Frequently Asked Questions (FAQs)
Congenital heart defects (CHDs) are the most common type of birth defect, accounting for nearly one-third of all major congenital anomalies. In an article published in the November 2011 issue of theJournal of the American College of Cardiology, the authors cited a worldwide study population of 24,091,867 live births, with CHD identified in 164,396 individuals.
Cholesterol is a waxy, fat-like substance needed by the body to build cell walls and to make several essential hormones. You have likely heard about good and bad cholesterol, or high-density lipoproteins (HDL) and low-density lipoproteins (LDL), respectively. HDL cholesterol is considered “good” because it helps remove LDL cholesterol from the arteries. LDL cholesterol is considered “bad” because it contributes to plaque – a thick, hard deposit that can clog arteries. When your cholesterol is too high, or the levels of the two types are not balanced (called dyslipidaemia), the plaque build-up narrows the arteries, eventually reducing blood flow to the heart or brain.
Atherosclerosis is a disease in which plaque builds up and hardens inside your arteries, causing them to narrow. Plaque consists of fat, cholesterol, calcium, and other substances found in the blood. The narrowing of the arteries limits the flow of oxygen-rich blood to organs and other parts of your body. If left untreated, atherosclerosis can lead to serious problems, including heart attack, stroke, or even death.
An EKG and echo are both painless, non-invasive tests that check a patient’s heart health. An EKG is a simple, initial test that measures the heart’s electrical efficiency by creating wave patterns. An electrical impulse or wave causes the muscle to squeeze and pump blood from the heart. A normal heartbeat on ECG will show the timing of the top and lower chambers. An EKG can determine if the electrical activity is normal or slow, fast or irregular. Secondarily, measuring the amount of electrical activity passing through the heart muscle can help determine if parts of the heart are enlarged or working too hard.
An echocardiogram is an ultrasound of the heart, using sound waves to create pictures of your heart’s chambers, valves, walls, and the blood vessels (aorta, arteries, and veins) attached to your heart. An echo determines the size and shape of your heart, pumping strength, and movement of the heart’s walls. It is used to diagnose coronary artery disease, heart valve disorders, cardiac tumors, and enlargement or thickening of the heart muscle.
The cardinal symptoms of heart attack in a man are intense chest pain, pain in the left arm or jaw, and difficulty breathing. A woman may have some of the same symptoms, but the pain and pressure may be more diffuse, and felt in the neck, jaw, shoulders, arms, abdomen and even the upper back. Other symptoms in women include shortness of breath with or without chest discomfort, nausea/vomiting, dizziness, breaking out in a cold sweat, lightheadedness or fainting, and an episode of extreme fatigue that precedes the attack.
Angioplasty is a procedure in which a tiny balloon is inserted via a catheter, and once in place, is inflated to clear the clogged artery. The catheter is inserted through a leg or arm artery and threaded into the heart. A stent is often placed inside the artery wall for support. The procedure restores normal blood flow to your heart muscle and can be lifesaving.
Balloon valvuloplasty (also called valvulotomy or valvotomy) is a procedure that widens a narrowed heart valve. During this procedure, a catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the affected heart valve, a balloon at the end of the tube is inflated, widening the valve opening. Although it is not used for most people with aortic valve stenosis, it may be recommended for young people whose stenosis is caused by a congenital heart defect such as a bicuspid aortic valve, or in patients who cannot undergo valve replacement surgery.
Resistant hypertension (RH) is the term used when patients cannot control their blood pressure despite the use of a diuretic and at least two other blood pressure medications. It can be treated by working closing with your healthcare team on medication management as well as the implementation of lifestyle changes. The American Heart Association recommends following a healthier diet, limiting alcohol, reducing sodium intake, losing weight if you are overweight, exercising more, managing stress, avoiding tobacco, and the safe, correct use of hot tubs and saunas.
Atrial fibrillation (AFib) is the most common irregular arrhythmia (heart rhythm). It originates from the upper right and left chambers (atria) of the heart that leads to the lower chambers (ventricles). A normal heartbeat is about 60 to 80 times per minute at rest. In people with AFib, abnormal electrical impulses in the atria cause the ventricle contraction (heartbeat) to be erratic and in some cases rapid. The atria can contract at a rate of 400-600 beats per minute, causing a disruption of blood flow to the ventricles and a resting heartbeat of 100-180 times per minute. If left untreated, AFib can lead to potentially fatal congestive heart failure or stroke.
Stents are frequently used in conjunction with angioplasty to help support the artery’s inner wall. The stent also reduces the chance that the artery will become narrow or blocked again, although in 10 to 20% of cases, blockage reoccurs the first year after angioplasty. Although it is an uncommon occurrence, a stent also can support an artery that was torn or injured during angioplasty.
Congestive heart failure is a term used when the pumping action of the heart becomes increasingly less powerful and effective. When this happens, blood does not move efficiently through the circulatory system and starts to back up, increasing pressure and causing fluid to leak from the capillary blood vessels. The fluid build-up in the arms, legs, ankles, feet, lungs, or other organs is where the congested part of the term derives. Symptoms include shortness of breath, weakness, dizziness, fatigue, and swelling from excessive fluid. The prognosis varies greatly from patient to patient, but has improved significantly in the last few decades.
When medication is ineffective or cannot be tolerated by patients with atrial fibrillation (AFib), a nonsurgical procedure called catheter ablation may be performed. Under light sedation, thin flexible wires are inserted into a vein in the groin and threaded up into the heart. An electrode at the tip of the wire sends out radio waves that create heat, destroying the heart tissue responsible for the arrhythmia. Cryoablation is a newer technique in which extreme cold is used to destroy the abnormal heart tissue responsible for the arrhythmia.
A total artificial heart is an option for individuals who have chronic end-stage heart failure that affects both ventricles. It is useful for patients who are waiting for human heart transplants or for those who are ineligible for transplantation. From 1969 to September 5, 2014, 1,413 artificial hearts with 13 different designs have been implanted in heart failure patients. Artificial hearts generally can function for about one year, but an Italian patient lived for nearly four years with an artificial heart, prior to undergoing a successful heart transplant.
In addition to a total artificial heart, there are several other devices that can bridge to heart transplantation for patients with worsening heart failure. A ventricular assist device (VAD) is a mechanical pump that is surgically placed in a patient’s chest, assisting the heart to pump blood throughout the body. A left ventricular assist device (LVAD) is a specific type of VAD that helps the left ventricle pump blood to the rest of the body. Ventricles are the two main chambers of the heart, on the left and right side.
Smoking damages the lining of blood vessels, increases fatty deposits in the arteries, raises the risk of blood clots, negatively affects blood lipid levels, and promotes coronary artery spasm. The nicotine in tobacco accelerates the heart rate and raises blood pressure temporarily, although it has not been conclusively proven to cause chronic high blood pressure.
There are many different types of blood pressure medications that doctors can use to treat patients, and medication management is very important due to changes in the effectiveness over time, potential side effects, and possible drug interactions. The medications fall within the basic classifications of diuretics, calcium channel blockers, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), Alpha-2 receptor agonists, combined alpha and beta-blockers, central agonists, peripheral adrenergic inhibitors, and blood vessel dilators (vasodilators).