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The UK has one of the highest rates of death from heart disease in the world - one British adult dies from the disease every three minutes - and stroke is the country's third biggest killer, claiming 70,000 lives each year. Heart attacks occur when blood flow is blocked, often by a blood clot, while strokes are caused either by blocked or burst blood vessels in the brain.
Heart disease and stroke may be inherited, but often they are the result of lifestyle. Changing eating, exercise and smoking habits can play a significant part in prevention.
Age - Four out of five people who die from coronary heart disease are aged 65 or older. The risk of stroke doubles with each decade after the age of 55.
Sex - Men are more at risk than women and have attacks earlier in life. But death rates from heart disease and stroke for women are twice as high as those for all forms of cancer. The risk for women increases as they approach menopause and continues to rise, as they get older, possibly because of the loss of the natural hormone oestrogen.
Family History (heredity) - Children of parents with heart disease are more likely to suffer from the disease. Some races, such as Afro-Caribbeans, are more prone to coronary heart disease and stroke than others.
Smoking - Smokers are twice as likely to suffer heart attacks as non-smokers, and they are more likely to die as a result. Smoking is also linked to increased risk of stroke. The nicotine and carbon monoxide in tobacco smoke damages the cardiovascular system. Passive smoking may also be a danger. Women who smoke and take the oral contraceptive pill are at high risk of heart disease and stroke.
Alcohol - Drinking an average of more than one drink a day for women or more than two drinks a day for men increases the risk of heart disease and stroke because of the effect on blood pressure, weight and levels of triglycerides - a type of fat carried in the blood. Binge drinking is particularly dangerous.
Drug Abuse - The use of certain drugs, particularly cocaine and those taken intravenously, has been linked to heart disease and stroke. Cocaine can cause abnormal heartbeat, which can be fatal, while heroin and opiates can cause lung failure. Injecting drugs can cause an infection of the heart or blood vessels.
Cholesterol - The higher the blood cholesterol level, the higher the risk of coronary heart disease, particularly if it is combined with any of the other risk factors. Diet is one cause of high cholesterol - others are age, sex and family history. High levels of LDL (low-density lipoprotein), or "bad cholesterol", are dangerous, while high levels of HDL (high-density lipoprotein), or "good cholesterol" lowers the risk of heart disease and stroke.
Blood Pressure - High blood pressure increases the heart's workload, causing it to enlarge and weaken over time. When combined with obesity, smoking, high cholesterol or diabetes, the risk increases several times. High blood pressure can be a problem in women who are pregnant or are taking high-dose types of oral contraceptive pill.
Physical Inactivity - Failure to exercise is a cause of coronary heart disease as physical activity helps control cholesterol levels, diabetes and, in some cases, can help lower blood pressure.
Obesity - People who are overweight are more likely to develop heart disease and stroke, even if they have none of the other risk factors. Excess weight causes extra strain on the heart, influences blood pressure, cholesterol and levels of other blood fats - including triglycerides - and increases the risk of developing diabetes
Diabetes - The condition seriously increases the risk of developing cardiovascular disease, even if glucose levels are under control. More than 80% of diabetes sufferers die of some form of heart or blood vessel disease.
Previous Medical History - People who have had a previous heart attack or stroke are more likely than others to suffer further events.
Stress - Some links have been made between stress and coronary artery disease. This could be because it encourages people to eat more, start smoking or smoke more than they would otherwise have done.
Understand the risk factors of heart disease and stroke and adopt a healthier lifestyle.
Stop smoking, drink less, eat better and exercise regularly.
Have regular blood pressure readings, height and weight monitoring, and tests for cholesterol levels.
Ask your GP if you have any concerns
People with heart disease and their partners are often understandably anxious about how sex may affect the heart. Many people with heart conditions continue to enjoy sex and for those people who have undergone a treatment for their heart condition, most of them are able to return to their sex life.
Like any other physical activity, having sex can increase the heart rate and blood pressure. This increases the work of the heart and for some people with a heart condition, sex may bring on symptoms such as breathlessness or chest discomfort. However, sex is just as safe as other equally energetic forms of physical activity or exercise. It is usually fine to have sex if you can climb two flights of stairs briskly without getting chest discomfort or becoming breathless.
It is helpful if you and your partner are relaxed about having sex again. Don't worry if your attempts seem difficult.
Here are some helpful suggestions:
Avoid having sex after a heavy meal
Don't have too much alcohol before sex
Keep the room warm and avoid cold sheets
Choose a relaxing atmosphere
Get into a comfortable position. Your partner may take the more active role
If you have a GTN spray or tablets, keep it where you can reach it just in case you need it.
Remember that there are alternatives to intercourse for giving and receiving pleasure. Touching and caressing may be a useful start to increase confidence.
Loss of sex drive is not uncommon after illness. Some men may experience impotence. This may be the result of the emotional stress you are feeling. However, occasionally it can also be the result of drug treatment, such as beta-blockers, which can affect your sex drive.
It may also be the result of cardiovascular disease or diabetes. Impotence is a common problem; so if you are having difficulties, talk to your doctor about it.
If you have had a heart attack or surgery you can resume sex as soon as you feel you have recovered, for most people this is within a few weeks. If you have had heart surgery, be careful not to put any pressure or stress on the chest wound.
There is so much information about concerning heart disease, heart attacks and the risk of lifestyle factors such as exercise, diet, smoking and drinking. But just how many risk factors do you have for heart disease and it is time for a lifestyle change?
There is overwhelming evidence that smoking increase your risk of lung cancer and heart disease. Smoking increases your risk of developing atherosclerosis – hardening of the arteries. It also makes it more likely that your capillaries, your smallest blood vessels will start to close up, causing peripheral circulation problems. See your doctor soon for help with quitting.
Obesity is a growing problem in the UK and in other developed countries. It is even becoming an issue in developing countries in some places as they become more affluent and adopt a Western lifestyle. There are plenty of weight reduction classes around. Why not find out about one locally and see if you can lose a few pounds? You don’t have to be stick thin but try to maintain a healthy body weight.
Small amounts of alcohol, taken in moderation can be preventive for heart disease. Drinking a glass of red wine a few times a week is fine – but half a bottle a night or more? Do you regularly exceed the maximum limits for men and women in the UK? Perhaps you don’t realise exactly how many units you are drinking. Try keeping a drink diary for a month and working out the units of alcohol you have had each week. You could be surprised...
High blood pressure is one of those strange health conditions that produces few symptoms. You can have it without even realising it but it’s very dangerous for both your kidneys and your cardiovascular health. Measuring your blood pressure takes less than 5 minutes and GP usually do it as part of a routine appointment. Get yours checked this week.
Diabetics need to take special care of their health to avoid all sorts of complications, including heart disease. Do you keep in touch with your healthcare team? Is your blood sugar very tightly controlled and do you help yourself with a good diet? Perhaps it’s time for a review?
Men are traditionally regarded as being at the greatest risk of heart disease. The person we think most likely to have a heart attack is a stressed out, overweight middle aged man. But, after the menopause, heart disease affects just as many women because your hormones then stop protecting you. If you have just passed through the menopause, get a health check soon and review your lifestyle. We can all improve...
You may have a family background of heart disease. This is a good sign that you have to watch your lifestyle to reduce your risk of heart attacks and strokes. Are you or your near ancestors from India, Pakistan, Bangladesh or Sri Lanka? These ethnic groups also carry a higher risk of having some sort of heart disease?
The level and balance of good cholesterol versus bad cholesterol in your blood can be a factor in heart disease. This is another thing that is easy to get checked out. GPs and pharmacies and some local health centres will do this for you – all it needs is a simple blood test. If you do have high cholesterol, this can be reduced by changing what you eat. If that isn’t quite enough, you can have drug therapy with statins, which is very safe and effective and will lower your cholesterol quickly.
A sedentary lifestyle is bad news for all sorts of reasons. Exercise, getting fresh air and keeping your heart healthy also makes you feel better mentally. It’s a great way of coping and dealing with stress, work and family pressures.
We all need to be thinking about our lifestyle. The affluent western way of living is not the best for health. Improving your diet to eat less fat, sugar and salt, taking some exercise, stopping smoking and getting regular health checks can make a big difference to your heart disease risk.
Cardiomyopathy is a disease of the heart muscle, making it abnormal with no obvious cause. There are four main types of cardiomyopathy:
Hypertrophic cardiomyopathy (HCM)
Dilated cardiomyopathy (DCM)
Restrictive cardiomyopathy (RCM)
Arrhythmogenic cardiomyopathy (ARVC)
Hypertrophic cardiomyopathy (HCM) is an excessive thickening of the heart muscle without any obvious cause. Sometimes this can be inherited but not always or in other cases this can be caused by a persistently high blood pressure.
Dilated cardiomyopathy (DCM) causes the heart to become dilated or enlarged. As a result the heart may become weak and is unable to pump blood efficiently around the body. In the majority of cases it’s unknown why DCM occurs, but excessive alcohol is known to be a cause.
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disorder where the heart muscle cells are gradually replaced by fibrous and fatty tissue. This causes the heart to dilate and its pumping action to weaken. There’s no known cause for this condition, but it has a tendency to run in families.
The least common of the cardiomyopathies, restrictive cardiomyopathy causes the walls of the heart muscle to become stiff. This restricts the flow of blood through the heart, leading to problems with blood flow to the rest of the body. The cause is unknown, but it has been linked to rare metabolic conditions. Recent evidence suggests that the disease may also be caused by a genetic abnormality.
Changes in the structure of the heart muscle may lead to problems with the pumping action of the heart, which can sometimes lead to heart failure. Cardiomyopathy may also disrupt the normal electrical pathway in the heart, increasing the risk of abnormal heart rhythms and palpitations.
Many people with cardiomyopathy are able to continue with their lives as normal, but some people will experience symptoms and may be at risk of complications. These vary greatly between each person and it’s important to be seen by a cardiologist who will assess your individual case and prescribe treatment if necessary.
Source - bhf
Chest pain or discomfort is a classic symptom of both angina and heart attack. But not all chest pain comes from the heart. The cause depends on what the pain feels like, how long it lasts, factors leading up to and accompanying the pain and how it is relieved.
Pain caused by coronary heart disease has a number of typical features and it is useful to be aware of them. Always tell your GP about any chest pain symptoms.
The characteristic features of a heart attack caused by a blood clot blocking a coronary artery are usually described as the following:
A crushing central chest pain, like a heavy weight on the chest
The pain may spread to or just affect the arms (particularly the left), the throat, neck, jaw, back or stomach
The pain is usually severe, grows in intensity and lasts more than 15 minutes
Weakness or fainting
Breathlessness, sickness and vomiting, sweating, pallor
The pain does not go away with rest
Even if you have doubts about the cause or exact location of your pain, if you experience any of these symptoms seek help immediately by phoning 999 for an ambulance and calling your doctor
Angina pain is the result of a disruption in the supply of blood and oxygen to the heart muscle (ischaemia). It is caused by narrowing of the coronary arteries. Angina symptoms differ between individuals, and different people use a variety of terms to describe their pain. However, typical features include the following:
The pain typically occurs during physical exertion or emotional stress
The pain occurs below the breastbone and is often described as a heavy, dull, tight, squeezing, burning discomfort
It may radiate to or just affect the arms (but particularly the left), the throat, jaw, back and stomach
Attacks of stable angina, or angina that usually only occurs after physical exertion, may last from 2-10 minutes and are generally relieved by resting or with a glyceryl trinitrate (GTN) spray.
Specialised tests such as a resting electrocardiogram (ECG) and a treadmill exercise ECG may be needed to confirm the diagnosis.
However, never wait longer than 15 minutes if the chest pain persists. If it does, even if you are unsure about the nature of your pain, seek medical help as soon as possible by phoning 999 for an ambulance and calling your doctor.
Source - bhf
Heart failure is a serious heart condition but it doesn’t mean that your heart stops completely, as it does in a heart attack. The heart carries on working but not very efficiently. It is like an engine that is getting worn out – it fails to pump blood round the body in the same way that it used to. People can live with heart failure for months, even years. It can be a disabling health problem but various treatments are available to improve symptoms and make the heart work more normally.
Heart Failure in Different Parts of the Heart
The heart is a muscular pump that consists of four separate chambers. Heart failure can affect different parts of the muscle; one side may be affected more than the other side. In people who have right-sided heart failure, the right ventricle is the most severely affected. This is the part of the heart responsible for pumping freshly oxygenated blood out into the body.
As the right ventricle fails, blood isn’t pumped out as strongly, and blood doesn’t return to the heart properly either. The capillaries, the small blood vessels in the arms and legs, become distended and circulation becomes sluggish. Fluid then builds up in the tissues, causing swelling in the arms and legs, swelling in the abdomen and fluid in the lungs. This causes some breathlessness and coughing, which is worse when lying down.
Left sided heart failure means that the left ventricle is failing. This is responsible for pumping blood out to the lungs to collect oxygen. When this becomes inefficient, the first and most severe symptom is breathlessness, which can occur even when the person affected is just resting. Any sort of exertion is impossible.
Heart failure has many causes, including a heart attack, high blood pressure, a problem with one of the valves of the heart, and any infection that attacks the heart muscle. It usually occurs in people over 65 and is less common in younger people. Some lifestyle factors increase the risk of heart failure, including smoking, being obese and leading a very sedentary lifestyle.
If the symptoms suggest heart failure, the usual first step to diagnosis is to have an echocardiogram, which uses ultrasound to investigate how well the heart is pumping blood. This can identify which part of the heart is affected, and can help doctors decide on the most effective treatment. An electrocardiogram – ECG – can also be used to detect any problems in heart rhythm. Blood tests for specific cardiac markers that rise in cases of heart failure may also be done.
The main treatment for chronic heart failure involves taking different kinds of cardiac drugs. The main drugs are from the family of ACE inhibitors, which have been shown in large trials to reduce symptoms and extend the life of someone with serious heart failure. Diuretics are also often used to help the body expel the excess fluid that builds up in the tissues and one the lungs. Beta blockers can also help.
In its early stages, heart failure can also be treated by making lifestyle changes. People are advised to cut down on the amount of salt they take in, and sometimes may have to restrict the amounts of fluid they drink. Although some people think they need to rest to stop their heart wearing out even more, the opposite is true. Moderate and regular exercise can improve the condition of the heart muscle and can reduce symptoms quite dramatically.