What to Do When You Have Heart Disease

Chapter 1 70 Million Americans The moment when a person first finds out that they have heart disease can be a hazy one. Some people discover they have heart disease during a visit with the doctor. Others have the misfortune of lying in a hospital bed when the diagnosis is made. Either way, life may never be the same again. Many cannot fully realize the extent of what is happening because it is an unexpected event. Chances are you or a loved one has heart disease. Heart disease is very common and affects as many as 70 million Americans. The American Heart Association estimated that 770,000 people had a heart attack in 2008. Just looking at the numbers, one can easily say that heart disease is an epidemic. Large organizations have taken on the task of trying to improve the statistics. An advance in modern medicine and public education about treating the risk factors has resulted in a decline in the risk of death. However, heart disease is still the number one cause of death in the United States. Most people know that heart disease is a very serious and life-threatening problem. Many important questions have to be answered after you learn that you have heart disease. Probably, the first questions people think of are  What happens next?  Am I going to die soon?  What can I do to make my heart better? Just when you think your situation is hopeless, the cardiologist arrives to tell you that something can be done. Coronary stents, bypass surgery, or medication can prevent significant heart damage and save lives. This book is intended to help people learn about heart disease and be able to get the best treatment possible. What motivates me to write about this subject? First and foremost, I am a physician assistant (PA) who specialized in cardiology (the study and treatment of the heart). Most of my patients were referred to as hospital follow-ups. This means that the person was recently released from the hospital after having a new heart problem and is seeing me in the office for post discharge care. I believe that spending time with these new patients and teaching them about heart disease and how to take better care of their heart is important. On a more personal note, my grandfather died as a result of a heart attack when I was a child. In addition to that tragedy, my father also had a heart attack when I was in high school. I have personally lived through the agony and confusion that follows when heart disease strikes a loved one. Chapter 2 What is Heart Disease? Heart disease can be defined many ways. The American Heart Association defines cardiovascular disease as high blood pressure, a previous heart attack, angina, a previous stroke, heart failure, or a birth defect in the heart. Patients who have problems with the heart valves or an irregular heart rhythm may also be considered to have heart disease. This book focuses primarily on people who have had a previous heart attack, angina, one or more blockages in the heart arteries, and heart failure. The condition of blocked arteries of the heart is called coronary artery disease (CAD) or coronary heart disease (CHD). This means that a plaque formed in one or more of the arteries leading to the heart. Some imaging studies of the heart can calculate the percentage of blockage. A blockage is called a stenosis. Blood flow is impaired by plaque buildup; but the blockage is usually not considered to be significant until the plaque blocks 70% or more of the artery. The large, main artery of the heart called the left main artery is considered to have a significant blockage when the plaque reaches 50% or more. A blockage of 100% is a completely blocked artery and no blood can get to that part of the heart. This is called a total occlusion. Sometimes the artery is said to be chronically occluded. [Illustration of 70% blockage]