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Heart Disease
Key points
- Coronary artery disease is the
most common type of heart
disease.
- There are many other conditions
that affect the heart.
- The term "heart disease" refers
to several types of heart
conditions.
- Know your risk for heart disease
so you can prevent it.
- High blood pressure, high blood
cholesterol, and smoking are key
risk factors.
- About 1 in 5 people in the
United States died from heart
disease in 2022.

What is heart disease?
Heart disease is a variety of issues that can affect your
heart. When people think about heart disease, they often
think of the most common type —
coronary artery disease
(CAD) and the heart attacks
it can cause. But you can have trouble with different parts
of your heart, like your heart muscle, valves or electrical
system.
When your heart isn’t working well, it has trouble sending
enough blood, oxygen and nutrients to your body. In a way,
your heart delivers the fuel that keeps your body’s systems
running. If there’s a problem with delivering that fuel, it
affects everything your body’s systems do.
Lifestyle changes and medications can keep your heart
healthy and lower your chances of getting heart disease.
What causes heart disease?
The most common type of heart disease is coronary artery
disease (CAD), and the leading cause of CAD is
atherosclerosis, the buildup of cholesterol plaque inside
the coronary arteries. Too much plaque limits blood flow
through the arteries that supply blood to the heart.
Restricted blood flow can cause chest pain or pressure
(known as angina) and requires immediate medical attention.
When plaque ruptures, it can form a blood clot that stops
blood flow and triggers a heart attack.
The risk factors for
atherosclerosis (and thus CAD) include:
- high total blood cholesterol level
- high level of LDL (bad) cholesterol
- high levels of triglycerides
- high levels of lipoprotein(a)
- high blood pressure (hypertension)
- diabetes
- family history of heart disease
- smoking
- obesity
- physical inactivityiInflammation
Symptoms
A variety of symptoms and signs may indicate heart disease.
If you experience any of the following for no apparent
reason, immediately report them to your doctor.
Fatigue. Fatigue can be caused by many illnesses
and medicines. But constant, new fatigue can sometimes
signal two kinds of heart disease: heart failure and
coronary artery disease.
Unexplained aches or pains. Blockage of blood to
the heart muscle can cause pain or pressure in the chest,
shoulders, arms, back, jaw, or abdomen, primarily when pain
in these locations occurs with exercise and disappears with
rest.
Shortness of breath. Unexplained shortness of
breath that occurs with small amounts of activity.
Swollen legs, feet, or ankles. The kind of swelling
that leaves an indentation if you press your finger into it
could be a sign of heart failure.
Heart palpitations. Palpitation refers to a
heartbeat that feels irregular or rapid. Most palpitations
may be caused by anxiety, caffeine intake, or dehydration.
But sometimes they indicate a heart problem.
Sometimes heart disease may be "silent" and not diagnosed until a
person experiences signs or symptoms of a heart attack, heart
failure, or an arrhythmia. When these events happen, symptoms may
include:
-
Heart attack: Chest pain or discomfort, upper back or neck
pain, heartburn, nausea or vomiting, extreme fatigue, dizziness,
and shortness of breath.
-
Arrhythmia:
Fluttering feelings in the chest (palpitations).
-
Heart failure: Shortness of breath, fatigue, or swelling of
the feet, ankles, legs, abdomen, or neck veins.
Conditions related to heart disease
Coronary artery disease, also called Coronary Heart Disease
or ischemic heart disease, is the most common type of heart
disease, but there are many other conditions that affect the
heart.
-
Acute coronary syndrome is a term that includes
heart attack and unstable angina.
-
Angina, a symptom of coronary artery disease,
is chest pain or discomfort that happens when the heart
muscle is not getting enough blood. Angina may feel like
pressure or a squeezing pain in the chest. The pain also
may occur in the shoulders, arms, neck, jaw, or back. It
may feel like indigestion.
- There are two forms of angina—stable or unstable:
-
Stable angina happens during physical
activity or under mental or emotional stress.
-
Unstable angina is chest pain that occurs
even while at rest, without apparent reason. This
type of angina is a medical emergency.
-
Aortic aneurysm and dissection are conditions
that can affect the aorta, the major artery that carries
blood from the heart to the body. An aneurysm is an
enlargement in the aorta that can rupture or burst. A
dissection is a tear in the aorta, which is a medical
emergency. For more information, see
the aortic aneurysm information page.
-
Arrhythmias are irregular or unusually fast or
slow heartbeats. Arrhythmias can be serious. One example
is called ventricular fibrillation. This type of
arrhythmia causes an abnormal heart rhythm that leads to
death unless treated right away with an electrical shock
to the heart (called defibrillation). Other arrhythmias
are less severe but can develop into more serious
conditions, such as atrial fibrillation, which can cause
a stroke.
see the arrhythmias information page
-
Atherosclerosis happens when plaque builds up
in the arteries that supply blood to the heart (called
coronary arteries). Plaque is made up of cholesterol
deposits. Plaque buildup causes arteries to narrow over
time.
-
Atrial fibrillation is a type of arrhythmia
that can cause rapid, irregular beating of the heart's
upper chambers. Blood may pool and clot inside the
heart, increasing the risk for heart attack and stroke.
For more information, see
the atrial fibrillation information page.
-
Cardiomyopathy happens when the heart muscle
becomes enlarged or stiff. This can lead to inadequate
heart pumping (or weak heart pump) or other problems.
Cardiomyopathy has many causes, including family history
of the disease, prior heart attacks, uncontrolled high
blood pressure, and viral or bacterial infections.
-
Congenital heart defects are problems with the
heart that are present at birth. They are the most
common type of major birth defect. Examples include
abnormal heart valves or holes in the heart's walls that
divide the heart's chambers. Congenital heart defects
range from minor to severe.
-
Heart failure is often called congestive heart
failure because of fluid buildup in the lungs, liver,
legs, and feet. Heart failure is a serious condition
that occurs when the heart can't pump enough blood to
meet the body's needs. It does not mean that the heart
has stopped but that muscle is too weak to pump enough
blood. Most of heart failure cases are chronic, or
long-term heart failures. The only cure for heart
failure is a heart transplant. However, heart failure
can be managed with medications or medical procedures.
For more information, see
the heart failure information page.
-
Marfan syndrome. Marfan syndrome is a genetic
condition that affects connective tissue, which provides
support for the body and organs. It can damage the blood
vessels, heart, eyes, skin, lungs, and the bones of the
hips, spine, feet, and rib cage.
-
Mental health disorders can be short- or
long-term and can interfere with a person's mood,
behavior, thinking, and ability to relate to others.
Various studies have shown the impact of trauma,
depression, anxiety, and stress on the body, including
stress on the heart.
see the mental health information page.
-
Peripheral arterial disease (PAD) happens when
the arteries that supply blood to the arms and legs (the
periphery) become narrow or stiff. PAD usually results
from atherosclerosis, the buildup of plaque and
narrowing of the arteries. With this condition, blood
flow and oxygen to the arm and leg muscles are low or
even fully blocked. Signs and symptoms include leg,
calf, buttock, hip, or thigh pain, and numbness in the
feet.
see
the Peripheral arterial disease information page
-
Pulmonary hypertension happens when the
pressure in the arteries leading from the heart to the
lungs is too high. There are many conditions that lead
to pulmonary hypertension, including connective tissue
disease, liver disease, emphysema, and chronic blood
clots in the lungs. Symptoms of pulmonary hypertension
include shortness of breath and fatigue.
-
Rheumatic heart disease is a complication of
rheumatic fever. Rheumatic fever can develop after a
sore throat caused by streptococcal bacteria. The
infection can cause damage to the heart valves.
-
Valvular heart disease. Healthy heart valves
can fully open and close during a heartbeat, but
diseased valves cannot. If the heart valves are
diseased, the heart can't effectively pump blood
throughout the body and must work harder to pump. This
can lead to heart failure, sudden cardiac arrest (when
the heart stops beating), heart palpitations (rapid,
fluttering, or pounding), shortness of breath, or
swelling in your legs and feet.
Diagnosis
Heart diseases are the number one killer in the United
States. They are also a major cause of disability. If you do
have heart disease, it is important to find it early, when
it is easier to treat. Blood tests and heart health tests
can help find heart diseases or identify problems that can
lead to heart diseases. There are several different types of
heart health tests. Your health care provider will decide
which test or tests you need, based on your symptoms (if
any), risk factors, and medical history.
Tests
Many different tests are used to diagnose heart disease.
-
Blood tests. Certain heart proteins slowly leak into the
blood after heart damage from a heart attack. Blood tests can be
done to check for these proteins. A high-sensitivity C-reactive
protein (CRP) test checks for a protein linked to inflammation of
the arteries. Other blood tests may be done to check cholesterol and
blood sugar levels.
-
Chest X-ray. A
chest x-ray creates pictures of the organs and
structures inside your chest, such as your heart, lungs,
and blood vessels. It can reveal signs of heart failure,
as well as lung disorders and other causes of symptoms
not related to heart disease.
-
Electrocardiogram (ECG or EKG). An
electrocardiogram, also called an ECG or EKG, is a
painless test that detects and records your heart's
electrical activity. It shows how fast your heart is
beating and whether its rhythm is steady or irregular.
An EKG may be part of a routine exam to screen for heart
disease. Or you may get it to detect and study heart
problems such as heart attacks, arrhythmia, and heart
failure.
For the test, you lie still on a table and a nurse or
technician attaches electrodes (patches that have
sensors) to the skin on your chest, arms, and legs.
Wires connect the electrodes to a machine that records
your heart's electrical activity.
-
Holter monitoring. A Holter monitor is a portable ECG
device that's worn for a day or more to record the heart's activity
during daily activities. This test can detect irregular heartbeats
that aren't found during a regular ECG exam.
-
Echocardiogram. Echocardiography,
or echo, is a painless test that uses sound waves to
create moving pictures of your heart. The pictures show
the size and shape of your heart. They also show how
well your heart's chambers and valves are working.
Providers use an echo to diagnose many different heart
problems, and to check how severe they are.
There are several different types of echocardiography.
For transthoracic echocardiography (the most common
type), a technician applies gel to your chest. The gel
helps sound waves reach your heart. The technician moves
a transducer (wand-like device) across your chest. The
transducer connects to a computer. It transmits
ultrasound waves into your chest, and the waves bounce
(echo) back. The computer converts the echoes into
pictures of your heart.
-
Exercise tests or stress tests. Stress
testing looks at how your heart works during physical
stress. It can help to diagnose coronary artery disease,
and to check how severe it is. It can also check for
other problems, including heart valve disease and heart
failure.
For the test, you exercise (or are given medicine if you
are unable to exercise) to make your heart work hard and
beat fast. While this is happening, you get an EKG and
blood pressure monitoring. Before or after the test, you
might also have an echocardiogram, or other imaging
tests such as a nuclear scan. For the nuclear scan, you
get an injection of a tracer (a radioactive substance),
which travels to your heart. Special cameras detect the
energy from the tracer to craeate pictures of your
heart. You have pictures taken after you exercise, and
then after you rest.
-
Cardiac catheterization. Cardiac catheterization is a medical procedure used to
diagnose and treat some heart conditions. For the
procedure, your provider puts a catheter (a long, thin,
flexible tube) into a blood vessel in your arm, groin,
or neck, and threads it to your heart. The provider can
use the catheter to:
- Do a coronary angiography. This involves putting a
special type of dye in the catheter, so the dye can
flow through your bloodstream to your heart. Then
your provider takes x-rays of your heart. The dye
allows your provider to see your coronary arteries
on the x-ray, and to check for coronary artery
disease (CAD). CAD is caused by plaque buildup in
the arteries.
- Take samples of your blood and heart muscle.
- Examine your heart valves.
- Do procedures such as angioplasty or minor heart
surgeries to repair congenital heart defects or
replace heart valves.
-
Heart CT scan, also called cardiac CT scan. A cardiac CT (computed tomography) scan is a painless
imaging test that uses x-rays to take detailed pictures
of your heart and its blood vessels. Computers can
combine these pictures to create a three-dimensional
(3D) model of your whole heart. This test can help
providers detect or evaluate various heart problems,
including:
- Coronary artery disease
- Calcium buildup in the coronary arteries
- Congenital heart defects
- Problems with the aorta (the main artery that
carries blood away from the heart)
- Problems with heart function and valves
- Pericardial diseases
Before you have the test, you get an injection of
contrast dye. The dye highlights your heart and blood
vessels in the pictures. The CT scanner is a large,
tunnel-like machine. You lie still on a table that
slides you into the scanner, and the scanner takes the
pictures.
-
Heart magnetic resonance imaging (MRI) scan. Cardiac MRI (magnetic resonance imaging) is a painless
imaging test that uses radio waves, magnets, and a
computer to create detailed pictures of your heart. It
can help your provider figure out whether you have heart
disease, and if so, how severe it is. A cardiac MRI can
also help your provider decide the best way to treat
heart problems such as:
- Congenital heart defects
- Coronary artery disease
- Heart valve problems
- Pericarditis
- Cardiac tumors
- Damage from a heart attack
The MRI is a large, tunnel-like machine. You lie still
on a table that slides you into the MRI machine. The
machine makes loud noises as it takes pictures of your
heart. Sometimes before the test, you might get an
injection of contrast dye. The dye highlights your heart
and blood vessels in the pictures.
-
Coronary Angiography. Coronary angiography
(angiogram) is a procedure that uses contrast dye and
x-ray pictures to look at the insides of your arteries.
It can show whether plaque is blocking your arteries and
how severe the blockage is. Providers use this procedure
to diagnose heart diseases after chest pain, sudden
cardiac arrest (SCA), or abnormal results from other
heart tests such as an EKG or a stress test.
You usually have a cardiac catheterization to inject the
dye into your coronary arteries. Then the provider will
take special x-rays while the dye is flowing through
your coronary arteries. The dye lets your provider study
the flow of blood through your heart and blood vessels.
Treatment and recovery
Heart disease treatment depends on the cause and type of heart damage.
Treatment for heart disease may include:
- Lifestyle changes such as eating a diet low in salt and saturated
fat, getting more exercise, and not smoking.
- Medicines.
- A heart procedure.
- Heart surgery.
Medications
Anticoagulants
Some commonly prescribed include:
- Apixaban
- Dabigatran
- Edoxaban
- Heparin
- Rivaroxaban
- Warfarin
What the medication does
Sometimes called blood thinners, although they do not
actually thin the blood. Decreases the clotting ability of
the blood. They are used to treat certain blood vessel,
heart and lung conditions.
Reason for medication
- Helps to prevent
blood clots from forming in the blood vessels.
- May prevent the
clots from becoming larger and causing more serious
problems.
- Often prescribed to
prevent first or recurrent stroke or heart attack.
Antiplatelet agents and dual antiplatelet therapy (DAPT)
Some commonly prescribed include:
- Aspirin
- Clopidogrel
- Dipyridamole
- Prasugrel
- Ticagrelor
What the medication does
Keeps blood clots from forming by preventing blood platelets
from sticking together.
Reason for medication
- Helps stop clotting
in people who have had a heart
attack, unstable
angina, ischemic
strokes, TIA (transient
ischemic attacks) and other forms of cardiovascular
disease.
- Can be used
preventively when plaque buildup is evident but there is
not yet a major blockage in the artery.
- Can stop clots from
forming inside stents or after coronary bypass graft
surgery (CABG).
- Certain people will
be prescribed aspirin and another antiplatelet drug.
This is known as dual antiplatelet therapy (DAPT).
Dual antiplatelet therapy
Some people are treated with two types of antiplatelet
agents at the same time to prevent blood clotting. It can be
used for people who have:
- Heart attacks
- Stents placed in
their coronary arteries
- Coronary artery
bypass graft surgery (CABG)
- Stroke and transient
ischemic attacks
- Angioplasty
One antiplatelet agent is aspirin. Many people with coronary
artery disease are treated with aspirin for the rest of
their lives. A second antiplatelet agent, called a P2Y12
inhibitor, is usually prescribed for months or years in
addition to the aspirin therapy.
The type of medication and length of treatment will vary
based on your condition and other risk factors. Talk to your
health care professional about the risks and benefits of
DAPT.
- If you had a heart
attack, it is recommended that you be on DAPT for at
least a year. If you don’t have a high bleeding risk,
taking it longer may lower your risk of a future heart
attack.
- If you received a
“bare metal” stent and you are a high bleeding risk,
your health care professional may give you a P2Y12 inhibitor
for a shorter period to decrease the chances of
bleeding. If you are at a lower risk of bleeding, you
may have been treated with a drug-eluting stent, and you
may be on DAPT for 6-12 months or longer. If you don’t
have a high bleeding risk, a longer duration may lower
your risk of future heart attack and clotting of the
stent. It’s important to take the medication as
prescribed. Stopping it on your own can increase risk of
clots forming inside the stent, particularly in the
first few months.
- If you had CABG, you
may be treated with a P2Y12 inhibitor
for a year after the surgery.
If you have questions about your treatment, talk to your
primary health care professional.
Angiotensin-converting enzyme (ACE) inhibitors
Some commonly prescribed include:
- Benazepril
- Captopril
- Enalapril
- Fosinopril
- Lisinopril
- Moexipril
- Perindopril
- Quinapril
- Ramipril
- Trandolapril
What the medication does
- Relax and widen
blood vessels
- Lower blood pressure
- Make it easier for
the heart to pump blood
Reason for medication
- Used to treat or
improve symptoms of cardiovascular conditions including high
blood pressure and heart
failure.
- They also provide
health benefits to people who have had a heart attack.
Angiotensin II receptor blockers (or inhibitors)
(Also known as ARBs)
Some commonly prescribed include:
- Azilsartan
- Candesartan
- Eprosartan
- Irbesartan
- Losartan
- Olmesartan
- Telmisartan
- Valsartan
What the medication does
- Relax and widen
blood vessels
- Lower blood pressure
- Make it easier for
the heart to pump blood
Reason for medication
- Used to treat or
improve symptoms of cardiovascular conditions including
high blood pressure, heart failure and chronic kidney
disease.
Beta blockers
(Also known as Beta-adrenergic blocking agents)
Some commonly prescribed include:
- Acebutolol
- Atenolol
- Betaxolol
- Bisoprolol
- Metoprolol
- Nadolol
- Propranolol
- Sotalol
What the medication does
- May lower blood
pressure
- Slow the heart rate
(how fast the heart beats)
- Make it easier for
the heart to pump blood
Reason for medication
- Used to treat some
types of heart attacks, high blood pressure, chest pain
(angina) caused by reduced blood supply to the heart
muscle and some arrhythmias (abnormal heart rhythms).
- Used to help prevent
future heart attacks in people who have had a heart
attack.
Combined alpha and beta-blockers
Combined alpha and beta-blockers are used to treat high
blood pressure and heart failure.
Some commonly prescribed include:
A possible side effect of combined alpha and beta-blockers:
- May cause a drop in
blood pressure when you stand up.
Calcium channel blockers
(Also known as calcium antagonists or calcium blockers)
Some commonly prescribed include:
- Amlodipine
- Diltiazem
- Felodipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Verapamil
What the medication does
May decrease the heart’s pumping strength and relax blood
vessels.
Reason for medication
- Used to treat high
blood pressure, chest pain (angina) caused by reduced
blood supply to the heart muscle and some abnormal heart
rhythms.
Cholesterol-lowering medications
Some commonly prescribed include:
- Statins:
Atorvastatin, Fluvastatin, Lovastatin, Pitavastatin,
Pravastatin, Rosuvastatin, Simvastatin
- Nicotinic acids:
Niacin
- Cholesterol
absorption inhibitor: Ezetimibe
- Combination statin
and cholesterol absorption inhibitors:
Ezetimibe/Simvastatin
- Bile acid
sequestrants: Cholestyramine, Colesevelam, Colestipol
- PCSK9 inhibitors:
Alirocumab, Evolocumab
What the medication does
Various medications can lower blood cholesterol levels. But
statins are the best first course of action. When statins
don’t work, or if a person has serious side effects from
statin therapy, other drugs may be used.
Cholesterol-lowering medications work in the body in
different ways. Some affect the liver, some work in the
intestines and some interrupt the formation of cholesterol
from circulating in the blood.
Reason for medication
Used to lower LDL ("bad") cholesterol.
*Some
cholesterol-lowering medications may interact with
grapefruit, grapefruit juice, pomegranate and pomegranate
juice. Please talk to your health care professional about
any potential risks.
Diuretics
(Also known as water pills)
Some commonly prescribed include:
- Acetazolamide
- Amiloride
- Bumetanide
- Chlorothiazide
- Chlorthalidone
- Furosemide
- Hydro-chlorothiazide
- Indapamide
- Metolazone
- Spironolactone
- Torsemide
What the medication does
Causes the body to rid itself of excess fluids and sodium
through urination. Helps to reduce the heart's workload.
Also decreases the buildup of fluid in the lungs and other
parts of the body, such as the ankles and legs. Different
diuretics remove fluid at varied rates and through different
methods.
Reason for medication
- Used to help lower
blood pressure.
- Reduce swelling
(edema) from excess buildup of fluid in the body.
Vasodilators
Some commonly prescribed include:
- Isosorbide dinitrate
- Isosorbide
mononitrate
- Hydralazine
- Nitroglycerin
- Minoxidil
What the medication does
Widens the blood vessels so the blood flows more
easily. Reduces the heart’s workload and decreases blood
pressure.
A type of vasodilators called nitrates increases the supply
of blood and oxygen to the heart while reducing its
workload. This can ease chest pain (angina). Nitroglycerin
is available as a pill to be swallowed or absorbed under the
tongue, a spray and as a topical cream.
Reasons for medication include
- Used to ease chest
pain (angina)
- Used to treat heart
attack
- Used to treat high
blood pressure
- Treats high blood
pressure caused by pregnancy
Surgery or other procedures
Devices for Heart Failure
Implantable cardioverter defibrillator (ICD)
Some people who have severe heart
failure or serious arrhythmias (irregular
heartbeats) might need implantable cardioverter
defibrillators, or ICDs. These devices are surgically placed
and detect life-threatening arrhythmias. When they do, they
deliver a shock to the heart to reset its rhythm so it can
resume normally. Some newer pacemakers can also work as ICDs.
ICDs have saved millions of lives but are only advisable in
certain circumstances. The physician and patient share the
decision to use an ICD.
Cardiac Resynchronization Therapy (CRT)
Some people with heart failure develop abnormal heart beats,
called arrhythmias. This can reduce how well the heart’s
lower chambers (ventricles) can function. Cardiac
resynchronization therapy, also known as biventricular
pacing, may be needed. In this procedure, a special
pacemaker makes the ventricles contract at the same time.
This helps the lower heart chambers pump and relax together.
This therapy can improve heart function, reduce
hospitalization risk and increase survival.
Left ventricular assist device (LVAD)
The left ventricle is the large, muscular chamber of the
heart that pumps blood out to the body. An LVAD is a
mechanical pump-type device. Some people use this device
permanently, but it’s most often considered a bridge to
transplant, or a short-term fix if surgery or a heart
transplant is needed.
Surgical procedures for heart failure
Surgery isn’t frequently used to treat heart failure. But
your health care team might recommend it when they identify
a correctable problem that’s causing heart failure, such as
a defect, including a heart valve or a blocked coronary
artery.
Surgery may also be needed if heart failure is so severe
that it can’t be helped with medications and lifestyle
changes.
Heart transplantation
Some people have severe, progressive heart failure that
can’t be helped by medications, other devices and
procedures, or eating and lifestyle changes. In such cases,
a heart transplant could be the only effective treatment
option.
Surgeons replace the damaged heart with a healthy one from a
donor who has identified themselves as an organ donor while
alive and been declared brain dead. It can take several
months to find a donor heart that closely matches the
tissues of the person receiving the transplant. But this
matching process is essential to reduce the chances of
rejection.
During a transplant procedure, the surgeon connects the
patient to a heart-lung machine, which takes over the
functions of the heart and lungs. The surgeon then removes
the diseased heart and replaces it with the donor heart.
Finally, the major blood vessels are reconnected, and the
new heart is ready to work.
The outlook for people with heart transplants is good after
the transplant. In fact, about 90% of patients live for more
than a year after their operations and on average, survival
is greater than 12 years. However, the number of patients
who receive heart transplants is still relatively low,
around 3,500 each year.
Percutaneous coronary intervention (PCI, also referred to as
angioplasty)
Heart failure can develop when blockages in the coronary
arteries restrict the blood supply to the heart muscle.
Removing these blockages can improve overall heart function,
which can improve or resolve heart failure symptoms. PCI,
often called angioplasty, is one procedure to reopen blocked
blood vessels.
The procedure is usually performed in the cardiac
catheterization lab. A small tube (catheter) with a tiny,
deflated balloon on the end is inserted through an incision
in the groin (or other area where the artery can be
accessed) and pushed through to the diseased artery. Then
the balloon is inflated to push open the artery. The balloon
is removed once the artery has been fully opened.
A stent can be placed during the procedure to keep the blood
vessel open.
Although there’s a slight risk of damage to the artery
during PCI, this procedure usually improves the patient’s
condition.
Coronary artery bypass
Coronary artery bypass surgery reroutes the blood supply
around a blocked section of the artery.
During this procedure, surgeons remove healthy blood vessels
from another part of the body, such as a leg, wrist or the
chest wall. They then surgically attach the vessels to the
diseased artery so that the blood can flow around the
blocked section.
After a bypass operation, it’s especially important to
reduce the amount of fat and cholesterol you eat because
these substances cause the arteries to clog. Health care
professionals also recommend increasing physical activity to
strengthen the heart muscles.
Valve replacement
Heart failure is sometimes caused by a defective or diseased
heart valve.
Heart valves regulate the flow of blood inside the heart.
When the valves don’t work properly, this puts extra strain
on the heart and can lead to heart failure.
For some valve problems, medical management is the first
step in treatment. Correcting the problem surgically often
improves or resolves the condition as well.
During valve repair, the damaged sections of the valve are
strengthened. During valve replacement, the failing valve is
removed, and a new valve is used in its place. A variety of
different replacement valves can be used, including a
mechanical valve made from metal and plastic, or one made
from human or animal tissue. During the surgery, the patient
is connected to a heart-lung machine that supplies blood to
the brain and body.
After the operation and depending on the type of replacement
heart valve used, patients can take medicines to prevent
blood clots from forming around the new heart valve. This
treatment is often long-term to ensure the new valve works
properly. Most heart valve surgeries are a success, but the
operation is only considered as an option when a defective
or diseased valve threatens someone’s life.
In some patients, heart valve replacement can occur without
surgery. TAVR is a minimally invasive procedure where a new
valve is inserted without removing the old, damaged valve.
But candidacy for this kind of procedure is highly
individualized.
What is cardiac rehabilitation?
Cardiac rehabilitation is an important program for anyone
recovering from a heart attack. This can also include heart failure,
or some types of heart surgery.
Cardiac rehabilitation is a
supervised program that includes
- Physical activity.
- Education about healthy eating.
- Taking medicine as prescribed.
- Ways to help you quit smoking.
- Counseling to find ways to relieve stress and improve mental
health.
A team of people may help you through cardiac rehabilitation.
This
may include
- Your health care team.
- Exercise and nutrition specialists.
- Physical therapists.
- Counselors or mental health professionals.
How can you prevent heart disease?
The best way to prevent heart disease is to adopt
heart-healthy habits. These include managing blood pressure
and cholesterol levels, eating a plant-based diet, adopting
regular exercise, maintaining a proper weight, getting
enough sleep, and not smoking.
Blood pressure. High blood pressure makes the heart
work harder, which can weaken the heart muscle over time.
Blood pressure is measured in millimeters of mercury (mm Hg)
and is categorized as follows:
- Normal: less than 120/80 mm Hg
- Elevated: 120/less than 80 to 129/less than 80 mm Hg
- Stage 1 hypertension: 130/80 to 139/89 mm Hg
- Stage 2 hypertension: 140/90 mm Hg and above.
Cholesterol. There are two main types: "bad"
low-density lipoprotein (LDL) and "good" high-density
lipoprotein (HDL). Ideally, most adults should keep their
LDL below 100 milligrams per deciliter (mg/dL) and their HDL
above 40 mg/dL. However, your ideal numbers may differ based
on your health, risk factors for heart disease, and
individual goals, as determined in consultation with your
doctor.
Diet. Following a plant-based diet is known to
protect against heart disease. The plant diets that have
been most studied for heart health are the Mediterranean
diet and the DASH (Dietary Approaches to Stop Hypertension)
diet. Each emphasizes eating foods associated with
heart-healthy benefits, such as whole grains, fruits,
vegetables, legumes, nuts and seeds, fatty fish, and healthy
oils like olive oil, and reducing the intake of red meat and
processed foods.
Exercise. Guidelines recommend that adults engage
in at least 150 minutes of moderate-intensity aerobic
activity per week, which breaks down to 30 minutes daily,
five days a week. But this is the minimum. Evidence suggests
that doing more is better.
Weight. About 30% of American adults are classified
as overweight. While it's natural for people's weight to
increase somewhat with age, even five to 10 pounds over your
ideal number is associated with an increased risk of heart
disease. Check with your doctor to determine your weight
range for your gender, age, and body type.
Sleep. Experts recommend that adults get at least
seven hours of sleep per night. Studies have found that less
than this amount is associated with heart disease risk
factors like higher stress levels, increased inflammation,
high blood pressure, and weight gain.
Smoking. Smokers have a much higher heart disease
risk than never-smokers, and two to three times the risk of
early death. Certain medications and nicotine replacement
therapies can help people quit. Speak with your doctor about
these or other options.
Heart Disease Facts
Heart disease in the United States
In the United States:
- Heart disease is the leading
cause of death for men, women, and people of most
racial and ethnic groups.
- One person dies every
33 seconds from cardiovascular disease.
- In 2022, 702,880
people died from heart disease. That's the equivalent
of 1
in every 5 deaths.
- Heart disease cost about $252.2
billion from 2019 to 2020. This includes the cost of
health care services, medicines, and lost productivity due to death.
- the top 10 states with the highest heart disease death
rates per 100,000 residents were:
- Oklahoma (264.2)
- Mississippi (255.2)
- Alabama (247.5)
- Louisiana (235.5)
- Arkansas (231)
- Tennessee (223.8)
- West Virginia (223)
- Kentucky (217.5)
- Michigan (209.6)
- Nevada (208.1)
- the 10 states with the lowest heart disease rates per
100,000 residents were:
- North Dakota (152.8)
- Florida (151.3)
- Oregon (148.5)
- California (147.8)
- Washington (147.7)
- Connecticut (136.7)
- Colorado (135.1)
- Massachusetts (134)
- Hawaii (126.5)
- Minnesota (123.9)
Coronary artery disease (CAD)
- Coronary heart disease is the most common type of heart disease.
It killed 371,506 people in 2022.
- About 1
in 20 adults age 20 and older have CAD (about 5%).
- In 2022, about 1 out of every 5 deaths from cardiovascular
diseases (CVDs) was among adults younger than 65 years old.
Heart attack
- In the United States, someone has a heart attack every 40
seconds.
- Every year, about 805,000
people in the United States have a heart attack. Of
these, 605,000 are a first heart attack, and 200,000 happen to
be people who have already had a heart attack.
- About 1 in 5 heart attacks are silent—the damage is done, but
the person is not aware of it.
Did you know?
Early action is important for heart attack. Know the
warning signs
and symptoms of a heart attack. As plaque builds up in the arteries of a person with heart
disease, the inside of the arteries begins to narrow, which
lessens or blocks the flow of blood.
Who is affected
Heart disease deaths vary by sex, race, and ethnicity
Heart disease is the leading
cause of
death for people of most racial and ethnic groups in the United
States. These include African American, American Indian, Alaska Native,
Hispanic, and White men. For women from the Pacific Islands and Asian
American, American Indian, Alaska Native, and Hispanic women, heart
disease is second only to cancer.
Below are the percentages of all deaths caused by heart disease in 2021,
listed by ethnicity, race, and sex.
Race or Ethnic
Group |
% of
Deaths |
American Indian or Alaska Native |
15.5 |
Asian |
18.6 |
Black (Non-Hispanic) |
22.6 |
Native Hawaiian or Other Pacific Islander |
18.3 |
White (Non-Hispanic) |
18.0 |
Hispanic |
11.9 |
All |
17.4 |
Prognosis
What can I expect if I have heart disease?
Medications and/or procedures can help people who have various types
of heart disease. It’s easier to treat most types of heart disease
if you get an early diagnosis instead of waiting for symptoms to get
worse. Many people can live full lives when they follow their
healthcare provider’s treatment plan.
Living With
How do I take care of myself?
If you have coronary artery disease (the most common kind of heart
disease), you can improve your health by making changes to your
daily life. This may include reducing how much salt and saturated
fat you eat and increasing how much you exercise. In addition, a
provider may recommend taking medicine to lower your cholesterol
and/or blood pressure.
When should I see my healthcare provider?
If you have a biological family history of heart disease, you may
want to ask your provider if you have other risk factors. If you do,
you can make a plan to help prevent heart disease.
Contact your provider if you have heart disease symptoms.
When should I go to the ER?
Call your local emergency number if you suddenly experience these
issues:
- Chest pain, pressure, heaviness or discomfort.
- Fainting.
- Shortness of breath.
What questions should I ask my doctor?
You may want to ask your healthcare provider:
- What kind of heart disease do I have?
- Is my family at risk for this type of disease?
- What’s the best treatment for my situation?
One Final Note..
Your heart has a crucial job, so it’s important to pay attention to
warning signs of a heart issue. Many heart diseases develop over
time. Identifying heart disease early gives you the best chance of
managing it well. Talk with a healthcare provider about the best
ways to prevent heart disease or keep it from getting worse. Even if
you have risk factors you can’t change, there are other things you
have the power to change.
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