how the heart breaks

David Frickman
June 06, 2023

The sudden onset of heart problems can be scary. Your life or the life of a loved one can change in an instant. But heart problems can often be treated successfully once you and your doctor know the condition and develop a treatment plan.

The American Heart Association says cardiovascular disease can come in many forms, each with its own unique characteristics and treatment. Many heart problems are caused by atherosclerosis, a condition caused by plaque buildup on the walls of the arteries, blocking blood flow. Heart attack or stroke (when a similar condition affects the arteries in the brain) can be the result if the condition isn’t treated.

Here’s a primer from the AHA on the various types of cardiovascular disease and their treatments.

Heart attack
This is caused by a blood clot blocking blood flow to a part of the heart. This can lead to heart muscle damage. The AHA says most people survive their first heart attack, but will often need to make changes to their lifestyle to help prevent subsequent attacks.

For many types of heart attacks, clot-busting medications should be administered as soon as possible. Common treatments include coronary angioplasty, where a balloon is inflated and a stent placed inside the coronary artery to widen the area where blood flow is restricted. Another treatment is coronary artery bypass graft surgery, where an artery is taken from another part of the body and grafted to reroute the flow of blood to the heart muscle.

Like a heart attack, this is also caused by a blood flow issue. In strokes, the flow of blood from the heart to the brain is blocked by a blood clot that deprives the brain tissue of oxygen and other nutrients (ischemic stroke) or a blood vessel to the brain that bursts and causes bleeding (hemorrhagic stroke). Recognizing the signs of a stroke early (FAST) can mean the difference between a quick recovery and permanent brain damage.

The AHA recommends clot-busting medications be administered within three hours of the onset of certain types of stroke. After testing for blockage of the carotid arteries, which supply blood and oxygen to the front part of the brain, carotid endarterectomy surgery may be needed. For this procedure, the doctor makes a small incision in the artery in the neck near the blockage and removes the blockage.

Congestive heart failure
This is the result of the heart pumping blood ineffectively. The heart doesn’t stop working altogether, but it’s not meeting the needs of the rest of the body as it should. Without treatment, this condition can worsen over time.

The AHA says heart failure caused by damage to the heart over time can’t be cured, but it can be managed with lifestyle changes, medication, surgical procedures, and ongoing care from your health care team and caregivers. Talk with your doctor about these treatment options.

An irregular heartbeat, arrhythmia comes in many forms, such as beating too fast (tachycardia), too slow (bradycardia), or in an irregular pattern. This may also lead to the heart not pumping enough blood to meet the body’s needs.

A pacemaker is often implanted to treat arrhythmia. It’s a small device that helps the heart beat at a normal rate and rhythm using electrical impulses. The pacemaker is implanted under the skin and attached to the heart with tiny wires. Some newer models are wireless.

Heart valve problems
Stenosis of a heart valve is caused when heart valves don’t open enough to allow proper blood flow. Regurgitation occurs when the heart valves don’t close properly and blood leaks through. Prolapse is the bulging of one or more valve flaps back into the upper chamber. The AHA says understanding the role that heart valves play can help you watch for problems.

Some heart valve problems respond to medication alone. But most often, surgical repair or valve replacement are needed. Whatever the treatment, the AHA says valve disease is a condition that can’t be ignored even if you don’t feel symptoms for many years.

Make sure your doctor knows your personal and family history of heart issues. Regular visits to the doctor will help you manage your condition and may even uncover problems before they become serious.

For more information about cardiovascular health, read our recent article about Heart Month in Hawaii.

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