Serious Heart Conditions Explained
What is "heart failure"?
Heart failure occurs whenever the heart can't pump enough blood to meet the needs of the body. That can happen for many reasons. It can happen because the heart muscle is weak. That could be caused by heart attacks or infection of the heart with a virus, a cardiomyopathy, a heart muscle problem. It can be caused by heart valves leaking. It can be caused by heart rhythm problems. But in any case, not sufficient blood can be pumped forward to cover the needs of the body. Initially, you see that lack when you try to do something that is more strenuous. You may be quite comfortable at rest, but be short of rest or unduly fatigued when you try to exercise or do some physical activity. If the inability of the heart remains present, then the kidneys think that there is not enough fluid in the system, and they tend to retain fluid. People will notice those symptoms as swelling of the ankles or shortness of breath when they lie down, and fluid in the body moves up toward the chest. So heart failure can be caused by multiple different processes, but the symptoms will be the same: shortness of breath, easy fatigue, ankle swelling, and particularly shortness of breath sometimes signaled by coughing when people first lie down.
What is a "cardiac arrest"?
A cardiac arrest occurs when the heart rhythm changes in a way that makes the heart ineffective at pumping blood. The rhythm can be something like ventricular fibrillation. That's a common rhythm in cardiac arrest. A cardiac arrest can be caused by ventricular tachycardia in some circumstances. Sometimes the heart actually does pause or arrest or have a very slow heart rhythm in a cardiac arrest. And sometimes during cardiac arrest the heart, even if the rhythm is OK, is unable to pump effectively as in a massive heart attack, for example.
What is a "stroke"?
A stroke occurs when there is insufficient blood supply to a part of the brain, and that part of the brain is unable to function. You can have strokes for two main reasons. The first has to do with having Atherosclerosis - hardening of the arteries - in the neck, in the blood vessels supplying the brain, and having a clot from that area break off and go and block a blood vessel supplying the actual brain tissue. The second is having a blood vessel in the brain leak, and actually have a hemorrhage or a bleed into or around the tissue of the brain. And in either case - either because the bleeding compresses an area of the brain, or, in the case of a clot, because you don't get blood supply to the brain - that part of the brain ceases to function. Remember, stroke is an emergency, and if you see any of those signs you should call 911.
What are the common signs of a stroke?
The signs of a stroke that you will see are either that the person suffering the stroke is unable to use or has numbness in some part of the body, a hand, an arm, a leg or face, particularly if it is all on the same side. If those symptoms are there, that's very important. Second symptom of a stroke is if they have confusion and are unable to speak or understand clearly. Third symptom of a stroke, if they are unable to see well out of either one eye, or in one area, or if they have difficulty with balance or coordination. And the last sign of a stroke is a patient telling you that they have a terrible and unexplained headache, one for which there is no known cause.
What is "angina"?
Angina (the full name is Angina Pectoris) really means pain in the chest. Doctors use the term angina particularly to mean the kind of pain in the chest that you have when you have coronary artery disease. Patients describe angina to us as a tightness, pressure or heaviness in the chest. They actually don't usually describe angina as pain. But that uncomfortable feeling of angina in the chest when it's caused by coronary artery disease occurs at times when the heart needs more blood flow than it can get through narrowed arteries. So when you exercise or do some physical activity and the heart needs more blood flow but the arteries can't expand because they have plaque in them, then the angina sensation that you get is an uncomfortable tight pressure sensation in the chest. Angina goes away (generally speaking) as soon as you stop, rest and relax and the heart needs less blood flow.
What is a "coronary spasm" or "Prinzmetal's angina"?
Coronary spasm, or Prinzmetal's angina, is a little different from conventional angina. It's also caused by a lack of blood flow to the heart muscle, but it occurs at times when the person is not necessarily exercising, or doing anything very strenuous or energetic, or even anything emotionally energetic. It can occur at rest, it can awaken people from sleep, and it just seems to come on without any warning. It feels just the same as regular angina; it's still a pressure, a tightness, a heaviness, and sometimes pain in the chest. It can last for minutes; it generally doesn't last longer than fifteen or twenty minutes, and generally it lasts one or two minutes, going away as quickly and as mysteriously as it came. When patients who have that symptom are looked at, they often will have a little atherosclerosis, which is a little hardening of the arteries; a little in the way of cholesterol deposits. However, they will often have nothing severe enough to seem to be the cause of angina. Therefore it's often a diagnosis that's difficult to make. Generally speaking, the best way to make a diagnosis is to wear a tape recorder of your electrocardiogram over a twenty-four or forty-eight hour period, sometimes even longer, so that an episode can actually be captured. Clearly an episode that only last two or fifteen minutes isn't long enough to get to the doctor's office and have an EKG recorded.
What is "atherosclerosis"?
"Atherosclerosis" is a process in arteries that we refer to by a number of names. We call it hardening of the arteries or cholesterol deposits or blockages in arteries. What happens is the arteries are affected by a number of different kinds of things. So they can be affected actually by some physical damage, by physical stress as in patients who have high blood pressure or hypertension. They can be affected by disorders like diabetes which affects how the blood vessels function. They can be affected by the amount of cholesterol in our diet, in our bloodstream. And in all of these circumstances, there is an abnormality in the blood vessel that develops into blockages.
What is a "heart attack" or "myocardial infarction"?
A heart attack, or a myocardial infarction, occurs when one of the coronary arteries is blocked. It can be partially blocked or completely blocked. Depending on where in the artery it's blocked, the amount of heart muscle that's affected is determined. If a tiny branch is blocked, just a small amount of heart muscle will be affected. If the artery is blocked right near the beginning, you can have a lot of heart muscle affected, making it very hard for the heart to pump effectively. This is the part of the heart muscle, the ventricle, that actually pumps blood out throughout the body. If the artery is blocked and stays blocked, then all of the muscle that it supplies will die and scar, unless there's blood supply from some other artery; sometimes there are connections.