The Heart

What Is Heart Disease?

The human heart is built for amazing endurance -- billions of beats in an average lifetime. But like any other part of the body, it is vulnerable to breakdowns. Heart problems vary widely in their nature and severity. They may be transient or chronic, slow-developing or sudden, inconvenient or deadly.

Some types of heart disease, closely linked to diet and lifestyle choices, are preventable; others are due to genetic inheritance, infections, or other uncontrollable factors. Two of every five Americans will ultimately die of heart disease. The daily toll is approximately 2,500 people. Fortunately, the death rate is declining steadily (by about 40% since 1960), thanks largely to improved medical care and widespread public education about risk factors.

The following is a list of the most common types of heart disease:

Coronary Artery Disease

Coronary artery disease, the most common of all heart problems, is characterized by blockages in the coronary arteries that result in a reduction in blood flow to the heart muscle, depriving it of vital oxygen. Usually, the disease stems from atherosclerosis, a condition sometimes called hardening of the arteries.

Severe coronary artery disease can lead to heart failure. Coronary heart disease can also result in painful episodes of angina (chest pain due to coronary disease) or a heart attack or, in the worst case, sudden death.

There are many things that can put a person at higher risk of developing coronary disease:

• Family history
• Gender -- Men are more apt to be affected than women.
• Genetics
• Age -- For both men and women, the likelihood of heart disease increases significantly after the age of 65. The risk rises sharply in women after menopause.
• Abnormal cholesterol levels -- high blood levels of "bad" (LDL cholesterol) or low levels of "good" (HDL cholesterol)
• High blood pressure (hypertension)
• Smoking
• Obesity
• Sedentary lifestyle
• Stress

Heart Arrhythmias

• Arrhythmias are disturbances in the heart's normal beating pattern. The irregularities occur in many forms, each with its own potential causes and treatments. Serious arrhythmias are a frequent consequence of other heart diseases but may also occur independently.

Heart Failure

• The term heart failure does not mean that the heart has "failed" or stopped working. Rather, it means that the heart does not pump blood as well as it should. Heart failure is usually caused by coronary artery disease, but it can also be caused by thyroid disease, high blood pressure, or heart muscle disease (cardiomyopathy) among other conditions.

Heart Valve Disease

The heart has four valves (the pulmonary, mitral, tricuspid and aortic) that open and close to direct blood flow between the heart's four chambers, the lungs and connected blood vessels. A defective valve may fail either to open properly, obstructing blood flow (stenosis or obstruction), or to close properly (regurgitation or insufficiency), allowing blood leakage. Congenital heart disease and various infections, including rheumatic fever, are among the causes of valve disorders.

Endocarditis is an inflammatory condition that affects heart valves. This disease is an infection or inflammation of the endocardium, the innermost layer of heart tissue that lines the chambers and valves. It is usually caused by bacterial infection, with the staphylococcus and streptococcus bacteria. Bacteria may enter the blood and take root in the heart during illness, after surgery, or as a result of intravenous drug use. Endocarditis tends to strike people with pre-existing valve problems. The disease can be fatal if left untreated, but it can generally be cured with antibiotics. If heart valves are seriously damaged as a result of endocarditis, valve replacement surgery may be needed.

Rheumatic heart disease, another type of heart disease affecting valves, was very common earlier in this century but is now largely preventable with antibiotic treatment, although it still occurs. The disease stems from damage to the heart muscle and valves caused by rheumatic fever, which itself is associated with strep throat and scarlet fever. Symptoms of rheumatic heart disease are usually delayed for many years after infection.

Pericardial Disease

• Any disease of the pericardium, the sac surrounding the heart, is called a pericardial disease. One of the more common is a condition called pericarditis. It is usually caused by viral infection, diseases such as lupus or rheumatoid arthritis, or trauma to the pericardium. Pericarditis often follows open-heart surgery.

Cardiomyopathy (Heart Muscle Disease)

• Diseases of the heart muscle, or myocardium, are collectively referred to as cardiomyopathies. When diseased, the myocardium becomes abnormally stretched, thickened or stiff. Among the many potential causes of cardiomyopathy are genetic heart conditions, reactions to certain drugs or toxins such as alcohol and viral infections. Sometimes, chemotherapy for cancer causes cardiomyopathy. Often, the precise cause of cardiomyopathy is unknown. In any event, either the heart muscle becomes too weak to pump efficiently or stiffening prevents adequate filling of the heart.
• When cardiomyopathy progresses to the point of causing serious arrhythmias or heart failure, the outlook for long-term survival is poor. Sudden death is another outcome associated with some cardiomyopathies, including idiopathic (meaning a disease with no known cause) hypertrophic subaortic stenosis, which has claimed the lives of a few prominent young athletes.
• If cardiomyopathy can be detected and treated early enough, either with drugs or with transplant surgery, symptoms can often be controlled and heart failure averted for many years.

Congenital Heart Disease

• Should anything go wrong in the formation of the heart during prenatal development, a baby will be born with one or more congenital heart defects. Such defects are quite common, occurring in about seven of every 1,000 babies.
• The exact causes of defects are generally hard to pin down; genes and environmental factors inside the mother's body may both contribute. Chromosome abnormalities, including the one that causes Down syndrome, have been linked to many congenital heart defects. Infections contracted during pregnancy by the mother, such as rubella, may also result in congenital heart defects for the child. Congenital heart defects range widely in their effects. Some are apparent immediately, but others do not produce noticeable symptoms until adulthood.
• Among the most common types are septal defects, or holes in septum, which is the wall dividing the left and right sides of the heart. If a septal defect is big enough to cause problems, it can be patched surgically. Another frequently seen defect is pulmonary stenosis, a condition in which one of the four heart valves -- the pulmonary valve -- is so narrow that blood flow to the lungs is restricted. With surgery, the valve can be pried open or replaced. In some babies, a small fetal blood vessel known as the ductus arteriosus fails to close at birth as it should. This condition, known as patent ductus arteriosus, allows some blood that is headed for the body via the aorta to leak back into the pulmonary artery, placing the heart under added strain. This problem can also be corrected surgically or sometimes with medication.
• Some so-called blue babies are born with a combination of four heart defects, which basically results in oxygen-poor blood flow to body tissues. The excess of poorly-oxygenated blood gives the baby a bluish tinge. Unless treated, most people with this condition would not survive to middle age. However, surgery successfully corrects the condition 90% of the time.

Inside the heart

Inside the heart, there are four clearly separate sections or chambers. The right side of the heart, consisting of the right atrium and right ventricle, receives oxygen-poor blood. On the left side of the heart, the left atrium and left ventricle receive oxygen-rich blood.

STATISTICS	FUNCTION	ANALYSIS
… Weight: Less than .45 Kg (one pound) … Length: 13 Cm (5 inches) … Width: 9 Cm (3.5 inches)	Muscular pump sending blood to all parts of the body though a highly intricate network of blood vessels called capillaries.	The heart beats on average 70 times every minute and 100,000 times a day without rest.

Your heart beats more than once a second every day of your life. As blood flows into your heart, the muscles contract, and the blood flows out again. The heart is made of a special muscle, which never tires. This muscles contracts and relaxes 60 to 80 times a minute and during exercise the rate can increase to over one hundred times per minute.

What causes heart failure

Heart disease can occur at any age. However, chronic heart disease becomes more common with advancing age. When your dog starts to age and becomes less active, you may consider having his heart checked.

The heart is a four-chambered pump whose role is to receive blood that needs oxygen and pump it into the lungs, where carbon dioxide is exchanged for oxygen. Then the heart pumps the oxygen-rich blood throughout the body.

Heart failure is a condition in which a heart, weakened by disease, cannot receive and pump blood adequately to meet the needs of the body. As a result, blood starts to pool, fluids build up (congestion) and causes coughing, weakness and breathing difficulties, which may result in death.

What causes heart failure?

There are many causes of heart failure. However, among the most common are:

Acquired heart disease (e.g. chronic disease of the heart valves)

Congenital heart disease

Acquired heart disease in older, small breeds of dogs usually involves degeneration of the valves which results in leakage and loss of pumping efficiency of the heart. There are some breeds which are very at risk such as Maltese, miniature and Toy Poodles, Pomeranians and Yorkshire Terriers.

In large breeds of dogs, such as Doberman, Great Danes, Boxers and Labrador Retrievers the disease usually involves a weakness in the heart muscle and is typically found in middle-aged male dogs.

Both conditions result in an increased workload on the heart, which gradually enlarges in size as the heart muscle stretches in an effort to pump more blood. As efficiency drops, fluid begins to build-up in the lungs
and/or abdomen. Dogs of any size can become affected by heart disease.

Congenital heart disease occurs more rarely and results from birth defects of the heart muscle and/or valves.

Physical examination - with careful exam-ination including listening to the heart and lungs with the stethoscope, your vet can detect heart murmurs, irregular beats, weak pulse, and the presence of congestion in the chest or abdomen.

What are the warning signs?

Rapid or difficult breathing
Cough (especially when the dog rises in the morning)
Tires easily, puffs and pants more
Appetite loss
Weight Loss
Pot-bellied appearance
Pale or grey/blue gums

These signs may be caused by other factors, not just heart failure. Be sure to have your dog checked by a veterinarian if you notice these changes.

How does the veterinarian determine the existence and cause of heart failure?

Electrocardiogram (ECG) - this simple test detects irregular and abnormal heart beats, called arrhythmia, and provides information that helps the veterinarian determine the type of treatment needed.

Chest X-ray - evaluates the size and shape of the heart, lungs and blood vessels. Heart en-largement and fluid congestion in the lungs can be detected and helps to make a correct diagnosis and an assessment of the severity of the condition.

Echocardiogram - this test uses sound waves to harmlessly examine the inside of the heart and blood vessels. It can also detect how strongly the heart beats, show abnormalities which cause heart murmurs, cancer and congenital birth defects.

What can be done if my dog has heart failure?

Exercise: may have to be limited to below the level that provokes signs of discomfort ­ fatigue, laboured breathing, or coughing.

Diet: Together with drug therapy, a change in diet is essential to help maintain heart function. Restricted salt content helps prevent excessive blood pressure, one of the dangerous effects of heart disease. Added Taurine and L-carnitine also helps to improve heart muscle contraction, thereby improving blood flow. All the above requirements are met in Hill№s® Prescription Diet® h/d®, a therapeutic pet food which is also low in protein and phosphorous to help the kidneys function at a time when they are under stress due to lack of blood flow.

Excess weight can exacerbate heart disease, so keep your pet№s weight under control by feeding correctly.

Drug therapy: Most heart conditions have traditionally been controlled by drug treatments that remove congestion (fluid build up), control irregular heartbeats (arrhythmia), or improve the action of the heart muscle (contraction). The latest advance in the treatment of heart failure in dogs is a drug that actually intervenes in the compensatory processes that the body instigates when the heart cannot adequately receive the pumped blood. These processes are initially beneficial to the dog. However in a chronically ill dog, the process eventually perpetuates the cycle of heart failure.

What can I do now?

Talk to your vet:

If your dog exhibits any of the signs indicating underlying heart disease, such as difficulty in breathing, chronic coughing, lethargy and appetite or weight loss, you should consult your veterinarian

exercise and decreased risk of heart disease

Women Who Walk Reduce Their Risk of Both Heart Disease and Stroke

A recent study has found that women who walk at least three hours a week can reduce the risk of heart attack and stroke by 40%, and the reduction is even greater for women who walk faster. The research was led by Dr. JoAnn Manson, director of women's health at Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School. Findings were presented at the American Heart Association (AHA) annual meeting in New Orleans on November 12, 1996.

The researchers studied 84,000 female nurses aged 40 to 65 who had no evidence of heart disease. The participants were surveyed about their walking habits once in 1986 and then twice more over the next eight years.The researchers found that for 50% of the participants, the only form of exercise that was performed was walking, while 10% of the participants did not exercise at all. During the eight years, 590 heart attacks and 456 strokes were reported.

The results of the study indicated that women who walked briskly (3 to 4 miles an hour) reduced the risk of heart disease by 54%, and those women who walked more slowly reduced their risk by 32% compared to women who did not walk at all. There were similar findings for the risk reduction of stroke.

Dr. Manson noted that there have been very few studies connecting physical activity to cardiovascular disease and stroke in women. The research is also important in light of recent federal exercise guidelines which recommend at least 30 minutes a day of moderate exercise. As of 1992, the AHA has identified a lack of physical activity as a risk factor for heart disease, and therefore recommends at least moderate intensity activity for those people who can not exercise more strenuously or who are inactive.

Dr. Manson also stressed the overall benefit exercise plays in a variety of other health concerns including lowering blood pressure and cholesterol, reducing weight, and reducing the risk of diabetes, osteoporosis and certain kinds of cancer. It also helps to reduce stress.

The link between exercise and decreased risk of heart disease and stroke is not simply theoretical, and this is one more study demonstrating the positive benefits of exercise. Importantly, it was done on women, on whom much less information is available. The good news is that the exercise need not be strenuous; even regular walking decreases risk. So if you're not in the habit--well, time to get moving!

Facts on Heart Disease

Physicians in on time have pointed out some factors that can put individuals at risk for heart disease. The following consist of family history, high blood pressure, high blood cholesterol level, cigarette smoking, diabetes mellitus, sedentary lifestyle, obesity, advancing age and being male.

What people with high blood pressure can do is to make some changes on diet and lifestyle, or using medication to lower it. In addition to that, individuals should make a detailed exercise plan, focusing on aerobic activities that increase lung capacity and the heart’s ability to work at higher levels.

People who are aware of this danger have checkups and take medication before high blood pressure damages their heart and blood vessels. Those who have high levels of cholesterol in the blood should have regular checkups and make sure to take proper medication before it damages one’s heart and blood vessels.

The best way to make each member of the family become aware of the threat is to educate the children at home regarding the harm that a heart disease could be brought to them. More importantly, parents must have the basic knowledge on how to prevent such an illness from getting into them.

Periodontitis & Heart Attack

Coronary heart disease is the leading cause of death worldwide, and Periodontitis, which leads to the loss of connective tissue and the bone support of teeth, is the major cause of tooth loss in adults over 40 years.

Periodontitis is very common, and around 90% of people aged over 60 suffer from it. Research has already shown a genetic basis for both diseases.

Scientists have discovered a genetic relationship between the two conditions, a researcher told the annual conference of the European Society of Human Genetics.

Because of its association with CHD, periodontitis should be taken very seriously by dentists and diagnosed and treated as early as possible

Both CHD and periodontitis are propagated by the same risk factors – most importantly:

• smoking



• diabetes
  
• obesity – and there is also a gender relationship, with men possibly more liable to these diseases than women.

Researchers have also shown similarities in the bacteria found in the oral cavity and in coronary plaques, and both diseases are characterised by an imbalanced immune reaction and chronic inflammation.

Patients with periodontitis should try to reduce their risk factors and take preventive measures at an early stage

Patients With Moderate To Severe Periodontitis Need Evaluation For Heart Disease Risk: (Jul/1/2009)

Patients should receive evaluation and possible treatment to reduce their risk of atherosclerotic cardiovascular disease (CVD), now there is a strong evidence that people with periodontitis are at increased risk of atherosclerotic CVD – the accumulation of lipid products within the arterial vascular wall.

The explanation for the link between periodontitis and atherosclerotic CVD is not yet clear, but a leading candidate is

• Inflammation caused by the immune system.
• Other explanations for periodontitis and atherosclerotic CVD are common risk factors such as smoking, diabetes mellitus, genetics, mental anxiety, depression, obesity, and physical inactivity.

Regardless of the cause, the expert panel believes that the current evidence is strong enough to recommend that doctors assess atherosclerotic CVD in their patients with periodontitis.

Patients should consider a medical evaluation if they have not done so in the past 12 months.

See also: Periodontal Disease: How To Protect Your Teeth And Gums

Sources:
European Society of Human Genetics
The American Journal of Cardiology
The American Journal of Periodontology

Heart Disease: Symptoms

Coronary artery disease, heart attack -- each type of heart disease has different symptoms, although many heart problems have similar symptoms. The symptoms you experience depend on the type and severity of your heart condition. Learn to recognize your symptoms and the situations that cause them. Call your doctor if you begin to have new symptoms or if they become more frequent or severe.

Coronary Artery Disease

The most common symptom is angina. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina is usually felt in the chest, but may also be felt in the shoulders, arms, neck, throat, jaw or back.

Other symptoms that can occur with coronary artery disease include:

• Shortness of breath
• Palpitations (irregular heart beats, skipped beats or a "flip-flop" feeling in your chest)
• A faster heartbeat
• Weakness or dizziness
• Nausea
• Sweating

Heart Attack (Myocardial Infarction or MI)

Symptoms can include:

• Discomfort, pressure, heaviness, or pain in the chest, arm or below the breastbone
• Discomfort radiating to the back, jaw, throat or arm
• Fullness, indigestion or choking feeling (may feel like heartburn)
• Sweating, nausea, vomiting or dizziness
• Extreme weakness, anxiety or shortness of breath
• Rapid or irregular heartbeats

During a heart attack, symptoms typically last 30 minutes or longer and are not relieved by rest or oral medications (medications taken by mouth). Initial symptoms can start as a mild discomfort that progresses to significant pain.

Some people have a heart attack without having any symptoms (a "silent" MI). A silent MI can occur among all people, though it occurs more often among diabetics.

If you think you are having a heart attack, DO NOT DELAY. Call for emergency help (dial 911 in most areas). Immediate treatment of a heart attack is very important to lessen the amount of damage to your heart.

Arrhythmias

When symptoms of arrhythmias are present, they may include:

• Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops," or feeling that your heart is "running away").
• Pounding in your chest.
• Dizziness or feeling light-headed.
• Fainting.
• Shortness of breath.
• Chest discomfort.
• Weakness or fatigue (feeling very tired).

Atrial Fibrillation

Atrial Fibrillation(AF) is a type of arrhythmia. Most people with AF experience one or more of the following symptoms:

• Heart palpitations (a sudden pounding, fluttering, or racing feeling in the heart).
• Lack of energy; tired.
• Dizziness (feeling faint or light-headed).
• Chest discomfort (pain, pressure, or discomfort in the chest).
• Shortness of breath (difficulty breathing during activities of daily living).

Some patients with atrial fibrillation have no symptoms. Sometimes these episodes are briefer.

eart Valve Disease

Symptoms of Heart valve disease can include:

• Shortness of breath and/or difficulty catching your breath. You may notice this most when you are active (doing your normal daily activities) or when you lie down flat in bed.
• Weakness or dizziness.
• Discomfort in your chest. You may feel a pressure or weight in your chest with activity or when going out in cold air.
• Palpitations (this may feel like a rapid heart rhythm, irregular heartbeat, skipped beats or a flip-flop feeling in your chest).
• If valve disease causes heart failure, symptoms may include:
• Swelling of your ankles, feet or abdomen. Swelling may also occur in your belly, which may cause you to feel bloated.
• Quick weight gain (a weight gain of two or three pounds in one day is possible).

Symptoms do not always relate to the seriousness of your valve disease. You may have no symptoms at all and have severe valve disease, requiring prompt treatment. Or, as with mitral valve prolapse, you may have severe symptoms, yet tests may show minor valve disease.

Heart Failure

Symptoms of Heart failure can include:

• Shortness of breath noted during activity (most commonly) or at rest, especially when you lie down flat in bed.
• Cough that is productive of a white mucus.
• Quick weight gain (a weight gain of two or three pounds in one day is possible).
• Swelling in ankles, legs and abdomen.
• Dizziness.
• Fatigue and weakness.
• Rapid or irregular heartbeats.
• Other symptoms include nausea, palpitations and chest pain.

Like valve disease, heart failure symptoms may not be related to how weak your heart is. You may have many symptoms, but your heart function may be only mildly weakened. Or you may have a severely damaged heart, with little or no symptoms.

Congential Heart Disease

Congenital heart defects may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. Sometimes it can be diagnosed because of a heart murmur on physical exam or an abnormal EKG or chest X-ray in an asymptomatic person.

In adults, if symptoms are present, they may include:

• Shortness of breath.
• Limited ability to exercise.
• Symptoms of heart failure (see above) or valve disease (see above).

Congenital Heart Disease in Infants and Children

Symptoms can include:

• Cyanosis (a bluish tint to the skin, fingernails and lips).
• Fast breathing and poor feeding.
• Poor weight gain.
• Recurrent lung infections.
• Inability to exercise.

Heart Muscle Disease (Cardiomyopathy)

Many people with heart muscle disease have no symptoms or only minor symptoms, and live a normal life. Other people develop symptoms, which progress and worsen as heart function worsens.

Symptoms can occur at any age and may include:

• Chest pain or pressure (occurs usually with exercise or physical activity, but can also occur with rest or after meals).
• Heart failure symptoms (see above).
• Swelling of the lower extremities.
• Fatigue.
• Fainting.
• Palpitations (fluttering in the chest due to abnormal heart rhythms).

Some people also have arrhythmias. These can lead to sudden death in a small number of people with cardiomyopathy.

Pericarditis

When present, symptoms of pericarditis may include:

• Chest pain. This pain is different from angina (pain caused by Coronary artery disease. It may be sharp and located in the center of the chest. The pain may radiate to the neck and occasionally, the arms and back. It is made worse when lying down, taking a deep breath in, coughing or swallowing and relieved by sitting forward.

• Low-grade fever.

• Increased heart rate.

Because many of the symptoms associated with each type of heart disease are similar, it is important to see your doctor so that you can receive a correct diagnosis and prompt treatment.