Types of Heart Disease
by Rashmi Gulati, MD
There is ongoing effort by cardiologists and other heart specialists to define and classify the different types of heart disease into a universally useful form, and to include the many types of symptoms and causes. But overall, there are four major types of heart disease.
Coronary Heart Disease/Coronary Artery Disease
Coronary heart disease is the most common type of heart disease and is the most prevalent cause of death for men and women in the United States. Coronary artery disease (CAD) is frequently equated with coronary heart disease (CHD), but is, categorically, a type of CHD and—while the most common form of CHD—not its sole cause.
Coronary artery disease is the result of plaque build-up, or atherosclerosis, in the coronary arteries that supply the heart muscles with oxygen-rich blood. Plaque is made up of cholesterol, other lipids, calcium, and other substances found in the blood, and is generally the result of a poor diet and a sedentary lifestyle. Atherosclerosis in coronary heart disease restricts the amount of blood, and therefore the oxygen, that reaches your heart muscles.
Poor oxygen and nutrient supply to the heart muscle is known as myocardial ischemia, or ischemic heart disease (IHD). The constriction or narrowing of the arteries also occurs in arteries elsewhere in the body besides those supplying the heart. In most cases it can be corrected with dietary and lifestyle changes, supplements, pharmaceuticals, and surgical procedures.
Peripheral Arterial Disease
Peripheral arterial disease, also known as atherosclerotic peripheral vascular disease, occurs when plaque builds up on the inside walls of the arteries that carry blood from the heart to the head, internal organs, and limbs, narrowing or constricting these vessels. The build-up of plaque on the arterial walls is also sometimes referred to "hardening of the arteries"; however, the hardening, or sclerosing process, is actually a loss of the natural pliability, or elasticity of the blood vessels, that develops wherever the plaque build-up is found.
Blocked blood flow can cause pain and numbness. It may also increase one's susceptibility to infection, or make it harder to fight one off, as our immune system's infection-control actions are hindered by blocked, constricted, or damaged blood vessels. If severe enough, blocked blood flow can cause an inability for wounds to heal, which can further result in gangrenous infection, and even potentially lead to amputation.
Having peripheral arterial disease increases one's risk of coronary heart disease by six to seven times, thereby increasing the risk of cardiac events such as heart attack, stroke, or mini stroke. Early diagnosis and treatment are important to prevent disability and save lives.
The process of plaque build-up in the arteries can be stopped or reversed with deliberate dietary changes, exercise, and efforts to control cholesterol and blood pressure. Blood flow in the vessels may also be improved with supplements, pharmaceuticals, or surgical intervention. Peripheral arterial disease occurs much more often in people who smoke, and far earlier, on average, than in nonsmokers.
Heart Failure
Heart failure is believed to affect as many as 5.7 million people in the United States, with as many as 300,000 deaths occurring yearly. Heart failure does not refer to the heart stopping, but to the heart's diminished capacity to pump blood to the rest of the body.
Failure of either the muscles or valves on the left side of the heart, on the right side, or from a combination of problems may account for the diminished capacity. The heart may not be able to fill sufficiently with blood, or once filled may be unable to pump with enough force. As the blood moves at a slower rate throughout the circulatory system, the body receives insufficient oxygen and nutrients required to keep the body's metabolic systems fully supplied.
Unaffected heart muscles may try to accommodate for the failure by stretching in order to hold more blood, pump harder to supply needed blood, or pump faster. Heart failure typically results in enlargement of the heart. Heart walls can thicken and stiffen, weakening over time and further decreasing the heart's ability to pump blood. The kidneys respond by retaining water and sodium, leading to water retention in the lungs, limbs, and other organs. The body becomes congested with excess fluid, giving rise to the term congestive heart failure.
Taking steps to prevent coronary heart disease can help prevent heart failure. These steps include following a heart-healthy diet, getting regular exercise and staying physically active, not smoking, and losing weight if one is overweight or obese. Working with your physician to control high blood pressure and diabetes can also help prevent heart failure.
Heart Valve Disease
Four valves separate the four chambers of the heart: the tricuspid, pulmonary, mitral, and aortic valves. These valves consist of flaps that open and close with each heart beat. Acting in concert, the valves ensure that the blood flows in the one direction through the heart's four chambers and out to the rest of the body. When one or more valves are faulty due to leaking, stiffening, or fusing of one or more of their flaps, the heart muscles must work harder to pump blood to the rest of the body.
Heart valve disease is a condition in which one or more of the heart valves are not working properly. Valves that do not close tightly and leak cause a condition known as regurgitation. This is most often caused by mitral prolapse, that is, when a flap on the mitral valve bulges back into the upper heart chamber during the heart beat.
In the case of leaky valves the heart must work harder to maintain blood pressure and flow to the rest of the body. In the case of valvular stenosis the flaps of the valve thicken, stiffen, or fuse, preventing the valve from opening properly and allowing the blood to flow efficiently.
Regurgitation and stenosis are considered acquired heart valve disease, in contrast to congenital (present at birth) heart valve defects that prevent proper valve function. Some types of congenital heart valve defects are so severe the valve has to be repaired or replaced during infancy or childhood.
Many people who have heart valve defects or disease do not experience symptoms. For some, the condition remains the same, essentially silent, throughout their lives and causes no problems. For others, the condition may worsen until symptoms develop. If left untreated, advanced heart valve disease may cause heart failure, stroke, blood clot, or sudden death due to heart attack.
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Types of Heart Disease—Citations and Further Reading
Date of Publication: 09/05/2005
Article Last Updated: 06/17/2010