Heart disease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Heart disease is an umbrella term for a number of different diseases which affect the heart and as of 2007 it is the leading cause of death in the United States.^[1]

Cardiomyopathy literally means “heart muscle disease”. It is the deterioration of the function of the myocardium (i.e., the actual heart muscle) for any reason. People with cardiomyopathy are often at risk of arrhythmia and/or sudden cardiac death.

• Extrinsic cardiomyopathies – cardiomyopathies where the primary pathology is outside the myocardium itself. Most cardiomyopathies are extrinsic, because by far the most common cause of a cardiomyopathy is ischemia. The World Health Organization calls these specific cardiomyopathies:
  • Alcoholic cardiomyopathy
  • Coronary artery disease
  • Congenital heart disease – see below
  • Nutritional diseases affecting the heart
  • Ischemic (or ischaemic) cardiomyopathy
  • Hypertensive cardiomyopathy
  • Valvular cardiomyopathy – see also Valvular heart disease below
  • Inflammatory cardiomyopathy – see also Inflammatory heart disease below
  • Cardiomyopathy secondary to a systemic metabolic disease
• Intrinsic cardiomyopathies – weakness in the muscle of the heart that is not due to an identifiable external cause.
  • Dilated cardiomyopathy (DCM) – most common form, and one of the leading indications for heart transplantation. In DCM the heart (especially the left ventricle) is enlarged and the pumping function is diminished.
  • Hypertrophic cardiomyopathy (HCM or HOCM) – genetic disorder caused by various mutations in genes encoding sarcomeric proteins. In HCM the heart muscle is thickened, which can obstruct blood flow and prevent the heart from functioning properly.
  • Arrhythmogenic right ventricular cardiomyopathy (ARVC) – arises from an electrical disturbance of the heart in which heart muscle is replaced by fibrous scar tissue. The right ventricle is generally most affected.
  • Restrictive cardiomyopathy (RCM) – least common cardiomyopathy. The walls of the ventricles are stiff, but may not be thickened, and resist the normal filling of the heart with blood. ** Noncompaction Cardiomyopathy – the left ventricle wall has failed to properly grow from birth and such has a spongy appearance when viewed during an echocardiogram.

Cardiovascular disease is any of a number of specific diseases that affect the heart itself and/or the blood vessel system, especially the veins and arteries leading to and from the heart. Research on disease dimorphism suggests that women who suffer with cardiovascular disease usually suffer from forms that affect the blood vessels while men usually suffer from forms that affect the heart muscle itself. Known or associated causes of cardiovascular disease include diabetes mellitus, hypertension, hyperhomocysteinemia and hypercholesterolemia. Research has shown that a low fat, vegetarian diet can reduce the chance of cardiovascular disease and may also reverse conditions such as restriction of the blood vessels or “clogging.”

Types of cardiovascular disease include:

• Atherosclerosis

Congenital heart disease, existing primarily at birth, refers to any of a number of heart diseases caused by unavoidable genetic factors.

• Aortic valve stenosis

Coronary heart disease is a disease of the heart caused by the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium. Angina pectoris and myocardial infarction (heart attack) are symptoms of and conditions caused by coronary heart disease.

• Ischaemic heart disease – another disease of the heart itself, characterized by reduced blood supply to the organ.

Heart failure, also called congestive heart failure (or CHF), and congestive cardiac failure (CCF), is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body.

• Cor pulmonale, a failure of the right side of the heart.

Hypertensive heart disease, heart disease caused by high blood pressure, especially localised high blood pressure. Conditions that can be caused by hypertensive heart disease include:

• Left ventricular hypertrophy
• Coronary heart disease
• (Congestive) heart failure
• Hypertensive cardiomyopathy
• Cardiac arrhythmias

Inflammatory heart disease involves inflammation of the heart muscle and/or the tissue surrounding it.

• Endocarditis – inflammation of the inner layer of the heart, the endocardium. The most common structures involved are the heart valves.
• Inflammatory cardiomyopathy
• Myocarditis – inflammation of the myocardium, the muscular part of the heart. It is generally due to infection (viral or bacterial). It may present with chest pain, rapid signs of heart failure, or sudden death.

Valvular heart disease is any disease process involving one or more valves of the heart. The valves in the right side of the heart are the tricuspid valve and the pulmonic valve. The valves in the left side of the heart are the mitral valve and the aortic valve.

• Aortic valve stenosis
• Mitral valve prolapse
• Valvular cardiomyopathy

• Aneurysm
  • Aortic aneurysm
• High blood pressure (Hypertension)
• Thrombosis

• VIDEO – Heart Disease in the Female Population: Prevalence, Presentation and Pathophysiology, Mary Zasadil, MD, speaks at the University of Wisconsin School of Medicine and Public Health (2007)

• Heart and Stroke Foundation of Canada – Information Resource on Heart Disease

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