What You Need to Know about Heart Disease, from Risks and Screenings to Diagnosis and Treatment
Cardiovascular disease (conditions involving the heart and blood vessels) remains the most frequent cause of premature mortality in the United States and the world over. We have learned much over a relatively short period of time about how each and every one of us can make important lifestyle choices to reduce our risk of cardiovascular diseases. A lifelong commitment to moderate intensity exercise, a healthy diet, and abstinence from tobacco products certainly improves our ability to avoid cardiovascular diseases.
In addition to adopting a healthy lifestyle, it is important to treat diabetes, high cholesterol, high blood pressure and other risk factors, if present. While all of these measures reduce the chances of developing problems, they do not eliminate the risk, and sometimes, despite our best efforts, we may be diagnosed with a cardiovascular condition. At Loyola’s Ryan Center for Heart and Vascular Medicine, we focus on prevention, diagnosis, and treatment of all cardiovascular conditions.
Coronary Artery Disease (CAD)
Symptoms associated with coronary artery disease may include discomfort in the chest, arms, neck and jaw, classically occurring with physical activity and getting better with rest. Symptoms such as breathlessness without other obvious cause and less common symptoms also may occur. If there is an unexplained change in your health or physical stamina, seeking medical attention is a good idea.
Some people with CAD do not develop symptoms. Depending on your risk profile, your doctor may recommend testing even if you don't have symptoms. Young and middle-aged adults with a family history of coronary artery disease should consider seeing a physician to better understand their personal cardiovascular risk and how best to lower it, if needed. This is especially true if the family member is a parent, sibling, aunt or uncle, and particularly if the CAD occurred before the age of 55 in a man or 65 in a woman.
To measure the risk of cardiovascular disease, we assess your height, weight and body mass index; ask you questions to better understand your diet, exercise, and other lifestyle factors that may require attention; take your blood pressure and test your blood sugar and cholesterol levels. Depending on these results, your doctor may suggest further testing that may include a stress test or a CT scan to evaluate for the presence of blockages.
Occasionally, an angiogram is recommended. Also called a heart catheterization, this procedure involves threading a narrow catheter to the heart to visualize the coronary arteries. Loyola University Medical Center is the only medical center in the area that offers a relatively new noninvasive test that can provide useful information about the presence and significance of coronary blockages if they exist, and may eliminate the need for stress testing or an angiogram in some people. If CAD is present, treatment could include medication to reduce the workload of the heart and eliminate symptoms; a stent procedure, or bypass surgery. What is best for you depends on the number and locations of blockages and other information about your personal health. Finding a cardiologist who understands and is knowledgeable about the various treatments and the comparative risks and benefits of each will be very helpful in allowing you to come to the right decision for your care.
Heart Valve Conditions
Other types of heart disease include degenerative conditions of the heart valves, such as aortic stenosis, which is a narrowing of the aortic valve. While this condition is not frequent in the overall population, our risk increases with age, and aortic stenosis is the third most frequent cardiovascular disease found in people over the age of 65. (High blood pressure and CAD are No. 1 and No. 2, respectively).
Even prior to the onset of symptoms, the murmur caused by this condition can be detected during a physical examination when a stethoscope is used to listen to the heart. Symptoms can be similar to those of CAD, and may also include breathlessness or lightheadedness with physical activity. Your doctor may suggest an echocardiogram, which is an ultrasound of the heart, to obtain additional information.
Another valve condition that we encounter is mitral regurgitation, or leakage of the mitral valve. Again, this may exist even without symptoms, but if a murmur is detected on examination, an echocardiogram will help clarify the diagnosis. There are effective treatments for such conditions if they are severe and /or cause symptoms. These include surgery to either replace or repair the valve, and newer less invasive treatments done through a catheter with a small incision rather a major incision. Which treatment may be best for you depends on a number of factors that a cardiologist who understands all of the treatment options can help clarify.
Heart Rhythm Disorders
The electrical system of the heart can sometimes get out of sync, and a number of abnormal heart rhythms can occur that may cause symptoms of palpitations, skipped beats, rapid heart rate, and a decrease in physical capacity. One common heart rhythm is atrial fibrillation, often referred to as Afib. It can be treated with either medications or a minimally invasive catheter therapy, called ablation, which eliminates the tiny areas in the heart that cause irregularity. If needed, the effectiveness of such treatments is often better when provided soon after the diagnosis, and may be less effective if the condition has been present for years. In addition, there are personalized treatment approaches that were pioneered by our heart rhythm experts at Loyola.
Your best defense against heart disease is a commitment to making healthy choices, being mindful of your body and aware of changes in how you're feeling or in how much you are able to do.
If you are concerned about your risk for cardiovascular disease or have been diagnosed with a cardiovascular condition by your doctor, you will find the expertise you need at Loyola's Ryan Center for Heart and Vascular Medicine.
Interventional cardiologist Verghese Mathew, MD, FACC, FSCAI, is director of the division of cardiology. A native of the Chicago area, Dr. Mathew came to Loyola Medicine from the Mayo Clinic. He is board certified in interventional cardiology and cardiovascular disease. Dr. Mathew is professor of cardiology at Loyola University Chicago’s Stritch School of Medicine.
Loyola Medicine is nationally recognized for its expertise in diagnosing and treating a broad range of cardiovascular conditions. The specialists at William G. and Mary A. Ryan Center for Heart & Vascular Medicine are dedicated to providing patient-centered care and to the advancement of medicine through clinical research.