Cardiovascular Disease

Cardiovascular is made up of the words “cardio” meaning heart and “vascular” meaning blood vessels. Cardiovascular disease (CVD) thus encompasses diseases of the heart and diseases of the blood vessels. CVD includes angina (chest pain), myocardial infarction (heart attack), and stroke.

Disease of the heart

Anything that injures the heart, making it less able to function properly, is a disease of the heart. Often the various types are grouped according to whether the dysfunction is congenital (i.e., inborn or present at birth) or acquired (e.g., due to another disease or condition).

Diseases of the heart include:

  • cardiomyopathy: diseases of the heart muscles;
  • congestive heart failure (CHF): heart failure due to weakened heart pump action that causes fluid to backup in the lungs and elsewhere;
  • heart valve defects: both congenital (e.g., Ebstein’s anomaly) and acquired ( e.g., infective endocarditis);
  • pericardial disease: an infection of the pericardium, the baglike membrane that surrounds the heart.

Diseases of the blood vessels

The most common disease in the industrialized world and the number one killer of Canadians is coronary heart disease (CHD), also sometimes called CAD, coronary artery disease. It is a disease of the arteries that supply blood to the heart muscle that can lead to heart attacks. When people speak of heart disease, they are usually talking about CHD.

Other diseases of the blood vessels include:

  • aneurysms
  • high blood pressure (hypertension)
  • varicose veins
  • vasculitis
  • venous incompetence
  • venous thrombosis

Symptoms

Some people with cardiovascular disease don’t realize it, especially in the early stages, but most people have some indication. Common symptoms include:
  • chest pain, from mild to crushing
  • shortness of breath, particularly during exertion or when lying down
  • weakness, fatigue
  • heart palpitations
  • disorientation, light-headedness
  • feeling faint, fainting
  • broken sleep
  • swollen ankles
  • fluttering or pounding in the chest
The symptoms experienced by some women may be different from those of men; they include indigestion-like discomfort, nausea, back pain.

Cause

Most acquired cardiovascular diseases are caused by atherosclerosis which occurs when fatty buildups of plaque narrow the arteries, thus slowing blood flow to the heart.

Diagnosis

If you think you may have CVD, visit your doctor as soon as possible. Besides taking a thorough medical history and carrying out a physical examination, your doctor will probably follow up with some tests. Diagnostic tests include blood tests, electrocardiograms (ECGs), echocardiograms (an ultrasound of the heart), chest X-rays, dynamic stress tests (using a treadmill), and tests involving nuclear medicine studies (MUGA scan) that use radioactive material injected into your vein to see how your heart is functioning. Another helpful diagnostic tool is the Holter monitor, a small box the size of a pocket book that’s really just an ECG. You wear it for about 24 hours as you go about your day and it records how your heart is behaving. When someone is diagnosed with cardiovascular disease, it often means that the person has more than one problem. Frequently the primary heart problem leads to other problems, all of them worsening each other. This is what happens with high blood pressure: It can lead to coronary heart disease, congestive heart failure, heart attack, stroke, and damage to vital organs such as the kidneys and eyes. Early diagnosis of CVD means that treatment can intervene before other diseases can develop.

Risk factors

There are certain things that make you more likely to develop heart disease; some of them you can change, and some you can’t:

Modifiable factors

  • smoking
  • being overweight
  • physical inactivity
  • high cholesterol or abnormal blood lipids (fats)
  • high blood pressure (hypertension)
  • diabetes

Unmodifiable factors

  • being male; until age 50, men are at greater risk than women of developing heart disease, though once a woman passes menopause, her risk triples
  • having a family history of heart disease
  • being older than 50 years old

Treatment

Doctors today have a broad range of medications at their disposal for the treatment of cardiovascular disease. Other treatment options include surgical procedures such as angioplasty and bypass surgery, valve replacement, pacemaker installation, and heart transplantation. But the most important treatments for cardiovascular disease usually involve lifestyle changes that only you can implement. At the top of the list are diet and exercise. Ask your doctor to help you put together an achievable program to become healthier. You may be referred to a nutritionist or dietician for advice on what to eat – and not eat. Many community health centres offer specialized exercise programs to help people with heart problems get in shape as well as support groups for dealing with the limitations created by the cardiovascular disease.

Prevention

You can reduce your risk of cardiovascular disease if you:
  • maintain a healthy weight with a low-fat diet rich in vegetables and fruit
  • are physically active; exercise for at least 30 minutes a day
  • don’t smoke, and avoid second-hand smoke
  • keep diabetes (if you have it) under control with diet and medication
  • keep your cholesterol or blood lipid levels within healthy limits; avoid saturated fats
  • manage your blood pressure properly; don’t let it get too high!
  • drink alcohol only moderately or not at all
  • visit your doctor regularly to assess your risk of heart disease

Did you know that…

  • cardiovascular disease causes about one death a minute among North American females — nearly half a million female lives every year? (Yet, according to an American Heart Association survey, only 13 percent of women consider CVD their greatest health risk.)
  • the relative risk of cardiovascular disease associated with physical inactivity is comparable to high blood cholesterol, high blood pressure, or cigarette smoking?
  • more than 60 percent of Canadians are considered to be inactive?
  • cardiovascular disease is the number 2 killer (after certain accidents) of children under the age of 15?
  • it’s not only the smoke but the nicotine that increases your risk of cardiovascular disease from cigarettes?
  • within 2 to 3 years of not smoking, your risk for cardiovascular disease and stroke will be as low as the risk of a person who has never smoked?
  • contrary to popular belief, hypertension (high blood pressure) is not usually caused by stress or anxiety? It is caused by a physical condition that makes your heart work too hard. Have your blood pressure checked regularly.

For more information or for support

The Heart and Stroke Foundation of Canada www.heartandstroke.com