that controls a particular body function, that part of the body won't work as it should. The effects of a stroke depend primarily on the location of the obstruction and the extent of brain tissue affected. Effects can include vision and other sensory impairment, speech/language/comprehension problems, paralysis, memory loss, severe disability and even death. A TIA is a transient form of stroke with symptoms lasting less than 24 hours due to a temporary obstruction of blood flow. Treatment to help reduce the risk of stroke includes anticoagulant and antiplatelet medications and carotid endarterectomy or carotid artery stenting.

Carotid Artery Stenting

The carotid arteries provide the main blood supply to the brain. Atherosclerosis can affect the carotid arteries causing a narrowing, much like the arteries in the heart. Often there are no symptoms, but as the amount of plaque builds up, it may eventually present as a stroke or stroke like symptoms. Carotid artery disease can be diagnosed with an ultrasound of the carotid arteries as well as a CT Scan. In carotid artery stenting, a small puncture is made in an artery in the leg and a catheter is threaded up to the arteries in the neck. The blockage is identified through an angiogram under x-ray. A balloon is then guided up to the blockage and inflated to open the blockage. Afterward, a stent is deployed in the same location to help the artery remain open.

Heart Rhythm Disorders

The heart is a muscular pump that is normally guided by its natural pacemaker, the sinus node, through a sequence of electrical impulses that travel through the heart allowing it to pump in a mechanically efficient manner. Heart rhythm disorders or “arrhythmias” are abnormal variations in the normal sequence of electrical impulses through the heart. The electrical impulses may happen too fast, too slowly, or erratically. Some arrhythmias are rather benign, and others can be life threatening.  When the heart doesn’t beat properly, it can’t pump blood effectively. When the heart doesn’t pump blood effectively, the lungs, brain and all other organs can’t work properly and may shut down or be damaged.

General Examples:
Bradycardia = too slow     Tachycardia = too fast
Fibrillation = quivering      Premature contraction = early beat

Specific Conditions:

  • Atrial Fibrillation    
  • Sick Sinus Syndrome
  • Supraventricular Tachycardia (SVT) 
  • Ventricular Tachycardia or Fibrillation
  • Bundle Branch Block
  • Wolff-Parkinson-White Syndrome

Congestive Heart Failure

Heart Failure is truly the failure of the heart to perform its normal duties as a pump. In general this is due to the heart becoming too weak or too stiff. This can result in poor blood flow to the body’s vital organs and elevated pressures in the heart and lungs which can ultimately lead to congestion or an abnormal build up of fluids in the chest, abdomen and extremities.

Causes can include: Coronary artery disease, past heart attacks, high blood pressure, abnormal heart valves, heart rhythm disorders, thyroid disease, drug or alcohol use, viral infections, congenital heart defects, genetic disorders and other rare causes.

Symptoms include: shortness of breath, fatigue and swelling. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult. Heart failure is a serious condition, and usually there’s no cure. But many people with heart failure lead a full, enjoyable life when the condition is properly diagnosed and managed. For optimal outcomes people need to work closely with their care providers to incorporate healthy lifestyle changes in addition to using medications and considering surgical options. It’s also helpful to have the support of family and friends who understand your condition.

Heart Valve Disease

There are 4 “one-way” valves in the heart. The tricuspid valve and pulmonary valve are on the right side of the heart, which receives deoxygenated blood back from the body’s tissues and pumps the blood into the lungs. The mitral valve and aortic valve are on the left side of the heart, which receive oxygenated blood from the lungs and pumps it out to the body. Disease of the mitral and aortic valves is more common because they are under higher pressure on the left side of the heart and take more “wear and tear.”
In general there are 3 disease conditions of heart valves:

  1. Regurgitation – leakage of blood backward through the “one-way” valve.
  2. Stenosis – the opening through the valve becomes restricted or narrowed.
  3. Endocarditis – valve infection leading to regurgitation and abnormal growths on the valve called “vegetations.”

Specific Conditions:
Aortic valve regurgitation 
Aortic valve stenosis - is surgery indicated?
Mitral valve regurgitation 
Mitral valve stenosis
Endocarditis

For severe heart valve disease, valve surgery is often the best (and sometimes the only) treatment option.

Click on the following to see how to prepare for heart surgery and what to expect after heart surgery.

Hypertension (High Blood Pressure)

About one in three U.S. adults has high blood pressure, but because there are no symptoms, nearly one-third of these people don't know they have it. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure or kidney failure. This is why high blood pressure is often called the "silent killer." The only way to tell if you have high blood pressure is to have your blood pressure checked. By controlling your high blood pressure, you'll lower your risk of diseases like stroke, heart attack, heart failure and kidney disease.

Pericarditis

Pericarditis is a swelling and irritation of the pericardium, the thin sac-like membrane that surrounds your heart. Pericarditis often causes chest pain and sometimes other symptoms. Pericarditis may be acute or chronic. The sharp chest pain associated with acute pericarditis occurs when the pericardium rubs against the heart's outer layer. The sharp chest pain typically is worse with lying down and deep breathing and improved with sitting up or leaning forward.  Mild cases may improve without treatment. Treatment for more-severe cases may include medications and, rarely, surgery. Early diagnosis and treatment may help to reduce the risk of long-term complications.

Aorta Disease (Aneurysm)

An aortic aneurysm is a weakened and bulging area in the aorta, the largest artery in the body, that originates from the heart and travels though the chest and abdomen. A ruptured aortic aneurysm can cause life-threatening bleeding. Although you may never have symptoms, finding out you have an aortic aneurysm can be frightening. Most small and slow-growing aortic aneurysms don't rupture, but large, fast-growing aortic aneurysms may. Depending on the size and rate at which the aortic aneurysm is growing, treatment may vary from watchful waiting to surgery.

Aorta Disease (Dissection)

An aortic dissection is a serious condition in which a tear develops in the inner layer of the aorta, the large blood vessel branching off the heart. Blood surges through this tear into the middle layer of the aorta, causing the inner and middle layers to separate (dissect). If the blood-filled channel ruptures or occludes flow to major branches of the aorta, death may result. Fortunately, Aortic dissection is relatively uncommon. Anyone can develop the condition, but it most frequently occurs in men between 40 and 70 years of age. The signs and symptoms of aortic dissection may mimic those of other diseases, often leading to delays in diagnosis. However, when an aortic dissection is detected early and treated promptly, your chance of survival greatly improves.

Congenital Heart Disease

Congenital heart defects occur as a result of a problem with the heart’s formation during fetal development. Some congenital heart defects are as simple as a small hole between heart chambers that may close without treatment. Other congenital heart defects are more complex and may require several surgeries performed over a period of several years. Treatment for children who have congenital heart defects doesn't end with surgeries or medication while they're young. Children who have heart defects should be mindful of their heart problems their entire lives, as their defect could have complications, such as increased risk of heart tissue infection (endocarditis), heart failure, heart valve problems or heart rhythm disorders.