Understanding cardiovascular disease
Cardiovascular disease is the broad term for problems with the heart and blood vessels. These problems are often due to atherosclerosis. This condition occurs when fat and cholesterol build up in blood vessel (artery) walls. This buildup is called plaque. Over time, plaque can narrow blood vessels and cause problems throughout the body. If an artery becomes blocked, it can lead to heart attack or stroke.
Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.
Atherosclerosis is a disease in which fatty material is deposited on the wall of an artery. Normally, the walls of an artery are smooth, allowing blood to flow unimpeded. However, if damage occurs to its inner lining, fat, cholesterol, platelets, and other substances may accumulate at a damaged section of the arterial wall. Eventually, the tissue builds up and a plaque is formed, narrowing the lumen of the artery. Where the narrowing is severe, there is a risk that the vessel can become blocked completely if a thrombus forms in the diseased segment.
Blood is the fuel that keeps your body alive and working. It's your blood that transports the oxygen your cells need to survive. To get to your heart and out the rest of your body, blood needs a clear pathway through your arteries. But as you get older - and if you eat too many French fries and cheeseburgers - your arteries can harden and narrow, fill with plaque, leaving less room for blood to flow through. Let's talk today about atherosclerosis. Your arteries are like the pipes your water flows through to get to your bathroom sink. When the pipes are clear, water flows easily through them. But when minerals, rust, and other debris get stuck in the pipes, it clogs them up, leaving less room for water to flow through. That's why you get nothing more than a drip when you turn on your bathroom sink. In your arteries, clogs are caused by plaque. Plaque is a substance made up of fat and cholesterol, which are found in unhealthy foods like those French fries and also bacon. Because plaque is sticky, it collects on your artery walls and blocks the flow of blood. Sometimes a clump of plaque breaks off and floats away to a smaller blood vessel leading to your heart or brain. If it gets stuck in that vessel, you can have a heart attack or stroke. Or, the plaque can weaken an artery wall, which is called an aneurysm. If that aneurysm breaks open, you could have a very life-threatening bleeding. How can you tell if you have atherosclerosis? Well, that's the tricky part, because often atherosclerosis doesn't cause any symptoms until you've got a blocked artery. And by then, you could already be having a heart attack or stroke. So that you don't discover the problem too late, see your doctor for regular check-ups. Get your cholesterol screened by age 35 if you're a man, age 45 if you're a woman. Also have your blood pressure checked every 1 to 2 years before age 50, and then once a year after that. You may need to have your blood pressure checked even more often if you have high blood pressure, heart disease, or you've already had a stroke. Although you can't reverse atherosclerosis once it starts, you can prevent it with some easy lifestyle changes. Eat a balanced diet that's high in heart-healthy fruits, vegetables, and fish. Exercise for at least 30 to 60 minutes a day. Stop smoking, cause that's really bad news for your arteries. If your cholesterol is high, ask your doctor whether you should take cholesterol-lowering medication. Lastly, you may also need to take aspirin or another blood-thinning drug to prevent clots from forming in your arteries.
Types of Cardiovascular Disease
Coronary heart disease (CHD) is the most common type of heart disease when plaque builds up in the arteries leading to the heart. CHD is also called coronary artery disease (CAD). When arteries narrow, the heart cannot get enough blood and oxygen. A blocked artery can cause a heart attack. Over time, CHD can weaken the heart muscle and cause heart failure or arrhythmias.
Heart failure occurs when the heart muscle becomes stiff or weak. It cannot pump out enough oxygen-rich blood, which causes symptoms throughout the body. The condition may affect only the right side or only the left side of the heart. More often, both sides of the heart are involved. High blood pressure and CAD are common causes of heart failure.
Arrhythmias are problems with heart rate (pulse) or heart rhythm. This happens when the heart's electrical system doesn't work properly. The heart may beat too fast, too slow, or unevenly. Certain heart problems, such as heart attack or heart failure can cause problems with the heart's electrical system. Some people are born with an arrhythmia.
Heart valve diseases occur when one or more of the four valves in the heart do not work properly. Blood can leak through the valve in the wrong direction (called regurgitation), or a valve may not open far enough and block blood flow (called stenosis). An unusual heart sound, called a heart murmur, is the most common symptom. Certain heart problems, such as heart attack, heart disease, or infection, can cause heart valve diseases. Some people are born with heart valve problems.
Peripheral artery disease occurs when the arteries to your legs and feet become narrow due to a buildup of plaque. Narrow arteries reduce or block blood flow. When blood and oxygen can't get to the legs, it can injure muscles, nerves, and other tissue.
High blood pressure (hypertension)is a cardiovascular disease that can lead to other problems, such as heart attack, heart failure, stroke, and kidney disease.
Stroke is caused by a lack of blood flow to the brain. This can happen because of a blood clot traveling to the blood vessels in the brain, or bleeding in the brain. Stoke has many of the same risk factors as heart disease.
Congenital heart disease is a problem with the heart's structure and function that is present at birth. Congenital heart disease can describe a number of different problems affecting the heart. It is the most common type of birth defect.
References
Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 39.
Newby DE, Grubb NR. Cardiology. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 16.
Version Info
Last reviewed on: 2/27/2024
Reviewed by: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
