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Understanding Heart Conditions
A glossary of terms that you may have heard about your heart, its condition, and treatment

by Thomas Ley

You may be confused by all the terms doctors use when they are talking about your heart. But since diabetes increases your risk of having heart troubles, it’s important for you to understand these terms:

Arteries: blood vessels that carry oxygen-rich blood to your heart and other parts of your body.

Aorta: the main artery leaving the heart, which supplies oxygen-rich blood to the rest of the body.

Plaque: plaque is made up of fat, cholesterol, calcium, and other substances in your blood which, over time, harden and narrow your arteries, reducing the flow of oxygen-rich blood to your organs and other parts of your body.

Atherosclerosis: also known as hardening of the arteries, this is when plaque builds up in the arteries.

Coronary Artery Disease (CAD): the most common type of heart disease. CAD occurs when plaque builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood. CAD is the leading cause of heart attacks and the leading cause of death in the United States for both men and women.

Symptoms and dangers of heart disease:

Heart Disease: when the heart does not receive enough oxygen due to coronary artery disease or other conditions, parts of the heart may be damaged. Symptoms can range from shortness of breath, fatigue and dizziness to heart arrhythmia, palpitations and angina. It may lead to heart attacks, sudden cardiac arrest, congestive heart failure or stroke.

Angina: chest pain or discomfort that occurs when an area of your heart muscle doesn’t get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest or cause pain in your shoulders, arms, neck, jaw, or back. It can feel like indigestion.

Arrhythmia: a problem with the speed or rhythm of the heartbeat when the heart can beat too fast, too slow, or with an irregular rhythm. CAD is a leading cause of arrhythmia. Most arrhythmias are harmless, but some can be serious or even life-threatening.

Atrial Fibrillation: the most common type of arrhythmia. It occurs when rapid, disorganized electrical signals in the heart’s two upper chambers, called the atria, cause them to contract very fast and irregularly (this is called fibrillation). As a result, blood is not fully pumped through the heart and pools in the atria.

Heart Attack: when blood flow to a section of heart muscle is blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.

Sudden Cardiac Arrest (SCA): also known as sudden cardiac death, this is when the heart suddenly and unexpectedly stops beating and blood stops flowing to the brain and other vital organs. SCA usually causes death if not treated in minutes. SCA is not the same thing as a heart attack. A heart attack is a problem with blocked blood flow to a part of the heart muscle. In a heart attack, the heart usually does not suddenly stop beating.

Stroke: sometimes called a “brain attack,” this is an interruption of the blood supply to any part of the brain. If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage.

Diagnosing Heart Disease:

Heart disease may affect the blood flow to the heart, the heart’s electrical system, the size and shape or rhythm of the heart, and the heart’s ability to pump blood. Many tests are used to determine whether you have heart disease, and if so, which parts of your heart are damaged and how badly. Here are some of the common tests used to diagnose heart disease:

Electrocardiogram (EKG or ECG): detects and records activity in the elaborate electrical system that creates each beat of the heart. It is used to detect and locate the source of heart problems.

Stress Test: provides information about how your heart works during physical stress. Some heart problems are easier to diagnose when your heart is working hard and beating fast. During a stress test, you exercise (walk or run on a treadmill or pedal a bicycle) or are given a medicine to make your heart work harder while readings of your heart’s activity and exertion level are taken.

Echocardiogram: uses sound waves to create images of your heart. It provides information about the size and shape of your heart and how well your heart’s chambers and valves are working. It can also identify areas of heart muscle that aren’t contracting normally due to poor blood flow or injury from a previous heart attack.

Coronary Angiography: uses dye and special x-rays to show the inside of your coronary arteries. It can help diagnose coronary artery disease (CAD) and determine how blood flows through the arteries and heart.

Cardiac Catheterization: a long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, doctors can perform diagnostic tests and treatments on your heart.

Treatments for Heart Disease:

There are many treatments for heart disease, depending on which ailment you have. Here are some definitions:

Pacemaker: a small, computerized device implanted under the skin, which helps regulate the heart beat to prevent arrhythmias. See related article on page 10.

Angioplasty: a common procedure performed during catheterization, in which a balloon is used to open and improve blood flow to an artery narrowed by artherosclerosis. Stents are also often inserted during angioplasty.

Stent: a small mesh tube implanted in a coronary artery to hold it open and help prevent it from becoming narrowed or blocked again in the months or years after angioplasty. Some stents are coated with medicines to assist in this process.

Coronary Artery Bypass Grafting (heart bypass surgery): a type of surgery called revascularization. It is used to improve blood flow to the heart in people with severe coronary artery disease (CAD) when angioplasty is not sufficient. During this major, open-heart surgery, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery or arteries. The grafted artery or vein bypasses (goes around) the blocked portion of the artery and carries oxygen-rich blood to the heart muscle. As many as four major blocked coronary arteries can be bypassed during one surgery.

This information has been adapted from the Department of Health and Human Services National Institutes of Health National Heart, Lung and Blood Institute. See http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD_All.html for more information.

If you think you are having a heart attack act FAST

• Call 9-1-1 within a few minutes—5 at the most—of the start of symptoms.
• Call your doctor or 9-1-1 even if symptoms start and stop.
• Take an ambulance to the hospital. Going in a private car can delay treatment.
• Take a nitroglycerin pill if your doctor has prescribed this type of medicine.
• Put an aspirin under your tongue. Aspirin reduces blood clotting and can help keep a heart attack from getting worse. But call 9-1-1 first.

Acting fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment within one hour of the beginning of symptoms is most effective.

Many more people could recover from heart attacks if they got help faster. About half the people who die from heart attacks die within an hour of the first symptoms and before they reach the hospital.