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What is heart disease?

December 25th, 2013


What is heart disease

This is one of the most frequently asked questions that I have come across, because a lot of people are afraid of heart disease. A lot of people do not even know where the heart actually is. Most believe it is between the lungs, on the left side of the chest. However, it is actually in the middle of the chest, very slightly to the left.

The “heart” can also mean emotions and feelings. They are actually different yet the same. Feelings are heart to control (but you can practice by meditating and keeping a conscious mind). The real heart is tangible, and as with other things in this world, it is not meant to last. The two are closely related.

The heart disease I will talk about in this article is about the physical aspect of the heart, not the emotions that the heart feels. I will divide the diseases into two groups.

- Heart diseases

- Diseases related to the heart

In order to know what the heart diseases are, we should get to know the roles of the heart first. The heart pumps blood out to various organs in the body. To do so, it needs help from many elements in the system.  Pericardium – a thin double-layered sac which encloses the heart.

 Heart muscles are intertwined, making the four chambers that send blood to the organs.

 Four heart valves which stand guard at the entry and exit points of the chambers.

 Three main coronary arteries, where clogging usually occurs, causing chest pain.

 The cardiac electrical system works like batter that controls the heart rate.

Diseases related to the heart include hypertension, diabetes, and high cholesterol level. These conditions affect the heart’s health in some ways. Some do not experience any symptom at the heart, and there might be no problem detected at the heart as well.

Other “diseases” such as weak heart is not about the physical aspect of the heart. However, a weak feeling in the heart could be a sign that something is wrong with it. (Please do not come see me for a heart break. I can’t even figure out how to heal that myself!)

The most common heart diseases can be divided into seven categories.

1. Myocardial infarction caused by insufficient blood supply to the heart muscles. The symptoms are chest pain in the middle, to the side, breathing problems, pain radiating to the jaws, neck, shoulders or arms, sweating, fainting and shaking heart. This disease usually comes in pair with narrowed coronary artery.

2. Congenital heart disease can come in many forms such as ventricular septal defect, valve stenosis (narrowing, not opened well) or regurgitation (leaking), and misplaced blood vessels. These conditions usually occur at birth but may become symptomatic in early childhood, but sometimes they can be found at later age. The symptoms include cyanosis (bluish lips and fingers, etc), shortness of breath, swelling or inability to lie on the back.

3. Rheumatic diseases are caused by inflammation at the heart valves, heart muscles or pericardium. The cause is a type of bacteria that causes inflammation in the throat. It was more common in the past, but now the more commonly causes valve stenosis or regurgitation, causing heart failure. The symptoms include shortness of breath, swelling, inability to lie on the back, or shaking heart.

4. Valve stenosis or regurgitation that is not related to rheumatic heart disease. Some patients have valve stenosis or regurgitation due to the valves’ weakness or infection at the heart valves.

5. Another common type of heart disease is cardiomyopathy (weakening heart muscle), which might be a result of the death of heart  muscle, viral infection or lack of some vitamins. The latter cause is more common in those who drink alcohol. They usually come back with breathing difficulties, swelling and inability of lie flat.

6. Hypertension-related heart disease is common in people with high blood pressure who refuse treatment, thinking they have it under control. We used to believe that blood pressure will be higher as we grow older, but in fact, blood pressure for people of all ages should not exceed 130/85 mmHg. For diabetic people, it should be lower than 120/80 mmHg.

7. Some condition or genetic can cause hypertrophic cardiomyopathy (thickening heart muscle, which in turn causes the heart to function poorly. The thickened heart muscles do not get sufficient blood supply, so the patient might feel tired and tight in the chest when doing activities.

8. The last category is cardiac arrhythmia, which occurs when electrical signals travel an unusual way, causing irregular heartbeat, whether too fast or too slow. The symptoms include shaking heart, dizziness, or fainting. It is even possible to die from this condition.

There are also other types of heart disease, which are less common, such as heart tumor, heart infection or pericardium infection.

For those who have heard of the term “enlarged heart”, you can see that it is not on the list. Enlarged heart needs careful examination, as EKG and X-ray alone won’t suffice. If it is really possible, an ultrasound (or so call echocardiogram) is needed to check in detail whether the heart is enlarged. The heart is enlarged due to some of the diseases. The enlargement itself is not a disease. There usually is a reason behind it.

Heart failure could be caused by any of the diseases above, but heart failure itself is not a disease, only a condition. When the heart overworks and does not get enough rest, heart failure can occur. The symptoms include shortness of breath, inability to lie flat, swelling or pulmonary edema (fluid flooded the lungs).

Now you might know whether you have a heart disease or not.

A patient of mine, about 50 years old, came to see me with a complaint that every time he came home late at night and saw his wife, his heart would shake and he could not breathe well. Sometimes his knees would be wobbly. The blood pressure at that moment would be around 100/70 mmHg. Could you please tell me what heart disease he had, or whether he was just scared of his wife?





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