Diseases of the Heart

Coronary Artery Disease – Due to a narrowing of the opening (lumen) of the coronary artery that supplies blood to a region of the heart. This narrowing is produced by the deposition of fat and cholesterol (plaque) within the lining of the artery. This condition is called atherosclerosis.
The plaque may rupture into the artery producing a thrombus or blood clot. This clot will occlude or block the artery. The occlusion deprives blood to a portion of the heart wall (myocardium). This is called ischemia and will cause to affected portion of the myocardium to die. This is referred to as a myocardial infarction.
The predisposing factors for coronary heart disease are hypertension, obesity, smoking, sedentary life style and a diet high in cholesterol and triglyceride fats.

Symptoms of the onset of a heart attack:

1. Severe chest pains (angina pectoris). This pain may also be felt or referred to the neck, left arm and jaw.
2. Sensation of being nauseous or having heart burn.
   
   
   

Treatment

1. Cardiopulmonary resuscitation (CPR) is performed to help push blood through the arrested heat to the body.
2. Use of a defibrillator to help restart the heart.
3. Early administration of anticoagulants such as tissue plasminogen activator and streptokinase.
4. Use of nitroglycerine to relieve the pain of angina.
5. Coronary bypass surgery during which a portion of a patient’s vein is used to replace the occluded coronary artery.
6. Angioplasty can be used to open a partially occluded coronary artery. In this treatment, a tube or catheter is threaded into the blocked coronary artery. At the end of the catheter is a small balloon is inflated which crushes and flattens the occluding plaque. This procedure widens the diameter of the coronary artery.

Hypertensive Heart Disease is the result of longstanding high blood pressure. The hypertension is due to a system wide narrowing (atherosclerosis) and hardening (arteriosclerosis) of the arteries. The heart is forced to pump blood against this great resistance. As a result, the left ventricle, which does most of the work, enlarges. Eventually, the left ventricle becomes exhausted and fail to adequately pump blood to the body.

Congestive Heart Failure can involve either the right or left side of the heart depending on which side is pumping inadequately. Right heart failure involves a build up in blood pressure in the veins of the body. This will lead to fluid build up in the legs and ankles, a condition known as edema. Left heart failure causes shortness of breath as excessive fluid accumulates in the lungs (pulmonary edema).

Congenital Disorders of the Heart – Heart defects a person is born with.

A. Septal Defects

1. Patent foramen ovale

2. Atrial septal defects (ASD)

3. Ventricular septal defects (VSD)

B. Tetralogy of Fallot – Four defects that may occur in one heart.

1. Pulmonary stenosis

2. Large septal defect

3. Hypertrophied right ventricle

4. Displaced aorta.

3. Patent ductus arteriosus
   
   
4. Valvular diseases - The valve opening may be too small (stenosis) for adequate movement of blood or too large to prevent backflow of blood in the heart (valvular insufficiency).
1. mitral stenosis – valve opening is too small.
2. mitral insufficiency – valve opening is too large or does not close completely.
3. aortic stenosis – narrowing of the opening leading into the aorta. This will force the left ventricle to enlarge.
4. aortic insufficiency – the aortic valve does not close properly. This will cause the blood to back up into the left ventricle from the aorta forcing the ventricle to work much harder and hypertrophy.

Infectious diseases of the Heart

1. Rheumatic Heart Disease – results from a streptococcal infection (group A hemolytic streptococci). The microbe releases toxins which produce damage to the endocardial lining and the atrioventricular valves.

2. Endocarditis – is an inflammation of the inner lining of the chambers of the heart and the atrioventricular valves due to a streptococcal infection.