What are the risk factors for non-coronary heart disease?
There are many processes that can lead to heart disease not associated with coronary disease or atherosclerosis, just as the same processes can cause disease in other organs. For example, trauma is such a cause. If we're in an auto accident, and we run our chest up against the steering wheel, the trauma of that; the actual physical force against the hardened blood vessels as they sort of swing forward and hit our chest wall, can actually damage the heart. It can particularly damage the great vessels. People recognise, for example, that Princess Diana died because blood vessels were torn in her chest when she was in an auto accident. This is a very common cause of death in people who die at the scene in an auto accident. Likewise, the process of infection can affect the heart. For example, intravenous drug users will often get an infection of the bloodstream. That infection can actually affect the valves of the heart, and can destroy the tissue of those valves, so that the valves leak, and that's a kind of heart disease. One can have inflammatory processes; inflammatory diseases that affect the heart. For example, lupus, systemic lupus erythematosus, is an inflammatory process and it can affect heart valves so that they leak. So, there are a whole series of processes that can affect the heart; infection with viruses, infection with bacteria, and trauma that can cause problems for the heart muscle. In that case we call that a cardiomyopathy, where the heart muscle doesn't pump and function so well. If we have inflammation of the pericardium, the sac around the heart, we have pericarditis, a painful process that fits into the category of these cardiovascular and heart diseases that are not caused by coronary artery disease and not necessarily related to it. Some processes are actually associated with other diseases or other risk factors. Hypertension, for example, which causes the heart to have to work harder, to pump against that higher pressure, will actually lead to the heart muscle getting thicker; just as when we exercise a muscle by lifting weights, we can exercise the heart and have it get thicker. That's not necessarily so good for the heart; if the heart muscle becomes thick, it becomes hard to fill the heart with blood so that it can pump it out, and that can cause a kind of heart failure. Diabetes, likewise, can affect the tissues of the heart so that the heart is stiffer than it normally would be, also leading to a kind of heart failure called diastolic dysfunction or diastolic heart failure.
