Heart Disease, also known as Coronary Artery Disease (CAD) or Cardiovascular Disease, is a condition that involves the narrowing or blocking of the coronary arteries. When fatty substances and calcium, called plaque, build up in the coronary arteries the flow rate of blood to the heart muscle starts to slow down, and coronary artery disease begins. If this build up continues, blood flow to the heart muscle is severely decreased, and less oxygen is brought to the heart. This lack of oxygen to the heart muscle may cause chest pain (angina pectoris). A heart attack (myocardial infarction) may occur if the blood flow is completely blocked by a blood clot in the narrowed artery.
Heart attack signs or symptoms may include*:
- Chest Discomfort: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath: May occur with or without chest discomfort.
- Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness.
*Signs and symptoms compiled from the National Heart Lung and Blood Institute.
Although chest pain is the most common symptom of a man's heart attack, women often experience vague chest discomfort frequently described as pressure, burning, tightness or an ache.
Additional heart attack signs or symptoms common in women may include:
- Heart palpitations or abnormally weak and/or rapid pulse.
- sick stomach
- Gray facial color
- Shoulder blade pain
- Change in migraine pattern, migraine with aura
If you or someone you're with has chest discomfort, especially with one or more of the other signs, call 9-1-1 right away.
Designated Cardiac Receiving Centers
Long Beach Memorial, Orange Coast Memorial and Saddleback Memorial emergency departments are designated cardiac receiving centers (ST Elevation Myocardial Infarction (STEMI) Center). Individuals experiencing heart attack symptoms will be taken by emergency medical response teams to a STEMI Center. STEMI Centers provide cardiac expertise 24-hours-a-day, seven days-a-week.
Risk Factors & Prevention
There are certain risk factors that cannot change, such as heredity, ethnicity and age. However, many risk factors can be changed to lower the overall risk of coronary artery disease.
Risk Factors That Can Be Changed
If your diet is high in saturated fat or cholesterol (a waxy, fatlike substance) your blood cholesterol increases. Overall cholesterol risk is best determined by looking at both LDL (“bad” cholesterol) and HDL (“good” cholesterol). Total cholesterol should be less than 200, LDL less than 130 and HDL greater than 45. Studies show that a higher percentage of women than men have a total cholesterol greater than 200 beginning at age 50. A 10 percent decrease in total cholesterol may result in a 30 percent decrease in cardiovascular disease.
Ways to improve your blood cholesterol and decrease your risk are:
- Achieve and maintain a healthy weight
- Limit animal and saturated fat intake
- Avoid high-cholesterol foods
- Eat high-fiber foods
- Get regular aerobic exercise
- Stop smoking
Numerous studies have shown that cigarette smoking increases the risk of coronary artery disease. It robs your heart of oxygen, damages your blood vessels, increases your blood pressure as well as your “bad” cholesterol, and can increase the likelihood of blood clots. According to the World Health Organization, one year after quitting, the risk of coronary artery disease decreases by 50 percent. Within 15 years, the risk of dying from heart disease is the same as a non-smoker.
Some helpful hints: Take a smoking cessation class
High Blood Pressure
High blood pressure (or hypertension) puts strain on your heart by increasing its workload. It also injures the lining of the arteries. People that are less active and less fit have a 30–50 percent greater risk of developing high blood pressure. There are two pressures measured when your blood pressure is taken. The top number represents the pressure in your arteries when your heart squeezes blood out to the body. The bottom number represents the pressure that is in your arteries when your heart is at rest. A pressure of less than 120/80 is recommended. Pressures above 120/80 increase your risk for prehypertension and cardiovascular disease, and you may need medical attention.
For a healthy blood pressure:
- Achieve and maintain a healthy weight.
- Get regular, moderate physical activity.
- Eat foods low in fat, high in fiber, and with adequate calcium and potassium.
- Limit alcohol intake as it can increase blood pressure.
- STOP SMOKING!!
- Keep stress moderate.
- Get adequate sleep (7–8 hours a night) and take relaxation breaks.
Lack of Exercise
Physical activity is protective to your heart and circulation. Regular aerobic activity improves the way the body uses nutrients, raises “good” cholesterol levels, lowers blood pressure, and helps control or prevent excess weight. Regular exercise also improves the way blood sugar and insulin act in your body and strengthens the heart muscle.
Maintain a regular exercise routine:
- Check with a health care professional before starting an exercise program.
- Aerobic activity—like walking, hiking, swimming or riding a bike—should be done for 30 minutes or more, most days of the week.
- Begin at a slow, steady pace to warm up and cool down the same way.
A fasting blood glucose (sugar) level of 100 or more may indicate a glucose tolerance problem, increasing your risk of diabetes. With diabetics, the risk of coronary artery disease is three to five times greater than in a non-diabetic.
Ways to lessen the effect diabetes has on heart disease:
- If you are diabetic, monitor and maintain your blood sugar within a normal range. Monitor your carbohydrate intake and manage your diet accordingly. Take medication as directed and avoid wide swings in your blood sugar.
- Achieve and maintain a healthy weight.
- Regular, aerobic exercise 30 minutes or more most days of the week.
Being overweight puts extra demands on your circulation, making the heart work harder. Excess body fat increases the risk for high blood pressure, high cholesterol and diabetes. Achieving a Body Mass Index (BMI) of less than 25.0 is desired. A BMI of 25.0 or greater is overweight and a BMI greater than 30.0 is obese.
Ways to achieve and maintain a healthy weight:
- Eat healthy portions of low-fat foods, avoiding late night snacks.
- Be active. Exercise at least 30 minutes most days of the week.
- Calculate Your BMI
Too much stress can strain the heart by making it pump harder and beat faster. Learning to listen to your body, identifying when tension “takes over” and stepping back to ease that stress can bring the numbers back to the normal range and allow you to be back in control.
There are actions that can help:
- Learn to relax. Favorite kinds of exercise can be a perfect way to release tension.
- Try deep, slow breathing when you feel the tension building.
- Keep your sense of humor! Being able to laugh at the world around you and at yourself is a wonderful and healthy ability.
Before menopause, women have a lower incidence of coronary events than men. After menopause, risks are similar in both groups. It was thought that post-menopausal hormone replacement therapy (HRT) would produce a reduced risk of coronary disease. However, in 2002, data from a major study showed an early increase in risk in women with pre-existing coronary disease. It currently remains unclear if HRT protects the heart. You should discuss this with your physician.
Risk Factors You Can Not Change
A history of heart disease in your father or brother aged 55 or younger or in your mother or sister aged 65 or younger increases your risk of developing coronary disease 1.3 to 1.6 times.
The risk of coronary disease increases with age. If you have a parent or brother or sister who has been diagnosed with cardiovascular disease before age 55, you are at greater risk for developing coronary artery disease at an earlier age. From age 35–54 the prevalence of cardiovascular disease is slightly greater in men, but from age 65 on men and women are equally affected. Surveys show that most women are more afraid of breast cancer than of heart disease even though 1 in 30 deaths are from breast cancer and 1 in 2.4 deaths for women are from cardiac disease.
The prevalence of cardiovascular disease in adults is highest in non-Hispanic African Americans, afflicting 40.5 percent of men and 39.6 percent of women. Thirty percent of non-Hispanic white men have cardiovascular disease as do 23.8 percent of non-Hispanic white women. The prevalence is lowest in Hispanics, 28.8 percent of men and 26.6 percent of women. There is not much that can be done to change your family, age and ethnic risk factors. However, there are other factors that are within your power to change.
- Ambulatory Blood Pressure Monitoring (ABPM)
- Cardiac Catheterization
- Cardiac Computed Tomography (Cardiac CT Scan)
- Cardiac Magnetic Resonance Imaging (Cardiac MRI)
- Cardiac Nuclear Study
- Computed Tomography Angiography (CTA)
- Coronary Angiography
- Digital Echocardiography
- Holter Monitoring
- Optical Coherence Tomography
- Stress Test