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(originally published to Helium writing site, now gone)

Someone in the United States dies of heart disease every 34 seconds. It is the country’s number one cause of death and is usually preventable.

Types of heart disease and their symptoms

The most common type of heart disease is coronary artery disease. This is where a build up of cell debris, including fatty acids and calcium, and connective tissue leads to swollen artery walls. These plaques finally rupture, restricting blood flow to the heart.

The build up can occur for decades without being noticed, with the first symptom often being a heart attack. Other symptoms can include heart failure, angina (chest pain), and pulmonary edema, or accumulation of fluid in the lungs causing breathing difficulties, blood being coughed up, pink frothy sputum, and excessive sweating.

Cardiomyopathies, or heart muscle diseases, are common too. Intrinsic cardiomyopathies are caused by heart muscle weakness itself. Most cardiomyopathies are due to extrinsic factors and are usually caused by ischemia or restricted blood supply.

An extrinsic cardiomyopathy can be congenital, or it can develop over time. For example, alcoholic cardiomyopathy is caused by long term alcohol abuse. Symptoms include fatigue, faintness, abnormal heart beat or pulse, breathing difficulties, reduced alertness, loss of appetite, coughing up mucus, chest pain, swelling, and more or less urination.

Hypertensive heart disease is where damage is caused by high blood pressure. Symptoms are similar to alcoholic cardiomyopathy but can also include nausea, difficulty sleeping, weight gain, and bloating.

Pulmonary heart disease is where a lung disorder causes slow blood flow to the lungs, resulting in the right side of the heart pumping harder and becoming enlarged. Symptoms can include breathing difficulties, chest pain, dizziness and fainting, tachycardia, fatigue, and weight loss.

Inflammatory heart disease is where the heart muscle or surrounding tissue is inflamed. Valvular heart disease affects the heart valves. Rheumatic heart disease is where rheumatic fever damages the heart, particular the valves. Symptoms are similar to other types of heart disease.

Tests to determine heart disease

Initial tests might include an exercise stress test, blood test and chest x-ray. The next test might be an electrocardiogram or ECG. For this, electrodes are placed on various spots around the body to pick up natural electrical changes with each heart beat. The tracing records whether the heart rate and rhythm is normal or affected by damaged oxygen-deprived heart muscles. A further test might measure how much blood is being pumped out of the heart’s left ventricle.

Depending on the results and the patient’s history and symptoms, the next step might be an echocardiograph or a multiple gated acquisition (MUGA) scan, or both. The echo is an ultrasound test that takes pictures of the heart to assess its structure and motion. A MUGA scan involves radioactive substances injected into the bloodstream, allowing computer generated images to show how the heart muscle and chambers are functioning.

New treatments for heart disease

New ways to treat heart disease are constantly appearing. Radio frequency ablation involves cutting pathways inside the heart with radio waves to correct irregular heartbeat. Transradial cardiac catheterization is where a tube and thin wire are threaded through an artery in the wrist to find and unblock clogged arteries in the heart. Miniature microwave antennas have been developed for use in keyhole heart surgery.

Another one is stent placement, involving putting a stent, or flexible wire mesh tube, over a catheter with a deflated balloon and guiding it through an artery to a blockage. The balloon is inflated and removed, with the stent left there permanently to restart and maintain blood flow.

Preventing heart disease

Regular exercise can protect against heart disease. Half an hour of moderate physical activity can include walking, housekeeping and gardening. Eating a diet low in salt, fat and cholesterol will help too. The best foods are vegetables, fruit, whole grains, low fat dairy products, legumes, fish and lean meat. Exercise and eating well will help maintain a healthy weight and reduce the risk of heart disease.

Avoid tobacco as nicotine makes the heart work harder. Minimising stress is thought to be good for the heart. Regular tests for blood pressure and cholesterol will also help guard against heart disease.

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