What Exactly Do I Need to Know about Heart Disease?

The most important thing to know about heart disease is that it is preventable. But, in order to prevent it, you must know the facts. Since it’s such a huge subject, what exactly do you need to know? 3 main things: 1) what puts you at risk for having it; 2) what symptoms to look for that may tell you that you have it; and 3) what you can you do to prevent it AND what you must do if you have the symptoms.

What Exactly Is “Heart Disease” Anyway?

Let’s talk about what we really mean when we say “heart disease.” There are several types of heart disease that one may get. These include: disease of the arteries that feed, or supply, the heart with the life-giving blood that has oxygen in it, known as coronary artery disease (CAD) or coronary heart disease (CHD); disease of the conduction system of the heart that keeps the heart beating at a regular rate and rhythm; diseases of the muscle of the heart, known as cardiomyopathy and myocarditis ; and disease of the valves and the inner lining of the heart, one of which is known as endocarditis.

By convention, whenever the term “heart disease” is used, it is referring to disease of the arteries of the heart, or CHD, which is far more common than the other types of heart disease.  Therefore, here we are only going to be talking about CHD. Stroke is mentioned because its cause is identical to that of CHD. What happens in a stroke is that the arteries feeding the brain with oxygenated blood are diseased, just like the arteries feeding the heart in CHD. Therefore, it makes sense that the risk factors that can lead to heart disease can also lead to stroke.

What Exactly are “Risk Factors?” What are the risk factors for CHD and stroke

A risk factor is exactly as it sounds: it is something that makes it more likely that you will get a disease or, that puts you at risk for getting it. Put another way, you are less likely to get a certain disease if you do not have the risk factors for it.

Unfortunately, we all become more at risk for heart disease as each year passes because one of the risk factors is increasing age. This is obviously a risk factor that you cannot change. The other risk factors that cannot be changed include: race, heredity, or having a family history of heart disease, and having already had a heart attack or stroke.

Having one or more of these risk factors that you cannot change does not automatically mean that you are definitely going to get heart disease, or have a heart attack or stroke. The risk goes up with the more risk factors you have. So, even though you cannot change this group of risk factors, you can still do something to help prevent CHD or stroke. And, what is that? You can make sure that you do not have any of the risk factors that can be changed as described below, or if you do have them, you are keeping them under control.

The risk factors for CHD and stroke that can be changed include: having high blood pressure; having high cholesterol levels; having diabetes; smoking cigarettes; being overweight and/or having your waistline be too large; being sedentary, or not being physically active; being depressed or stressed for long periods of time; being on hormone replacement therapy for too long.

How you can change these is obvious: keep your blood pressure, cholesterol, and diabetes under control; stop smoking; maintain a normal weight for your height, and a normal waistline measurement; do regular physical exercise; seek help for your depression and try to cut down on your stress levels; and discuss with your doctor whether you should or should not be on hormone therapy.

All of the above are also risk factors for having a stroke as well. However, there is an additional risk factor for stroke alone: an arrhythmia of the heart known as atrial fibrillation. With this problem, the heart beats way too fast and irregularly.

How Do I Even Know if I have Risk Factors?

The answer to that question is obvious with some of the risk factors: you obviously know if you smoke or used to smoke, if you are physically active, if you have gained weight or are very overweight, or are feeling stressed or depressed. You need to find out as much about your family history as possible.

Equally as important is getting a complete physical examination by your primary care provider, even if you are feeling fine. This will include a full evaluation of all your organ systems. With reference to your cardiac risk factors, it will include: checking your weight, height, and waist measurement, as well as your blood pressure, a heart examination, an EKG, and full panel of bloodwork including a fasting blood sugar and fasting cholesterol (lipid) levels. If an abnormality in your pulse (heartrate) is found on exam, the EKG will also include a longer strip just to look at your heart rhythm, especially to see if you atrial fibrillation.

If you have a family history of heart disease, other of the risk factors, symptoms, or are in midlife, your clinician will want to have you do a test of the heart when you are exercising, called an exercise stress test, and will probably want to do the type of stress test that involves taking pictures of the heart as well – called either a stress echo or a thallium stress test.

Paying attention to ourselves- our family histories and your risk factors – is a must now that we’ve reached midlife. Next, we’ll talk about the symptoms of heart disease.