Abdominal Aortic Aneurysm
A weakened, "ballooned" segment located in the largest artery in the body, the Aorta. This most commonly occurs in the mid abdominal region. Often without symptoms, this condition can go undetected and can be potentially life-threatening if not treated and it may rupture or tear.
Acute Myocardial Infarction
A sudden blockage in one or more of the heart vessels (coronary arteries), that causes immediate loss of blood to a region of the heart. May be caused by blood clot, cholesterol plaque deposits that ruptures, or drugs such as cocaine, methamphetamine, pseudoephedrine that cause a "spasm" in the artery (like a Charley Horse).
Angina Pectoris, Stable
Chest pain that occurs with exercise and is felt to be from the heart. The frequency, intensity, and length of episodes are consistent for more than 2 weeks.
Angina Pectoris, Unstable
Chest pain that in new, or has change in its frequency, intensity, or length of episodes with in the past 2 weeks. This type of angina may be a sign of impending heart attack and therefore should be evaluated on an urgent basis.
Aortic Valve Disease
Either a narrowing or a leaking of the valve that leads from the heart to the Aorta (the major blood vessel in the body). This may be caused by Rheumatic Fever as a child, or a sudden blood infection. The valve may also be congenital (structure is different from birth i.e. some are born with 2 leaflets, or doors, rather than with 3).
Cholesterol plaque deposits in the major blood vessel called the Aorta, as it splits into the iliac arteries that feed the legs. Often present in smokers.
Rhythms that originate in the upper chambers of the heart. May be a fast, regular heart beat (Supraventricular Tachycardia), or an irregular rhythm such as Atrial Fibrillation or Flutter. These rhythms are often treated by medications or in some cases can be cured by a procedure called "ablation". Sometimes you may have an early beat (often referred to as a skipped beat), called a Pre-Atrial contraction (PAC). These extra beats are often benign, but can be bothersome, feeling like a "flutter in your chest."
Carotid Artery Disease
Cholesterol buildup that is located in the major arteries in the neck, that lead to the brain and if clogged can cause a stroke.
When your heart looses its ability to increase its heart rate in response to movement or activity. You may feel very fatigued or have shortness of breath with activities like walking, showering, or tying your shoes. This may be a problem with the electrical system of the heart or it may be due to medications.
Congenital Heart Disease
Often referred to as "Birth Defects" and involve the heart. Sometimes these "defects" are fixed at birth or may go undetected until adulthood. Some examples are ASD, PFO, VSD ("holes in the heart"); transposition of the Great Vessels (Arteries go to the wrong chambers of the heart); Bicuspid Aortic Valve (2 leaflets rather than 3 which is customary)
Congestive Heart Failure
When blood backs up into the lungs from the heart. It may be a slow, chronic problem or may occur very rapidly even within minutes. This is most commonly caused by a weakened heart muscle. This may also be caused by the heart becoming stiffer and have a hard time relaxing (called diastolic dysfunction, most often caused by high blood pressure). This may also be caused by congenital heart disease (see above) or valvular heart disease (severe narrowing or leakage of one or more of the valves in the heart). In addition, sudden events such as a very rapid heart rate, a heart attack, or a blood clot in the lungs may also lead to congestive heart failure. Most common symptoms include shortness of breath, bloating in the abdomen, and swelling in the feet.
Chronic Obstructive Pulmonary Disease (COPD)
A group of diseases that obstruct the air in the lungs from being easily oxygenated commonly known as emphysema, chronic bronchitis, and asthma.
The heart muscle enlarges and weakens. Most commonly from Coronary Artery Disease. May occur over time or acutely from a heart attack or a viral infection or abuse of drugs. Some chemotherapy agents can have the side effect of a dilated cardiomyopathy.
This occurs when the impulse from the top of the heart (the atrium) to the bottom of the heart (the ventricle) is delayed or prevented. There are different degrees in heart block (Type I, Type 2, Type 3). Some of these blocks require a pacemaker. Symptoms may include dizziness or fainting.
Although there are many components to blood cholesterol, the term "High Cholesterol" most often is referred to as a high total cholesterol (greater than 200mg/dl) or a high "bad cholesterol" (LDL cholesterol)- which should be less that 130 in all individuals. Those with risk for Coronary Artery Disease (obesity, smokers, high blood pressure, diabetes, family hx, etc) should aim for LDL < 100mg/dl. Those individuals with known CAD or PVD should have LDL cholesterols < 80mg/dl.
High blood pressure. AKA "the silent killer". A blood pressure > 140/90 is considered high, except in the diabetic patient in which a BP is considered high if >130/85. Those without diabetes a blood pressure between 130-139/85-89 is considered "pre-hypertensive" and should be put on a low sodium diet and exercise program with close monitoring for the development of hypertension.
A thickened heart that has increased muscle mass. May be congenital with an asymmetrical muscle build up in the septum of the heart that may block the blood from exiting the heart. This type often runs in families and can cause sudden death, especially in young athletes. There are many programs that screen athletes for this type of Cardiomyopathy. A second type of hypertrophic cardiomyopathy is one that develops over time in response to hypertension or heart valve disease. It is a symmetrical build up of muscle in the ventricle of the heart, most commonly on the left side. Occasionally, may occur on the right side of the heart in response to severe lung disease.
There are many disorders affecting cholesterol. One may have high bad cholesterol (see above). Equally concerning in a good cholesterol which is too low (HDL < 60 in women and < 50 in men). The best way to improve your "clean up crew" is to exercise. One may have high triglycerides (fat) in the blood often seen in diabetic patients and often improves with better blood sugar control. Lastly, there are genetic disorders that include elevated Lp(a), Apo-B, homocysteinemia, Pattern B, etc that should be excluded in individuals who develop CAD/PVD, or have a family history for CAD/PVD, prior to age 60.
Lower Extremity Disease
Cholesterol plaque deposits that occur in the arteries in the legs. Symptoms include cramping or aching of the leg muscles with walking that is relieved with rest. A loss of hair on the toes, foot, or lower leg may also be present. A "cold" foot or leg, that is sudden, can be a medical emergency.
Mitral Valve Disease
A narrowing or leakage of the mitral valve (the valve between the top and bottom chambers of the heart on the left side).
Patent Foramen Ovale
A small hole (sometimes called a shunt) in the heart located in the septum (muscle dividing the two top chambers of the heart into the right and left atrium) that does not close at birth. This is a common defect that occurs in 1 in 4 or 5 people. In most cases patients are asymptomatic lifelong. This is commonly a cause of stroke.
An inflammation of the sac around the heart. This can lead to a collection of fluid in the heart sac. Often treated with anti inflammatory. Occasionally severe and can restrict the hearts ability to beat effectively, requiring the fluid to be drained.
A blood clot in the lungs. Can be life threatening. Often the clot originates in the veins in the legs from inactivity, prolonged travel, surgery, blood clotting disorders, smoking, birth control pills (or hormone replacement), to name a few. The clot then travels to the lungs and causes shortness of breath.
An elevation of the blood pressure in the pulmonary arteries. This puts strain on the heart and decreases the lungs ability to oxygenate the blood. Can lead to both heart and lung failure.
Renal Artery Disease
There are two primary varieties. The first is from cholesterol plaque deposits involving the arteries that feed blood to the kidneys, causing a blockage. Usually affects the individual over age 50. The second is an overgrowth of the muscle layer of the artery and is most often seen in younger patients. Both of these interrupt blood flow to the kidney, and if not treated can lead to renal failure. It is commonly fixed by either a stent or a balloon angioplasty, depending on which type it is. The most common symptom is uncontrolled high blood pressure despite 2 or more medications.
Fainting, or brief loss of consciousness. Not associated with a seizure disorder. May be caused by a change in heart rhythm, or may reflect a problem with the communication between the heart and the nervous system.
Sudden loss of blood flow to a part of the brain. May be caused by carotid artery disease (see above), a blood clot from the heart, or a ruptured aneurysm or trauma in the brain. One form is considered embolic, while the other is related to bleeding.
Upper Extremity Disease
Usually referred to as cholesterol plaque deposits buildup in the arms. Often detected by a > 30mmHg difference in blood pressures between the right and left arms. Patients may notice a fatiguing or cramping of the arm when using it (especially above the level of the head i.e. changing a light bulb).
Refers to the veins in the body. This is most commonly known as venous insufficiency or varicose veins. The little valves (doors) in the vein that help move the blood upward toward the heart become incompetent and the blood leaks backward. This causes swelling and aching in the legs, especially when sitting or standing for a prolonged period of time. Veins may become inflamed referred to as phlebitis. This may be caused by an IV, infection or injury. Disease in the deep vessels have increased risk for blood clots called DVT (Deep venous thrombosis) and require immediate attention.
Abnormal beats that originate from the bottom of the heart. May be a pre-ventricular beat (PVC) that causes a flutter in one's chest. May be a life threatening rhythm that causes sudden cardiac death such as ventricular tachycardia (a fast regular rhythm from the bottom of the heart the ventricle) or ventricular fibrillation (an irregular, chaotic rhythm). Patients with a weakened or severely thickened heart muscle (cardiomyopathy) are at greatest risk of death from ventricular arrhythmias. These patients often receive an AICD as a life saving device.