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Cardiovascular Diseases

Q
What is a heart attack?
A
AGE2B consultant
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The signs and symptoms of a heart attack include: • Prolonged or severe chest pain or discomfort not relieved by rest or nitroglycerin. This involves uncomfortable pressure, squeezing, fullness, or pain in the center or left side of the chest that can be mild or strong. This pain or discomfort often lasts more than a […] Read More

The signs and symptoms of a heart attack include:

• Prolonged or severe chest pain or discomfort not relieved by rest or nitroglycerin. This involves uncomfortable pressure, squeezing, fullness, or pain in the center or left side of the chest that can be mild or strong. This pain or discomfort often lasts more than a few minutes or goes away and comes back.

• Nausea, vomiting, light-headedness or fainting, or breaking out in a cold sweat. These symptoms of a heart attack are more common in women.

• Shortness of breath. This may accompany chest discomfort or happen before it.

• Upper body discomfort. This can be felt in one or both arms, the back, neck, jaw, or upper part of the stomach.

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Q
How to live with coronary heart disease?
A
AGE2B consultant
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If you have been diagnosed with coronary heart disease, it is important that you continue your treatment plan. Get regular follow-up care to control your condition and prevent complications. • Receive follow-up care It is critical to get routine medical care and to take all medicines regularly, as your doctor prescribes. Do not change the […] Read More

If you have been diagnosed with coronary heart disease, it is important that you continue your treatment plan. Get regular follow-up care to control your condition and prevent complications.

• Receive follow-up care

It is critical to get routine medical care and to take all medicines regularly, as your doctor prescribes. Do not change the amount of your medicine or skip a dose unless your doctor tells you to. Talk with your doctor about how often you should schedule office visits and blood tests.

Between visits, call your doctor if you have any new symptoms, if your symptoms worsen, or if you have problems with your blood pressure or blood sugar.

• Cardiac rehabilitation

You may be referred for exercise-based cardiac rehabilitation, also called cardiac rehab, to manage symptoms and reduce the chances of future issues such as heart attack. Studies have shown that cardiac rehabilitation lowers the risk of hospitalization and death. It can also improve your quality of life.

• Prevent complications over your lifetime

Your doctor will work with you to manage medical conditions that can raise your risk of heart issues and complications.

Your doctor will likely suggest heart-healthy lifestyle changes, such as eating heart-healthy foods, being physically active, and quitting smoking. Your doctor may refer you to other professionals, such as a registered dietitian or exercise physiologist. Your healthcare team can help you set up a personal plan to meet your health goals.

There are benefits to quitting smoking no matter how long or how much you have smoked. Coronary heart disease risk associated with smoking begins to decrease soon after you quit, and it generally continues to decrease over time. In addition:

• You will likely be given a statin to lower your LDL cholesterol, especially after a heart attack.

• Your doctor may recommend aspirin to prevent a heart attack or stroke. Low-dose aspirin may help prevent blood clots and lower the risk for heart attacks and other complications of coronary heart disease for some people, particularly those with microvascular disease or who have diabetes. Talk to your doctor before taking aspirin, because it raises the risk of serious bleeding.

• If you have diabetes, you will need to check your blood sugar regularly and keep taking any prescribed medicines.

• If your coronary heart disease becomes unstable or has led to a heart attack or sudden cardiac arrest, your doctor may recommend a pacemaker or defibrillator to detect and treat certain types of serious arrhythmias.

• Take care of your mental health

Living with heart disease may cause fear, anxiety, depression, and stress. You may worry about having heart problems or making lifestyle changes that are necessary for your health. Talk with your healthcare team about how you feel. Your doctor may talk to you about:

• Talking to a professional counselor. If you have depression or anxiety, your doctor also may recommend medicines or other treatments that can improve your quality of life.

• Joining a patient support group. This may help you adjust to living with heart disease. You can find out how other people manage similar symptoms. Your doctor may be able to recommend local support groups, or you can check with an area medical center.

• Seeking support from family and friends. Letting your loved ones know how you feel and what they can do to help you can help relieve stress and anxiety.

 •          Learn the warning signs of serious complications and have a plan.

Coronary heart disease can lead to heart attack or stroke. If you think that you are or someone else is having the following symptoms, call 9-1-1 right away. Every minute matters.

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Q
What is the treatment of coronary artery disease?
A
AGE2B consultant
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Your treatment plan depends on how severe the disease is, the severity of your symptoms, and any other health conditions you may have. Possible treatments for coronary heart disease include heart-healthy lifestyle changes, medicines, or procedures such as coronary artery bypass grafting or percutaneous coronary intervention. Your doctor will consider your 10-year risk calculation when […] Read More

Your treatment plan depends on how severe the disease is, the severity of your symptoms, and any other health conditions you may have. Possible treatments for coronary heart disease include heart-healthy lifestyle changes, medicines, or procedures such as coronary artery bypass grafting or percutaneous coronary intervention.

Your doctor will consider your 10-year risk calculation when deciding how best to treat your coronary heart disease.

• Heart-healthy lifestyle changes

Your doctor may recommend that you adopt lifelong heart-healthy lifestyle changes, including:

• Aiming for a healthy weight. Losing just 3% to 5% of your current weight can help you manage some coronary heart disease risk factors, such as high blood cholesterol and diabetes. Greater amounts of weight loss can also improve blood pressure readings.

• Being physically active. Routine physical activity can help manage coronary heart disease risk factors such as high blood cholesterol, high blood pressure, or overweight, and obesity. Before starting any exercise program, ask your doctor what level of physical activity is right for you.

• Heart-healthy eating, such as the DASH (Dietary Approaches to Stop Hypertension) eating plan. A heart-healthy eating plan includes fruits, vegetables, and whole grains and limits saturated fats, trans fats, sodium (salt), added sugars, and alcohol.

• Managing stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

• Quitting smoking. Talk to your doctor if you vape. There is scientific evidence that nicotine and flavorings found in vaping products may damage your heart and lungs.

• Get enough good-quality sleep. The recommended amount for adults is 7 to 9 hours of sleep a day.

• Medicines

Your doctor may recommend medicines to manage the risk factors or treat underlying causes of coronary heart disease. Some medicines can reduce or prevent chest pain and manage other medical conditions that may be contributing to your coronary heart disease.

• ACE inhibitors and beta-blockers help lower blood pressure and decrease the heart's workload.

• Calcium channel blockers lower blood pressure by allowing blood vessels to relax.

• Medicines to control blood sugar, such as empagliflozin, canagliflozin, and liraglutide, help lower your risk for complications if you have coronary heart disease and diabetes.

• Metformin controls plaque buildup if you have diabetes.

• Nitrates, such as nitroglycerin, dilate your coronary arteries and relieve or prevent chest pain from angina.

• Ranolazine treats coronary microvascular disease and the chest pain it may cause.

• Statins and/or non-statin therapies control high blood cholesterol. Your doctor may recommend statin therapy if you have a higher risk for coronary heart disease or stroke, or if you have diabetes and are between ages 40 and 75. Non-statin therapies may be used to reduce cholesterol when statins do not lower cholesterol enough or cause side effects. Your doctor may prescribe non-statin drugs, such as ezetimibe, bile acid sequestrants, alirocumab, or evolocumab to lower cholesterol or omega-3 fatty acids, gemfibrozil, or fenofibrate to reduce triglycerides.

• Procedures

You may need a procedure or heart surgery to treat more advanced coronary heart disease.

Percutaneous coronary intervention (PCI) opens coronary arteries that are narrowed or blocked by the buildup of atherosclerotic plaque. A small mesh tube called a stent is usually implanted after PCI to prevent the artery from narrowing again.

Coronary artery bypass grafting (CABG) improves blood flow to the heart by using normal arteries from the chest wall and veins from the legs to bypass the blocked arteries. Surgeons typically use CABG to treat people who have severe obstructive coronary artery disease in multiple coronary arteries.

Transmyocardial laser revascularization or coronary endarterectomy treats severe angina associated with coronary heart disease when other treatments are too risky or did not work.

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Q
How is coronary heart disease diagnosed?
A
AGE2B consultant
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Your doctor will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results from tests and procedures. Because women and their doctors may not recognize coronary heart disease symptoms that are different from men’s, women may not be diagnosed and treated as quickly as men. It […] Read More

Your doctor will diagnose coronary heart disease based on your symptoms, your medical and family history, your risk factors, and the results from tests and procedures.

Because women and their doctors may not recognize coronary heart disease symptoms that are different from men’s, women may not be diagnosed and treated as quickly as men. It is important to seek care right away if you have symptoms of coronary heart disease:

• Medical history

Your doctor will ask about your eating and physical activity habits, your medical history, your family history, and risk factors for coronary heart disease. Your doctor may ask whether you have any other signs or symptoms. This information can help your doctor determine whether you have complications or other conditions that may cause coronary heart disease.

• Diagnostic tests and procedures

To diagnose coronary heart disease, your doctor may order some of the following tests:

• Blood tests to check the levels of cholesterol, triglycerides, sugar, lipoproteins, or proteins, such as C-reactive protein, that are a sign of inflammation.

• Electrocardiogram (EKG or ECG) to determine whether the heart’s rhythm is steady or irregular. An EKG also records the strength and timing of electrical signals as they pass through the heart.

• Coronary calcium scan to measure the amount of calcium in the walls of your coronary arteries. A buildup of calcium can be a sign of atherosclerosis, coronary artery disease, or coronary microvascular disease. This test is a type of cardiac CT scan. Coronary calcium scans can also help assess coronary heart disease risk for people who smoke or for people who do not have heart symptoms.

• Stress tests to check how your heart works during physical stress. During stress testing, you walk or run on a treadmill or pedal a stationary bike to make your heart work hard and beat fast. If you have a medical problem that prevents you from exercising, your doctor may give you medicine to make your heart work hard, as it would during exercise. To detect reduced blood flow to your heart muscle, while you exercise you will be monitored by ECG and possibly an echocardiogram or a CT scan.

• Cardiac MRI (magnetic resonance imaging) to detect tissue damage or problems with blood flow in the heart or coronary arteries. It can help your doctor diagnose a coronary microvascular disease or nonobstructive or obstructive coronary artery disease. Cardiac MRI can help explain results from other imaging tests such as chest X-rays and CT scans.

• Cardiac positron emission tomography (PET) scanning to assess blood flow through the small coronary blood vessels and into the heart tissues. This is a type of nuclear heart scan that can diagnose coronary microvascular disease.

• Coronary angiography to show the insides of your coronary arteries. To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization. This procedure is often used if other tests show that you are likely to have coronary artery disease. To diagnose coronary microvascular disease, your doctor will use coronary angiography with a guidewire technology. A guidewire with sensors is inserted into the heart’s arteries. The sensors measure how easily blood flows through the small vessels. Usually, measurements are done before and after giving you medicine to enhance blood flow in your heart.

• Coronary computed tomographic angiography shows the insides of your coronary arteries rather than an invasive cardiac catheterization. It is a noninvasive imaging test using CT scanning.

If you have coronary heart disease risk factors, your doctor may recommend diagnostic tests even if you do not have symptoms.

Nonobstructive coronary artery disease and coronary microvascular disease can be missed because patients or doctors may not recognize the warning signs. Diagnosing these types often requires more invasive tests or specialized tests, such as cardiac PET scans, that are not widely available.

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Q
What are preventive means?
A
AGE2B consultant
0
The same lifestyle habits used to help treat coronary artery disease can also help prevent it. A healthy lifestyle can help keep your arteries strong and clear of plaque. To improve your heart health, follow these tips: • Quit smoking. • Control conditions such as high blood pressure, high cholesterol, and diabetes. • Stay physically […] Read More

The same lifestyle habits used to help treat coronary artery disease can also help prevent it. A healthy lifestyle can help keep your arteries strong and clear of plaque. To improve your heart health, follow these tips:

• Quit smoking.

• Control conditions such as high blood pressure, high cholesterol, and diabetes.

• Stay physically active.

• Eat a low-fat, low-salt diet that's rich in fruits, vegetables, and whole grains.

• Maintain a healthy weight.

• Reduce and manage stress.

Working with a team of healthcare providers may help with making changes in your diet, being physically active, managing other medical conditions, and helping you quit smoking.

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Q
What are the risk factors of coronary artery disease?
A
AGE2B consultant
0
• Sleep apnea. This disorder causes you to repeatedly stop and start breathing while you’re sleeping. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system, possibly leading to coronary artery disease. • High-sensitivity C-reactive protein (hs-CRP). This protein appears in higher-than-normal amounts when there’s inflammation […] Read More

• Sleep apnea. This disorder causes you to repeatedly stop and start breathing while you're sleeping. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system, possibly leading to coronary artery disease.

• High-sensitivity C-reactive protein (hs-CRP). This protein appears in higher-than-normal amounts when there's inflammation somewhere in your body. High hs-CRP levels may be a risk factor for heart disease. It's thought that as coronary arteries narrow, you'll have more hs-CRP in your blood.

• High triglycerides. This is a type of fat (lipid) in your blood. High levels may raise the risk of coronary artery disease, especially for women.

• Homocysteine. Homocysteine is an amino acid your body uses to make protein and to build and maintain tissue. But high levels of homocysteine may increase your risk of coronary artery disease.

• Preeclampsia. This condition that can develop in women during pregnancy causes high blood pressure and a higher amount of protein in the urine. It can lead to a higher risk of heart disease later in life.

• Alcohol use. Heavy alcohol use can lead to heart muscle damage. It can also worsen other risk factors of coronary artery disease.

• Autoimmune diseases. People who have conditions such as rheumatoid arthritis and lupus (and other inflammatory conditions) have an increased risk of atherosclerosis.

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Q
When to see a doctor?
A
AGE2B consultant
0
If you have risk factors for coronary artery disease, such as high blood pressure, high cholesterol, tobacco use, diabetes, obesity, strong family history of heart disease — talk to your doctor. Your doctor may want to test you for coronary artery disease, especially if you have signs or symptoms of narrowed arteries. Read More

If you have risk factors for coronary artery disease, such as high blood pressure, high cholesterol, tobacco use, diabetes, obesity, strong family history of heart disease — talk to your doctor. Your doctor may want to test you for coronary artery disease, especially if you have signs or symptoms of narrowed arteries.

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Q
What are the symptoms?
A
AGE2B consultant
0
If your coronary arteries narrow, they can’t supply enough oxygen-rich blood to your heart, especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any symptoms. As plaque continues to build up in your coronary arteries, however, you may develop the following coronary artery disease signs and […] Read More

If your coronary arteries narrow, they can't supply enough oxygen-rich blood to your heart, especially when it's beating hard, such as during exercise. At first, the decreased blood flow may not cause any symptoms. As plaque continues to build up in your coronary arteries, however, you may develop the following coronary artery disease signs and symptoms:

• Chest pain (angina). You may feel pressure or tightness in your chest as if someone were standing on your chest. This pain, called angina, usually occurs in the middle or left side of the chest. Angina is generally triggered by physical or emotional stress. The pain typically goes away within minutes after stopping the stressful activity. In some people, especially women, the pain may be brief or sharp and felt in the neck, arm, or back.

• Shortness of breath. If your heart can't pump enough blood to meet your body's needs, you may develop shortness of breath or extreme fatigue with activity.

• Heart attack. A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating.

Women are somewhat more likely than men to have less typical signs and symptoms of a heart attack, such as neck or jaw pain. And they may have other symptoms such as shortness of breath, fatigue, and nausea.

Sometimes a heart attack occurs without any apparent signs or symptoms.

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Q
What is coronary heart disease?
A
AGE2B consultant
0
Coronary heart disease is also known as Coronary Artery Disease, Coronary Microvascular Disease, Coronary Syndrome X, Ischemic Heart Disease, Nonobstructive Coronary Artery Disease, Obstructive Coronary Artery Disease. Coronary heart disease is sometimes called ischemic heart disease or coronary artery disease. It develops when major blood vessels that supply the heart become damaged or diseased. In […] Read More

Coronary heart disease is also known as Coronary Artery Disease, Coronary Microvascular Disease, Coronary Syndrome X, Ischemic Heart Disease, Nonobstructive Coronary Artery Disease, Obstructive Coronary Artery Disease.

Coronary heart disease is sometimes called ischemic heart disease or coronary artery disease. It develops when major blood vessels that supply the heart become damaged or diseased.

In normal physiological conditions, the coronary arteries supply the myocardium with blood, oxygen, and nutrients. Though, these arteries can be narrowed by arteriosclerotic plaque,  decreasing blood flow to your heart. Eventually, the reduced blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But you can take steps to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.

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Q
How is arteriosclerosis diagnosed?
A
AGE2B consultant
0
Blood tests – blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood and abnormal levels may indicate risk factors for atherosclerosis. EKG (Electrocardiogram) – an EKG is a simple test that detects and records the electrical activity of the heart and shows how fast the heart is beating and […] Read More

Blood tests - blood tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood and abnormal levels may indicate risk factors for atherosclerosis.

EKG (Electrocardiogram) - an EKG is a simple test that detects and records the electrical activity of the heart and shows how fast the heart is beating and whether it has a regular rhythm. It also shows the strength and timing of electrical signals as they pass through each part of the heart. Certain electrical patterns that the EKG detects can suggest whether CAD is likely. An EKG can show signs of a previous or current heart attack.

Chest X-Ray - a chest x-ray takes a picture of organs and structures inside the chest, including heart, lungs, and blood vessels - a chest x-ray can also reveal signs of heart failure.

Ankle/Brachial Index - this test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose PAD.

Echocardiography - this test uses sound waves to create a moving picture of your heart and provides information about the size and shape of your heart and how well your heart chambers and valves are working. The test can identify areas of poor blood flow to the heart, areas of the heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow.

Computed Tomography Scan - a computed tomography, or CT, scan creates computer-generated images of the heart, brain, or other areas of the body. The test can often show hardening and narrowing of large arteries.

Stress Testing - during stress testing, exercise is used to make the heart work hard and beat fast while heart tests are performed - if a person is unable to exercise, medicines are given to speed up the heart rate. When the heart is beating fast and working hard, it needs more blood and oxygen and arteries narrowed by plaque cannot supply enough oxygen-rich blood to meet the heart's needs - a stress test can show possible signs of CAD, such as:

• Abnormal changes in the heart rate or blood pressure;

• Symptoms such as shortness of breath or chest pain;

• Abnormal changes in your heart rhythm or your heart's electrical activity.

During a stress test, if a person is unable to exercise for as long as it is considered normal for their age, it may be a sign that not enough blood is flowing to the heart. Other factors besides CAD can prevent a person from exercising long enough (for example, lung diseases, anemia, or poor general fitness).

Some stress tests use a radioactive dye, sound waves, positron emission tomography (PET), or cardiac magnetic resonance imaging (MRI) to take pictures of the heart when it's working hard and when it's at rest. These imaging stress tests can show how well blood is flowing in the different parts of the heart, and can also show how well the heart pumps blood when it beats.

Angiography - angiography is a test that uses dye and special x-rays to show the insides of arteries and can reveal whether plaque is blocking the arteries and how severe the plaque is. A thin, flexible tube called a catheter is put into a blood vessel in the arm, groin (upper thigh), or neck. A dye that can be seen on an x-ray is then injected into the arteries and by looking at the x-ray picture, a doctor can see the flow of blood through the arteries.

There are currently no treatments that can reverse atherosclerosis, but healthy lifestyle changes may help stop it from getting worse.

Sometimes additional treatment to reduce the risk of problems like heart attacks and strokes may also be recommended, such as:

• statins for high cholesterol; 

• medicines for high blood, medicines to reduce the risk of blood clots;

• dietary changes and medication for diabetes; 

• a procedure to widen or bypass an affected artery – such as coronary angioplasty, a coronary artery bypass graft, or carotid endarterectomy.

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