February is full of pink and red hearts but Valentine’s Day isn’t the only reason to focus on your heart this month. The second month of the year is also American Heart Month and is meant to remind you and your patients to keep a pulse (ha, get it?) on your cardiovascular health.
Heart disease remains a leading cause of death and encompasses a wide variety of disorders. In addition to heart disease, arrhythmias and heart valve issues can disrupt your patient’s quality of life and should be disorders you routinely screen for.
Today we’re going to share some of the things you should know about these common cardiovascular diagnoses, what to look for, and the most popular treatment options.
When talking about American Heart Month, you’ve got to start with cardiovascular diseases (CVDs). This group of cardiac disorders is the leading cause of death around the globe and are often things that slowly progress, making it sometimes tough to spot in a new patient.
CVDs can affect the blood vessels around the heart (coronary artery disease), blood vessels supporting the brain (cerebrovascular disease), and blood vessels in the extremities (peripheral artery disease).
Coronary artery disease (CAD) is one of the most common types of CVD and patients typically present with chest pain (angina), shortness of breath, and dizziness. This happens due to plaque buildup interfering with how well-oxygenated blood is flowing to the rest of the body.
A person’s first symptom can also be a heart attack making identifying CAD all the more important.
If someone is at risk of CAD, doing routine ECGs and even an echocardiogram can help further investigate a person’s heart function and CAD risk. Stress tests can also be helpful. While more invasive, cardiac catheterization and coronary angiograms help look inside the arteries for blockages and measure the strength of the heart.
Treating CAD involves lifestyle changes to be more physically active and lose weight if needed. Medications to lower high cholesterol (and prevent further plaque build-up), antihypertensives, and drugs to manage arrhythmias can also help manage CAD.
Cerebrovascular disease includes all issues related to blood flow to the brain. Stroke, carotid stenosis, intracranial stenosis, and aneurysms are a few examples of cerebrovascular diseases and cerebrovascular events.
Cerebrovascular disease tends to be asymptomatic and is often discovered through thorough exams and testing. Carotid stenosis can be discovered by the presence of a bruit and then confirmed with ultrasound or cerebral angiography.
If someone is having an acute cerebrovascular event, symptoms such as dizziness, confusion, numbness, and weakness are common. Cerebral angiography, computed tomography (CT), and magnetic resonance imaging (MRI) can all be used to identify the presence of an acute stroke as well as an aneurysm.
Both stroke and aneurysms are considered medical emergencies and patients should be taken to the nearest emergency department for further evaluation. Depending on the type of stroke, a blood clot may need to be removed or an intracerebral hemorrhage may need to be treated.
While carotid stenosis can lead to vascular obstruction, oftentimes people can be managed with antihypertensives, medication to reduce cholesterol, and anticoagulation therapy.
Symptoms of peripheral artery disease include muscle pain in the legs when walking or exercising. This pain or cramping tends to go away when the patient stops walking which is the classic symptom of peripheral artery disease and is called claudication. Other peripheral artery disease symptoms include poor wound healing in the toes or feet, lack of hair growth on the lower legs, and even erectile dysfunction.
Diagnosing peripheral artery disease typically involves doing an ankle-brachial index test, but ultrasounds and angiograms are often performed to make the diagnosis.
Treating peripheral artery disease involves reducing symptoms and further progression of the disease. Many of these interventions involve lifestyle changes like quitting smoking, increasing physical activity, and losing weight if the patient is obese.
Medications to lower the risk of stroke and blood clots as well as drugs to reduce cholesterol and hypertension are also used to manage peripheral vascular disease.
In addition to issues within the blood vessels, there can be issues with how the heart pumps. Patients can have tachycardic arrhythmias like atrial fibrillation and atrial flutter or they can have bradycardic arrhythmias like sick sinus syndrome and conduction block.
Symptoms of arrhythmias can be vague and difficult to differentiate from other diagnoses. Patients can have heart palpitations, chest pain, or shortness of breath when they’re acutely experiencing an arrhythmia.
Oftentimes patients will complain of anxiety, fatigue, and dizziness with arrhythmias.
If someone is experiencing an arrhythmia regularly, an ECG can often catch it. But a lot of times patients need to wear a continuous monitor at home for 48 hours and up to 14 days to monitor their heart to try and capture the arrhythmia.
Treatment options for arrhythmias include:
The type of treatment needed is usually decided by the severity of the arrhythmia.
When rounding out heart-related issues to cover for American Heart Month, you can’t forget the heart valves. The blood flows through the vessels thanks to proper rhythms – but the valves themselves can get stiff, thickened, or leaky.
Issues with the heart valves are often discovered by the presence of a heart murmur. Murmurs can signify several valve issues including:
It’s difficult to know which type of valve disorder is occurring by osculating alone – this is why an echocardiogram is needed to make a diagnosis.
Not everyone needs an intervention to treat a heart valve issue, especially if it isn’t interfering with cardiac output or function. But if it is, procedures like valve repair or replacement can resolve or improve a dysfunctional valve.
Whether you’re a med student or currently in practice, it’s always helpful to keep a pulse (we can’t help ourselves on this one) on the latest cardiology updates.
One simple way to do this is to use your Juisci app to receive cardiology specific updates straight to your inbox. Our Juisci ‘shots’ are quickly digestible and entertaining so you don’t have to spend a lot of time reading a ton of articles and abstracts with the little free time you have.
You can get your shot of cardiology medical knowledge and get back to the important things like happy hour with friends, a nice walk outside, or even a nap (if you remember those).
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