Heart disease can have many consequences, the major seven are:
- Causes of Heart Diseases
- Cardiac arrest
- Sudden death
- Stable angina
- Acute coronary syndrome(unstable angina)
- Heart attack
- Silent heart disease and silent ischemia
- Heart failure
The rate of heart disease among Indians is two to four times higher than people of other ethnic origin. Heart disease begins in childhood and progresses silently for many decades.
How do we detect it when there are no obvious symptoms ? A tread mill test (TMT) and 2D ECHO is a good screening modality however a negative stress test does not mean you are off the hook.
Advanced coronary disease is relatively easy to detect either through stress test or symptoms like chest pain that disease itself generates. A 50 % block or less severe disease is a greater challenge and has to be further investigated to establish a correct diagnosis.With heart , time is of utmost importance.
Cardiac Arrest
Cardiac arrest is an abrupt loss of heart function in which the heart suddenly stops pumping ,is one of the dreaded complications of heart disease.It can occur unexpectedly with or without heart attack.If the person is not resuscitated immediately it can lead to sudden death within an hour of any symptoms.
If case of arrest we need to call emergency or your Cardiologist immediately.
Sudden Death
The most frightening of all the consequences of heart disease is the prospect of dying suddenly with no warning.For about 30% of people with heart disease sudden death with no chest pain whatsoever is the first and last symptom of heart disease they ever face.The important thing to bear in mind is that heart disease often kills without giving any advance warning symptom at all.That is why aggressive prevention is so important .
Stable Angina
Angina pectoris or simply angina refers to pain or discomfort in the chest that may radiate down your arm or into your jaw and typically lasts 2-15 minutes.Angina occurs when one or more coronary arteries that supply the heart muscle with blood and oxygen becomes severy narrowed through plaque buildup depriving the heart muscle of oxygen rich blood .The result is pain.
It is important not to rely on the onset of angina as the first warning sign to adopt a heart heathy lifestyle.
Not all chest pain is angina .Disease of the lung,stomach,esophagus and chest wall muscle can cause chest pain.Cardiologist use the presence and absence of risk factors to differentiate cardiac chest pain from non-cardiac.
It is nevertheless better to be over-cautious than under cautious ,and take all chest pain seriously.
Unstable Angina
Unstable anginal pain is caused by partially blocked coronary arteries but is more severe and occur at random and without warning often while resting.It lasts longer than stable angina ,is less responsive to medication and happens more often.Unstable angina usually advances to a heart attack unless the person receives adequate treatment.Unlike a full blown heart attack ,however blood tests after unstable angina typically show no evidence of actual heart muscle damage .Ocassionally a coronary spasm can also lead to unstable angina.This needs to be differentiated by blood tests and ECG tracings.
Heart Attack(Myocardial infarction)
Myocardial infarction or MI occurs when one of the coronary arteries that supply the heart muscle with blood and oxygen becomes completely blocked with a blood clot,usually one that formed after the rupture of a soft ,fatty plaque.Pain of a heart attack lasts more than 15 minutes and does not go away with rest .Immediate treatment like a rescue PAMI can minimise a heart muscle damage.
Heart Failure
The term heart failure can be misleading : it does not mean your heart has stopped . It means it can no longer pump effectively.It has varying degrees of severity. Hear failure may result from several things : a large heart attack,several minor and often unrecognised heart attacks or other causes like high blood pressure, obesity,diabetes and viral infection.Hear failure develops gradually over years.
The most common symptoms of heart failure are shortness of breath ,swollen feet and legs, a build of fluids in lungs and fatigue.It is one of the most common cause of hospitalisation in elderly patients and is a recurring medical expense.Fortunately ,heart failure is often a treatable and thus reversible condition.
Silent Heart Disease and Silent Ischemia
A heart attack can be silent or painless but the underlying heart disease usually progresses silently for several decades.You may have a severe heart disease that is depriving your heart muscle of oxygen, yet experience few or no symptoms.This is called silent ischemia.The risk of having a heart attack when you have silent ischemia is as high as when you have symptoms of angina.
Silent ischemia can be detected by ECG, 24 hour ECG called holter monitor or aTMT whatever the Cardiologist decides based on your symptoms