We've all heard of "heart disease." Sometimes we hear, "Oh, I was doing well, and then suddenly I had a heart attack and passed away." When we hear stories like this, we actually feel a little scared. But this "heart disease" is not just one disease. It is a collection of diseases that affect our heart and the vascular system that carries blood throughout the body. In medicine, we call all of these diseases together as cardiovascular disease . So today we're going to talk about exactly this, because it's very important to be aware of this.
Simply put, what is cardiovascular disease?
Imagine your body as a city. The heart is the main water pump of the city. The blood vessels are like the pipes that carry water from the water pump to every house in the city. So, if something goes wrong with this pump or the water pipes, the whole city will lose water, right? That's how it is.
Cardiovascular disease is any condition that affects either our heart (the pump) or our blood vessels (the vascular system). There are several main things that can happen:
- Narrowing of the blood vessels in the heart or other organs of the body: like dirt clogging a water pipe.
- Congenital heart or blood vessel problems: Sometimes there may be some weaknesses in this system at birth.
- Heart Valves Not Working Properly: There are door-like parts inside the heart that help blood flow in only one direction. If they don't close or open properly, problems can occur.
- Heart palpitations: Any change in the rhythm of the heart, such as beating too fast, too fast, or without rhythm.
Some people show symptoms when they have these diseases. But some people can develop this disease internally without any symptoms. That's why it's important for us all to be aware of this.
How common are these diseases really?
To be honest, this is much more common than you might think. Cardiovascular diseases are the leading cause of death in Sri Lanka as well as the world.
Most importantly, it is wrong to think that this is a disease that only affects the elderly. Anyone of any age, regardless of gender, can develop these conditions. Women in particular have a higher risk of dying from heart disease.
How do I know if I have this disease? What are the symptoms?
This is a problem that many people have. The way symptoms appear can vary depending on the type of disease. Sometimes the symptoms that occur in older people and women can be a little vague. But it is not good to ignore these symptoms.
Let's see what the main symptoms are in the table below.
| Heart-related symptoms | Symptoms of blockage of other blood vessels in the body |
|---|---|
| Chest pain or discomfort (Angina): A feeling of tightness, weight, or tightness in the chest. | Cramps in the legs, especially when walking. |
| Dyspnea: Shortness of breath , fatigue, even when walking a short distance or climbing stairs. | Non-healing wounds on the legs. |
| Dizziness or fainting: A sudden loss of consciousness. | Cold or red skin on the legs. |
| Feeling extremely tired: Feeling extremely tired even without doing anything. | Swelling of the legs. |
| Numbness in the face or arm/leg (often on one side of the body). | |
| Difficulty speaking, seeing, or walking (these could be signs of a stroke). |
What are the other main diseases that belong to the cardiovascular disease category?
As we said before, this is a collection of diseases. There are several main types of diseases that we are talking about.
- Arrhythmia: This is an irregular heart rate or rhythm caused by a defect in the heart's electrical system.
- Valve Disease: Heart valves that do not open properly or close properly, causing blood to leak backward.
- Coronary Artery Disease: Cholesterol and other substances build up in the blood vessels (coronary arteries) that supply blood to the heart, blocking them. This is the main cause of heart attacks, as we all know.
- Heart Failure: This does not mean that the heart has stopped working. It is a condition in which the heart is unable to pump enough blood to the body. This can cause fluid to build up in the lungs and legs.
- Peripheral Artery Disease: Narrowing or blockage of the arteries that supply blood to organs in the arms, legs, or abdomen.
- Aortic Disease: Problems with the aorta, the main blood vessel that carries blood from the heart to the brain and other parts of the body. For example, an aneurysm.
- Congenital Heart Disease: Heart defects present at birth.
- Pericardial Disease: Problems with the thin membrane that surrounds the heart. For example, it becomes inflamed (pericarditis).
- Cerebrovascular Disease: Blockages in the blood vessels that supply blood to the brain. A major cause of stroke.
- Deep Vein Thrombosis (DVT): A blood clot in the veins deep in the body (especially in the legs).
Why do we get these diseases? What are the risk factors?
There is no single cause for cardiovascular disease. The causes vary depending on the type of disease. For example, the main cause of `Coronary Artery Disease` and `Peripheral Artery Disease` is the deposition of fats such as cholesterol in the artery walls (Atherosclerosis).
However, risk factors that increase the likelihood of developing these diseases have been clearly identified. Some of these are things we can control. Some we cannot control.
| Risk Factor | This means... |
|---|---|
| High blood pressure (Hypertension) | We all talk about the increase in 'pressure'. If this is not controlled, it will damage the heart and blood vessels. |
| High cholesterol (Hyperlipidemia) | Increased levels of 'bad' cholesterol in the blood. These are what build up in the arteries. |
| Tobacco use | This includes smoking, vaping, and chewing tobacco. This directly damages the arteries. |
| Diabetes (Type 2 Diabetes) | High blood sugar levels cause damage to blood vessels over time. |
| Family history | If one of your close relatives (parents, siblings) has had heart disease at a young age, you are also at higher risk. |
| Lack of physical activity | Staying in one place without exercising. |
| Overweight or obesity | Excess body weight for height. |
| Unhealthy diet | Eating foods high in salt, sugar, and oil (especially saturated fat). |
| Excessive alcohol use | Drinking too much alcohol. |
How does a doctor accurately diagnose this disease?
If you have any symptoms or risk factors, your doctor will first ask you a question. He or she will ask about your symptoms, your family history, and your lifestyle. Then they will perform a physical exam.
In addition, various tests can be performed to accurately confirm the disease.
- Blood tests: Blood work can measure cholesterol, sugar levels, and special proteins that indicate heart health.
- Ankle Brachial Index (ABI): A simple test that compares the blood pressure in the legs and arms to check for blockages in the veins in the legs.
- Electrocardiogram (EKG/ECG): Records the electrical activity of the heart, allowing you to see things like the rhythm of your heartbeat and signs of a heart attack.
- Echocardiogram (Echo): This uses sound waves to create a video-like image of the heart. This allows you to clearly see the heart's chambers, valves, and how it pumps blood.
- Ultrasound Scan: Sound waves can be used to see blood flow in the veins in the legs and neck.
- Cardiac CT and MRI Scan: These can produce very clear three-dimensional (3D) images of the heart and blood vessels.
- Stress Test (Exercise EKG): An EKG is taken while you walk or run on a treadmill. This can see if your heart's blood supply decreases during exercise.
- Cardiac Catheterization (Angiogram): A very thin tube is passed through a vein in the arm or leg to the heart's veins, a special fluid is injected, and X-rays can be used to see exactly where the veins are blocked.
What are you doing as treatment?
The treatment method depends on your condition and its severity. However, treatment can be divided into several main parts.
1. Lifestyle Changes
This is the foundation of treatment.
- A healthy diet: Eat less salt, sugar, and oil, and more vegetables, fruits, herbs, and fiber-rich foods.
- Regular exercise: Exercise for at least 30 minutes a day, most days of the week.
- Complete abstinence from smoking: It is essential to abstain from all tobacco products, including vaping.
2. Medications
Your doctor will prescribe various medications to control your blood pressure, cholesterol, diabetes, prevent blood clots, and improve your heart function. It is very important to take these medications exactly as your doctor tells you.
3. Procedures or Surgeries
These may be necessary in cases where medication alone cannot control the condition.
- Stenting: Placing a small mesh-like tube inside a blocked artery to reopen it.
- Bypass Surgery: Creating a new path around a blocked artery using a piece of artery taken from another part of the body.
- Ablation: 'Melting' and destroying the areas in the heart that send out faulty electrical signals that cause irregular heartbeats.
4. Cardiac Rehabilitation
This is a medically supervised exercise and counseling program that can help strengthen the heart.
When do you need to see a doctor urgently or go to the ETU?
There are some symptoms that you should not ignore . These could be signs of a heart attack or stroke. If you experience any of these symptoms, go to the nearest hospital Emergency Department (ETU) immediately.
- Sudden chest pain, tightness, heaviness, or discomfort (especially when you are tired)
- Sudden fainting (syncope) or loss of consciousness.
- Severe shortness of breath (especially if it's new or getting worse)
- Pain or numbness in the arms/legs.
- A severe pain in the back, as if it were tearing.
Don't ignore these symptoms. Timely treatment can save a life.
Take-Home Message
- Cardiovascular disease is not a single disease, but a collection of diseases that affect the heart and blood vessels.
- Always be aware of symptoms such as chest pain, difficulty breathing, and fainting.
- It is essential to keep your blood pressure, cholesterol, and diabetes under control. To do this, get regular medical checkups.
- Quit smoking and unnecessary alcohol consumption completely. This is a great help for your heart.
- Make a healthy diet and daily exercise a part of your life.
- Use the medicine exactly as prescribed by the doctor, at the time he says.
- If you experience any serious symptoms, do not hesitate to seek medical advice immediately or go to the hospital's Emergency Treatment Unit (ETU).
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