Subject Contents

Heart disease

Heart disease involves any disorder that affects the heart's ability to function normally. The most common cause of heart disease is narrowing or blockage of the coronary arteries, which supply blood to the heart itself. Some patients are born with abnormalities (congenital heart disease). Other causes include the following:
  • Abnormal function of the heart valves
  • Abnormal electrical rhythm of the heart
  • Weakening of the heart's pumping function caused by infection or toxins
  • Various forms of heart disease include:
  • Alcoholic cardiomyopathy
  • Aortic regurgitation
  • Aortic stenosis
  • Arrhythmias
  • Cardiogenic shock
  • Congenital heart disease
  • dilated cardiomyopathy
  • Endocarditis
  • Heart attack
  • (myocardial infarction)
  • Heart failure
  • Heart tumor
  • Hypertrophic cardiomyopathy
  • Idiopathic cardiomyopathy
  • Ischemic cardiomyopathy
  • Mitral regurgitation; acute
  • Mitral regurgitation; chronic
  • Mitral stenosis
  • Mitral valve prolapse
  • Peripartum cardiomyopathy
  • Pulmonary stenosis
  • Stable angina
  • Unstable angina
  • Tricuspid regurgitation
  • See also
  • chest pain .
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    Alternative Names
    Cardiovascular disorders
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    Causes, incidence, and risk factors


    Signs and tests


    Support Groups

    Expectations (prognosis)


    Calling your health care provider


    Heart disease and diet

    Dietary guidelines based on the American Heart Association's Year 2000 recommendations.
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    Alternative Names
    Diet - heart disease
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    The purposes of the American Heart Association diet are:
  • to reduce the risk of
  • heart disease
  • to reduce the risk of certain contributors to heart disease, including
  • high cholesterol , hypertension , and obesity
  • to reduce the risk of other chronic health problems, including
  • type 2 diabetes , osteoporosis , and some forms of cancer
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    Food Sources
    Fruits and vegetables are good sources of fiber , vitamins , and minerals. Most are low in fat , calories, sodium, and cholesterol . Most fruits and vegetables are appropriate for a heart-healthy diet. Dairy products and milk are good sources of protein , calcium, the B vitamins niacin and riboflavin , and the vitamins A and D. Use skim milk, 1/2%, or 1% milk.  Cheese, yogurt, and buttermilk should be low-fat or nonfat. Breads, cereals, pasta and starchy vegetables are high in the B vitamins, iron, and fiber. They are low in fat and cholesterol.
  • Eat low-fat breads, cereals, crackers, rice, and pasta, and starchy vegetables like peas, potatoes, corn, winter squash, and lima beans.
  • Avoid baked goods with eggs, such as egg rolls or egg noodles; butter rolls; cheese crackers; croissants; cream sauces for pasta and vegetables; and cream soups.
  • Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, the B vitamins, iron, and other vitamins and minerals.
  • Eat skinless poultry, very lean beef, lamb, veal, and pork; lentils, legumes, dried beans and peas; egg whites; and wild game.
  • Avoid prepared meats such as sausage, frankfurters, and
  • high-fat lunch meats; marbled meats; prime cuts of high fat meats; duck; goose; and organ meats such as kidneys and liver. Avoid oils and fats . They are high in fat and calories, and people should eat less of all types of fat. Some fats are better choices than others but should still be used in moderate amounts.
  • Use liquid vegetable oils such as safflower, soybean, corn, sesame, olive, canola, avocado and cottonseed. Use margarines made from any of these oils in their tub or squeeze form, not their stick form. Salad dressings and mayonnaise should be made with the recommended oils.
  • Seeds, nuts, olives, avocados and peanut butter are also acceptable in moderate amounts.
  • Avoid butter, lard, bacon, shortening, sour cream, whipping cream, and coconut, palm or palm kernel oil. These contain saturated fats and are not recommended.
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    Side Effects
    Diet recommendations for children over the age of 2 years are similar to those of adults. Children and teenagers must have enough calories to support growth and activity level while they achieve and maintain a desirable body weight. Children following low-fat diets may have difficulties maintaining desired levels of growth. Consult a physician or dietitian for assistance in planning adequate low-fat meals for children and adolescents. Note: For an individualized meal plan incorporating the dietary guidelines of the American Heart Association, a nutrition consultation with a registered dietitian is helpful. Each state's American Heart Association is also an excellent resource for information on heart disease .
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  • Eat 5 or more servings per day of fruits and vegetables.
  • Eat 6 or more servings per day of grain products, including whole grains.  Grain products provide fiber, vitamins, minerals, and complex
  • carbohydrates .  The daily calories should be appropriate for the maintenance of desirable body weight and should support growth in children and adolescents.
  • Reduce total
  • fat intake. (The average fat intake of most Americans is too high.) Reduce saturated fat -- the fat that raises your cholesterol level -- by using liquid or tub margarine, canola oil, or olive oil. These have 2g or less of saturated fat per serving.
  • Eat less than 300mg of
  • dietary cholesterol daily. (For example, one egg yolk contains an average of 213 mg.)
  • Limit salt intake (salt is also called sodium chloride. Sodium chloride should be less than 6 grams/day, which is equal to 2400mg of pure sodium per day.  Increased salt intake can be associated with fluid retention, which leads to an increase in the blood volume and is a risk factor for
  • high blood pressure and heart disease . Maintain a healthy body weight and a diet that is rich in fruits, vegetables, and low-fat dairy products, and that is low in fat. EATING TIPS
  • To reduce fat and cholesterol, eat no more than 6 cooked ounces of meat, poultry, and fish daily. One serving of meat should be about the size of a deck of cards on your plate.
  • Use skinless turkey, chicken, fish or lean red meat to reduce the amount of saturated fat in your diet. Lean cuts of red meat may be used occasionally.
  • Trim all the visible fat prior to cooking the meat. Eat two servings of fish per week. Cook by baking, broiling, roasting, steaming, boiling, or microwaving rather than deep fat frying. For the main entree, substitute less meat or meatless meals a few times a week. Use smaller amounts of meat to reduce the total fat content of the meal. Use no more than 5 or 8 teaspoons of fats or oils per day for salads, cooking, and baking.
  • To reduce
  • high cholesterol , do not use more than 3 to 4 egg yolks per week, including eggs used in cooking. Eat less organ meats (such as liver) and shellfish (such as shrimp and lobster).
  • To reduce salt, reduce the amount of table salt used, and limit the use of prepared foods that have salt added to them, such as canned soups and vegetables, cured meats, and some frozen meals. Always check the nutrition label for the sodium content per serving.
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    Heart disease and vitamin E


    Alternative Names
    Vitamin E and heart disease
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    Question: Can vitamin E reduce your risk of getting heart disease? Answer: According to the American Heart Association, some studies have shown that eating foods (fruits, vegetables and whole grains) high in antioxidants (Vitamins A, E, and C) may lower a person's risk of heart disease . However, the studies done so far have not been able to show clear-cut benefits for taking supplemental vitamin E (pill-form) to aid in reducing the risk for heart disease. vitamin E is an antioxidant. As such, it protects body cells from oxidation. (Oxidation is a process that can lead to cell damage and may play an important role in atherosclerosis.)
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    Heart disease - resources


    Alternative Names
    Resources - heart disease
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    RESOURCES FOR HEART DISEASE American Heart Association National Center 7272 Greenville Avenue Dallas, Texas 75231 (800) AHA-USA-1 www.americanheart.org Mended Hearts 7272 Greenville Avenue Dallas, TX 75231 (800) HEART99 www.mendedhearts.org Call the toll-free number to find a Mended Hearts Chapter, or to receive educational brochures related to your condition -- just ask the Heart and Stroke Information Specialist for assistance in selecting the brochures. The American College of Cardiology Heart House 9111 Old Georgetown Road Bethesda, MD 20814-1699 (800) 253-4636 ext. 694 (301) 897-5400 www.acc.org GENERAL INFORMATION: Additional resources can be found through local libraries, your health care provider, and the yellow pages under "social service organizations."
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    Alternative Names

    Mention the term " heart attack " and most people imagine a pudgy, middle-aged man drenched in sweat and clutching his chest. Ask a woman what she fears most and chances are good she'll reply "breast cancer." Few patients seem to consider cardiovascular disease (CVD) as a "woman's disease." But in fact, heart disease kills more women each year than the next 14 causes of death combined. Approximately 250,000 American women will die from a heart attack this year. Yet only a handful of women believe that heart attack and stroke are their greatest health threat. The misleading notion that heart disease is not a real problem for women can be blamed in part on medical research. For a very long time, heart disease studies have focused primarily on men. Changes are under way, but some doctors still fail to recognize the warning signs displayed by female patients. EARLY HEART SIGNS A study funded by the National Institute of Nursing Research found that women experience undiagnosed warning signs weeks, months, and even years before having a heart attack. "We're finding that, on average, most women experience warning signs four to six months prior to their heart attack," says study investigator Jean McSweeney, a professor at the University of Arkansas for Medical Sciences. To obtain her results, McSweeney's team interviewed more than 600 female heart attack survivors at medical centers and hospitals in Arkansas, Ohio, and North Carolina. Significant differences exist in the symptoms displayed by women and men. Men typically experience the "classic" heart attack signs: tightness in the chest, arm pain, and shortness of breath. Women's symptoms -- nausea, an overwhelming fatigue, and dizziness -- are strikingly different and are often chalked up to stress. "Women started telling me how they had a hard time getting physicians to listen to them about these early warning symptoms," explains McSweeney. Unusual fatigue, trouble sleeping, shortness of breath, indigestion and anxiety were the top five symptoms reported by both black and white women in the study. However, black women had more intense episodes and reported them more often. "That surprised us, and we plan to look into it," admits McSweeney. "We do know that black women have more co-existing conditions, such as obesity and diabetes , that could increase their likelihood of having heart disease." ACT IN TIME Recognizing and treating a heart attack right away dramatically improves a patient's chance for survival. The typical American, however, waits two hours before calling for help. "Time is heart muscle," says Nieca Goldberg, M.D., chief of the Women's Heart Program at Lenox Hill Hospital in New York and author of Women are Not Small Men: Life-Saving Strategies for Preventing and Healing Heart Disease in Women . "If you get to the hospital during a heart attack, we can administer aggressive clot-busting treatments." Studies have shown that drugs that dissolve coronary blood clots during a heart attack can reduce the death rate in both men and women, although women have a higher risk of stroke from the therapy. Unfortunately, statistics show that a woman in the midst of having a heart attack receives clot-busting therapy much later than a man would. "Women coming into the hospital for a heart attack have a higher death rate and higher risk of complications. A premenopausal woman having a heart attack has twice the death rate of a similarly aged man, " says Goldberg. Know the warning signs and always call 911 within five minutes of the onset of symptoms, advises James Atkins, M.D., program director of emergency medicine education at UT Southwestern Allied Health Sciences School. By acting quickly, a heart attack victim is less likely to experience cardiac arrest (where the heart stops beating). PREVENTION TIED TO BELIEF There is no denying that an ounce of prevention is worth a pound of cure. But preventing a disease means believing you are actually at risk -- and many women fail to see that. "Women absolutely need to become more aware of their risk for heart disease," Goldberg says. "Whenever a woman comes to see me after a heart attack, I always ask when they last felt well. Often it was several months, even a year, before the attack." Women are advised to be proactive with their doctor by addressing the risk factors and keeping tabs on cholesterol levels, blood pressure, and lifestyle. According to the American Heart Association, low blood levels of "good" cholesterol (high density lipoprotein, or HDL) are a stronger predictor of heart disease death in women than in men. "Heart disease is the leading women's health care issue," says Goldberg. "If your symptoms aren't taken seriously, seek a second opinion." WOMEN & HEART DISEASE Source: American Heart Association
  • Cardiovascular disease (CVD) ranks first among all disease categories in hospital discharges for women
  • More than 43% of all female deaths in the US and most developed countries are due to CVD.
  • In 1997, CVD killed about twice as many women as all forms of cancer combined.
  • More women than men will die within the first year after a heart attack
  • Only 8% of women in America believe CVD is their greatest health threat.
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