Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. Four out of five CVD deaths are due to heart attacks and strokes.
Cardiovascular diseases (CVDs)
According to the World Health Organization (WHO), cardiovascular diseases are the leading cause of deaths globally. More people die from these diseases than from anything else.
An estimated 17.9 million people died from cardiovascular diseases in 2016, representing 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke.
Over three quarters of cardiovascular diseases deaths take place in low- and middle-income countries.
Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2015, 82% are in low- and middle-income countries, and 37% are caused by CVDs.
By 2030, it is predicted that 23.6 million people will die from cardiovascular diseases annually, mostly due to stroke and heart disease.
Major cardiac (heart-related) diseases and conditions include:
- Congenital heart defect
- Coronary heart disease (CHD)
- Dilated cardiomyopathy (DCM)
- Heart attack (myocardial infarction)
- Heart failure
- Hypertrophic cardiomyopathy (HCM)
- Rheumatic heart disease
Coronary heart disease — disease of the blood vessels supplying the heart muscle. Coronary heart disease refers to a narrowing of the coronary arteries, the blood vessels that supply oxygen and blood to the heart. It is a major cause of illness and death.
Coronary heart disease normally happens when cholesterol accumulates on the artery walls, creating plaques. The arteries narrow, reducing blood flow to the heart. Sometimes, a clot can obstruct the flow of blood to the heart muscle.
Coronary heart disease commonly causes angina pectoris (chest pain), shortness of breath, myocardial infarction, or heart attack.
Angina is chest pain or discomfort caused when the heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or squeezing in the chest. The discomfort also can occur in the shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
Angina is not a disease, it is a symptom of an underlying heart problem, usually coronary heart disease (CHD).
Arrhythmia is a problem with the rate (rhythm) of the heartbeat. It is when the heart beats too quickly, too slowly, or with an irregular pattern. When the heart beats faster than normal, it is called tachycardia. When the heart beats too slowly, it is called bradycardia. The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heartbeat.
Congenital heart defect is malformations of heart structure existing at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely.
Dilated cardiomyopathy is the most common type of cardiac diseases. Dilated cardiomyopathy occurs mostly in adults 20 to 60. Dilated cardiomyopathy affects the heart's ventricles and atria, the lower and upper chambers of the heart.
Dilated cardiomyopathy often starts in the left ventricle, which is the heart's main pumping chamber. The heart muscle begins to dilate, stretches and becomes thinner, leading to enlargement of inside chamber. Dilated cardiomyopathy often spreads to the right ventricle and then to the atria.
As the heart chambers dilate, the heart muscle doesn't contract normally and cannot pump blood efficiently. Dilated cardiomyopathy can lead to heart failure, heart valve problems, arrhythmias and blood clots in the heart.
Heart attack happens when the blood supply to the heart is cut off and the heart muscle begins to die. Heart attack is also called myocardial infarction. Some people who are having a heart attack have warning signs, while others show no signs. Some symptoms that many people report are:
- chest pain
- upper body pain
- trouble breathing
A heart attack is a serious medical emergency. Heart attack requires immediate medical attention.
Heart failure is when the heart is unable to pump blood around the body properly. It usually occurs because the heart has become too weak or stiff. It can occur at any age, but is most common in older people. Heart failure is a long-term condition that tends to get gradually worse over time.
Hypertrophic cardiomyopathy is a disease in which the heart muscle (myocardium) becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood.
Hypertrophic cardiomyopathy is very common disease and can affect people of any age, men and women equally. It is a common cause of sudden cardiac arrest in young people, including young athletes.
Some people who have hypertrophic cardiomyopathy have no signs or symptoms, and the disease doesn't affect their lives. Others have severe symptoms and complications, such as shortness of breath, serious arrhythmias or an inability to exercise.
Rheumatic heart disease is a damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria. Rheumatic heart is an inflammatory disease that begins with strep throat. It can affect connective tissue throughout the body, especially in the heart, joints, brain and skin.
Major vascular diseases (diseases that affect the blood vessels: the arteries, veins, or capillaries) include:
- Peripheral artery disease (PAD)
- Renal artery stenosis
- High blood pressure (hypertension)
- Raynaud's phenomenon
- Buerger's disease
- Peripheral venous disease (PVD)
- Stroke (transient ischemic attack, ischemic stroke, hemorrhagic stroke)
- Venous thromboembolism (VTE), deep vein thrombosis, pulmonary embolism
- Blood clotting disorders
- Varicose veins, spider veins
- Chronic venous insufficiency (CVI)
Atherosclerosis is a disease in which plaque builds up inside the arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows the arteries. This limits the flow of oxygen-rich blood to the organs and other parts of the body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death.
Peripheral artery disease is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Peripheral artery disease causes leg pain when walking (claudication). Peripheral artery disease is also likely to be a sign of a more widespread accumulation of fatty deposits in the arteries (atherosclerosis). This condition may be reducing blood flow to the heart, brain, and legs.
Aneurysm is the enlargement of an artery caused by weakness in the arterial wall. Often there are no symptoms, but a ruptured aneurysm can lead to fatal complications. An aneurysm refers to a weakening of an artery wall that creates a bulge, or distention, of the artery. Most aneurysms do not show symptoms and are not dangerous. However, at their most severe stage, some can rupture, leading to life-threatening internal bleeding.
Renal artery stenosis is the narrowing of one of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney, resulting in renovascular hypertension – a secondary type of high blood pressure.
The symptoms of renal artery stenosis include uncontrolled hypertension (high blood pressure), congestive heart failure, and abnormal kidney function.
Blood pressure is the force of blood pushing against the walls of the arteries, which carry blood from the heart to other parts of the body. Blood pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage the heart and lead to health problems. High blood pressure (hypertension) raises the risk for heart disease and stroke, which are leading causes of death worldwide.
High blood pressure (hypertension) has no warning signs or symptoms, and many people do not know they have it. The only way to know it is to measure the blood pressure.
High blood pressure (hypertension) increases the risk for dangerous health conditions:
- First heart attack: about 70% of people having their first heart attack have high blood pressure (hypertension)
- First stroke: about 80% of people having their first stroke have high blood pressure (hypertension)
- Chronic heart failure: about 70% of people with chronic heart failure have high blood pressure (hypertension)
Raynaud's phenomenon consists of spasms of the small arteries of the fingers, and sometimes, the toes, brought on by exposure to cold or excitement.
Buerger's disease most commonly affects the small and medium sized arteries, veins, and nerves. Although the cause is unknown, there is a strong association with tobacco use or exposure. The arteries of the arms and legs become narrowed or blocked, causing lack of blood supply (ischemia) to the fingers, hands, toes and feet. Pain occurs in the arms, hands, and more frequently the legs and feet, even at rest. With severe blockages, the tissue may die (gangrene), requiring amputation of the fingers and toes.
Peripheral venous disease involves any vessel outside of the heart and usually affects the legs and feet. Peripheral venous disease is characterized by a narrowing of the vessels that carry blood to the leg and arm muscles. The most common cause is the build-up of plaque inside the artery wall (atherosclerosis). Blood clots can also cause peripheral venous disease. There are two types of clots that can form: a superficial vein thrombosis and a deep vein thrombosis.
A stroke is a medical emergency that happens when the blood flow to the brain is interrupted. This can cause serious symptoms, lasting disability, and even death. There are three main types of stroke: transient ischemic attack, ischemic stroke, and hemorrhagic stroke.
Transient ischemic attack (TIA) is often called by doctors as a warning or mini-stroke. Anything that temporarily blocks blood flow to the brain causes a transient ischemic attack. The blood clot and transient ischemic attack symptoms last for a short period of time.
An ischemic stroke occurs when a blood clot keeps blood from flowing to the brain. The blood clot is often due to atherosclerosis, which is a buildup of fatty deposits on the inner lining of a blood vessel. A portion of these fatty deposits can break off and block blood flow in the brain. The concept is similar to that of a heart attack, where a blood clot blocks blood flow to a portion of the heart.
An ischemic stroke can be embolic or thrombotic.
An embolic ischemic stroke is when the blood clot travels from another part of the body to the brain.
A thrombotic ischemic stroke is caused by a clot forming in a blood vessel in the brain.
Unlike a transient ischemic attack (TIA), the blood clot that causes an ischemic stroke won’t go away without treatment.
A hemorrhagic stroke results when a blood vessel in the brain ruptures or breaks, spilling blood into the surrounding tissues.
Venous thromboembolism is a condition in which a blood clot forms most often in the deep veins of the leg, groin or arm (known as deep vein thrombosis, DVT) and travels in the circulation, lodging in the lungs (known as pulmonary embolism, PE).
Blood clotting disorders occur when the body is unable to make sufficient amounts of the proteins that are needed to help the blood clot, stopping bleeding. These proteins are called clotting factors (coagulation factors). All clotting factors are made in the liver. The liver requires vitamin K to make some of the clotting factors.
Varicose veins are bulging, swollen, purple, ropy veins, seen just under the skin, caused by damaged valves within the veins.
Spider veins are small red or purple bursts on the knees, calves, or thighs, caused by swollen capillaries (small blood vessels).
Chronic venous insufficiency is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs.
International Classification of Diseases and Related Health Problems 10th Revision (ICD-10):
D50-D53 Nutritional anaemias
D55-D59 Haemolytic anaemias
D60-D64 Aplastic and other anaemias
D65-D69 Coagulation defects, purpura and other haemorrhagic conditions
D70-D77 Other diseases of blood and blood-forming organs
I00-I02 Acute rheumatic fever
I05-I09 Chronic rheumatic heart diseases
I10-I15 Hypertensive diseases
I20-I25 Ischaemic heart diseases
I26-I28 Pulmonary heart disease and diseases of pulmonary circulation
I30-I52 Other forms of heart disease
I60-I69 Cerebrovascular diseases
I70-I79 Diseases of arteries, arterioles and capillaries
I80-I89 Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified
I95-I99 Other and unspecified disorders of the circulatory system
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