Let's Talk About Heart Disease
From irregular rhythms to chest pain, the term "heart disease" covers a lot of territory. We'll walk you through it all.by Matt McMillen Health Writer
Nearly half of all American adults have some form of cardiovascular disease—an umbrella term that covers everything from high blood pressure to stroke. If you’ve been told you’re among them, you may be confused or even a little scared. That’s normal, and everyone featured on HealthCentral with a chronic condition felt just like you do now. But we—and they—are here for you. On this page alone, you’ll discover not only the realities and challenges of heart disease, but also the best treatments, helpful lifestyle changes, and critical information you need to help you not just manage—but thrive. We’re sure you’ve got a lot of questions. We’re here to answer them.
Our Pro Panel
We went to some of the nation’s top experts in heart disease to bring you the most up-to-date information possible.
Guy Mintz, M.D.
Director of Cardiovascular Health & Lipidology
Sandra Atlas Bass Heart Hospital
Michael Goyfman M.D., MPH
Director of Clinical Cardiology
Long Island Jewish Forest Hills
David Friedman, M.D.
Director of Heart Failure Services
Northwell Health’s LIJ Valley Stream
Long Island, NY
Yes and no. Some risks for heart disease, like high blood pressure (HBP), can be greatly influenced by family history. But there is plenty you can do to lower your risk for developing heart problems by eating right, not smoking, getting regular exercise and quality sleep, lowering your stress levels, and taking your prescribed medications as directed by your doctor.
Unless you’re in the end stages of heart failure, there is usually time to lower your odds of a serious cardiac event by taking great care of yourself. Lower high cholesterol by avoiding foods loaded with saturated and trans fats. Move your body every day to help treat hypertension, quit smoking, and lose weight if you’re obese.
Genetics can play a role, but how you choose to live, day in and day out, year after year, often has a huge impact, too. Are you constantly stressed at work? Try meditation, doing yoga, or switching jobs. Love cigarettes, fried fare, and drinking a lot of alcohol? You might need a rethink on those unhealthy habits, too.
This is when you’re born with a heart defect, when one or more abnormalities of the heart’s structures affect how well blood and oxygen flow through the heart. Defects range from simple and benign to complex and dangerous (or even life-threatening).
So, What Is Heart Disease, Anyway?
The term heart disease encompasses a huge amount of cardiovascular territory. That’s because it’s not a single disease but one that refers to all sorts of heart-related health conditions, many of them chronic, that impact how well your heart functions.
Some of the more common forms of heart disease include:
Hypertension (high blood pressure)
Coronary artery disease (CAD)
Congestive heart failure
Heart valve disease
Atrial fibrillation and other arrhythmias (irregular heartbeat)
Heart disease accounts for more deaths each year than any other health concern. According to the Centers for Disease Control and Prevention (CDC), nearly 650,000 people die of heart disease annually. That’s about one death every 37 seconds—a shocking number, to be sure. And heart disease does not discriminate: Whether you are a man or a woman of any race or ethnicity, cardiovascular disease is your number-one health threat.
The good news? You can do a lot to prevent heart disease. And, if you already have some form of this condition, there are medications, lifestyle-management tips, and other strategies to help protect you and your ticker.
How Is the Heart Supposed to Function?
Before diving into what can go wrong, let’s take a step-by-step look at the heart, what it does, and how it works:
A one-pound, fist-sized muscle with an oversized job, the heart is responsible for the nonstop circulation of blood throughout your body.
That blood passes through your arteries, veins, and capillaries that form your blood vessels. (Fun fact: According to the Cleveland Clinic, you have approximately 60,000 miles of blood vessels in your body.)
As it flows out from your heart through the arteries in your circulatory system, blood provides oxygen and other essential nutrients to all the cells in your body.
Once it’s made its deliveries, blood returns via your veins to the heart, discarding toxins (via the kidneys) along the way.
Once back in the heart, the blood flows along to the lungs, where it disposes of carbon dioxide and restocks its supply of oxygen before cycling through your body once more.
How does your ticker make all this happen? For starters, the heart is made up of four chambers:
On the bottom are the left and right ventricles.
On top are the right and left atria.
Those chambers work in tandem, employing a system of valves that open and close as your heart beats in order to bring blood in and pump blood out. Remember, the heart is a muscle, and when it’s healthy, it’s quite strong. As a pump, it provides sufficient pressure so that your entire blood supply cycles through your body every 60 seconds.
More heart smarts:
A healthy adult’s heart will beat anywhere from 60 to 100 times per minute while lounging around. If you’re quite fit—an athlete, for example—your heart works more efficiently, and your resting heart rate may be closer to 40 beats per minute.
Like the rest of the body, the heart requires blood in order to thrive. In fact, it needs a bigger supply of blood than any other muscle in the body, so it relies on its own network of coronary arteries to provide that blood.
Electricity powers the beating of your heart and sets its pace. That’s a critical function. You need your heart to beat properly in order to supply your body with sufficient blood and oxygen. Your heart contracts with each beat, and the timing of those beats must remain precise so that those contractions stay in sync.
These electrical signals originate in your heart’s right atrium and are controlled by your central autonomic nervous system, telling your heart how fast or slow it should beat. When you exercise, your nervous system signals your heart to speed up in order to pump more blood. Other factors—not all of them healthy, like smoking and over-indulging in alcohol—can also affect your heart rate.
Your heart functions in incredibly complex ways—this is just a thumbnail sketch. Needless to say, there are also a great number of ways in which things can go wrong that can lead to heart disease.
What Are the Types of Heart Disease?
How does your body tell you that something’s troubling your heart? It depends on the type of trouble. While some diseases that affect the heart share similar symptoms, others vary greatly. And some types of heart disease have no symptoms at all.
Let’s review some of the major types of heart disease and how to recognize them:
Having high blood pressure (HBD), aka hypertension—which has no symptoms—ups your odds of developing numerous other types of heart disease, including CAD. It is the result of plaque buildups in your arteries that reduce the amount of blood that reaches your heart, leaving you at higher risk for heart attack, heart failure, and stroke. HBP hardens and thickens your arteries, reducing blood flow. If you have a systolic pressure of 130 or higher, or a diastolic pressure of 80 or higher, it’s critical to reduce it.
Coronary Artery Disease (CAD)
The heart’s two major arteries branch off from the aorta, the artery that sends blood to the rest of the body. These two arteries, in turn, branch off into smaller and smaller arteries that supply the heart with blood. CAD, the most common type of heart disease, develops when your arteries can’t provide enough oxygen-rich blood to your heart. The heart receives its own supply of blood from the coronary arteries.
Often, CAD is caused by plaque buildups that restrict or block the flow of blood through your blood vessels. CAD often develops over many years, even decades, and it does not always make itself known until it has progressed significantly and you’re closing in on a heart attack. At that stage, the affected blood vessel is about 70% blocked. Even people who have plaque blockages in the 40% to 50% range may have no symptoms. But when they do occur, they're typically:
Angina, which is a fancy word for chest pain, discomfort, pressure, or a squeezing sensation that can spread out to other parts of your upper body, such as your shoulders, arms, neck, jaw and back—and a sign that something’s wrong with your heart.
Shortness of breath
A less common, but related, condition called coronary microvascular disease (MVD) or small vessel disease occurs when the walls of the small arteries in the heart are damaged. It is often diagnosed after a doctor finds little or no narrowing in the main arteries of your heart, despite your having symptoms that suggest heart disease, such as angina. MVD is more common in women and in people who have diabetes or HBP. The condition can be difficult to detect. Other symptoms of MVD include pain in your left arm, neck, jaw, abdomen, or back; pronounced fatigue; and shortness of breath.
A heart attack occurs when the plaque in your blood vessel ruptures, causing a clot to form as the body attempts to repair the damage. This blockage cuts off blood flow to the heart, starving the muscle of needed oxygen and other nutrients.
For men, this often happens suddenly; women’s symptoms tend to be more gradual. While chest pain is the most common symptom of heart attack for both men and women, their symptoms can be different. For example, women are more likely to have shortness of breath, fatigue, and nausea. Men normally experience the classic symptom of crushing chest pain. Men are also more likely than women to have sudden heart attacks; women, on the other hand, have higher odds of developing symptoms over a period of hours, days, or even weeks.
Either way, common symptoms of heart attack include:
Angina, a radiating chest pain and pressure that can feel as if an elephant is sitting on your chest
Shortness of breath
Lightheadedness and dizziness
Congestive Heart Failure
This progressive disease occurs when your ticker’s ability to pump blood starts to decline. CAD, heart attack, diabetes, obesity, and high blood pressure are among the common causes of heart failure—so it doesn’t happen overnight. As your heart can no longer pump as well as it used to, the blood that would normally cycle through it can get backed up. Your kidneys also filter less blood, leading to fluid retention and swelling in your extremities.
Several different symptoms can get worse as heart failure progresses. Some of the most common:
Shortness of breath due to an inadequate supply of blood reaching the rest of your body or a buildup of fluid in the lungs, often accompanied by a cough or wheezing
Swelling in your legs, ankles, and abdomen caused by fluid buildup, accompanied by rapid weight gain.
Extreme fatigue due to the reduced amount of oxygen-rich blood being delivered to your organs and muscles
Loss of appetite and nausea because of digestive problems caused by the reduced flow of blood
Increased heart rate
Heart Valve Disease
As its name implies, heart valve disease involves the system of four valves that helps regulate the flow of blood through the heart. For example, one of your valves might narrow to the point that a reduced amount of blood can pass through it. This is called valvular stenosis.
When one of your heart’s valves stop working properly, a variety of symptoms, many of them similar to those of heart failure, can occur, including:
Increasing shortness of breath
Swelling in your abdomen, ankles, and feet
Dizziness and/or fainting
Rapid weight gain
An abnormal heartbeat, called an arrhythmia, can trigger a variety of symptoms, some benign, some dangerous, depending on which kind of arrhythmia you have. Tachycardia, for example, accelerates your heartbeat to a too-fast rhythm, while bradycardia slows it down. Both can sometimes be dangerous and lead to higher risk of stroke and other complications, but not always. If you experience either type of arrhythmia, be sure to consult with your doctor.
Atrial fibrillation is the most common type of sustained arrhythmia, with anywhere between 2.7 and 6.1 million Americans currently sharing a diagnosis of it. (As the U.S. population ages, that number is expected to increase, reports the CDC.) A-fib, as it’s often called, causes your heart to beat erratically—it can feel like it is skipping beats—rather than rhythmically. In some cases, abnormal heartbeats are not a cause of concern, but other times they can lead to stroke, heart failure, or even cardiac arrest, a quickly fatal event in which the heart stops beating. It’s important to get to the root of A-fib, so you know whether or not your symptoms require treatment.
In general, abnormal heartbeats also lead to many symptoms shared by other forms of heart disease, including:
Shortness of breath
Dizziness and lightheadedness
A stroke occurs when your heart’s blood supply gets cut off, denying it the oxygen it needs to keep working. This can cause brain tissue to begin to die within a few minutes. Stroke is the fifth-leading cause of death in the U.S., accounting for one out of every 20 deaths that occur in this country annually, and it’s the leading cause of serious long-term disability, according to the CDC.
A stroke can greatly affect the brain. You may have trouble understanding what others are saying, you may slur your speech, and you may experience confusion.
Other symptoms include:
Paralysis or numbness, often on only one side of your body, commonly affecting the face, legs and arms
Vision problems that may blur or blacken your eyesight in one or both eyes, and/or double vision
Sudden and severe headache, which may be accompanied by vomiting
Balance problems that make it difficult to walk
If you are experiencing stroke symptoms or recognize them in others, think F.A.S.T.:
Time to call 911
There are two major types of stroke plus a third, less-severe kind:
Ischemic stroke: These account for nearly 90% of strokes, and they happen when a blood vessel in your brain becomes blocked by a clot. These clots can develop in the brain, known as a thrombotic stroke, or they can result from the same plaque that causes CAD and travel from the heart to the brain. This is called embolic stroke.
Hemorrhagic stroke: The most serious type of stroke, it occurs when a blood vessel that supplies the brain suddenly bursts. Not only does this cut off much needed oxygen, it also causes pressure to build up in the surrounding tissue, leading to harmful swelling and irritation. The bleeding can occur inside the brain, which is called an intracerebral hemorrhage, or it can happen in the space between the brain and the membranes that surround it. This is called a subarachnoid hemorrhage.
Transient ischemic stroke: Also referred to as a mini-stroke, these cause stroke symptoms but do not damage the brain. They are temporary, lasting as little as five minutes. However, they are a warning sign that a full-blown stroke is in your future.
What Causes Heart Disease?
Let’s go back to the good news: About four out of five cases of heart disease can be prevented. That’s because it’s most often caused by lifestyle factors, such as smoking, poor diet, lack of exercise, and by other health conditions that can arise, including diabetes and high blood pressure (HBP), that can arise from these choices. While it’s never too late to make positive, healthy changes, the sooner you begin, the better.
Risk Factors for Heart Disease
Before getting into the risk factors that you can work to reduce, let’s cover the few that you can’t do anything about.
This one’s pretty simple. The older you get, the likelier you are to develop heart disease. In fact, more than 80% people who die from heart disease are older than 65, because the heart tends to grow weaker as you move into your golden years.
While heart disease may be the number cause of death for both men and women, it tends to develop later in women. Why? Experts believe that hormones such as estrogen, which women have in much greater abundance than men, may provide some protection against heart disease. However, those hormones decline during menopause. By age 65, a woman’s odds of heart disease match those of a man of similar age.
Genetics and Family History
It’s true: Heart disease tends to run in the family. Did your dad develop heart disease before the age of 55 or your mom before she turned 65? If so, your own risk is higher than normal because one or both of your parents may have passed along a genetic ingredient in the recipe for heart disease.
According to a 2019 study in The Lancet Public Health, going through “The Change” before age 40 increases risk of heart diseases like CAD, heart failure, arrhythmia, and heart valve disease among the approximately 10% of women who experience early menopause. It remains unclear why, though a decline in estrogen may be a factor.
These four factors make up only part of the complex swirl of possible causes of heart disease. You can’t change your genes or age, but don’t despair. Instead, use that knowledge as motivation to address the risks you can change. These include:
High Blood Pressure (HBP)
Having hypertension, a.k.a. high blood pressure, is a red flag for other forms of heart disease, increasing your risk for CAD, heart attack, heart failure, and stroke. HBP results from plaque buildups in your arteries, thickening them and reducing blood flow.
Unhealthy cholesterol levels contribute to blockages in your blood vessels that can eventually lead to heart attack. Your body produces cholesterol naturally—we all need it to make important hormones and absorb Vitamin D—but it’s easy to get more than you need by eating foods that are high in saturated and trans fats (like red meat, eggs, and dairy). There are two types of cholesterol: low-density lipoprotein (LDL, or “bad” cholesterol) and high-density lipoprotein (HDL, or “good” cholesterol). LDL contributes to plaque buildups in your arteries. HDL protects against heart disease by transporting excess LDL to the liver to be processed as waste.
Being obese forces your heart to work harder because your body requires more of the oxygen and nutrients that your blood supplies. This leads to high blood pressure. Excess weight also increases risk for heart disease, or makes them worse if you already have them, including high cholesterol and type 2 diabetes. Obesity has been linked to heart failure and CAD.
Type 1 and type 2 diabetes both limit your body’s ability to maintain a healthy level of glucose, a form of sugar that your body produces and uses for energy. Uncontrolled blood glucose damages your blood vessels and the nerves that control your heart, eventually leading to heart disease. In fact, as many as three out of four people with diabetes die from some form of heart disease.
The couch potato life not only directly puts you at higher risk of heart disease, it opens the door to other risk factors like HBP, high cholesterol, and type 2 diabetes.
Smoking or Vaping
Lighting up does more than damage your lungs. It accelerates your heartbeat while narrowing your blood vessels and contributes to the formation of blood clots that can lead to heart attack or stroke. Less is known about the risks of vaping, but many of the chemicals involved have been linked to heart disease.
Pressure and tension can elevate your heart rate and blood pressure—and too much eventually damages your blood vessels. Stress also can lead some people to abuse alcohol and eat too much, as well as smoke. (And, remember, any amount of smoking or vaping is too much.)
Too much alcohol also can harm your heart. Excessive drinking ups your blood pressure and heart rate as well as your triglycerides, a type of fat linked to heart disease, because they may contribute to hardening and thickening of your arteries.
This sleep disorder causes breathing trouble as you sleep, reducing the amount of oxygen to your blood and raising your blood pressure. Together, these can weaken your heart and put you at heightened risk chronic HBP, atherosclerosis, arrhythmia, and heart failure.
How Do Doctors Diagnose Heart Disease?
Before we get into how your doctor will determine whether you have heart disease, let’s make one thing very clear: Diagnosis is your doctor’s job. If you have heart attack symptoms, such as shortness of breath or chest pain, don’t waste time searching the internet to figure out the problem. Call 911 immediately. How fast you act just might save your life.
However, cardiac arrest is just one of many potentially serious heart concerns. Diagnosing heart disease involves a range of screening tests and, sometimes, tracking devices, too. Your doctor will ask you about your symptoms, your health history, and any risk factors you may have. He or she will also give you a physical exam in order to listen to your heart, check its rhythm and the timing of your pulse, and look for signs of swelling and accompanying weight gain due to fluid buildup in the hands, feet, legs, or abdomen—a possible indication of heart failure or heart valve disease.
You may undergo a variety of blood tests to measure your:
Cholesterol levels, which include your total cholesterol, LDL, HDL, and non-HDL, your total cholesterol minus your HDL, which many experts believe is a better indicator of heart disease risk than the ratio of good to bad cholesterol.
Triglycerides, a type of fat found in the blood; high “tri” levels signal heart disease.
High-sensitivity C-reactive protein, which is an indication of inflammation somewhere in the body (not necessarily the heart). High levels may suggest that a chronic inflammatory disease (such as rheumatoid arthritis or lupus) is present, which could also increase your risk for heart disease and stroke.
Plasma ceramides, or fat molecules, which accumulate throughout your body as a result of inflammation, high cholesterol and triglycerides, and other heart disease risks. They circulate in your blood and have been linked to plaque buildups.
Natriuretic peptides, which are proteins produced in your heart and blood vessels; high levels indicate heart failure.
Troponin T, which is a protein released by the heart when it's injured, such as after a heart attack; it can confirm one has indeed occurred or is occurring, especially when you have chest pain but no other heart attack symptoms. (Troponin levels may also be tested to help diagnose other types of heart disease, such as heart failure.)
In addition to the above measurements, you could be given non-invasive diagnostic tests or tools to montior your heart rhythms. They include:
Chest X-ray, which offers a view of the heart and lungs, allowing doctors to identify signs of heart failure, such as fluid in the lungs or an enlarged heart
Computer-assisted tomography (CAT) scans, which create 3D images of your heart, helping your doctor spot coronary artery disease (CAD), heart valve problems, and other heart problems
Magnetic resonance imaging (MRI), which provides 2D and 3D images of your heart and blood vessels that may reveal tissue damage caused by a heart attack, reduced blood flow, blocked arteries, heart failure, and more
Electrocardiogram (EKG), which is a routine, non-invasive and painless screening that measures the electrical signals produced with each heartbeat; it's used to detect irregularities in the strength and timing of those signals to help identify heart attacks, arrhythmia, heart failure, and other types of heart problems.
Holter monitors or event recorders, which are used if your arrhythmia or irregular heart activity doesn’t occur during your EKG, and your doctor wants to monitor your heart’s activity while you go about your daily life. Event recorders are turned on by the user when symptoms begin, whereas holter monitors—considered more effective because they capture the first stages of any irregular activity—are worn around the clock (except when you’re in the shower.) These smartphone-size devices record your heart’s activity for anywhere from a few days to a few weeks.
Implantable loop recorders, which are used if you have infrequent symptoms of arrhythmia, and your doctor is trying to capture what type of arrhythmia you have. This device is implanted just under the skin on your chest, enabling your doctor to record your heart’s rhythms whenever you experience symptoms—even in the middle of the night or when you’re in the shower. Your cardiologist will track your heart’s activities for up to three years, with the chip recording a continual log for your doctor to review. When the device is removed, it may leave a slight scar—but you’ll likely know exactly what kind of arrhythmia you’re dealing with, and how it should be treated.
An exercise stress test, which is given while you are hooked up to a heart monitor, and is done during a standard cardiac exam. To do one, you walk on a treadmill, gradually increasing your pace and the incline until it feels like you’re walking up a small hill. This makes your heart work harder. Your doctor will monitor your blood pressure, heart rate, and any discomfort you feel to identify signs of coronary artery disease.
Echocardiogram, which is an ultrasound of the heart that works by bouncing sound waves off various parts of your heart. It is a painless test without side effects or the use of radiation. Your doctor will place a wand-like device on your chest. The sound waves it emits will bounce off your heart are recorded and converted into a detailed picture of your ticker that will help your doctor identify any problems, such as malfunctioning valves or signs of infection.
Carotid and abdominal ultrasound, which are used to evaluate your stroke risk or to screen for an abdominal aortic aneurysm, respectively—and they both use sound waves, too. During this safe, painless, and non-invasive test, a gel is spread over your neck, where your carotid artery can be found, or your abdomen. An instrument sends sound waves through the gel, which then bounce back and form an image of the part of your body under examination.
You may be given more invasive diagnostic tests, too, to screen for heart disease. They include:
Cardiac catheterization, which is the gold standard for diagnosing CAD. During this procedure, you’ll be awake, and you may feel some pressure but no pain. You receive a local anesthetic before your doctor inserts a tube, or sheath, into a blood vessel that leads to your heart. Next, a catheter, inserted into the tube, travels to your heart. It delivers a special dye which shows up on x-rays allows your doctor to evaluate blood flow. The tip of the catheter can be used to measure the pressure in each of your heart’s chambers as well as in the blood vessels connected to your heart. It also can help diagnose valve problems and identify heart defects.
Coronary angiography, which is performed at the same time as cardiac catheterization. A special dye gets injected into your coronary arteries via a catheter. That dye, which can be viewed on an x-ray, shows your doctor where, exactly, your arteries are blocked.
Electrophysiology (EP) study, which is done by inserting an electrode catheter into a blood vessel (usually in your groin) that leads to your heart in order to record your heart’s electrical activity and/or to trigger arrhythmia to identify an electrical current’s specific pathway. A procedure called ablation—where rogue electrical pathways are sealed to prevent certain types of arrhythmia from occurring—can be done during an EP study.
How Is Heart Disease Treated?
There is no cure for heart disease. That said, there’s a lot you can do to live well despite having it. Treating heart disease can include lifestyle changes, medication, and sometimes surgery, but this condition—or conditions, rather—is never one size fits all. Your individual plan will be based on numerous factors, such as your age, overall health, and other chronic conditions (such as diabetes or kidney disease) you might have.
Lifestyle Changes for Heart Disease
You know the drill: Eat better, exercise, lose weight, and quit smoking. We know—easier said than done, but so worth it. That’s because the everyday choices you make today can halt the progression of heart disease tomorrow—leading to a healthier and likely longer life.
Let’s walk through the basic lifestyle choices you can implement to help make happen:
Lower your cholesterol. Cut back and avoid plaque buildup by swapping red meats for lean poultry and fish, consuming fibrous veggies and whole grains, and limiting (or even avoiding altogether) the saturated and trans fats found in fried and processed foods. Additional ways to get your cholesterol in check? Lose a few pounds, exercise more, and if that still isn’t enough, talk to your doctor about medication.
Lower your blood pressure. The same lifestyle changes that help bring down unhealthy cholesterol levels can also help manage your blood pressure, often in tandem with one of the various blood-pressure lowering medications available.
Do everything you can do to quit smoking. We know—it’s really hard. But we also know that smoking causes lung cancer and seriously hurts your heart. Plus, a nicotine or vaping habit damages your arteries, ups your risk of dangerous blood clots, raises your heart rate, and contributes to HBP and high cholesterol. So make quitting smoking your top priority. Going cold turkey works for some, while others have to slowly wean themselves from lighting up with the help of nicotine patches and other aids, including medications and support groups. Your doctor can walk you through your options, so have that conversation as soon as possible. Visit the American Heart Association to learn more about how to quit.
Get moving. Physical activity of just about any kind beats the couch potato life. That’s because exercise strengthens your heart muscle so that it can do its job more efficiently. It helps lower your cholesterol, blood pressure, and, if you have diabetes, blood sugar levels, too. An added benefit? Breaking a sweat leads to a slimmer, fitter you. Exactly how much exercise you can do depends on your current state of health. Talk to your doctor, who might advise you to start slow and gradually build up endurance. If a walk around the block is your limit, that’s OK—lace up your shoes and get going. Tomorrow, you’ll likely go even further. If you’re recovering from a serious heart issue, cardiac rehabilitation programs can get you started safely.
Eat less, and eat better. Changing how you stock your fridge and pantry is often connected to lowering your cholesterol levels—so follow the same advice: Try high-fiber foods, lean proteins, vegetables, and whole grains, and skip overly processed junk food and fried fare. If you need guidance, consider enlisting a registered dietitian/nutritionist to outline a healthy eating plan for you—and provide strategies to stick with your plan to reach your goals.
Lose weight. It can’t be overstated: Being overweight or obese is hard on your heart. Your body mass index (BMI) measures body fat based on your weight in relation to your height. A BMI of 25 to 29 is considered overweight. You are considered obese if your BMI is 30 or higher. While use of BMI has been questioned by researchers as of late, partly because even the super-fit and muscle-bound may technically have “unhealthy” BMI numbers, some doctors still use it as a guide. More and more, however, physicians are concerned when excess body fat is concentrated around your waist, likely because a lot of belly fat can cause chronic inflammation, a risk factor for heart disease. The result? Your blood pressure and cholesterol go up and stay up—and you want neither to happen.
If your heart health is at risk, and you find losing weight slowly and safely to be an impossible task, consider securing the services of a registered dietician, or ask your doctor if gastric bypass surgery is right for you.
Manage your diabetes. Diabetes and heart disease are a deadly combination. People with diabetes have as much as four times the risk of dying from heart disease than someone without this condition. This is in part due to the effect diabetes has on your blood vessels, and also because many other health conditions often accompany diabetes, including HBP, high cholesterol levels, and obesity. Controlling your diabetes through medication and lifestyle changes benefits your heart.
Consider medications for heart disease, if you need them. Many drugs treat coronary artery disease, or CAD. (Remember, CAD occurs when your arteries become clogged with plaque, restricting the flow of blood.) Here are the more commonly prescribed types of medication for CAD and other heart ailments:
Cholesterol lowering drugs, like statins, lower the amount of plaque-forming materials in your bloodstream.
Anti-coagulants (a.k.a. blood thinners) help prevent the formation of dangerous blood clots in your arteries, where they would block the flow of blood.
Anti-platelets, including aspirin, also help prevent clots from forming.
Beta blockers both lower your blood pressure and reduce your heart rate. That, in turn, causes your heart’s need for oxygen to drop.
Calcium channel blockers are often used in tandem with beta blockers. They lower blood pressure and heart rate while relaxing arteries in order to boost blood flow to the heart.
Nitroglycerin eases chest pain, or angina, caused by restricted blood flow to the heart. It works by allowing more oxygen-rich blood into your heart.
ACE inhibitors lower blood pressure and ease the heart’s workload, which helps prevent further weakening of the heart.
Heart failure as well as heart valve disease are both treated with some of the same medications, such as diuretics, which help rid your body of excess fluids. In heart failure, for example, fluid can build up in your lungs and make it difficult to breathe. You may also be prescribed digitalis, a type of drug that strengthens the contractions of your heart and lowers your heart rate. Beta blockers and anti-clotting medications are also among the drugs that may be used to treat both conditions.
Surgery for Heart Disease
A wide range of surgical options also exists when heart disease requires more aggressive treatment, including:
Angioplasty is performed to relieve chest pain and increase blood flow within a blocked artery. Your doctor threads a long, thin tube through your blood vessels to the point where the blockage is found. Next, a deflated balloon gets directed to the point of the blockage and is briefly inflated to widen the passage. At the same time, you’ll likely have a mesh stent permanently placed at the site of the blockage to keep it open.
Coronary artery bypass grafting is done to re-route the flow of blood. Your surgeon will take a healthy blood vessel from your chest, leg, or arm, and connect it to a point beyond the blockage, allowing it to bypass the blockage in your artery.
Transmyocardial laser revascularization is a treatment for angina that involves using a laser to make channels in the heart muscle and left ventricle in order to let more oxygen-rich blood into the heart. It’s not well-understood why this procedure eases chest pain. And, according to the American College of Cardiology, its safety concerns often outweigh the potential benefits of the procedure.
Heart valve repair or replacement is done when a heart valve no longer works properly. The valve can be repaired surgically or replaced with a synthetic or biological valve. The latter can be made from pig, cow, or human heart tissue and may include synthetic parts as well. Catheters may also be used for poorly functioning valves.
Implants for arrhythmia, such as a pacemaker or an implantable cardioverter defibrillator (ICD), are implanted when drugs do not adequately restore your heart’s normal rhythm. Both restore your heart’s proper rhythm at times when your heartbeat becomes dangerously irregular.
Surgical placement of a ventricular assist device is a procedure that involves implanting a mechanical, battery-powered device that aids one or both of your ventricles when they can no longer do an adequate job due to heart failure. Often, they are implanted during the period before a heart transplant.
Heart transplant is done during the last stage of heart disease, replacing your diseased heart with a healthy heart from a donor who has recently died.
What’s Life Like With Heart Disease?
You’ve received your diagnosis of heart disease, and your doctor has presented you with a treatment plan. What’s next? How much of your old life will you be able to get back? Living with heart disease has challenges—some physical, some emotional, some big, some small. Your goal: to take care of all of you and live your best life.
Your Emotional Life
If you’re not doing well emotionally, you might struggle with all of the other aspects of your treatment, from eating right and exercising to taking your medications. Often, depression is to blame. In fact, about one in five heart disease patients develops serious depression, while many others have milder cases. Research is mixed on why this is, although some scientists believe inflammation is involved. Fortunately, counseling and medication can help. Talk to your doctor if you feel down, unmotivated, or discouraged for more than a week.
Your Stress Levels
Heart disease can feel scary. But those worries can overwhelm you and interfere with enjoying your life. If you struggle with anxiety, try to shift your focus to what’s happening today rather than looking with worry at the future. Talk about your concerns with friends and family and ask them for support. And consider joining a support group to connect with others who face the same struggles that you do. Join the American Heart Association's Support Network.
Your Activity Levels
Regular exercise and other physical activity help your heart. A minimum of 150 minutes of exercise will not only improve your heart function. It also may enable you stop taking some of your heart medications. But first, ask your doctor what exercises are right for you.
Your Work Life
If you’re recovering from a heart attack or surgery, it may be a few weeks before you can return to your job, but you’ll likely be able to pick up right where you left off. Of course, it depends on the job—if your current one puts too much strain on your heart—physical and, perhaps mental, in the form of stress--you may have to dial back your workload. The Americans with Disabilities Act, a federal law, offers workplace protections for people with heart disease.
Your Sex Life
You may have to wait up to six weeks before you resume your sex life—and only your doctor can tell you when you can safely return to romance. How long abstinence lasts will depend on your symptoms, like lingering chest pain or other complications. To get the all-clear, you may have to undergo an exercise stress test to measure your heart’s capacity to handle any under-the-sheets action.
Return to the Road
Before you climb behind the steering wheel, check your state’s regulations for driving after a serious illness. Also, if you have symptoms like chest pain, don’t drive until they clear up.
Get Help If You Need It
You can kickstart your new life with cardiac rehabilitation. This is a medically supervised program that typically lasts for three months. Working with doctors, nurses, exercise specialists, dietitians and mental health counselors, you will receive exercise training, lessons in healthy eating, methods to reduce stress, and other education designed to help you reduce your risk of worsening heart health.
Remember, you and over 121 million other Americans are facing some type of heart disease together—so you’re not—and never will be—alone in this. We’ve got you.
Where Can I Find My Heart Disease Communities?
With half of the American population affected by some sort of cardiovascular disease, one thing's for sure—you are not alone. And we’ve got your heart-community covered, whether you're in the mood for a podcast to help you better understand your new (and necessary) lifestyle changes; a support group that's been there, lived that, and wants to pay the guidance forward; or an organization who will not only support you with research but will also invite you to a fun run.
Top Heart Disease Instagrammers
Steven Burns, @that_heart_guy
Follow because: With seven open-heart surgeries under his belt, he knows a thing or two about living the life of someone who takes every day to heart (pun intended). The best thing about his feed, aside from his grace and guidance, are the heart warriors he features on the regular. It’s a feel-good inspiring feed if there ever was one.
Star Jones, @starjonesesq
Follow because: You know her for her beaming smile and her seat at the table on The View—yet she’s made it her mission to make sure you know her as the face of heart disease, too, since 2010. Despite the fact that she lost more than 100 pounds after gastric bypass surgery, she still went on to learn she had heart disease. She's now a spokeswoman for the American Heart Association and travels around the globe speaking to women about the dangers of heart disease and how simple lifestyle changes can literally save their lives.
Follow because: Picture this: A completely healthy 30-year-old physician who never had any health issues other than a bout with appendicitis. How on earth, then, did she become a heart transplant patient overnight? Her personal experience, mixed with her professional POV, makes her feed and blog endlessly fascinating—and don’t worry, she tells you every single bit of her story.
Top Heart Disease-Related Podcasts
Love Your Heart: A Cleveland Clinic Podcast.: Your many Qs, answered by experts. Trending topics, diets, and public health scares—discussed by experts. All things heart, all the time, brought to you from, yes, the experts at the Cleveland Clinic, presented in layman’s terms.
Cholesterol Podcasts from The American Heart Association (AHA): By now you should know that a huge factor in heart disease is the health of your heart, your diet, and your cholesterol. The AHA gives tips on how to better manage your LDLs and HDLs through these informative podcasts.
Plant Proof — Plant Based Nutrition & Inspirational Stories: Hosted by Simon Hill, nutritionist, physiotherapist, and certified in plant-based nutrition (it’s a thing), this podcast hones in one the biggest lifestyle change you will be forced to make if you have heart disease: diet. Episodes feature diet approaches, people who have tried them, and guidance for how you can get in on the action.
Top Heart Disease Nonprofits
American Heart Association.: They make two appearances in this line-up, and for good reason. The AHA is the bees knees of heart health guidance. Not only do they have endless resources to help you navigate life with heart disease, but they also have the hands-on manpower to quite literally walk you through it. Hosting local events like fun runs (or walks), plus galas across the country, you will never feel alone as long as you’re a part of this nonprofit.
Women Heart: In the U.S., one in four women die from heart disease, so it’s only fitting there’s a nonprofit completely dedicated to women battling it. They will make you feel empowered and in control of your own health, while connecting you with women—a sisterhood—who will navigate this new reality with you.
The Heart Foundation: The power behind this foundation is overwhelmingly heartfelt—it was started in memory of a healthy 35-year-old husband and father who suffered a massive heart attack on the basketball court. Today, this foundation fuels research under the direction of world-renowned cardiologist Dr. P.K. Shah, in the quest to find more effective ways to prevent these sudden tragedies.
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