Aortic aneurysm

Pulmonary hypertension

Pericarditis

Peripheral vascular disease

Stroke

Congenital heart disease

 

Aortic aneurysm

Most aneurysms occur in the aorta. The aorta is the main artery that carries blood from the heart to the rest of the body. The aorta comes out from the left ventricle of the heart and travels through the chest and abdomen. There are two types of aortic aneurysm:

 

• Thoracic aortic aneurysm. An aortic aneurysm that occurs in the part of the aorta running through the thorax (chest). One in four aortic aneurysms is a TAA. Most TAAs do not produce symptoms, even when they are large. Only half of all people with TAAs notice any symptoms. TAAs are identified more often now than in the past because of chest computed tomography (CT) scans performed for other medical problems. In a common type of TAA, the walls of the aorta become weak and a section nearest to the heart enlarges. Then the valve between the heart and the aorta cannot close properly and blood leaks backward into the heart. Less commonly, a TAA can develop in the upper back away from the heart. A TAA in this location can result from and injury to the chest such as from an auto crash.
• Abdominal aortic aneurysm.  An aortic aneurysm that occurs in the part of the aorta running through the abdomen. Three in four aortic aneurysms are AAAs. An AAA can grow very large without producing symptoms. About 1 in 5 AAAs rupture.

 

Signs & Symptoms

It is often not until an aneurysm ruptures or grows large enough to press on nearby parts of the body or block blood flow that it produces any signs or symptoms.

 

Most abdominal aortic aneurysms (AAAs) develop slowly over years and have no signs or symptoms until (or if) they rupture. Sometimes, a doctor can feel a pulsating mass while examining a patient's abdomen. When symptoms are present, they can include:

 

• Deep penetrating pain in your back or the side of your abdomen
• Steady gnawing pain in your abdomen that lasts for hours or days at a time
• Coldness, numbness, or tingling in your feet due to blocked blood flow in your legs

 

If an AAA ruptures, symptoms can include:

 

• Sudden, severe pain in your lower abdomen and back
• Nausea and vomiting
• Clammy, sweaty skin
• Lightheadedness
• Rapid heart rate when standing up.

 

Internal bleeding from a ruptured AAA can send you into shock. Shock is a life-threatening condition in which the organs of the body do not get enough blood flow.

 

A thoracic (chest) aortic aneurysm may have no symptoms until the aneurysm begins to leak or grow. Signs or symptoms may include:

 

• Pain in your jaw, neck, upper back (or other part of your back), or chest
• Coughing, hoarseness, or trouble breathing

 

Outlook

Most aneurysms (3 out of 4) are found by chance when a diagnostic test, such as x ray or ultrasound, is performed for a different reason. Many cases of ruptured aneurysm can be prevented with early diagnosis and medical treatment. Medicines and surgery are the two main treatments for aneurysms. Medicines may be prescribed before surgery or instead of surgery.

 

To prevent an aneurysm and keep blood vessels healthy, quit smoking, eat a low-fat, low-cholesterol diet, get regular physical activity, and control high blood pressure and high cholesterol.

 

Pulmonary hypertension

Pulmonary hypertension (PH) is increased pressure in the pulmonary arteries, the arteries that carry blood from your heart to your lungs to pick up oxygen.  Three types of changes can affect the pulmonary arteries and cause PH:

 

• Walls of the arteries tighten.
• Walls of the arteries are stiff at birth or become stiff from an overgrowth of cells.
• Blood clots form in the arteries.

 

These changes make it hard for the heart to push blood through the arteries and into the lungs. Thus, the pressure in the arteries rises. Also, as a result of the heart working harder, the right ventricle becomes strained and weak.  The heart may become so weak that it can't pump enough blood to the lungs. This causes heart failure. Heart failure is the most common cause of death in people who have PH.

 

Signs & Symptoms

 

• Shortness of breath during routine activity, such as climbing two flights of stairs
• Tiredness
• Chest pain
• A racing heartbeat

 

As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include:

 

• Feeling lightheaded, especially during physical activity
• Fainting at times
• Swelling in your legs and ankles
• A bluish color on your lips and skin

 

Outlook

PH diagnosis is based on your medical and family histories, a physical exam, and the results from tests and procedures. PH can develop slowly. In fact, you may have it for years and not know it. This is because the disease has no early symptoms. When symptoms do develop, they're often like those of other heart and lung conditions, such as asthma. This makes PH hard to diagnose.

 

PH has no cure, but treatments may help relieve symptoms and slow the progress of the disease. PH is treated with medicines, procedures, and other therapies. Treatment will depend on what type of PH you have and how severe it is. The earlier PH is treated, the easier it is to control. You can work with your doctor to manage your symptoms and slow the progress of PH. Get ongoing care. Follow your treatment plan and call your doctor if your symptoms worsen or change. Make lifestyle changes, such as eating healthy, quitting smoking, and doing regular physical activity.

 

Pericarditis

Pericarditis is a condition in which the membrane, or sac around your heart, called the pericardium, is inflamed. The pericardium holds the heart in place and helps it work properly. The sac is made of two thin layers of tissue that enclose your heart. Between the two layers is a small amount of fluid. This fluid keeps the layers from rubbing against each other and causing friction. In pericarditis, the layers of tissue become inflamed and can rub against the heart.

 

Many factors can cause pericarditis. Viruses and infections are common causes. Less often, pericarditis occurs after a heart attack or heart surgery. Lupus, scleroderma, rheumatoid arthritis, or other autoimmune disorders also can cause the condition. In about half of all cases, the cause is unknown.

 

Pericarditis can be acute or chronic. “Acute” means that it occurs suddenly and usually doesn’t last long. “Chronic” means that it develops over time and may take longer to treat. Both acute and chronic pericarditis can disrupt your heart’s normal function and possibly (although rarely) lead to death. However, most cases of pericarditis are mild and clear up on their own or with rest and simple treatment.

 

Signs & Symptoms

 

• Sharp, stabbing chest pain is a common symptom of acute pericarditis. The pain usually comes on quickly. It often is felt in the middle or the left side of the chest. The pain tends to ease when you sit up and lean forward. Lying down and deep breathing worsens it. For some people, the pain feels like a dull ache or pressure in their chests. The chest pain may feel like pain from a heart attack. If you have chest pain, you should call 9–1–1 right away, as you may be having a heart attack.
• Fever 
• Weakness
• Trouble breathing
• Coughing

 

Chronic pericarditis often causes tiredness, coughing, and shortness of breath. Chest pain is often absent in this type of pericarditis. Severe cases of chronic pericarditis can lead to swelling in the stomach and legs and low blood pressure (hypotension).

 

Outlook

Pericarditis is diagnosed based on your medical history and the results from a physical exam and tests. Most cases of pericarditis are mild and clear up on their own or with rest and simple treatment. Other times, more intense treatment is needed to prevent complications. Treatment may include medicines and, less often, procedures and/or surgery.

 

You usually can’t prevent acute pericarditis. But, you can take steps to reduce your chances of having another acute episode, having complications, or getting chronic pericarditis. Get prompt treatment, follow your treatment plan, and get ongoing medical care (as your doctor advises). In some cases, it may take weeks or months to recover from pericarditis. Full recovery is likely with rest and ongoing care. These measures also can help reduce the chances of having the condition again.

 

Peripheral vascular disease

Peripheral arterial disease (P.A.D.) occurs when plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When plaque builds up in arteries, the condition is called atherosclerosis. Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.  P.A.D. usually affects the legs, but also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach.

 

Signs & Symptoms

At least half of the people who have peripheral arterial disease (P.A.D.) don't have any signs or symptoms of it. Others may have a number of signs and symptoms. Even if you don't have signs or symptoms, discuss with your doctor whether you should get checked for P.A.D. if you're:

 

• Aged 70 or older
• Aged 50 or older and have a history of smoking or diabetes
• Younger than 50 and have diabetes and one or more risk factors for atherosclerosis

 

People who have P.A.D. may have symptoms when walking or climbing stairs including:

 

• Pain, numbness, aching, or heaviness in the leg muscles.
• Cramping in the affected leg(s) and in the buttocks, thighs, calves, and feet

 

These symptoms are called intermittent claudication. During physical activity, your muscles need increased blood flow. If your blood vessels are narrowed or blocked, your muscles won't get enough blood. When resting, the muscles need less blood flow, so the pain goes away. About 10 percent of people who have P.A.D. have claudication. This symptom is more likely in people who also have atherosclerosis in other arteries.

 

Other signs and symptoms of P.A.D. include:

 

• Weak or absent pulses in the legs or feet
• Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
• A pale or bluish color to the skin
• A lower temperature in one leg compared to the other leg
• Poor nail growth on the toes and decreased hair growth on the legs
• Erectile dysfunction, especially among men who have diabetes

 

Outlook

P.A.D. is diagnosed based on medial and family histories, a physical exam, and results from various tests. An accurate diagnosis is important, because people who have P.A.D. are at increased risk for coronary artery disease, heart attack, stroke, and transient ischemic attack. If you have P.A.D., your doctor also may want to look for signs of these conditions.

 

Treatments for P.A.D. include lifestyle changes, medicines, and surgery or procedures. Treatment is based on your signs and symptoms, risk factors, and results from a physical exam and tests. Taking action to control your risk factors can help prevent or delay P.A.D. and its complications.

 

You can take steps to treat and control P.A.D. and lower your risk for complications. Talk to your doctor about taking part in a supervised exercise program. This type of program has been shown to reduce P.A.D. symptoms. Take good care of your feet and legs. See your doctor for checkups as he or she advises, and take all medicines as your doctor prescribes.

 

Stroke

A stroke is an interruption of the blood supply to any part of the brain. A stroke is sometimes called a "brain attack."  There are two types of stroke:

 

• Ischemic stroke. The most common type of stroke. Usually results from clogged arteries (atherosclerosis.) Fatty deposits collect on the wall of the arteries, forming a sticky substance called plaque. Over time, the plaque builds up. Often, the plaque causes the blood to flow abnormally, which can cause the blood to clot. There are two types of clots:

1. 1. Cerebral thrombus - a clot that stays in place in the brain.
2. 2. Cerebral embolism - a clot that breaks loose and moves through the bloodstream to the brain. Causes of cerebral embolisms include: atrial fibrillation, endocarditis, an abnormal heart valve, and having a mechanical heart valve. A clot can form on a heart valve, break off, and travel to the brain. For this reason, those with mechanical or abnormal heart valves often must take blood thinners.

• Hemorrhagic stroke. Bleeding in the brain that occurs when small blood vessels in the brain become weak and burst. Some people have defects in the blood vessels of the brain that make this more likely. The flow of blood after the blood vessel ruptures damages brain cells.

 

Signs & Symptoms

The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not even be aware that he or she has had a stroke. Usually, a SUDDEN development of one or more of the following indicates a stroke:

 

• Weakness or paralysis of an arm, leg, side of the face, or any part of the body
• Numbness, tingling, decreased sensation
• Vision changes
• Slurred speech, inability to speak or understand speech, difficulty reading or writing
• Swallowing difficulties or drooling
• Loss of memory
• Vertigo (spinning sensation)
• Loss of balance or coordination
• Personality changes
• Mood changes (depression, apathy)
• Drowsiness, lethargy, or loss of consciousness
• Uncontrollable eye movements or eyelid drooping

 

If one or more of these symptoms is present for less than 24 hours, it may be a transient ischemic attack (TIA). A TIA is a temporary loss of brain function and a warning sign for a possible future stroke.

 

Outlook

A stroke is a medical emergency. Physicians have begun to call it a "brain attack" to stress that getting treatment immediately can save lives and reduce disability. Treatment varies, depending on the severity and cause of the stroke. For virtually all strokes, hospitalization is required, possibly including intensive care and life support. The goal is to get the person to the emergency room immediately, determine if he or she is having a bleeding stroke or a stroke from a blood clot, and start therapy -- all within 3 hours of when the stroke began.

 

Congenital heart disease

Congenital heart defects are problems with the heart’s structure that are present at birth. These defects can involve the interior walls of the heart, valves inside the heart, or the arteries and veins that carry blood to the heart or out to the body. Congenital heart defects change the normal flow of blood through the heart.There are many different types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms.

 

Example of simple defects include:

 

• Holes in the Heart (Septal Defects). The septum is the wall that separates the chambers on the left side of the heart from those on the right. It prevents mixing of blood between the two sides of the heart. Sometimes, a baby is born with a hole in the septum. When that occurs, blood can mix between the two sides of the heart.
• Atrial septal defect (ASD). An ASD is a hole in the part of the septum that separates the atria—the upper chambers of the heart. This heart defect allows oxygen-rich blood from the left atrium to flow into the right atrium instead of flowing to the left ventricle as it should. Many children who have ASDs have few, if any, symptoms. An ASD can be small or large. Small ASDs allow only a little blood to leak from one atrium to the other. Very small ASDs don’t affect the way the heart works and therefore don’t need any special treatment. Many small ASDs close on their own as the heart grows during childhood. Medium to large ASDs allow more blood to leak from one atrium to the other, and they’re less likely to close on their own. Half of all ASDs close on their own or are so small that no treatment is needed. Medium to large ASDs that need treatment can usually be repaired using a catheter procedure.
• Ventricular septal defect (VSD). A VSD is a hole in the part of the septum that separates the ventricles—the lower chambers of the heart. The hole allows oxygen rich blood to flow from the left ventricle into the right ventricle instead of flowing into the aorta and out to the body as it should. A VSD can be small or large. A small VSD doesn’t cause problems and may often close on its own. Large VSDs cause the left side of the heart to work too hard and increase blood pressure in the right side of the heart and the lungs because of the extra blood flow. The increased work of the heart can cause heart failure and poor growth. If the hole isn’t closed, the high blood pressure in the lungs can cause the delicate arteries in the lungs to scar, a condition called pulmonary arterial hypertension. Open-heart surgery is used to repair VSDs.
• Narrowed Valves. Simple congenital heart defects also can involve the heart’s valves, which control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart (the aorta and the pulmonary artery). Valves can have the following types of defects:

1. 1. Stenosis. Occurs when the valve doesn’t open completely, and the heart has to work harder to pump the blood through the valve.
2. 2. Atresia. Occurs when the valve doesn’t form correctly, so there is no opening for blood to pass through.
3. 3. Regurgitation. Occurs when the valve doesn’t close completely, so blood leaks back through the valve.

 

Signs & Symptoms

Many congenital heart defects have few or no symptoms. A doctor may not even detect signs of a heart defect during a physical exam. Some heart defects do have symptoms. These depend on the number and type of defects and how severe the defects are. Severe defects can cause symptoms, usually in newborn babies. These symptoms can include:

 

• Rapid breathing
• Cyanosis (a bluish tint to the skin, lips, and fingernails)
• Fatigue (tiredness)
• Poor blood circulation

 

Congenital heart defects don’t cause chest pain or other painful symptoms.

 

Abnormal blood flow through the heart caused by a heart defect will make a certain sound. Your doctor can hear this sound, called a heart murmur, with a stethoscope. However, not all murmurs are a sign of a congenital heart defect. Many healthy children have heart murmurs.

 

 

Source: "Heart and Vascular Diseases." Disease and Conditions Index. The National Heart, Lung, and Blood Institute. The National Institutes of Health.