Patient Education

THIS IS NOT A DIAGNOSTIC SITE, IF YOU HAVE SYMPTOMS PLEASE SEEK GUIDANCE FROM A CARDIOLOGIST.

Anatomy of the heart: The heart is a muscle and like all muscles it requires blood to supply it oxygen in order to function properly. Because the heart can never rest, it requires special arteries to supply its blood. These arteries are known as coronary arteries and supply oxygen rich blood specifically to the heart. The two major coronary arteries are the left main coronary artery which supplies the left side of the heart with blood and to the right coronary artery (RCA) which supplies the right side of the heart with blood. The major coronary arteries branch off into smaller arteries such as the Circumflex and the Left Anterior Descending (LAD) arteries.

 

Coronary artery disease:
Coronary artery disease is specific to the arteries of the heart. These arteries, known as coronary arteries, supply the heart muscle with blood. Coronary artery disease is caused by a buildup or hardening of the arteries. The arteries become narrowed by a buildup of plaque or when a blood clot becomes lodged in the artery. When the supply of blood to the heart muscle is decreased due to plaque build up, blood clots, or heart spasm you may experience chest pain or angina. A heart attack occurs when the blood supply is completely cut off and the portion of the heart muscle that is lacking blood dies.

Peripheral vascular disease: Peripheral vascular disease refers to blockages in arteries of the brain, kidneys, arms and legs. Peripheral vascular disease is a form of hardening of the arteries as found in the heart or coronary arteries. Hardening of the arteries, atherosclerosis, is caused when fatty substances such as cholesterol build up inside the artery walls. Over time, this build up can create a narrowed opening which restricts the blood flow through the artery. Restricted blood most commonly occurs in the iliac arteries (lower abdomen leading to the legs), the femoral and popliteal arteries (legs), the renal arteries (kidneys), and the carotid arteries (in the neck leading to the brain). Symptoms of Peripheral Vascular Disease When organs and muscles in the body receive a restricted amount of blood they become starved of oxygen and alert you be producing pain in the affected area. If the blockage occurs in the arteries supplying the legs, the resulting symptom is a cramping pain in the hips, thighs or calf muscle and can limit even casual walking. You may also experience coldness or paleness in the leg or foot; loss or decreased growth of hair on the legs; dry skin, numbness, tingling or pain in the leg, foot or toes; sores that do not heal. When you suffer from peripheral vascular disease in the carotid arteries you may experience sudden, temporary weakness or numbness of the face, arm and/or leg on one side of the body; temporary loss of speech or trouble speaking or understanding speech; temporary dimness or loss of vision, particularly in one eye; unexplained dizziness, unsteadiness or sudden falls. These are symptoms of a stroke and need immediate attention. Transient Ischemic Attacks (TIA's) are mini-strokes and illicit the same symptoms named above except they are temporary. Symptoms of peripheral vascular disease in the renal arteries include; hypertension (high blood pressure - consistently higher than 140/90); and abnormal kidney function blood tests

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Warning signs of a heart attack:
Any uncomfortable pressure, fullness, squeezing or pain in the chest area lasting more than 15 minutes or after 3 Nitroglycerin Tablets.  Pain, discomfort may spread to the shoulders, arms, neck or jaw.

In addition:

Call 911 or your Emergency Medical Service and get to the nearest hospital emergency room.

Risk factors for heart disease:
Many deaths from cardiovascular disease are preventable. In addition, for people who already have been diagnosed with cardiovascular disease, the risk of death and further complications can be reduced. Research has uncovered several factors that contribute to heart attacks and strokes. The more risk factors a person has, the greater their chance of developing cardiovascular disease. Although some risk factors cannot be changed, you can modify others with your doctor's help, and still others can be eliminated altogether. The following checklist can help you determine your risk.

Major risk factors that cannot be changed:

Heredity. A tendency towards heart disease runs in families. If one or both parents had cardiovascular disease, one's chances of developing it are higher.

Race. For reasons presently unknown, African Americans have a much greater risk of developing high blood pressure than Caucasians; twice as many have moderately high blood pressure, and three times as many have extremely high blood pressure. As a result, their risk of heart disease is greater.

Gender. Men have a higher risk of heart attack and stroke than women. During their childbearing years, women produce hormones that keep blood cholesterol levels low. Male hormones have the opposite effect - they raise blood cholesterol. However, women lose this protection after menopause or surgical removal of the ovaries, and women over age 55 have a 10 times greater risk than younger women. In recent years, however, more women under age 40 have developed coronary artery disease and high blood pressure. This probably results from the use of oral contraceptives and increased smoking.

Age. Fifty-five percent of heart attacks occur in people age 65 and older.

Major risk factors that can be changed:

Smoking. Smokers have more than twice as many heart attacks as nonsmokers. Sudden cardiac death occurs two to four times more frequently in smokers. Peripheral vascular disease (narrowing of the blood vessels in the arms and legs) is almost exclusively a disease of smokers. When people stop smoking, the risk of heart disease drops rapidly, and 10 years after quitting, their risk of death from cardiovascular disease is about the same as for people who never smoked.

High Blood Pressure. High blood pressure makes the heart work harder, causing it to enlarge and become weaker over time. This can lead to stroke, heart attack, kidney failure, and congestive heart failure. For some people, high blood pressure can be controlled by a low-salt diet, weight reduction, and regular exercise. Other people also require medication to lower their blood pressure.

Blood Cholesterol Levels. A cholesterol level between 200 and 240 mg/dl increases the risk of heart disease. A cholesterol level greater than 240 mg/dl doubles the risk of coronary artery disease. The American Heart Association Diet, which is low in cholesterol and other fats, is recommended for anyone with a level of 200 or higher. Medication may also be necessary.

Physical inactivity. Researchers have found that people who seldom exercise do not recover as well from heart attacks. Although it is not clear if lack of exercise alone is a risk factor for developing heart disease, in combination with other risk factors, such as being overweight, this risk is higher.

Obesity. Excess weight forces the heart to work harder. People who are overweight are more prone to high blood pressure and high blood cholesterol levels. Obesity is defined as 30% or more over your ideal weight.

Other Risk Factors:

Diabetes. Diabetes increases the risk of heart attack because it raises blood cholesterol levels. In addition, people who develop diabetes in midlife are often overweight, which is an additional risk factor.

Stress. Excessive emotional stress over a prolonged period appears to increase the risk of heart disease. Stress can increase other existing risk factors, such as overeating, smoking, and high blood pressure.

Alcohol. Heavy drinking can cause high blood pressure and can lead to heart failure. Alcohol should be consumed only in moderate amounts - 2 ounces of liquor a day or less.

Oral Contraceptives. Birth control pills can worsen other risk factors. They raise blood cholesterol levels and increase blood pressure, so women who already have these problems should not take oral contraceptives. Smokers who take "the pill" run the risk of developing dangerous blood clots (thrombosis).

Homocysteine. Researchers have found evidence of a new risk factor for heart disease. Studies are concluding that excess levels of an amino acid, homocysteine, may raise your risk of developing coronary artery disease. The exact level of risk has been shown to be anywhere from two to fourteen times greater in individuals with the highest levels of homocysteine. Exactly how high levels of homocysteine contribute to the development of CAD has not yet been determined. In addition, there is no easy way to measure your levels of homocysteine. Homocysteine levels are determined by genetics and nutrition - particularly B vitamins. Eating a well balanced diet will help increase your levels of B vitamins which in turn will lower your homocysteine levels.

Calculate your Risk of a Heart Disease:
Cardiovascular disease is the number one killer in the United States. Most of the public believes this is primarily a disease in men, but in fact, this is not the case. Cardiovascular disease kills more women than the next 14 causes of death combined.

Therefore, the cardiologists at the Michigan Heart Group (who practice at both William Beaumont Hospital in Royal Oak and William Beaumont Hospital in Troy) are pleased to offer you this tool to calculate your risk of developing angina or having heart attack within the next ten years. This data is derived from the longstanding Framingham Study which looks at cardiovascular disease in a particular town in Massachusetts. Most of this data was derived in Caucasians, which might limit this study. We have, however, found this data to be helpful in getting patients to realize the potential risks they have in developing cardiovascular disease.

Those patients who find their ten-year risk significantly high should consider an evaluation by their personal physician, dietary guidance, daily exercise, cessation of smoking, and weight loss. In addition to this, patients at extremely high risk may be good candidates to be evaluated by a cardiologists.

We hope this information is of interest to you.

Respectfully,

The Michigan Heart Group

Calculate your risk