The heart is a hollow, muscular organ approximately the size of a fist. It is located in the centre of the chest, slightly to the left, and below the sternum or breastbone.

The function of the heart is to pump blood that contains oxygen and nutrients to all parts of the body. The heart is divided into four chambers, which consist of two atriums and two ventricles. The right side of the heart receives blood that has been used by the body and pumps it to the lungs, where it acquires oxygen. The blood that is rich in oxygen then returns to the left side of the heart and is pumped through the aorta to reach all parts of the body.

There are a total of four valves in the heart. These valves are positioned between the upper and lower chambers of the heart, as well as in the major blood vessels of the heart. Their primary function is to ensure that blood flows in a single direction, effectively maintaining circulation.

At rest, a heart beats 60-100 times a minute. This is caused by an electrical stimulus from specialized cells called the SA node. The impulse travels through fibers in the heart chamber and causes a contraction of the muscle.

What are Coronary Arteries?

Coronary arteries serve a vital function by supplying the heart muscle with oxygen-enriched blood. Originating from the aorta, these arteries span the surface of the heart and feature multiple branches to nourish the entire heart muscle.

Coronary Artery Disease

In a healthy coronary artery, the internal lining remains smooth. However, damage to this lining can result in the gradual accumulation of fatty layers and other substances, a condition known as atherosclerosis. Such blockages can hinder blood flow, eventually leading to severe health issues like angina or heart attacks.

The situation is similar to an old, rusty pipe where only a minimal amount of blood can pass through. This creates a discord between the oxygen requirements of the heart muscle and the restricted blood flow due to the narrowed artery.

Treatment Options for Heart Disease

Medications for Heart Disease

Various medications are available to treat heart conditions, each with its unique mechanisms. Some medications aim to reduce the heart's workload, while others enhance its blood-pumping capability.

Coronary Angioplasty and Stent Insertion

This treatment involves inflating a special balloon to open up a blocked artery. A catheter, equipped with a balloon at its tip, is threaded through an artery from either the arm or the groin. The balloon expands at the blockage site to compress cholesterol plaque, creating a new blood flow channel. If feasible, a stent, acting like a scaffold, is placed to maintain the opened artery.

Surgical Interventions for Heart Disease

  • Open Heart Surgery Open heart surgery becomes necessary when standard circulation is compromised due to coronary artery disease, valve disorders, or other heart conditions. Common surgical procedures include:
  • Coronary Artery Bypass Graft Bypasses blocked arteries using a healthy vein or artery, typically from the leg or chest.
  • Heart Valve Repair or Replacement Addresses issues related to stenosis or insufficiency by either repairing or replacing damaged heart valves.
  • Atrial Septal Defect Repair Fixes the hole in the atrial septum, ensuring that blood follows the correct pathway within the heart.

What is Angina?

Angina is a medical condition characterized by discomfort or pain that occurs when the heart does not receive a sufficient supply of oxygen-rich blood. This can also be triggered by a spasm in the coronary arteries. Angina serves as a warning signal from the heart, indicating that it requires more oxygen to function effectively.

Symptoms of Angina

The manifestation of angina can vary among individuals and may include the following symptoms:

  • Pain, aching, or discomfort
  • Indigestion or stomach upset
  • Sensations of squeezing or cramping
  • Numbness or tingling
  • Shortness of breath
  • Feelings of tightness or pressure
  • A sense of fullness or heaviness
  • Burning sensations
  • Sweating or dizziness

The discomfort may be felt in various areas, such as the chest, shoulders, upper back, arms, neck, throat, or jaw. Angina can occur under stressful conditions, during strenuous physical activities, or after heavy meals. It is crucial not to ignore angina symptoms; rest and medication are generally effective means of relief.

What is a Heart Attack or Myocardial Infarction?

A heart attack, also known as myocardial infarction, transpires when there is a blockage in a coronary artery, disrupting blood flow to the heart. Since the coronary arteries act like pipelines that fuel the heart, any clot, blockage, or spasm can severely restrict blood flow.

Consequently, the portion of the heart deprived of oxygen may sustain irreversible damage. This occurs as the heart cells die off due to lack of oxygen, ultimately leading to the formation of scar tissue.

What Causes Heart Disease: Identifying Risk Factors

When it comes to heart disease, risk factors can be categorised into two main types: controllable and uncontrollable.

Uncontrollable Risk Factors for Heart Disease

  • Family History: A family history of heart disease increases your likelihood of experiencing a cardiac event.
  • Ageing: Individuals 55 or older are more susceptible to coronary artery disease due to the ageing process.
  • Gender Factors: Men are generally at higher risk of developing coronary artery disease, although post-menopausal women also face increased risks.

Controllable Risk Factors for Heart Disease

  • Smoking: Smokers are more likely to suffer from heart attacks and sudden cardiac death. Passive smoking also poses risks.
  • High Blood Pressure: Hypertension accelerates atherosclerosis and increases the risk of heart issues. Lifestyle changes can help manage it.
  • High Cholesterol Levels: Elevated cholesterol levels can speed up the development and progression of coronary artery disease.
  • Diabetes: Poorly controlled diabetes can damage blood vessels and facilitate plaque buildup.
  • Inactive Lifestyle: Lack of exercise contributes to the risk of coronary artery disease. Regular physical activity offers numerous benefits for heart health.

Additional Considerable Factors

  • Diet: A diet high in saturated fats can contribute to atherosclerosis.
  • Stress: Psychological stress can negatively affect your heart health.
  • Obesity: Excess weight places additional strain on your heart.
  • Alcohol Consumption: Excessive use of alcohol can elevate triglyceride levels and damage heart muscles.

How to Diagnose Heart Disease?

The absence of symptoms doesn’t necessarily mean the absence of heart disease. There are several tests to detect it:

  • Medical History and Physical Examination
  • Electrocardiogram (ECG or EKG)
  • Exercise Stress Test
  • Blood Enzyme Tests
  • Echocardiogram
  • Radionuclide Scan
  • Heart Catheterisation (Angiogram)

Treatment Options for Heart Disease

Treating heart disease is a multifaceted approach, dependent on various factors such as:

  • Number of blockages
  • Location of blockages
  • Medical history
  • Individual needs

Recovery of the Heart Muscle Post-Heart Attack

Following a heart attack, the heart muscle undergoes a healing process. Scar tissue begins to form in the damaged area, and tiny blood vessels may enlarge to nourish the surrounding tissue. A partial scar generally forms within three to four weeks, while a firmer scar takes between six weeks and three months to develop.

Importance of Collateral Circulation and Aerobic Exercise

The newly formed blood circulation around the damaged area is referred to as "collateral circulation." Aerobic exercise plays a vital role in fostering this new circulation, which in turn nourishes the heart.

A structured approach involving rest and a gradual increase in physical activity can be highly effective. Engaging in regular aerobic exercise will strengthen the heart muscle, helping it become a more efficient pump over time.