Friday 26 March 2010

Heart Diseases- Types

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III. Types of Heart Diseases

The heart is a four chambered, hollow muscle and double acting pump that is located in the chest between the lungs. Heart diseases caused by high blood pressure contributes to hardening of the arteries. High levels of bad cholesterol (LDL) build up in the arteries as a result of uncontrolled diet with high levels of saturated fat and trans fat. All these add to the formation of atherosclerosis lesions and eventually arterial blockage.
There are some major types of heart diseases:

1. Type of heart disease affecting heart chambers

As we mention in the previous article, the heart is a four chambered hollow muscle and double acting pump that is located in the chest between the lungs. Heart diseases caused by high blood pressure contributes to hardening of the arteries. High levels of bad cholesterol (LDL) build up in the arteries as a result of uncontrolled diet with high levels of saturated fat and trans fat. All these add to the formation of atherosclerosis lesions and eventually arterial blockage.
In this article, we will discuss heart disease affecting the heart chambers.

Heart failure is caused by the heart not pumping as much blood as it should and so the body does not get as much blood and oxygen that it needs. The malfunctioning of the heart chambers are due to damage caused by narrowed or blocked arteries leading to the muscle of your heart.

There are 4 heart chambers as follow:

* The right atrium
* The left atrium
* The right ventricle
* The left ventricle.

Heart diseases affect the heart chambers include:

A. Congestive heart failure

Heart failure is caused by the heart not pumping as much blood as it should and so the body does not get as much blood and oxygen that it needs. The malfunctioning of the heart chambers are due to damage caused by narrowed or blocked arteries leading to the muscle of your heart.

a) Diastolic dysfunction:

The contraction function is normal but there's impaired relaxation of the heart, impairing its ability to fill with blood causing the blood returning to the heart to accumulate in the lungs or veins.

b) Systolic dysfunction:

The relaxing function is normal but there's impaired contraction of the heart causing the heart to not pump out as much blood that is returned to it as it normally does as a result of more blood remaining in the lower chambers of the heart.


B. Pulmonary heart disease

Pulmonary heart disease is caused by an enlarged right ventricle. It is known as heart disease resulting from a lung disorder where the blood flowing into the lungs is slowed or blocked causing increased lung pressure. The right side of the heart has to pump harder to push against the increased pressure and this can lead to enlargement of the right ventricle.


2. Heart Disease affecting heart muscles

In the case of heart diseases affecting heart muscles, the heart muscles are stiff, increasing the amount of pressure required to expand for blood to flow into the heart or the narrowing of the passage as a result of obstructing blood flow out of the heart.
Heart diseases affecting heart muscles include:

1. Cardiomyopathy

Heart muscle becomes inflamed and doesn't work as well as it should. There may be multiple causes such as high blood pressure, heart valve disease, artery diseases or congenital heart defects.

a) Dilated cardiomyopathy

The heart cavity is enlarged and stretched. Blood flows more slowly through an enlarged heart, causing formation of blood clots as a result of clots sticking to the inner lining of the heart, breaking off the right ventricle into the pulmonary circulation in the lung or being dislodged and carried into the body's circulation to form emboli .

b) Hypertrophic cardiomyopathy

The wall between the two ventricles becomes enlarged, obstructing the blood flow from the left ventricle. Sometimes the thickened wall distorts one leaflet of the mitral valve, causing it to leak. The symptoms of hypertrophic cardiomyopathy include shortness of breath, dizziness, fainting and angina pectoris.

c) Restrictive cardiomyopathy

The ventricles becomes excessively rigid, so it's harder for the ventricles to fill with blood between heartbeats. The symptoms of restrictive cardiomyopathy include shortness of breath, swollen hands and feet.

2. Myocarditis

Myocarditis is an inflammation of the heart muscles or the weaken of the heart muscles. The symptoms of myocarditis include fever, chest pains, congestive heart failure and palpitation.

3. Heart disease affecting heart valves

Heart diseases affecting heart valves occur when the mitral valve in the heart narrows, causing the heart to work harder to pump blood from the left atrium into the ventricle.

Here are some types of heart disease affecting heart valves:

1. Mitral Stenosis

Mitral Stenosis is a heart valve disorder that involves a narrowing or blockage of the opening of the mitral valve causing the volume and pressure of blood in the left atrium increases.

2. Mitral valves regurgitation

Mitral regurgitation is the heart disease in which your heart's mitral valve doesn't close tightly causing the blood to be unable to move through the heart efficiently. Symptoms of mitral valve regurgitation are fatigue and shortness of breath.

3. Mitral valves prolapse

In mitral valve prolapse, one or both leaflets of the valve are too large resulting in uneven closure of the valve during each heartbeat. Symptoms of mitral valves prolapse are palpitation, shortness of breath, dizzy, fatigue and chest pains.

4. Aortic Stenosis

With aging, protein collagen of the valve leaflets are destroyed and calcium is deposited on the leaflets causing scarring, thickening, and stenosis of the valve therefore increasing the wear and tear on the valve leaflets resulting in the symptoms and heart problems of aortic stenosis.

5. Aortic regurgitation

Aortic regurgitation is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. Symptoms of aortic regurgitation include fatigue or weakness, shortness of breath, chest pain, palpitation and irregular heart beats.

6. Tricuspid stenosis

Tricuspid stenosis is the narrowing of the orifice of the tricuspid valve of the heart causing increased resistance to blood flow through the valve. Symptoms of tricuspid stenosis include fatigue, enlarged liver, abdominal swelling, neck discomfort and leg and ankle swelling.

7. Tricuspid regurgitation

Tricuspid regurgitation is the failure of the right ventricular causing blood to leak back through the tricuspid valve from the right ventricle into the right atrium of the heart. Symptoms of tricuspid regurgitation include leg and ankle swelling and swelling in the abdomen.

4. Heart disease affecting coronary arteries and coronary veins

Heart disease affecting coronary arteries and coronary veins:

The malfunctioning of the heart may be due to damage caused by narrowed or blocked arteries leading to the muscle of your heart as well as blood backing up in the veins. Types of heart disease that affect the coronary arteries and veins include:

A. Angina pectoris

Angina pectoris occurs when the heart muscle doesn't get as much blood oxygen as it needs. Here are 3 types of angina pectoris:

a) Stable angina

Stable angina is chest pain or discomfort that typically occurs with activity or stress due to oxygen deficiency in the blood muscles and usually follows a predictable pattern. Symptom of stable angina include chest pain, tightness, pressure, indigestion feeling and pain in the upper neck and arm.

b) Unstable angina

Unstable angina is caused by blockage of the blood flow to the heart. Without blood and the oxygen, part of the heart starts to die. Symptoms of unstable angina include pain spread down the left shoulder and arm to the back, jaw, neck, or right arm, discomfort of chest and chest pressure.

c) Variant angina also known as coronary artery spasm

Caused by the narrowing of the coronary arteries. This is caused by the contraction of the smooth muscle tissue in the vessel walls. Symptoms of variant angina include increasing of heart rate, pressure and chest pain.

B. Heart attacks known as myocardial infarction or MI

Heart attacks caused by plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium. Symptoms of MI include a squeezing sensation of the chest, sweating, nausea and vomiting, upper back pain and arm pain.

C. Heart disease also known as coronary artery disease or coronary heart disease
Caused by arteries hardening and narrowing, cutting off blood flow to the heart muscle and resulting in heart attack. Symptoms of heart disease include shortness of breath, chest pains on exertion, palpitation, dizziness and fainting.

D. Atherosclerosis or hardening of arteries

Arteries are blood vessels that carry oxygen-rich blood to your heart and to other parts of your body. Atherosclerosis is caused by plaques that rupture in result of blood clots that block blood flow or break off and travel to another part of the body. Atherosclerosis has no symptom or warning sign.

E. Silent ischemia

Ischemia is a condition in which the blood flow is restricted to a part of the body caused by narrowing of heart arteries. Silent ischemia means people have ischemia without pain. There is also no warning sign before heart attack.

5. Heart disease affecting heart lining

Rheumatic heart disease results from inflammation of the heart lining when too much fluid builds up in the lungs leading to pulmonary congestion. It is due to failure of the heart to remove fluid from the lung circulation resulting in shortness of breath, coughing up blood, pale skin and excessive sweating. Heart disease resulting from inflammation of either the endocardium or pericardium is called heart disease affecting heart lining.

Endocardium is the inner layer of the heart. It consists of epithelial tissue and connective tissue. Pericardium is the fluid filled sac that surrounds the heart and the proximal ends of the aorta, vena vava and the pulmonary artery.

1. Endocarditis

Endocarditis, which is an inflammation of the endocardium is caused by bacteria entering the bloodstream and settling on the inside of the heart, usually on the heart valves that consists of epithelial tissue and connective tissue. It is the most common heart disease in people who have a damaged, diseased, or artificial heart valve. Symptoms of endocarditis include fever, chilling, fatigue, aching joint muscles, night sweats, shortness of breath, change in temperature and a persistent cough.


2. Pericardium

Pericarditis is the inflammation of the pericardium. It is caused by infection of the pericardium which is the thin, tough bag-like membrane surrounding the heart. The pericardium also prevents the heart from over expanding when blood volume increases. Symptoms of pericarditis include chest pain, mild fever, weakness, fatigue, coughing, hiccups, and muscle aches.


6. Heart disease affecting electrical system

The electrical system within the heart is responsible for ensuring the heart beats correctly so that blood can be transported to the cells throughout our body. Any malfunction of the electrical system in the heart causes a fast, slow, or irregular heartbeat. The electrical system within the heart is responsible for ensuring that the heart beats correctly so that blood can be transported throughout our the body. Any malfunction of the electrical system in the heart malfunction can cause a fast, slow, or irregular heartbeat.

Types of heart disease that affect the electrical system are known as arrhythmias. They can cause the heart to beat too fast, too slow, or irregularly. These types of heart disease include:

a. Sinus tachycardia

Sinus tachycardia occurs when the sinus rhythm is faster than 100 beats per minute therefore it increases myocardial oxygen demand and reduces coronary blood flow, thus precipitating an ischemia heart or valvular disease.

b. Sinus bradycardia

Sinus bradycardia occurs when a decrease of cardiac output results in regular but unusually slow heart beat less than 60 beats per minute. Symptoms of sinus bradycardia includes a feeling of weightlessness of the head, dizziness, low blood pressure, vertigo, and syncope.

c. Atrial fibrillation

Atrial fibrillation is an irregular heart rhythm that starts in the upper parts (atria) of the heart causing irregular beating between the atria and the lower parts (ventricles) of the heart. The lower parts may beat fast and without a regular rhythm. Symptoms of atrial fibrillation include dizziness, light-headedness, shortness of breath, chest pain and irregular heart beat.

d. Atrial flutter

Atrial flutter is an abnormal heart rhythm that occurs in the atria of the heart causing abnormalities and diseases of the heart. Symptoms of atrial flutter includes shortness of breath, chest pains, anxiety and palpitation.

e. Supraventricular tachycardia

Supraventricular tachycardia is described as rapid heart rate originating above the ventricles, or lower chambers of the heart causing a rapid pulse of 140-250 beats per minute. Symptoms of supraventricular tachycardia include palpitations, light-headedness, and chest pains.

f. Paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia is described as an occasional rapid heart rate. Symptoms can come on suddenly and may go away without treatment. They can last a few minutes or 1-2 days.

g. Ventricular tachycardia

Ventricular tachycardia is described as a fast heart rhythm that originates in one of the ventricles of the heart . This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation and/or sudden death. Symptoms of ventricular tachycardia include light headedness, dizziness, fainting, shortness of breath and chest pains.

h.Ventricular fibrillation

Ventricular fibrillation is a condition in which the heart's electrical activity becomes disordered causing the heart's lower chambers to contract in a rapid, unsynchronized way resulting in little heart pumps or no blood at all, resulting in death if left untreated after in 5 minutes.

There are many heart diseases affecting electrical system such as premature arterial contractions, wolf parkinson, etc.

7. Congenital heart disease

There are several heart diseases that people are born with. Congenital heart diseases are caused by a persistence in the fetal connection between arterial and venous circulation. Congenital heart diseases affect any part of the heart such as heart muscle, valves, and blood vessels. Congenital heart disease refers to a problem with the heart's structure and function due to abnormal heart development before birth.Every year over 30,000 babies are born with some type of congenital heart defect in US alone. Congenital heart disease is responsible for more deaths in the first year of life than any other birth defects. Some congenital heart diseases can be treated with medication alone, while others require one or more surgeries.
The causes of congenital heart diseases of newborns at birth may be in result from poorly controlled blood sugar levels in women having diabetes during pregnancy, some hereditary factors that play a role in congenital heart disease, excessive intake of alcohol and side affects of some drugs during pregnancy.

Congenital heart disease is often divided into two types: cyanotic which is caused by a lack of oxygen and non-cyanotic.

A. Cyanotic

Cyanosis is a blue coloration of the skin due to a lack of oxygen generated in blood vessels near the skin surface. It occurs when the oxygen level in the arterial blood falls below 85-90%.

The below lists are the most common of cyanotic congenital heart diseases:

a)Tetralogy of fallot

Tetralogy of fallot is a condition of several congenital defects that occur when the heart does not develop normally. It is the most common cynaotic heart defect and a common cause of blue baby syndrome.

b)Transportation of the great vessels

Transportation of the great vessels is the most common cyanotic congenital heart disease. Transposition of the great vessels is a congenital heart defect in which the 2 major vessels that carry blood away from the aorta and the pulmonary artery of the heart are switched. Symptoms of transportation of the great vessels include blueness of the skin, shortness of breath and poor feeding.

c)Tricuspid atresia

In tricuspid atresia there is no tricuspid valve so no blood can flow from the right atrium to the right ventricle. Symptoms of tricuspid atresia include blue tinge to the skin and lips, shortness of breath, slow growth and poor feeding.

d)Total anomalous pulmonary venous return

Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect that causes cyanosis or blueness. Symptoms of total anomalous pulmonary venous return include poor feeding, poor growth, respiratory infections and blue skin.

e)Truncus arteriosus

Truncus arteriosus is characterized by a large ventricular septal defect over which a large, single great vessel arises. Symptoms of truncus arteriosus include blue coloring of the skin, poor feeding, poor growth and shortness of breath.
There are many more types of cyanotic such as ebstein's anomaly, hypoplastic right heart, and hypoplastic left heart. If you need more information please consult with your doctor.


B. Non-cyanotic

Non-cyanotic heart defects are more common because of higher survival rates.
The below lists are the most common of non-cyanotic congenital heart diseases:
a)Ventricular septal defect
Ventricular septal defect is a hole in the wall between the right and left ventricles of the heart causing right and left ventricles to work harder, pumping a greater volume of blood than they normally would in result of failure of the left ventricle. Symptoms of ventricular septal defect include very fast heartbeats, sweating, poor feeding, poor weight gain and pallor.

b)Atrial septal defect

Atrial septal defect is a hole in the wall between the two upper chambers of your heart causing freshly oxygenated blood to flow from the left upper chamber of the heart into the right upper chamber of the heart. Symptoms of atrial septal defect include shortness of breath, fatigue and heart palpitations or skipped beats.

c)Coarctation of aorta

Coarctation of aorta is a narrowing of the aorta between the upper-body artery branches and the branches to the lower body causing your heart to pump harder to force blood through the narrow part of your aorta. Symptoms of coarctation of aorta include pale skin, shortness of breath and heavy sweating.

There are many more types of non-cyanotic such as pulmonic stenosis, patent ductus arteriorus, and atrioventricular cana. These problems may occur alone or together. Most congenital heart diseases occur as an isolated defect and is not associated with other diseases.


8. OtherTypes of Heart Diseases

In this article, we will discuss other types of heart diseases that can affect any part of the heart including the following:

*A cardiac tumor can be either malignant or benign

A) Benign tumors

a. Myxoma

Myxoma is a cardiac benign tumor. It is the most common tumor inside of cavities of the heart and most of them occur in the left atrium of the heart obstructing the normal flow of blood within the chambers of the heart. Symptoms of Myxoma include paroxysmal dyspnea, weight loss, feverhemoptysis, lightheadedness and sudden death.

b. Rhabdomyomas

Most of rhabdomyomas occur in children or infants and are associated with tuberous sclerosis. It develops in the myocardium or the endocardium and accounts for about one out of every five tumors that originate in the heart causing obstruction of blood flow, valvular insufficiency, and cardiac arrhythmias. Symptoms of rhabdomyomas include palpitations, chest pains, shortness of breath, and nausea.

c. Fibromas

Fibromas develop in the myocardium or the endocardium. These tumors are composed of fibrous or connective tissue and tend to occur on the valves of the heart and may be related to inflammation. Other than seeing or feeling the fibroma, there are no usual symptoms.

d. Teratomas of the pericardium

It is often attached to the base of the great vessels, usually occuring in infants. They are rarer than cysts or lipomas, usually causes no symptoms.

B) Malignant tumors

Malignant tumors that originated elsewhere in the body and spread to the heart are more common than ones that originate in the heart. Malignant heart tumors can originate from any heart tissue. They occur mostly in children.

a. Angiosarcomas

Angiosarcomas account for about a third of all malignant heart tumors and usually start on the right side of the heart. The cause of angiosarcomas is usually unknown and symptoms of angiosarcomas differ according to the location of the tumour. Often symptoms of the disease are not apparent until the tumour is well advanced.

b. Fibrosarcomas

Fibrosarcomas occur as a soft-tissue mass or as a primary or secondary bone tumor. The 2 main types of fibrosarcoma of bone are
i) Primary fibrosarcoma is a fibroblastic malignancy that produces variable amounts of collagen
ii) Secondary fibrosarcoma of bone arises from a preexisting lesion or after radiotherapy to an area of bone or soft tissue. Symptoms of fibrosarcomas include broken bone, pain, swelling, lump found under skin or bone, frequent urination and urinary obstruction.

c. Rhabdomyosarcomas

Rhabdomyosarcomas are a cancer made up of cells that normally develop into skeletal muscles of the body and are also more common in children. They usually have some type of chromosome abnormality in the cells of the tumor, which are responsible for the tumor formation. Symptoms of rhabdomyosarcomas include bleeding from the nose, vagina, rectum, throat and tingling, numbness, and pain.

d.) Liposarcomas

Liposarcoma normally appears as a slowly enlarging, painless, nonulcerated submucosal mass in a middle-aged person. Symptoms include palpation, weakness, limitation of motion weight loss, fatigue, and lassitude.

*Sudden cardiac death

The victim may or may not have diagnosis of heart diseases, and the death is totally unexpected. Sudden cardiac death is a result from abrupt loss of heart function. The cause of sudden cardiac dealth might be a result of coronary heart disease.

* Hypertensive heart disease

Hypertensive heart disease are caused by high blood pressure that increases the work load of the heart. Overtime the muscles of the heart become thick in result of an enlarged left ventricle and decreased blood pump from the heart. Symptoms of heart failure include shortness of breath, swelling in the feet, ankles, or abdomen, fatigue, irregular pulse, nausea and frequent urination at night.

By: Kyle J. Norton

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