Heart Disease - World Health Day Special

Dateline: 03/29/98

On World Health Day, I thought I'd highlight one of the most important issues that face health care providers all over the world - the deadly problem of Heart Disease.

What is Heart Disease ?

Heart disease isn't a single entity. The heart is a complex organ, made up of chambers with walls and valves, and its own energy supply through coronary arteries. Any portion of the heart may be damaged by illness.

In broad terms, heart disease may be grouped as

• Coronary Artery Disease - heart attacks, angina, bypass surgery, angioplasty and coronary stents would come under this category
• Valvular Heart Disease - includes diseases of the mitral and aortic valves (narrowing or leaks), or pulmonary and tricuspid valves
• Congenital Heart Disease - which comprises birth defects due to disorders in development of the heart
• Heart Muscle Disease - also called cardiomyopathy which results in heart failure requiring surgery

Coronary Artery Disease

This is the most common heart ailment in adults and results from narrowing of the coronary arteries by a disease process called atherosclerosis. It may result in chest pain called angina, or a heart attack. Treatment for coronary artery disease accounts for the largest number of health care dollars spent, and includes procedures like

1. surgery (Coronary Artery Bypass Graft or CABG, where conduits are used to bypass diseased coronary arteries, and Minimally Invasive Coronary Bypass or MIDCAB)
2. catheter based treatment (also called angioplasty, which might include placement of stents inside the coronary).

Valvular Heart Disease

In many developing countries, a disease called rheumatic fever damages the heart valves. In contrast, in the developed nations, heart valves are affected by the aging process (degenerative disease). The aortic valve is often damaged, causing narrowing (stenosis) or leaks. Many different kinds of operations are available to treat aortic stenosis, including valve replacement, homografts and the Ross operation. The mitral valve also may be narrowed by disease, a condition called mitral stenosis.

Congenital Heart Disease

Birth defects of the heart may be simple ones like a hole in the heart (ASD or VSD), or abnormal connections or narrowing of arteries (PDA or Coarctation). More complex ("blue baby") defects might occur, such as Tetralogy of Fallot (ToF) and Transposition of Great Arteries (TGA), which require difficult operations to repair.

Heart Failure

This is the common end pathway of advanced heart disease, and indicates that the heart is weakening and unable to continue its work. Treatment includes medications and operations like cardiomyoplasty, heart transplantation, LVAD and the recent innovation of a Brazilian surgeon, the Batista operation.

How is heart disease detected ?

Doctors use many different kinds of tests to find out if a person suffers from heart disease. These tests include an x-ray, EKG, echocardiogram, catheterization and angiography. More sophisticated tests like stress EKG or exercise testing, CT scans, MRI, Thallium scintigraphy and PET scans might be required sometimes.

How is heart disease treated ?

Some kinds of heart disease can be controlled by medicines and lifestyle modifications. Other kinds require intervention - catheter based or surgical. Operations for heart defects using a heart-lung machine is called Open Heart Surgery.

Can heart disease be prevented ?

In many instances, YES. The focus of most health care programs is now on primary prevention rather than treatment. The old adage "Prevention is better than a cure" was never truer ! Smoking high blood pressure, high serum cholesterol, diabetes and sedentary lifestyles increase risk of heart attacks. To learn more about risk factors for heart disease and preventive methods, you can read the article on this topic.

What other resources on heart disease can you suggest ?

On this website, I have collected a large amount of material that you might find useful.

You can read more on fetal heart surgery, the concept and issues, at the Fetal Heart Surgery Forum site.

For more information on minimally invasive surgery, visit the MICAS website.
And there's a lot more on congenital heart disease at Heart Disease Online.

Let me know:
How did you like this week's article ? Please write to me and let me know.

What's new ?
And if you would like to read more about the latest breaking information on heart disease, visit "The Newsdesk" ... it's brand new, and has a lot more exciting stuff.

Suggested Reading on Heart Disease:
For more information on Congenital Heart Disease, visit the Heart Disease Online site.
And you can buy the latest and best books online at the bookstore. And Order your books right away to avail seasonal discounts.