Blood is supplied to the heart by two coronary arteries. These arteries can be narrowed by a fatty deposit that accumulates on their inner walls. A blood clot can form in the section of a coronary artery narrowed by atheroma (coronary thrombosis), blocking the artery and causing myocardial infarction, in which an area of heart muscle dies. When the coronary arteries are narrowed but not altogether blocked and when the workload on the heart is increased by exercise, the heart can become short of blood: the result is angina (angina pectoris).
All these conditions come under the term “coronary artery disease”, which mostly occurs in people over 50 years of age but can also occur in younger people. The term “heart attack” is usually used to mean myocardial infarction but some people use it to mean angina or attacks of severe breathlessness caused by heart disease: it is important, therefore, to be clear about what a patient means by “heart attack”.
Angina is pain or discomfort in the chest caused by inadequate blood supply to the heart. Stable angina is an event that has been occurring in episodes for weeks or months, each time after about the same amount of exercise but rarely when the patient is at rest. With stable angina, there is only a low risk of a heart attack occurring in the near future.
Unstable angina is an event that began only recently or occurs at rest or occurs following much less exercise than the patient was in the habit of doing previously: with unstable angina there is a high risk of a heart attack occurring in the near future.
Other Cardiovascular diseases include:
- Arrhythmia: when the heart beats irregularly; the most common arrhythmia is atrial fibrillation
- Heart valve disease: when a chamber is diseased or damaged, for example, a valve does not open fully, causing obstruction of the flow of blood
- Congenital heart disease: a heart abnormality from birth, for example, a hole between chambers of the heart, or valves that have not properly formed
Chest pain is probably coming from the heart if:
- it is felt:
- in the middle of the chest under the breast bone (sternum); AND/OR
- in the left arm or in the neck and lower jaw;
- it is described by the patient as:
- “heavy” or “like a heavy weight on the chest”;
- “a tightness”;
- “a pressing”;
- “a squeezing”; and
- the patient clenches one fist over the centre of his chest when trying to say what he feels;
- is consistent over different episodes in the same patient (patients can reliably recognize pain as myocardial infarction if they have had one before);
- is like pain previously happening on exercise but more severe;
- comes on gradually;
- lasts from 30 minutes to one to two hours;
- is accompanied by breathlessness, nausea, and sweating.
Tips for better heart health
- Smoking – Reduce and/or stop smoking
- Hypertension – Control high blood pressure (BP) as it is considered to be a major risk factor
- Alcohol – Reduce to minimum the alcohol consumption
- Diabetes –Control blood-sugar levels, as diabetes significantly increases the risk of cardiovascular disease
- High blood cholesterol – Control the level of cholesterol through an effective diet program
- Overweight – Healthy eating helps to reduce weight, minimizes the risks of heart problems and maintain healthy cholesterol and BP levels.
- Lack of exercise/physical inactivity – Try to follow exercise or athlete programs in regular intervals. Aerobic activity (designed to increase the body’s oxygen intake) helps to relieve stress, build muscle tone and bone strength, and provides a sense of wellbeing.
- Stress and anxiety – Try to control stress and mental factors. Learn to anticipate and manage them, to relax or to engage in a physical activity that helps you to relax