The signs of heart disease

Heart attack is the leading killer in the United States, and one-third of its victims die with the disease undiagnosed. Dr. Stephen Pollock, a cardiologist at University of Maryland St. Joseph Medical Center, talks about the best ways to detect, prevent and treat heart disease. Pollock himself had two stents installed to clear blockages after findings from a stress test.

What is heart disease?

Cardiovascular disease or heart disease is a broad term that refers to several different types of issues an individual may have with their heart. A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. ... Heart failure occurs when the heart isn't pumping blood as well as it should. Arrhythmia is an abnormal rhythm of the heart. Stenosis occurs when heart valves don't open enough to allow the blood to flow through as it should.

The first symptom of undiagnosed coronary disease is sudden death in almost one-third of patients with the disease. The sudden death is the result of a heart attack that causes a lethal heart rhythm abnormality, known as ventricular fibrillation.

How significant is the problem of heart disease in America?

Most people have some risk of heart disease: It is the leading cause of death in the United States. More than 800,000 people die of cardiovascular disease each year — that's one in every three deaths, and about 160,000 of them occur in people under age 65. Heart disease kills roughly the same number people in the United States each year as cancer, lower respiratory diseases and accidents combined.

We hear the terms "heart attack" and "cardiac arrest" often, and many people use them interchangeably, but in fact they are two different conditions. Can you explain?

A heart attack is the result of a sudden occlusion of a coronary artery by a blood clot. This actually is caused when the cholesterol plaque breaks and precipitates the formation of a blood clot.

"Cardiac arrest" is the term used to describe when the heart no longer pumps blood effectively and thus there is no blood pressure. Most common cause of this is ventricular fibrillation. This rhythm is most often associated with a heart attack.

What is the best test to diagnose heart disease, and are an EKG or stress test accurate detection tools?

An EKG or a stress test does not predict heart disease. The best test available to diagnose heart disease is coronary calcium score test, but many people don't know about it. Every man over the age of 45 and every woman over the age of 50 should have a coronary calcium test. The test uses CT scanning to measure the location and amount of calcified plaque in the arteries. The test can catch the presence of disease even when the arteries are less than 50 percent blocked.

How big of a role does family history play in heart disease?

The risk of heart disease is strongly tied to family history. However, just because your family has a history of cardiovascular disease, does not mean that you will certainly have the same disease. It just means that the potential is higher.

What is the best preventative therapy?

The best preventive therapy is first to have a health care professional make the diagnosis of heart disease. Then, it's a fairly simple therapy — patients should take an aspirin a day, a statin like Lipitor or Crestor daily — with a goal of significantly lowering total cholesterol and bad cholesterol. Regular exercise and appointments with a cardiologist can also help prevent the disease. This won't guarantee that you won't have a heart attack, but it reduces the chances.

Lifestyle changes that are most effective include maintaining an ideal weight, engaging in regular exercise, ensuring a normal blood pressure and not smoking.

How are the symptoms of heart disease different in women than in men?

Men and women alike can experience heart attack symptoms such as chest pains and cold sweats. But women can also have subtler, less recognizable symptoms such as fatigue, nausea, shortness of breath and pain or discomfort in the stomach, jaw, neck or back.

Does a heart attack always lead to cardiac arrest?

A heart attack does not always lead to a cardiac arrest, but it is the most lethal complication.

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