Heart (Cardiovascular) Diseases, Diagnosis, Medical Treatment, and Prevention

Cardiovascular diseases are a group of diseases related to the heart and blood vessels. CVDs are the most prevalent diseases in India and are endemic to India.

CVDs include Myocardial Infarction (heart attack), Coronary Artery Diseases, Arrhythmias, Valvular diseases (stenosis, regurgitation), Pericarditis, Heart failure, Peripheral artery disease, congenital heart disease, Stroke, Hypertension. Coronary artery disease is the most common of them.

When to See a Cardiologist?

Are you feeling pain in your chest in the middle or slightly left side of the center? Then don't wait; even if the pain is mild, see a cardiologist. A Cardiologist is a doctor who does the diagnosis of cardiovascular diseases (heart and Vascular diseases) and specialize in its treatment.

Any shortness of breath? Frequent palpitations (aware of your heartbeat)? Have your feet or other parts of the body swollen? It may indicate Oedema (fluid retention), if not inflammation, and Oedema can be a sign of CVDs.

Diagnosis of cardiovascular diseases

When you visit a cardiologist, he will check your blood pressure, pulse rate, oxygen saturation level. These are the vitals for your heart functioning. Diagnosis of cardiovascular diseases is done by various methods that gives you a clear idea. Let's see what these are:

1. Physical Examination 

Your cardiologist will examine you for any asymmetry in your chest, for cyanosis (bluish colouration due to lack of oxygen), Oedema. He/she will hear your heart sounds with a stethoscope. He/she will ask you for the symptoms, pain, family history, diet, etc.

2. Blood Tests

They take your blood sample to test for cholesterol level, C-reactive protein (CRP), other cardiac biomarkers that indicate any heart or vascular diseases.

There is good cholesterol (HDL) as well as bad cholesterol (LDL). LDL level should not exceed 130 mg/dl. If you have diabetes or any related heart disease, then LDL should not be more than 70 mg/dl.

Specific biomarkers, when found in blood, indicate cardiovascular diseases. C-reactive protein, Apolipoprotein A1 and B are indicative of inflammation. Cardiac Troponin-T, fibrinogen, homocysteine, increased brain natriuretic peptide (BNP) are some of the biomarkers. 

3. ECG

An electrocardiograph is a device that helps to record the electrical activity of your heart. It is a painless process in which the cardiologist place leads on your wrists, legs and six leads on the epicardium (skin over the heart). The leads are connected to a machine and record the electrical activity as graphs. This graph is called an electrocardiogram.

ECG tells about the rhythm of the heart, strength and timing of your heartbeats. It detects arrhythmias (irregular heartbeats), angina, heart attack.

4. Stress Test

This test is to examine how your heart recovers from an exercise. The cardiologist will ask you to run on a treadmill or do cycling for 5-6 minutes. Chest leads connected to a machine will record the continuous electrical activity of your heart during the exercise and afterwards. The device will take continuous ECG for another 5 minutes. It detects Atherosclerosis, heart failure, CHD.

5. Echocardiogram

In this test, Ultrasound is done with the help of a handheld device placed on your chest to get detailed and moving images of your heart's valves and chambers. It is often combined with Doppler ultrasound and colour Doppler to check the blood flow of your heart valves.

It detects hypertrophy (enlarge walls of the heart), calcification of valves (calcium deposits on heart valves), leading to valvular disease.

6. Chest X-ray

Chest X-ray is for the image of the heart, the orientation of the heart, pericardium. It detects congenital heart diseases, pericarditis, hypertrophy.

7. EBCT

Electron Beam CT scan. The machine uses an electron beam (electron gun) instead of an X-ray to detect any calcification in the walls of the coronary arteries of the heart, Atherosclerosis. It is a fast and highly sensitive test. This test can detect calcification as mild as 10% to 20%, which is not possible with the help of a standard physiologic stress test.

8. MRI

This machine uses a magnetic field or computer-generated radio waves. MRI gives images of the heart during a cardiac cycle (between your heartbeats). It does not use ionizing radiation, and hence it's a safer option for a pregnant woman. MRI of heart diagnoses CVDs like:

• Congenital heart defects
• Valvular defects
• Pericarditis
• Coronary heart diseases

9. Catheterization and Angiography

Catheterization is a method that helps your doctor to check if your blood vessels are fine. Your doctor will insert a catheter (thin tube-like) in your femoral vein (in the groin) or your hand. He/she will use a contrast dye to get an X-ray view of the vessels. The X-ray view on a monitor will guide your doctor. Then he/she will pass this catheter through the veins to the heart with the help of images on the monitor.

The catheter will help your doctor to see the flow of blood. It is also for measuring the pressure of the blood in vessels and the heart for different heart conditions like hypertrophy. 

Angiography detects blockage in the arteries that supply the heart (coronary arteries). This blockage is Atherosclerosis.

Medical Treatment

As we discussed above there are many ways to do the diagnosis of Cardiovascular diseases there can be different ways for its treatment as well. Your cardiologist will tell you what's best for you. If your condition is not severe, some lifestyle changes will suffice. But if it worsens, then you need to take medicines, you may undergo surgery, or in the most severe case, you may need a heart transplant. 

1. Lifestyle Change

Specific lifestyle changes can save you from deadly heart diseases. Improve your diet, take fresh fruits and vegetables, take low fat, low sodium diet to control your blood pressure and cholesterol level.

Physical activity is a must. Do some exercise, not too much as it will stress your heart, but some movement is necessary. Keep your sugar in control.

2. Medications

Your cardiologist will give you the best suitable medicines. Certain types of medicines for cardiovascular diseases are:

• Beta-blockers
• ACE inhibitors
• Cardiac glycosides
• Blood thinners
• Antihypertensive
• Antiarrhythmic
• Antianginal
• Vasoactive peptides

3. Surgery

If lifestyle changes and medications do not cure you, then your cardiologist may suggest surgery for your recovery. It may be a coronary artery bypass surgery, valve repair surgery or implantation of a pacemaker or defibrillator. 

4. Angioplasty and Stenting

Angioplasty is a method to open a blocked coronary artery by stenting. In this method, the cardiologist will insert a stent (meshwork of metal wire) at the site of blockage with the help of a catheter. 

5. Pacemakers

An artificial pacemaker is a battery-like device that produces electrical signals on its own. Suppose the heart cannot have constant electrical signals required for the regular beating. In that case, this artificial pacemaker is inserted near your collar bone to give the necessary electrical signals to the heart.

6. Ablation

Cardiologists use this method to cure any faulty pathway of electrical signals in the heart. With the help of a catheter, cardiologists destroy the cardiac tissues involved in the abnormal course.

Prevention

Prevention is always better than cure. So, be healthy and avoid these complicated disorders.

• Quit smoking: Smoke particles damage your heart and blood vessels. They can also form plaques in them.
• Control your Blood Pressure: Hypertension is one of the most critical risk factors for CVDs. Keep control of your BP. Get your BP check from time to time and if it's getting high, take a low sodium diet.
• Keep your Cholesterol in Control: Your LDL (low-density lipid) should not be more than 130 mg/dl. Eat vegetable oils instead of saturated fat. Avoid processed food.
• Control your Diabetes: Keep your sugar under control. Diabetes can lead to serious heart diseases.
• Food: Minimize your consumption of sodium, added sugar & processed food.
• Control your Weight: Your BMI should be less than 25.
• Avoid Stress: Keep yourself calm and take proper rest. Don't take stress—practice yoga.