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A heart attack happens when the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can’t get oxygen. If blood flow isn’t restored quickly, the section of heart muscle begins to die. When the heart muscle is dying or getting damaged, there is pain which is the pain that occurs during a heart attack.

Heart attacks most often occur as a result of coronary heart disease (CHD), also called coronary artery disease. CHD is a condition in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to the heart.

After a heart attack, healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.

Sometimes a coronary artery temporarily contracts or goes into spasm. In this case, the artery narrows and blood flow to part of the heart muscle decreases or stops. A severe spasm can cause a heart attack.

 

What are the signs of heart attack?

ØChest discomfort:  Most heart attacks involve discomfort in the center of the chest; it can feel like uncomfortable pressure, squeezing, fullness or pain.   

ØDiscomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.   

ØShortness of breath with or without chest discomfort.  

Ø Acidity like symptoms can be there

Other signs may include breaking out in a cold sweat, nausea or lightheadedness, sudden loss of consciousness.

 

Who Is at Risk for a Heart Attack?

Risk factors you can control

·         Smoking

·         High blood pressure

·         High blood cholesterol

·         Overweight and obesity

·         An unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium)

·         Lack of routine physical activity

·         High blood sugar due to insulin resistance or diabetes

Some of these risk factors—such as obesity, high blood pressure, and high blood sugar—tend to occur together. When they do, it's called metabolic syndrome.

Risk Factors You Can't Control

·         Age: The risk of heart disease increases for men after age 45 and for women after age 55 (or after menopause).

·         Family history of early heart disease. Your risk increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.

·         Male sex :male sex is a risk factor also To further understand about Heart attack kindly copy and paste the following link to your browser

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Arrhythmia:

An arrhythmia is a change in the rhythm of your heartbeat, it occurs when the electrical impulses that produce heartbeat don't work properly or don’t travel in the proper pathway causing your heart to beat too fast, too slow or irregularly. One may feel sensation of fluttering or a brief pause or feeling that the heart thumps from time to time. Some arrhythmias don’t cause any symptoms. Others can make you feel lightheaded or dizzy.

There are two basic kinds of arrhythmias.

i. Bradycardia: When the heart rate is too slow — less than 50-60 beat per minute i.e,

a. Sinus Bradycardia

b. 2nd degree AV block

c. Complete Heart block.

       ii. Tachycardia:  When the heart rate is too fast — more than 100 beats per minute. i.e,

                a. Atrial Fibrillation

                b .Venticular  Fibrillation

                c. Supra-Venticular Tachycardia

                d .Venticular  Tachycardia

Causes of Arrhythmia :

Arrhythmias may be caused by many different factors, including:

• Coronary artery disease.
• Electrolyte imbalances in your blood (such as sodium or potassium).
• Changes in your heart muscle.
• Injury from a heart attack.
• Healing process after heart surgery.
• Too much coffee, alcohol, tea, anxiety etc Irregular heart rhythms can also occur in "normal, healthy" hearts without any abnormalities.

 

Symptoms of Arrhythmia :

An arrhythmia can be silent and not cause any symptoms. When symptoms of an arrhythmia occur, they may include:

• Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops," or feeling that your heart is "running away").
• Pounding in your chest.
• Dizziness or feeling light-headed.
• Fainting.
• Shortness of breath.
• Chest discomfort.
• Weakness or fatigue (feeling very tired).

How are Arrhythmias Diagnosed:

Tests used to diagnose an arrhythmia or determine its cause include:

• Electrocardiogram
• Holter monitor
• Event monitor
• Stress test
• Echocardiogram
• Cardiac catheterization
• Electrophysiology study (EPS)
• Head-up tilt table test

Treatment Of Arrhythmia:

Treatment depends on the type of arrhythmia you have. Some mild arrhythmias may not require treatment. Other types can be treated with medicine. Severe cases require additional treatment, such as:

·         Artificial pacemaker: 

This electronic device is placed under the skin on your chest. It helps your heart maintain a regular beat.

·         Cardiac defibrillator: 

This device gives an electric shock which can stop an abnormal rhythm and restore a normal one. This device may many a times be life saving in certain subgroup of patients.

·         Surgery: 

Procedures can correct certain types of arrhythmias. If the arrhythmia occurs due to an abnormal pathway in your heart that pathway can be ablated (removed) by delivering certain electrical energy using certain catheters, a procedure called cardiac ablation.

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The heart is like a water pump, it has certain force with which it pumps blood. A weak heart is one whose force of contraction has gone down and cannot generate enough force to pump blood to meet the needs of the tissues in the body.  

 

 

Treatment

Aim:

Relief symptoms

Improve heart function

 Measures:

·      Lifestyle changes:  If you have heart failure, you should have less sodium, based on your doctor's recommendations. He may point you toward aerobic exercise, but don't do heavy weightlifting.

·      Regular medication

·      Possible Procedures

People with severe DCM may need one of the following surgeries:

·      Cardiac resynchronization by biventricular pacemaker

·      Implantable cardioverter defibrillators (ICD)

·      Surgery: surgery for coronary artery disease or valve disease

·      Heart transplant

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Heart valve disease occurs if one or more of heart valves don't work well. The heart has four valves. These conditions occur largely as a consequence of aging, but may also be the result of congenital (inborn) abnormalities or specific disease or physiologic processes including rheumatic heart disease.

Heart has four valves that keep blood flowing in the correct direction. In some cases, one or more of the valves don't open or close properly. This can cause the blood flow through your heart to your body to be disrupted. Heart valve disease treatment depends on the heart valve affected and the type and severity of the valve disease. Sometimes heart valve disease needs just watchful waiting and regular follow up with your doctor. When the time for valve replacement comes it requires surgery to repair or replace the heart valve.

Causes

Heart has four valves that keep blood flowing in the correct direction. These valves include the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps (leaflets or cusps) that open and close once during each heartbeat. Sometimes, the valves don't open or close properly, disrupting the blood flow through your heart to your body.

Heart valve problems may include:

·         Regurgitation. In this condition, the valve flaps don't close properly, causing blood to leak backward in your heart. This commonly occurs due to valve flaps bulging back, a condition called prolapse.

·         Stenosis. In valve stenosis, the valve flaps become thick or stiff, and they may fuse together. This results in a narrowed valve opening and reduced blood flow through the valve.

 

Risk factors

Several factors can increase your risk of heart valve disease, including:

·         Older age

·         History of certain infections that can affect the heart

·         History of certain forms of heart disease or heart attack

·         High blood pressure, high cholesterol, diabetes and other heart disease risk factors

·         Heart conditions present at birth (congenital heart disease)

 

Signs and Symptoms

The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur and shortness of breath. However, many people have heart murmurs without having heart valve disease or any other heart problems. Others may have heart murmurs due to heart valve disease, but have no other signs or symptoms.

Heart valve disease often worsens over time, so signs and symptoms may occur years after a heart murmur is first heard. Many people who have heart valve disease don't have any symptoms until they're middle-aged or older.

Other common signs and symptoms of heart valve disease relate to heart failure which heart valve disease can cause. These signs and symptoms include:

·         Unusual fatigue (tiredness)

·         Shortness of breath, especially when you exert yourself or when you're lying down

·         Swelling in your ankles, feet, legs, abdomen, and veins in the neck

 

Diagnosis

Doctor may evaluate your signs and symptoms and conduct a physical examination. In a physical examination, doctor will likely listen for a heart murmur, as this can be a sign of a heart valve condition. Doctor may order several tests to diagnose the condition.

Tests may include:

·         Echocardiography.  This test assesses the structure of heart, the heart valves and the blood flow through heart.

·         Electrocardiogram (ECG) - An ECG can detect enlarged chambers of your heart, heart disease and abnormal heart rhythms.

·         Chest X-ray. A chest X-ray can help doctor to determine whether the heart is enlarged, which can indicate certain types of heart valve disease.

·         Cardiac MRI.  This test may be used to determine the severity of condition and assess the size and function of lower heart chambers (ventricles).

·         Exercise tests or stress tests. Different exercise tests help measure activity tolerance and monitor heart's response to physical exertion

Treatment

Heart valve disease treatment depends on how severe condition is, if you're experiencing signs and symptoms, and if your condition is getting worse.

A doctor trained in heart disease (cardiologist) will provide your care.  Your doctor may suggest monitoring your condition with regular follow-up appointments. Your doctor may also recommend making healthy lifestyle changes and taking medications to treat symptoms.

You may eventually need heart valve surgery to repair or replace the diseased heart valve. Doctors may suggest heart valve surgery even if you aren't experiencing symptoms, as this may prevent complications and improve outcomes.

Surgery options include:

Heart valve repair

Your doctor may often recommend heart valve repair when possible, as it preserves your heart valve and may preserve heart function.

Heart valve replacement

·         Biological valve replacement

In some cases, the valve can't be repaired, and surgeons may perform heart valve replacement.

·         Mechanical valve replacement

People with mechanical valves will need to take blood-thinning medications for life to prevent blood clots. Your doctor will discuss with you the benefits and risks of each type of valve and discuss which valve may be appropriate for you.

Complications

Heart valve disease can cause many complications, including:

·         Heart failure

·         Stroke

·         Blood clots

·         Heart rhythm abnormalities

·         Death

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