There are many types of heart diseases, and some can lead to heart attacks. Let’s explore the main types and how to treat them.

Heart disease: Main types

A multitude of cardiac conditions manifest, each characterized by distinct symptomatic profiles and necessitating tailored therapeutic strategies. Lifestyle adjustments and pharmaceutical interventions wield profound efficacy in ameliorating certain conditions. Conversely, instances arise where surgical intervention becomes imperative to reinstate optimal cardiac functionality.

Learn about common types of heart conditions and understand how to prevent them, and explore the details of their specific treatment plans: [10.1]

• Coronary Heart Disease (CAD): blockages might develop within your coronary arteries, which are responsible for delivering blood to your heart. This obstruction can result in reduced blood flow to your heart muscle, consequently depriving it of the necessary oxygen supply.
• Heart Arrhythmias: it occurs when heart has an irregular beating pattern.
• Heart Valve Disease : your heart is equipped with four valves that play a crucial role in regulating blood flow between the heart's chambers, the lungs, and blood vessels. If there's an irregularity, it might impede a valve's proper opening and closing mechanism. Consequently, this can lead to obstructions in blood flow or leakage. In such cases, the valve might not function as intended.
• Congenital heart disease: it occurs when there are developmental issues with the heart while a baby is still in the womb. This heart anomaly can result in immediate challenges after birth, or it might not exhibit any symptoms until the individual reaches adulthood.
   
   

Coronary or ischemic heart disease

Coronary heart disease is a heart disease that primarily affects the arteries that supply blood to the heart, the coronary arteries. They result in a gradual or sudden decrease in blood and oxygen supply to the heart. This decrease, which results in insufficient vascularisation of the heart, is called myocardial ischaemia. The two main coronary heart diseases are angina and myocardial infarction [1.1].

Valvular heart disease

Valvular heart disease is a heart disease that affects the valves of the heart. [2.1] As a reminder, the heart is an organ composed of four chambers, which are separated by four valves. Each of these valves opens one of the four chambers of the heart to let blood in and closes the chamber to prevent blood from flowing back out. These four valves are the aortic, mitral, tricuspid, and pulmonary valves.

Congenital heart disease

Congenital heart diseases are malformations of the heart that occur during its formation in utero. [4.1] These malformations are remarkably diverse, complex, and severe. Some are very mild and have no impact on the child’s growth, while others are extremely serious and fatal to the newborn.

Heart disease: Symptoms

Symptoms of coronary or ischaemic heart disease

The main symptoms of coronary heart disease (angina pectoris and myocardial infarction, or heart attack), which are typical of cardiovascular diseases, are chest pain, fatigue, malaise, nausea, vomiting, breathing difficulties, pain in the shoulder, jaw or arm [1.2].

Symptoms of heart valve disease

Heart valve disease may remain asymptomatic [2.2] and only known by chance during other tests or examinations. Nevertheless, its non-specific symptoms may include [2.3] chest discomfort shortness of breath - dyspnoea - on exertion, at rest, and swelling.

Symptoms of congenital heart disease

The symptoms of congenital heart disease are remarkably diverse and severe. However, abnormal pulse (rapid heart palpitations), fainting, cyanosis (blue disease, with bluish skin, lips), fatigue during physical activities [6.1].

Heart disease: Risk factors 

Risk factors for coronary or ischemic heart disease

In addition to a family history of heart failure, age, and gender (45 for men, 55 for women) are among the most important risk factors for atherosclerosis (the main type of coronary heart disease) [1.3]that cannot be controlled. However, the majority of other risk factors are related to lifestyle choices and are therefore potentially actionable. These include smoking, high blood pressure, cholesterol (high LDL, low HDL levels), diabetes, overweight and obesity, lack of exercise and stress [1.4].

Risk factors for heart valve disease

Valvular heart disease can develop before or at birth (congenital causes) or normal valves may become damaged during one’s lifetime (acquired causes). The cause of valvular heart disease is not always known.

Risk factors for congenital heart disease

In most of cases, the origin of congenital heart disease is unknown, so prevention of this risk is difficult or impossible. However, known risk factors include gestational diabetes [4.3][6.2]. A family history of congenital heart disease also increases the risk of a heart defect in the foetus.

Treatment of heart disease

Treatments for coronary or ischaemic heart disease

Depending on the exact nature and severity of the disease, coronary heart disease can be treated with medicines to inhibit atherosclerosis as early as possible, slow its progression or relieve symptoms. Medications that may be prescribed by the doctor include nitrates, calcium channel blockers, beta-blockers, statins, and aspirin [11.1].

However, if the coronary arteries are already too damaged or obstructed, especially after a heart attack, coronary bypass surgery may be performed, especially in an emergency, to restore blood flow and vascularisation of the heart [11.2]. This is a surgical procedure under general anaesthesia in which a healthy part of a vein or artery is removed from the patient’s leg, arm or chest and then grafted onto the blocked coronary artery. The heart can be stopped during this procedure, and blood circulation is provided by extracorporeal circulation (ECG). Beating heart bypass surgery is much less conventional and requires special equipment but is more suitable for some patients.

Finally, advances in minimally invasive coronary surgery offer alternatives to bypass surgery. These include minimally invasive cardiac surgery, stenting, and transluminal angioplasty [11.3]. Minimally invasive cardiac surgery (MICS) [12.1] is performed on a beating heart by making a micro-incision in the skin. Stenting, which is performed by inserting a tiny balloon that is inflated into the artery, also aims to restore good circulation. Similarly, angioplasty uses a balloon to widen the inside of the artery and promoting better blood flow.

Treatment of heart valve disease

After medical examinations and specialised cardiac tests (electrocardiogram and echocardiogram, Doppler, catheter) to establish the diagnosis, the doctor usually recommends rest, a salt-free diet, diuretics, and vasodilators. In extreme cases, defective or damaged valves can be replaced with an artificial valve [2.4].

Treatment of congenital heart disease

The treatment of congenital heart disease varies depending on the exact nature of the defect, its severity, and the age of the patient. It may include medicinal products (diuretics, beta-blockers, antiarrhythmics, ACE inhibitors) [13.1], surgical procedures (closure of holes between chambers, repair or replacement of valves and/or major blood vessels, heart transplant) [13.2]. Catheter procedures (repair of simple cardiac holes, enlargement of narrowed areas, transcatheter aortic valve implantation (TAVI) [9.1], and lifestyle adaptations or changes (non-smoking, physical activity, appropriate weight, healthy and balanced diet, reduction of stress, reduction of alcohol consumption).

In conclusion, if you suspect heart disease, have family history of heart attacks, have high blood pressure or cholesterol, are on long-term treatment for a condition such as diabetes, or have recognised any of the causes, risk factors or symptoms in this article, it is important to contact a doctor.

References

1. https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease - 1, 2, 3, 4
2. https://www.heartandstroke.ca/heart-disease/conditions/valvular-heart-disease - 1, 2 , 3 , 4
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303989/ - 1, 2
4. https://www.mayoclinic.org/diseases-conditions/adult-congenital-heart-disease/symptoms-causes/syc-20355456 - 1, 3
5. https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/symptoms-causes/syc-20370709 - 1
6. https://www.nhs.uk/conditions/congenital-heart-disease/symptoms/ - 2
7. https://www.heart.org/en/health-topics/cardiomyopathy/understand-your-risk-for-cardiomyopathy - 1
8. https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/diagnosis-treatment/drc-20370714 
9. https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698
10. https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698 - 1
11. https://www.webmd.com/heart-disease/heart-disease-types-causes-symptoms - 1
12. https://www.webmd.com/heart-disease/heart-disease-treatment-care - 1, 2
13. https://ctvstexas.com/about-ctvs/our-services/cardiac-services/minimally-invasive-cardiac-surgery-mics/ - 1
14. https://www.mayoclinic.org/diseases-conditions/congenital-heart-defects-children/diagnosis-treatment/drc-20350080 - 1, 2