Heart disease is Australia’s biggest killer, but it’s often preventable. Knowing your risk factors can go a long way to keeping your ticker healthy Cardiovascular disease (CVD) is the term used for heart, stroke and blood-vessel diseases. It is the leading cause of death in Australia – accounting for 34 per cent of all deaths in 2006 – and kills one Australian almost every 10 minutes, but the facts aren’t all grim. Heart disease is largely preventable – and knowledge is the key.
This health handbook, compiled from Heart Foundation information, will help you to understand what you need to do to take charge of your heart health. It details how your heart works and what can go wrong, helps you identify if you are at risk and outlines the positive steps you can take to live well.
Your heart does a remarkable job performing its life-sustaining work, yet when things go wrong, the results can be serious. This section outlines some common heart conditions, symptoms, diagnosis and treatments.
CORONARY HEART DISEASE
Coronary heart disease is the most common cause of death in Australia. It is also a major cause of disability, with many people needing assistance with daily activities.
If you have coronary heart disease, the blood vessels that carry oxygen and nutrients to your heart muscle are clogged and narrowed. If these vessels (the coronary arteries) become too clogged, the blood supply to your heart muscle is reduced, which can lead to symptoms such as angina (see ‘Angina’).
If a blood clot forms in the narrowed artery and completely blocks the blood supply to part of your heart, it can cause a life-threatening heart attack. The underlying cause of coronary heart disease is a slow build-up of fatty deposits on the inner wall of the coronary arteries. This process, which is called atherosclerosis, begins when people are young, and can be well advanced by middle age.
There is no single cause for coronary heart disease, but there are risk factors which may increase your chance of developing it. See ‘Are You At Risk?‘. Many people don’t know they have coronary heart disease until they experience angina or have a heart attack.
However, if your doctor thinks you have coronary heart disease or is assessing your risk of developing it, he or she may arrange a number of tests to check your heart health and any treatments you may need. Although there is no cure for coronary heart disease, modern treatments and healthy lifestyle choices can greatly reduce your risk of further heart problems and relieve or control symptoms such as angina.
To reduce your risk and aid your recovery:
Take your medicines as prescribed.
Enjoy healthy eating.
Be physically active.
Control your blood pressure and cholesterol.
• Achieve and maintain a healthy body weight is very important.
• Maintain your social and psychological health.
If you have diabetes, you should generally aim to keep your blood glucose levels within the normal non-diabetic range and follow individual advice from your doctor or accredited diabetes educator.
A heart attack occurs when a blood clot suddenly blocks one of the coronary arteries. The affected part of the heart muscle can die, so it is vital to provide emergency treatment in order to try and quickly restore the blood flow to minimise damage.
The risk of a heart attack increases for both men and women with increasing age. Although a heart attack is serious and can be fatal, with access to modern treatments, most people who survive can recover and return to living a normal life, especially if they get to a hospital quickly and receive emergency treatment.
For information on heart attack symptoms and treatment, see ‘Heart Attack’.
Angina is temporary chest pain or discomfort resulting from a reduced blood supply to the heart muscle. It occurs because part of the heart muscle is temporarily unable to get enough blood and oxygen to meet its needs.
Angina usually occurs when the heart has to work harder than usual, because it: requirement for blood and oxygen has increased. This can happen, for example, during exercise or effort, or in response to emotion. It does not occur all the time because the blood supply, although reduced, is usually able to keep up with the heart’s normal demands.
Angina does not mean the heart muscle is damaged, so it is not the same as a heart attack. Many people with angina never experience a heart attack, but those with a history of angina have a higher risk of a heart attack. If not treated effectively, angina can interfere with an active lifestyle.
The symptoms of angina include tight, gripping or squeezing pain which can vary from mild to severe. Angina is usually felt in the centre of the chest, but may spread to either or both shoulders, the neck or jaw, or down the arm, and can even be felt in the hands. Sometimes pain or discomfort is experienced in these other areas of the body without being felt in the chest. Many people, however, do not feel pain, just an unpleasant sensation or discomfort in the chest.
Angina can affect people in many ways, and individuals can experience various symptoms at different times.
People may get the pain early in the morning only or they may get it at rest, even while sleeping. Many people tend to get the symptoms in cold weather or after a heavy meal.
Rest usually relieves angina. When rest alone does not bring rapid or effective relief, nitrate medication, such as nitro-glycerine tablets or spray, is often needed. The pain or discomfort is usually relieved within a couple of minutes. If the symptoms last for 10 minutes, are severe or get worse rapidly, an ambulance should be called.
Heart failure is an ongoing condition that occurs when the heart muscle has become too weak to pump blood through the body as effectively as normal.
This can cause fluid to collect in the lungs and other body tissues, which is called oedema.
Heart failure has many causes, including coronary heart disease (CHD), high blood pressure, previous heart attack, cardiomyopathy or a faulty heart valve.
- Shortness of breath.
- Swelling in the legs or ankles.
- Weight gain.
- Loss of appetite.
- Heart palpitations.
- Chest pain.
- A dry, irritating cough.
Treatment of heart failure includes medications and lifestyle changes. Symptoms are controlled and the potential for further damage reduced by maintaining and controlling fluid balance, restricting salt and alcohol intake, not smoking, being physically active, monitoring your weight and taking medication as prescribed.
Arrhythmias are disturbed rhythms of your heartbeat. Some arrhythmias may make your heart skip or add a beat now and again, but do not affect your general health or ability to lead a normal life. Other arrhythmias are more serious. Without treatment, they can affect your heart’s pumping action, which can lead to dizzy spells, shortness of breath, faintness or serious complications.
Different abnormalities of your heart’s electrical system can cause different kinds of arrhythmias, including bradycardia and tachycardia.
While bradycardia may be normal, for example, associated with improved physical fitness, it can also happen as a result of many physical disorders.
It is serious when your heart beats so slowly that it cannot pump enough blood to meet your body’s needs. Untreated, bradycardia can cause excessive tiredness, dizziness, light headedness or fainting, because not enough blood is reaching your brain.
Tachycardia might be a normal response to physical activity, however certain kinds of tachycardia could be a cause for concern. Ventricular tachycardia is a potentially life-threatening condition, which will need to be treated as a medical emergency. See ‘Heart Attack/Cardiac Arrest’.
Treatments for palpitations and arrhythmias can vary depending on the cause and the extent to which your health or lifestyle is affected. Treatments include lifestyle modifications, medicines, surgery or other medical procedures.
Blood supply is vital for carrying oxygen and nutrients to the brain so it can function. A stroke occurs when an artery supplying blood to a part of the brain becomes blocked or bursts. As a result, that part of the brain is damaged because it is suddenly deprived of its blood supply. Common symptoms of stroke are the sudden onset of one or more of the following:
Weakness or paralysis – of the face, arm and/or leg on either or both sides of the body.
• or understanding, for example, difficulty finding the correct words to say.
• or feelings of dizziness.
•or for example, double vision or poor vision.
treatment for stroke is vital. If you think somebody might be having a stroke call 000 immediately. Regular medical supervision, rehabilitation, medication and lifestyle changes will be required to care for a stroke survivor.
DEEP VEIN THROMBOSIS
Deep vein thrombosis (DVT) is a blood clot in one of the deep veins of the body, usually in the leg. Symptoms include swelling, pain and tenderness in the leg. If DVT is not treated, there is a risk that part of the blood clot may become dislodged and travel through the bloodstream to the lungs, where it can get stuck and block the flow of blood.
This is called pulmonary embolism, and it is a life-threatening condition. If you think that you may have DVT and are experiencing its symptoms, see your doctor urgently.
If you experience pain in your lungs or chest, or have difficulty breathing, contact your doctor immediately
or go straight to a hospital emergency department.
Each year, thousands of Australians have heart attacks. The good news is that with early medical treatment most people return to a normal life
WHAT IS A HEART ATTACK?
‘Heart attack’ is the term used when a blood clot suddenly blocks one of the coronary arteries that supply the heart muscle with the blood it needs. The medical term for this sudden blockage by a blood clot (thrombus)
in a heart artery is coronary thrombosis or coronary occlusion (blockage). The medical term for permanent damage to the heart muscle is myocardial infarction. People who have a heart attack nearly always have coronary heart disease.
HEART ATTACK SYMPTOMS
A heart attack usually causes pain or a feeling of discomfort in the centre of the chest. It usually comes on over minutes and lasts for at least 10 minutes. This pain or discomfort is often described as a pressure, tightness, heaviness, fullness or squeezing: ‘like someone standing on my chest’ or ‘like a band around my chest’. While it is often severe, it can also only be moderate or even mild. The pain or discomfort may spread to the neck and throat, jaw, shoulders, the back, either or both arms, and even into the wrists and hands. This throat discomfort is frequently described as a choking feeling. At times the arms feel ‘heavy’ or ‘useless’. Warning signs vary from person to person and they may not always be sudden or severe. Although chest pain.
About the author: Allen Young is a Heart & Nutrition expert who writes for Free Business Listings Australia