The most common heart diseases, and how to watch for—and prevent—them!
Katrien Limón was only 37 when she experienced what felt like acid reflux—and then a pain in her chest when she walked up a steep hill. She had just lost 30 pounds, and her annual physical had shown normal cholesterol and blood pressure. Doctors gave her medication for reflux, and even anxiety, but her symptoms worsened. After a few weeks, she visited a cardiologist—who discovered that her main coronary artery was 90 percent blocked, and another was 95 percent blocked. Despite family history of heart disease and high blood pressure, Katrien hadn’t dreamed she would receive such an urgent diagnosis at such a young age. She could have had a heart attack![i]
Truth is, it can happen to anyone. And the heart is more than just an invisible machine tucked in your chest. Every day—even without underlying health conditions—we have more influence on heart health than we might imagine.
The heart is one of the most “communicative” organs we have. It races when we are excited, seems to “fall” when we are disappointed—and we “give it away” when we are in love. In fact, Harvard’s Medical School reports that psychological factors are literally felt in our hearts—and can contribute to cardiac risk. Consider this: when you exercise—or when you experience exciting or devastating news—your heart beats faster, your blood pressure increases, and your breathing picks up. However, the difference between exercise and emotional reactions is the suddenness of the change. During anxiety, stress hormones can flood circulation, which predisposes the heart to rhythmic disturbances—even the coronary arteries can spasm, suddenly decreasing blood supply.[ii] Stress, intense grief, and anxiety can cause actual damage to your ticker, even if you’re otherwise healthy. That’s why doctors emphasize a work-life balance, getting enough sleep, relaxing, and being active.
Katrien is living proof that this is true. After her life-saving surgery, she completely changed her diet and started practicing yoga and meditation. She also emphasizes the fact that she was correctly diagnosed because she listened to her body.[iii]
What’s going on inside our chests?
From a purely physical standpoint, the heart literally provides the pulse that keeps us alive. It’s our body’s pumping station, sending blood throughout the body that fuels us with oxygen and nutrients.
Let’s start with some facts[iv]:
- Worldwide, heart disease causes more deaths each year than anything else; in the United States, about one in five deaths—nearly 700,000—is caused by heart disease.
- The most common form of heart disease is the narrowing of arteries that provide blood flow and oxygen to the heart muscle itself. The narrowing is caused by a buildup of “plaque” that sticks to the arterial walls—and it can cause heart attacks and stroke.
- Every year, more than 800,000 people in the US suffer a heart attack. Almost that number have a stroke.
- When it comes to heart valve disease, mitral valve regurgitation (MR) is the most common[v], followed by aortic stenosis (AS) and aortic regurgitation (AR). Among these diseases, AS causes the most deaths worldwide.[vi]
But what does all that mean? And what more can we learn about the big picture of heart health? Perhaps most important, what helpful, preventative habits can the average person easily keep in mind? Let’s begin with what you might hear from your doctor—and end with some basic go-to behaviors that can keep you healthy for the long term.
What test results or conditions should i pay attention to?
Several “risk factors” are directly linked to heart disease, heart attack, and stroke. These include high blood pressure, high blood cholesterol, hardened arteries (atherosclerosis), diabetes, and obesity. Work with your doctor to determine whether you are at risk for any of these conditions, and what you can do to minimize or reverse them.
What symptoms should i pay attention to?
Various heart conditions—including the most common ones, listed below—have unique subtleties that doctors can diagnose. However, in general, “heart trouble” can hide in the shadows with several common symptoms that come on slowly, and don’t necessarily shout “Go to the doctor right now!” For example, patients might report shortness of breath, fatigue, irregular heartbeat, and feeling lightheaded. Even a heart attack might at first present with a rather routine cold sweat, or heartburn, indigestion, or nausea; not everyone experiences the more prominent, acute symptoms—such as pain or discomfort in the chest and other areas.
The vagueness of heart symptoms is why James Garrett, one of the star patients in Superhuman Body, didn’t at first know that he had any sort of heart problem. He was fatigued and experienced shortness of breath—but he just thought he was getting old. Finding out if you have any of the conditions listed below is easiest if you’re taking care of yourself—eating right, exercising, and managing underlying illnesses—because you’ll be most likely to notice if something doesn’t feel right. But that’s not all. It’s also important to get regular checkups—and don’t overlook those “age-related” changes.
What are the most common heart conditions?
Coronary Artery Disease (CAD) [vii]
This is the most common form of heart disease, and it can develop slowly over time. Therefore, a person can have significant CAD and not even know it—which means that CAD might not be diagnosed until the onset of signs or symptoms of arrhythmia (irregular heartbeat), congestive heart failure, or heart attack.
CAD is caused by the buildup of fat, cholesterol, and other substances in the blood, collectively known as “plaque,” in the arteries supplying blood to the heart. The buildup is called “atherosclerosis,” and it narrows and hardens the vessels, which restricts the supply of blood and oxygen to the heart. If severe enough, plaque can compromise the heart’s ability to pump blood properly, and cause chest pain. Also known as “angina,” this pain can feel like a squeezing, pressure, heaviness, tightness, or generalized discomfort, and can be your first indication of a heart attack.
CAD is related to similar conditions elsewhere in the body. Peripheral Artery Disease (PAD) [viii] is the narrowing of arteries that carry blood away from the heart to other parts of the body, most commonly the legs and feet. Carotid Artery Disease[ix] affects the vessels that deliver blood to the brain and head. Thrombosis[x], or the formation of a blood clot, can stimulate a heart attack or a stroke, among other things. The clot can form when a piece of the plaque breaks off, causing blood components to coagulate around the rupture.
Heart failure / congestive heart failure[xi]
Despite its name, heart “failure” doesn’t mean that the heart has actually failed, or that it’s about to stop working. Instead, this serious condition means that the heart is not pumping as efficiently as it should, and therefore is unable to keep up with the body’s demand. As the muscle becomes less able to contract, blood returns to the heart faster than it goes out—and that’s when the heart becomes “congested,” or backed up.
Heart attack[xii]
Also known as “myocardial infarction,” a heart attack occurs when a blocked artery restricts or stops blood flow to the heart, which deprives the heart of oxygen. Without treatment of the blockage, damage to the heart is more likely, and can be permanent. It’s not surprising that the most common cause of heart attack is CAD, because the plaque in the arteries reduces blood flow.
Symptoms of an impending heart attack are varied, including shortness of breath, nausea or vomiting, heartburn or indigestion, light-headedness or dizziness, fatigue, and cold sweats. However, it’s interesting to note that men and women can present different symptoms of heart attack. While men are more likely to experience chest pressure and pain—along with pain in arms, shoulders, neck, back, and jaw—women might not feel chest pain at all. They might report discomfort in the neck, jaw, shoulder, upper back, or abdomen.
Atrial fibrillation (AF, or “AFib”)[xiii]
This is the most common form of “arrhythmia,” which means that the heartbeat is not steady. Arrhythmia is experienced as a general rate that is slower or faster than normal, or the heart might race, flutter, “skip a beat,” or have occasional, extra beats. In AFib particularly, the heart beats rapidly and irregularly, either due to a problem with its valves (“valvular AFib”) or its chambers (“nonvalvular AFib”). This condition might go undetected, or occur sporadically, and in general is not dangerous in itself. However, AFib is important to screen for and treat, especially because the irregularity of the heartbeat can encourage the occurrence of blood clots, which can cause heart attack.
AFib is closely associated with other illnesses, including: Strokes[xiv],[xv] and transient ischemic attacks (TIA),[xvi] which can occur when a blood clot blocks an artery. AFib can cause blood to pool in one of the heart’s atria and form the clot—which breaks loose and heads to either the brain or lungs.
Valvular heart disease (VHD)[xvii]
Although some people are born with a heart defect, most diseases that affect valves are commonly found in older adults. Valves can “wear out” with age, become damaged from an infection, or stiffen because of calcium that is left behind as blood flows through the valves, year after year. According to the Centers for Disease Control and Prevention, this is the overview of how the valves work, and what happens when they’re compromised.
The heart and its all-important valves
- The normal heart has four chambers—right and left atria, and right and left ventricles—and four corresponding, one-way valves.
- Blood from the body enters the heart by the right atrium; from there, the tricuspid valve allows blood to flow from the right atrium to the right ventricle.
- The pulmonary valve then allows blood to flow from the right ventricle to the pulmonary artery, which carries blood to the lungs. After picking up oxygen, the blood comes back into the left atrium.
- Next is the mitral valve, also called the bicuspid valve, which allows blood to flow from the left atrium to the left ventricle—the heart’s main pumping chamber.
- Finally, the aortic valve allows blood to flow from the left ventricle to the aorta, the largest artery in the body. The aorta carries blood from the heart to the circulatory system.
- Three of the valves are composed of three “leaflets,” or flaps. The leaflets work together to open and close, which allows blood to flow across the opening. The mitral valve has only two leaflets.
To control the blood flowing into and away from the heart, the valves open and close—causing the “lub-dub” sounds healthcare workers listen for. Healthy heart valve leaflets are able to fully open and close the valve during the heart’s contractions, but diseased valves might not—and they create different sounds, like swishing, humming, or rasping.
A couple of common conditions occur in these cases, both of which cause less blood than normal to be pushed forward through the heart and into the circulatory system. “Regurgitation” happens when a valve doesn’t completely close—causing blood to leak back into the chamber that it came from. “Stenosis” occurs when the opening of the valve is narrowed, often due to stiff or malformed leaflets that prevent the valve from opening fully when blood is trying to pass through. Either of these conditions cause the heart to work harder to pump, which can lead to heart failure, sudden cardiac arrest, and death.
If VHD is not too severe, it can be managed with medications, but other interventions are indicated if the disease has progressed. The “gold standard” for most heart valve repairs or replacements has long been open-heart surgery—but in Superhuman Body, we explored a third treatment option, Transcatheter Aortic Valve Replacement (TAVR). That story is detailed in “What is Aortic Stenosis, Anyway?”
Stroke[xviii],[xix]
While not a “heart condition” in itself, “ischemic stroke” can occur because of several heart-related causes, including: CAD; AFib; some valvular conditions, especially calcification of the mitral valve, or “mitral stenosis” ([xx]); and even as a side-effect of valve replacement.([xxi]) One cause of stroke is a clot that blocks a blood vessel to the brain, causing the loss of all or a significant amount of its blood supply and oxygen. Obviously, the longer the condition remains untreated, the greater the chance of brain damage. The most obvious and immediate signs of stroke are facial weakness, arm weakness, and difficulty with speech, but patients can experience more profound numbness or paralysis of the face and limbs, as well as difficulty understanding others, loss of vision, loss of balance, headache, and other symptoms.
A transient ischemic attack (TIA)[xxii]
is often called a “ministroke,” because it results from a short-term blockage to the brain. TIAs are an indication that a patient is vulnerable to a full stroke, so early diagnosis and treatment are crucial.
Does what i do each day really matter to my heart?
Yes! What you take into your body and do with your body can minimize your risk of heart problems. For more on how to play an active role in your heart health, read our “Couch Potato” [NOTE: HYPERLINK THIS TITLE] story, but below are a few of the most important changes you can make to your daily routine.
Move your body!
The heart is a muscle, and it needs exercise. The stronger the heart, the more blood it can pump through the body—and the more it can do so with little strain. Exercise also helps keep arteries and other vessels flexible, which helps keep blood pressure at optimal levels. What does “exercise” look like? Regular, brisk walks, climbing stairs, biking, swimming, or other aerobic exercise for 30 minutes a day, five days a week.[xxiii]
Stop smoking tobacco
The nicotine in tobacco reduces oxygen to the heart, increases blood pressure and heart rate, causes blood clotting, and damages cells that line coronary arteries and other vessels. Nonsmokers can also die from heart disease through secondhand smoke![xxiv] Note: When burned, cigarettes also create more than 7,000 chemicals, and at least 69 of those are known to cause cancer. Many of these very chemicals are labeled as “poison” when they’re in other products.
Minimize eating foods high in fat and cholesterol
While doctors around the world have long associated fatty foods with blocked arteries, a recent study at UC Davis might have found a more direct answer to why these foods are toxic. A study published in Science suggests that “consuming food rich in saturated fat and choline—a nutrient found in red meat, eggs and dairy products—increases the number of metabolites that build plaques in the arteries.”[xxv] The study showed that high-fat diets disrupt the gut’s bacterial balance, which in turn produces the harmful substances that lead to cardiovascular disease. Note: Salt can contribute to high blood pressure, and it is often present in fatty and processed foods. So “keeping track of salt” means much more than watching your salt shaker.
Don’t drink alcohol to excess
Alcohol intake can lead to high blood pressure, heart failure, or stroke, along with a heart disease unique to alcohol: ACM, Alcoholic cardiomyopathy. [xxvi] Above, we mentioned that the most common heart disease is the narrowing of arteries that serve the heart. The most common cause for this narrowing is the buildup of fat, cholesterol, and other blood-borne substances. However, ACM is one of the leading causes of heart conditions when a person does not have narrowing of the arteries or other heart problems. That is, without other indications of coronary heart disease, alcohol can damage the arteries and the heart itself.[xxvii],[xxviii]
Of course, the question then becomes “what is excessive drinking?” According to Johns Hopkins Medicine, those with heart rhythm abnormalities or heart failure should not drink at all, and others should stop at one or two drinks a day, depending on body weight and other health factors.
Resources
Please be sure to work with your doctor if you are experiencing any heart-related symptoms! However, for further reading or background, curious readers can access helpful online summaries about heart conditions and treatment options from research institutes, teaching hospitals, universities, and medical providers. Plus, excellent general knowledge is routinely updated by:
- American Heart Association—heart.org
- Centers for Disease Control and Prevention—cdc.gov
- National Heart, Lung, and Blood Institute (National Institutes of Health)—nhlbi.nih.gov
[i] Susanne Marta, “Misdiagnosed with acid reflux and anxiety, her heart’s arteries were blocked,” American Heart Association (website), News, published online 28 April, 2021, https://www.heart.org/en/news/2021/04/28/misdiagnosed-with-acid-reflux-and-anxiety-her-hearts-arteries-were-blocked.
[ii] Abbott, “What Science Tells Us About Emotion and Our Hearts,” Abbot (website), Newsroom / Healthy Heart, published online 6 April, 2017, https://www.abbott.com/corpnewsroom/healthy-heart/heart-emotion.html.
[iii] Ibid.
[iv] New York State Department of Health, “Heart Disease and Stroke Prevention,” New York State (website), revised March 2024, https://www.health.ny.gov/diseases/cardiovascular/heart_disease/.
[v] Luca Testa et al, “Transcatheter Mitral Valve Replacement in the Transcatheter Aortic Valve Replacement Era,” Journal of the American Heart Association, Vol 8, 2019, e013352, DOI: 10.1161/JAHA.119.013352.
[vi] Hollenberg, Steven M., Valvular Heart Disease in Adults: Etiologies, Classification, and Diagnosis, FB Essentials, 2017 June, Vol. 457: 11-16, PMID: 28671804.
[vii] Centers for Disease Control and Prevention (CDC), “Coronary Artery Disease (CAD),” CDC (website), About Heart Disease, last reviewed 19 July, 2021, https://www.cdc.gov/heartdisease/coronary_ad.htm.
[viii] American Heart Association (AHA), “What is Peripheral Artery Disease?” AHA (website), Health Topics, accessed 12 April, 2024, https://www.heart.org/en/health-topics/peripheral-artery-disease/about-peripheral-artery-disease-pad.
[ix] Mayo Clinic, “Carotid artery disease,” Mayo Clinic (website), Diseases & Conditions, accessed 12 April, 2024, https://www.mayoclinic.org/diseases-conditions/carotid-artery-disease/symptoms-causes/syc-20360519.
[x] Kimberly Holland, “What to Know About a Coronary Thrombosis,” healthline (website), Heart Health, medically reviewed by Uzochukwu Ibe, MD, published online 20 October, 2022, https://www.healthline.com/health/coronary-artery-disease/coronary-thrombosis#bottom-line.
[xi] Johns Hopkins Medicine, “Congestive Heart Failure: Prevention, Treatment and Research,” Johns Hopkins Medicine (website), Conditions and Diseases with featured experts Dr. Roger Blumenthal and Dr. Steven Jones, accessed 12 April, 2024, https://www.hopkinsmedicine.org/health/conditions-and-diseases/congestive-heart-failure-prevention-treatment-and-research.
[xii] Heart Research Institute (HRI), “The 12 most common heart and cardiovascular conditions and what you can do about them,” HRI (website), Cardiovascular Disease, accessed 12 April, 2024, https://www.hri.org.au/health/learn/cardiovascular-disease/the-12-most-common-heart-and-cardiovascular-conditions.
[xiii] HRI, “12 most common conditions.”
[xiv] StopAfib.org, “Stroke Risks from Atrial Fibrillation,” StopAfib.org website, last modified 7 July, 2021, https://www.stopafib.org/learn-about-afib/why-is-afib-a-problem/stroke-risks-from-afib/.
[xv] Heart Research Institute (HRI), “Stroke: symptoms, causes and prevention,” HRI (website), Cardiovascular disease, accessed 12 April, 2024, https://www.hri.org.au/health/learn/cardiovascular-disease/stroke.
[xvi] Cedars Sinai, “Transient Ischemic Attack (TIA),” Cedars Sinai (website), Health Library, accessed 14 April, 2024, https://www.cedars-sinai.org/health-library/diseases-and-conditions/t/transient-ischemic-attack-tia.html.
[xvii] Centers for Disease Control and Prevention (CDC), “Valvular Heart Disease (VHD),” CDC (website), About Heart Disease, last reviewed 9 December, 2019, https://www.cdc.gov/heartdisease/valvular_disease.htm.
[xviii] StopAfib.org, “Stroke Risks from Atrial Fibrillation,” StopAfib.org website, last modified 7 July, 2021, https://www.stopafib.org/learn-about-afib/why-is-afib-a-problem/stroke-risks-from-afib/.
[xix] Heart Research Institute (HRI), “Stroke: symptoms, causes and prevention,” HRI (website), Cardiovascular disease, accessed 12 April, 2024, https://www.hri.org.au/health/learn/cardiovascular-disease/stroke.
[xx] Hamza Islam et al, “Risk of Stroke With Mitral Stenosis: The Underlying Mechanism, Treatment, and Prevention,” Cureus Journal of Medical Science, Vol. 14(4): 3 April, 2022, doi: 10.7759/cureus.23784.
[xxi] Bitao Xiang et al, “Rhythm outcomes after aortic valve surgery: Treatment and evolution of new-onset atrial fibrillation,” Clinical Cardiology, Vol. 44, 10: Oct. 2021. Published online 14 August, 2021, doi: 10.1002/clc.23703.
[xxii] Cedars Sinai, “Transient Ischemic Attack (TIA),” Cedars Sinai (website), Health Library, accessed 14 April, 2024, https://www.cedars-sinai.org/health-library/diseases-and-conditions/t/transient-ischemic-attack-tia.html.
[xxiii] Elizabeth Pratt, “Can Exercise Reverse or Prevent Heart Disease?,” healthline (website) Heart Health, updated 12 January, 2021, https://www.healthline.com/health/heart-disease/exercise#The-Danger-of-Inactivity.
[xxiv] WebMD Editorial Contributors, “Smoking and Heart Disease,” WebMD (website) Heart Disease Guide, Medically Reviewed by James Beckerman, MD, FACC, on 30 June, 2023, https://www.webmd.com/heart-disease/smoking-heart-disease.
[xxv] Nadine A. Yehya, “Study explains why food high in saturated fat may lead to plaque build-up in arteries,” UCDavis (website) Health News, published online 13 August, 2021, https://health.ucdavis.edu/news/headlines/study-explains-why-food-high-in-saturated-fat-may-lead-to-plaque-build-up-in-arteries/2021/08.
[xxvi] Johns Hopkins Medicine, “Alcohol and Heart Health: Separating Fact from Fiction,” Johns Hopkins Medicine (website), Wellness and Prevention, accessed 12 April, 2024, https://www.hopkinsmedicine.org/health/wellness-and-prevention/alcohol-and-heart-health-separating-fact-from-fiction.
[xxvii] Mariann R. Piano, “Alcohol’s Effects on the Cardiovascular System,” Alcohol Research 38, Vol. 2, 2017: 219:241, PMID: 28988575; PMCID: PMC5513687.
[xxviii] Adnan Shaaban et al, “Alcoholic Cardiomyopathy,” Updated 2023 Aug 8, In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513322/#.