Chapter 2 : The Different Kinds of Heart Disease

There are many different diseases and disorders that can affect your heart, but all of them can basically be placed into two different categories: congenital and adult.

Congenital Heart Diseases

A congenital heart disease is one that a person is born with - a birth defect. However, if you have a mild congenital defect, you may not find out about it until you are an older child or even an adult.¬† Congenital heart diseases can be thought of as defects in the construction of the heart. They could include malformed valves, holes in the heart, and other problems in the heart’s physical structure. Here are some of the more common congenital heart diseases:

  • Patent ductus arteriosus - This defect is most common in preemie babies. Basically, when an unborn baby is developing in the womb, the mother supplies it with blood and oxygen. Before birth, the developing baby has a large artery called the ductus arteriosus that keeps blood from going to the lungs while the baby is still in the womb. Patent ductus arteriosus occurs when this artery doesn’t close after birth like it is supposed to. This disease can be treated successfully with drugs or surgery.
  • Septal defect - Septal defects are known more simply as a “hole in the heart.” Basically, babies born with a septal defect have a hole in the wall that separates the right side of the heart and the left side of the heart. Remember, the right side of the heart handles poorly oxygenated blood and sends it to the lungs, while the left side handles oxygenated blood and distributes it to the rest of the body. If the wall separating the right and the left sides has a hole in it, blood with oxygen and blood without oxygen will mix when they shouldn’t, which creates a lot of extra work for the heart. Septal defects can occur in either the upper or lower chambers of the heart. Surgery is more likely to be required for atrial septal defects than for ventricular septal defects because many ventricular septal defects close on their own.
  • Complete Atrioventricular Canal - This is a serious defect that includes a septal defect in both the upper and lower chambers of the heart, as well as malformations of the valves in the heart. Usually, this defect can be repaired surgically. However, even after surgical correction, the heart valves may not work exactly like they are supposed to.
  • Coarctation of the Aorta - This occurs when a child is born with an aorta that is too narrow to allow blood to flow at the correct rate. This can be corrected surgically, using the same type of techniques that are used to help adults whose arteries are narrowed or clogged.
  • Heart Valve Abnormalities - Being born with heart valves that are formed abnormally can cause one of two different issues. The valves can become hard and narrowed, not allowing enough blood to flow through and increasing the pressure on the heart. This is known as “stenosis,” and it can damage the heart. Abnormally formed valves can also become leaky, which forces the heart to work harder than it should to get blood where it needs to go. These defects often go unnoticed because they don’t always cause symptoms at first. Sometimes the defective valves work perfectly for an entire lifetime, and no treatment is needed. However, if the valves do go bad, surgical options are available for treatment.
  • Tetralogy of Fallot - This is basically a quadruple-whammy of a congenital heart defect. It consists of 4 different defects: a hole between the ventricles; stenosis in the pulmonary valve, which leads to the lungs; thickened muscle in the right ventricle; and the aorta enters the heart directly over the ventricular defect. Tetralogy of Fallot is a serious defect that prevents the body from getting enough oxygen, because a lot of the oxygen-poor blood gets pumped back into the body instead of going to the lungs. Fortunately, several different surgical options have been developed to repair this defect, and most babies born with it today will have normal lives once the surgery is complete.
  • Transposition of the great arteries - Babies born with this defect have the aorta on the side of the heart where the pulmonary artery should be, and vice-versa. This is an extremely serious defect because it means that oxygenated blood is pumped back to the lungs instead of being distributed to the body. Fortunately, surgery is usually successful in allowing children with this birth defect to live relatively normal lives.
  • Single-Ventricle Defects - This is a subset of birth defects in which an entire ventricle is underdeveloped and small. This type of birth defect is the most serious cardiac birth defect. It is also the one most likely to cause death. Surgical options are available to help your child live a more normal, longer life. However, they will always need follow-up care and are likely to have limits placed on physical activities.

It can be heart-breaking to realize that your child has one of the illnesses listed above. The most important thing to remember, especially for the mother, is that most of these defects are not your fault. We tend to focus so much on doing everything right during pregnancy that some people have a tendency to blame the mother if the child is born with a birth defect. However, most congenital heart defects are not preventable. Some behaviors in pregnancy can increase the risk of cardiac birth defects - for example, drinking heavily, using drugs, or being exposed to certain industrial chemicals or taking certain medications. These behaviors only account for a small percentage of congenital heart defects.

It’s also important to realize that there are many medical and surgical options available today that will help your child live a normal life. Most serious congenital heart diseases can be corrected surgically before the child reaches their first birthday.

Adult Heart Diseases

Most people who have heart disease today were not born with it. Instead, it is something that developed over time. Adult heart diseases are usually caused by hereditary factors, lifestyle factors, or a combination of the two. When most people think of adult heart disease, they picture the typical heart attack as it is portrayed on TV and in the movies. The victim gasps, clutches their chest, and collapses. However, heart attacks are not really a heart disease in and of themselves - rather, they are the result of heart disease that has gone untreated until it was too late. Here is a list of common heart diseases in adults:

  • Coronary Artery Disease - This is the single most common form of heart disease in adults today, and also the main cause of heart attacks. Coronary artery disease occurs when the coronary arteries, the arteries that feed blood to the heart, are blocked or obstructed. Remember, no other muscle in your body works as hard as your heart does, or has such a crucial job. Because the heart is so busy, it needs more blood and oxygen to function than the other muscles in your body do. If that blood flow is cut off, the heart can’t pump like it should and starts to die.
  • Peripheral Artery Disease - Peripheral artery disease occurs when arteries other than the coronary arteries are blocked. For example, an artery in the leg might narrow and become blocked or obstructed. This can also cause a heart attack or a stroke.
  • Valvular Heart Disease - Not all heart valve problems are congenital. Some people are born with heart valve defects, but in many other people, problems in the heart valves develop over time. This can occur when the valves become hardened, or calcified, as a result of old age. It can also be a result of rheumatic fever or of other types of heart disease. ¬†Valvular heart disease occurs when a valve becomes either stenotic or leaky. Both types can weaken the heart and cause it to fail if they are left untreated. Valvular heart disease sometimes produces no symptoms other than a heart murmur.
  • Cardiomyopathy - Cardiomyopathy is a doctor’s way of saying that your heart muscle is getting weaker. This can occur as a result to other heart conditions, such as coronary artery disease or valvular heart disease. Also, it may be caused by illnesses in other bodily systems. For example, kidney failure can cause it. There are two types of cardiomyopathy: dilated and hypertrophic. Dilated cardiomyopathy happens when the muscle in the heart becomes enlarged, or dilated. When heart muscle enlarges it also becomes more flaccid and can’t contract with as much force as it should. On the other hand, hypertrophic cardiomyopathy occurs when the heart muscle becomes too thick and stiff, and can’t pump enough blood to keep up with the body’s needs. This type of cardiomyopathy is usually caused by genetics.
  • Cardiac Arrhythmias - Cardiac arrhythmias are disturbances in the rhythm of your heart. Each side of your heart is told when and how fast to pump by an electrical impulse. These impulses originate in the sinus node, and are communicated throughout the heart via electrical pathways that function like invisible wires. If anything happens to the sinus node or disrupts the flow of electricity through the wires, arrhythmia can result. There are two different kinds of arrhythmia. When the heart beats too slowly, doctors refer to it as bradycardia. When the heart beats too quickly, it is called tachycardia. Arrhythmias can either be mild and self-correcting, or serious enough to kill.
  • Pericarditis - A thin lining of tissue known as the pericardium encircles your heart and protects it. However, some times this protective sac can become inflamed, a condition called pericarditis. This can cause chest pain, shortness of breath, and sometimes complications if the inflammation is severe or does not resolve itself quickly.
  • Heart Failure - Contrary to what you might think, heart failure does not mean that the heart stops beating. However, it means that the heart is no longer able to pump blood with as much power as it should be able to. Therefore, none of your organs are getting as much blood as they need, and waste products are also not being removed as fast as they should be. Heart failure cannot be cured, but it can be managed. At least 5 million Americans live with a diagnosis of heart failure.
  • Coronary Artery Spasm - In this disorder, the coronary artery experiences an involuntary contraction or spasm. This can interfere with blood flow to the heart, even causing a heart attack. Medical scientists are not yet sure why this happens. It does not appear to be connected to narrowed or hardened arteries, or to other forms of heart disease. Drug treatment is available.

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