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UNDERSTANDING HEART DISEASE

Coronary Artery Disease

Blockages in the Blood Vessels of the Heart

Coronary Artery Disease (CAD) is the most common type of heart disease and is the number 1 cause of death in India and all over the world. Whenever we say 'heart disease' on this website, we are talking about CAD, unless otherwise specified.

WHAT IS CORONARY ARTERY DISEASE?

Coronary artery disease (CAD) occurs due to blockages in the blood vessels that supply blood and oxygen to the heart. 

HOW DOES IT DEVELOP?

These blockages develop over a very long period of time. However, the disease-related changes in the blood vessels usually begin to occur much earlier than the symptoms. This is the best time to take action to prevent development of significant blockages.

WHAT ARE THE SYMPTOMS?

Once CAD develops, the most common symptom is 'angina', which is felt as pain, discomfort or pressure in the chest, especially during physical activity. Although angina can occur at rest in advanced stages, patients usually begin to notice chest pain during activity, which goes away when the activity is stopped. 

Angina occurs because blockages in the vessels don't allow enough oxygen-rich blood to reach the heart muscle.

Stages of blockages in blood vessels of the heart leading to heart disease, chest pain, angina and eventually heart attacks

HOW IS IT DIAGNOSED?

Coronary artery disease (CAD) is commonly diagnosed by doing a stress test or stress echo. Some doctors may also recommend a Cardiac CT scan.

CAD

Heart Attack or 'myocardial infarction' is the most feared consequence of coronary artery disease because in some people, the first symptom may be sudden death. 

WHAT IS A HEART ATTACK?

A Heart Attack or 'myocardial infarction' occurs due to a sudden and complete blockage in the blood vessels supplying the heart.

WHY IS IT DANGEROUS?

10% of heart attacks occur in people younger than 40 years of age.

WHAT ARE THE SYMPTOMS?

Heart Attack is an emergency that requires immediate medical attention. Therefore, it is important to promptly recognize the warning signs.

Patients usually experience sudden, severe, crushing chest pain that can travel to the left arm or back. It is not usually relieved by rest or medicines and can be accompanied by sweating and difficulty breathing.

Warning signs for heart attack- severe crushing chest pain, pain arms, jaw, back or stomach, sweating, nausea, lightheadedness

HOW IS IT DIAGNOSED?

A Heart Attack is diagnosed using ECG and certain blood tests (Trop-I and CPK-MB).

Complete blockage can result in permanent damage to the heart muscle. The longer the blockage remains, the greater is the damage. Therefore, promptly opening up the blockage is absolutely essential. 

In some people the first symptom can be sudden death. 

Development heart disease leading to heart attacks; importance of early treatment for heart attacks
MI

WHAT IS HEART FAILURE?

Heart Failure is a serious, chronic (long-term) condition. In heart failure, the the heart is not able to properly pump blood to the rest of the body. It can be of two types- one, due to inadequate squeezing of the heart because of which blood is not properly propelled out of the heart, and two, due to  inadequate relaxation of the heart because of which it cannot properly get filled with blood before pumping. In both cases, the result it that the blood is not properly pumped to the body.

HOW DOES IT DEVELOP?

WHAT ARE THE SYMPTOMS?

The most common symptoms are shortness of breath, especially while walking or lying down, swelling of feet and ankles, fatigue, persistent cough and decreased ability to exercise.

HOW IS IT DIAGNOSED?

Heart Failure is diagnosed based on a measurement called 'ejection fraction' that is obtained during an echocardiogram and a blood test (NT-proBNP or BNP).

The most common causes of heart failure are coronary artery disease, high blood pressure (BP), a previous heart attack and diabetes.

HF

Heart Disease in Indians

EARLY DISEASE IN INDIANS

Coronary Artery Disease (CAD) occurs at an earlier age in Indians. In fact, 35% of heart disease occurs in the working age groups (35-64 years), which is almost 3 times that of the U.S., where only 12% of heart disease occurs before the age of 65 years.

Although earlier disease in Indians was previously believed to be due to a genetic predisposition, recent research has shown that this is not the case. The same risk factors are present in Indians, but they develop at a younger age.

This can partly be attributed to lifestyle. Additionally, preventative check-ups are not a regular feature because people spend out of pocket.

Percentage of heart disease according to age group, showing high proportion of heart disease in young Indians
Newspaper article showing high mortality rate / death rate of heart attacks and lifestyle as an important risk factor
Newspaper article showing that heart disease - coronary artery disease is the leading cause of death in India and worldwide

LEADING CAUSE OF DEATH

Coronary Artery Disease (CAD) is the leading cause of death in India, with mortality 2 times that of the US and 3-5 times that of some European countries.

In fact, over half (52%) of cardiovascular death occur in people under the age of 70 years.

Newspaper article - heart attacks occur because of undiagnosed heart disease, often in young people, early prevention is key
HD Indians

For the purpose of patient education, some images on this webpage have been adapted from the Patient Benefit Handbook provided by Hoechst Marion Roussel.

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