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Heart Diseases

What is heart disease?

Heart disease is a general term that includes many types of heart problems. It's also called cardiovascular disease, which means heart and blood vessel disease.

Heart disease is the leading cause of death in the United States, but there are ways to prevent and manage many types of heart disease.

What are the types of heart disease?

There are many different types of heart disease. Some you may be born with, called congenital heart disease. Other types develop during your lifetime.

Coronary artery disease (also called coronary heart disease) is the most common type of heart disease. It happens slowly over time when a sticky substance called plaque builds up in the arteries that supply your heart muscle with blood. The plaque narrows or blocks blood flow to the heart muscle and can lead to other heart problems:

  • Angina - chest pain from lack of blood flow
  • Heart attacks - when part of the heart muscle dies from loss of blood flow
  • Heart failure - when your heart can't pump enough blood to meet your body's needs
  • Arrhythmia - a problem with the rate or rhythm of your heartbeat

Other types of heart diseases may affect your heart valves or heart muscle (cardiomyopathy).

What causes heart diseases?

The causes of heart disease depend on the type of disease. Some possible causes include lifestyle, genetics, infections, medicines, and other diseases.

Who is more likely to develop heart diseases?

There are many different factors that can make you more likely to develop heart disease. Some of these factors you can change, but others you cannot.

  • Age. Your risk of heart disease goes up as you get older.
  • Sex. Some factors may affect heart disease risk differently in women than in men.
  • Family history and genetics. A family history of early heart disease raises your risk of heart disease. And research has shown that some genes are linked to a higher risk of certain heart diseases.
  • Race/ethnicity. Certain groups have higher risks than others.
  • Lifestyle habits. Over time, unhealthy lifestyle habits can raise your risk heart disease:
    • Eating a diet high in saturated fats, refined carbohydrates, and salt.
    • Not getting enough physical activity.
    • Drinking too much alcohol.
    • Smoking and exposure to secondhand smoke.
    • Too much stress.
  • Having other medical conditions can raise your risk of heart diseases. These conditions include:
    • High blood pressure.
    • High cholesterol levels.
    • Diabetes.
    • Obesity.
    • Autoimmune and inflammatory diseases.
    • Chronic kidney disease.
    • Metabolic syndrome.
What are the symptoms of heart disease?

Your symptoms will depend on the type of heart disease you have. You may not have symptoms at first. In some cases, you may not know you have heart disease until you have a complication such as a heart attack.

How are heart diseases diagnosed?

To find out if you have heart disease, your health care provider will:

  • Ask about your medical history, including your symptoms
  • Ask about your family health history, including relatives who have had heart disease
  • Do a physical exam
  • Likely run heart tests and blood tests

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart disease?

Treatment plans for heart disease depend on the type of heart disease you have, how serious your symptoms are, and what other health conditions you have. Possible treatments may include:

  • Heart-healthy lifestyle changes
  • Medicines
  • Procedures or surgeries
  • Cardiac rehabilitation
Can heart diseases be prevented?

You may be able to lower your risk of certain heart diseases by making heart-healthy lifestyle changes and managing any other medical conditions you have.

NIH: National Heart, Lung, and Blood Institute

Coronary Artery Disease

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.

CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.

Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

NIH: National Heart, Lung, and Blood Institute

Heart Failure

What is heart failure?

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

  • With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
  • With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
    • Too weak to pump enough blood.
    • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

What causes heart failure?

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

  • Arrhythmia (a problem with the rate or rhythm of your heartbeat)
  • Cardiomyopathy
  • Congenital heart defects or other types of heart diseases that you are born with
  • Coronary artery disease
  • Endocarditis
  • Heart attack
  • Heart valve diseases
  • High blood pressure
  • A blood clot in your lung
  • Diabetes
  • Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
  • Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Who is more likely to develop heart failure?

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

  • You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
  • Your family health history includes relatives who have or have had heart failure.
  • You have changes in your genes that affect your heart tissue.
  • You have habits that can harm your heart, including:
    • Smoking
    • Eating foods high in fat, cholesterol, and sodium (salt)
    • Having an inactive lifestyle
    • Alcohol use disorder (AUD)
    • Illegal drug use
  • You have other medical conditions that can affect your heart, including:
    • Any heart or blood vessel conditions, including high blood pressure
    • Serious lung diseases
    • Infection, such as HIV or COVID-19
    • Obesity
    • Diabetes
    • Sleep apnea
    • Chronic kidney disease
    • Anemia
    • Iron overload disease
    • Cancer treatments that can harm your heart, such as radiation and chemotherapy
  • You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.
What are the symptoms of heart failure?

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

  • Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
  • Fatigue or weakness even after rest.
  • Coughing.
  • Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
  • Difficulty sleeping when lying flat.
  • Nausea and loss of appetite.
  • Swelling in the veins of your neck.
  • Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

What other problems does heart failure cause?

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

  • Breathing problems from fluid in and around your lungs (also called congestive heart failure)
  • Kidney or liver damage including cirrhosis
  • Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
  • Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
  • Pulmonary hypertension
How is heart failure diagnosed?

To find out if you have heart failure, your doctor will:

  • Ask about your medical history, including your symptoms
  • Ask about your family health history, including relatives who have had heart failure
  • Do a physical exam
  • Will likely order heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your doctor may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart failure?

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

  • Taking medicine
  • Eating less sodium and drinking less liquid to control fluid buildup
  • Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your health care provider recommends
  • Treating any conditions that may make heart failure worse

You may need heart surgery if:

  • You have a congenital heart defect or damage to your heart that can be fixed.
  • The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
    • An implantable cardioverter defibrillator.
    • A biventricular pacemaker (cardiac resynchronization therapy).
    • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
  • Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

Can heart failure be prevented?

You may be able to prevent or delay heart failure if you:

  • Work with your provider to manage any health conditions that increase your risk of developing heart failure
  • Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Atrial Fibrillation

What is atrial fibrillation (AFib)?

Atrial fibrillation, also known as AFib or AF, is one of the most common types of arrhythmias. Arrhythmias are problems with the rate or rhythm of your heartbeat. They can cause your heart to beat too slowly, too fast, or in an irregular way.

If you have AFib, your heart beats irregularly and sometimes much faster than normal. Also, your heart's upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can cause symptoms such as dizziness, fatigue, and a pounding heartbeat.

AFib may happen in brief episodes, or it may be a permanent condition. It's very important to treat it, since AFib can put you at risk for stroke and other heart conditions.

What causes atrial fibrillation (AFib)?

AFib is most often caused by changes to the heart's tissue or the electrical signaling that helps the heartbeat. These changes can happen due to different conditions and factors, such as high blood pressure, coronary artery disease, congenital heart defects, infections, and aging. Sometimes the cause is unknown.

Who is more likely to develop atrial fibrillation (AFib)?

Anyone can develop AFib, but there are certain things that raise your risk for it:

  • Aging. The risk of atrial fibrillation increases as you get older, especially when you are over age 65.
  • Family history and genetics. AFib can run in families. So can heart disease, which raises your risk of AFib.
  • Some lifestyle choices. Your risk is higher if you drink a lot of alcohol, use certain illegal drugs such as cocaine and methamphetamines, or smoke.
  • Having certain health conditions, such as:
    • High blood pressure
    • Diabetes
    • Heart failure
    • Heart valve diseases
    • Obesity
    • Hyperthyroidism
    • Chronic kidney disease
    • COPD and other lung diseases
    • Sleep apnea
  • Race. AFib is more common in people with European ancestry.
  • Recent surgery. You may be at risk of atrial fibrillation in the early days and weeks after surgery on your heart, lungs, or esophagus.
What are the symptoms of atrial fibrillation (AFib)?

Some people who have AFib don't have any symptoms and don't know they have it. If you do have symptoms, you may only notice them once in a while. Or you may have symptoms that are more frequent. And in some cases, the symptoms might be severe. If you have heart disease, you are more likely to notice your symptoms. And those symptoms could get worse if your heart disease gets worse.

The symptoms of AFib can include:

  • Extreme fatigue, which is the most common symptom
  • Heart palpitations (the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)
  • Trouble breathing, especially when lying down or when exercising
  • Chest pain
  • Dizziness or fainting
  • Low blood pressure
What other problems can AFib cause?

If AFib is not treated, it can lead to serious health problems (complications) such as:

  • Stroke
  • Heart failure
  • Blood clots
  • Sudden cardiac arrest (SCA)
  • Cognitive impairment and dementia

To help prevent these problems, it's important to contact your health care provider if you are having symptoms. If you do have AFib, the sooner you are diagnosed and treated, the better.

How is atrial fibrillation (AFib) diagnosed?

To find out if you have AFib, your provider:

  • Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have
  • Will ask about your family history, to find out if you have relatives who have or had AFib
  • Will do a physical exam
  • May order blood tests
  • Will likely order heart tests, such as an electrocardiogram (also called an EKG or ECG) and echocardiogram
  • May ask you to wear a heart monitor device that records your heart's electrical activity
What are the treatments for atrial fibrillation (AFib)?

The treatments for AFib may include:

  • Blood thinner medicines that help prevent blood clots from forming.
  • Medicines to control your heart's rhythm and rate.
  • Following heart-healthy lifestyle changes, such as:
    • Following a heart-healthy eating plan that limits saturated fats, salt, and cholesterol. An example is the DASH eating plan.
    • Limiting or avoiding alcohol, because it can increase your heart rate.
    • Aiming for a healthy weight.
    • Getting regular physical activity.
    • Managing stress.
    • Quitting smoking.
  • Procedures such as:
    • Electrical cardioversion, which restores your heart rhythm using low-energy shocks to your heart.
    • Catheter ablation, which scars the tissue that is causing the arrhythmia. The scar tissue blocks the abnormal heart signals.
  • Surgeries such as:
    • Surgery to put in a pacemaker to help control the arrhythmia.
    • A Maze procedure, which creates scar tissue in a maze-like pattern in certain parts of the heart.
    • Left atrial appendage closure, a surgery on a small sac in the muscle wall of your left atrium (the upper left chamber of your heart). It helps prevent blood clots and can reduce your risk of stroke. This surgery is for people who are not able to take blood thinners.
Can atrial fibrillation (AFib) be prevented?

There are steps you can take to help lower your risk of atrial fibrillation, such as:

  • Making heart-healthy lifestyle changes:
    • Following a heart-healthy eating plan
    • Limiting or avoiding alcohol
    • Aiming for a healthy weight
    • Getting regular physical activity
    • Managing stress
    • Not smoking
  • Avoiding illegal drugs, such as cocaine and methamphetamines
  • Taking antiarrhythmic medicine (medicine to treat arrhythmia) if you are having heart surgery
  • Treating any health conditions that could raise your risk of AFib

NIH: National Heart, Lung, and Blood Institute

Angina

Angina is chest pain or discomfort you feel when there is not enough blood flow to your heart muscle. Your heart muscle needs the oxygen that the blood carries. Angina may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw, or back.

Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.

There are three types of angina:

  • Stable angina is the most common type. It happens when the heart is working harder than usual. Stable angina has a regular pattern. Rest and medicines usually help.
  • Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It does not go away with rest or medicine. It is a sign that you could have a heart attack soon.
  • Variant angina is rare. It happens when you are resting. Medicines can help.

Not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.

NIH: National Heart, Lung, and Blood Institute