Cardiovascular Diseases

The following are brief descriptions of the various types of heart disease that we diagnose and treat at Emerson Cardiovascular Associates. As cardiologists who are trained in and emphasize preventive care, we work with patients to perform a comprehensive evaluation and design a personalized plan of care aimed at keeping you healthy.

For more information, please go to Diagnostic Tests or Treatment: An Overview.

Coronary artery disease

Coronary artery disease (CAD) is caused when plaque, which consists of fatty material, including cholesterol, forms in the lining of the coronary arteries. CAD is a progressive disease; as the space in the blood vessel narrows, the heart must work harder to pump blood through the vascular system (blood vessels). Chest pain, known as angina, is a common symptom, as is pressure, aching or tingling in the back, neck, throat, jaw, arms or shoulders. Individuals with CAD may also complain of feeling tired and experiencing shortness of breath, dizziness or nausea. As the artery becomes further blocked, plaque or a blood clot potentially can lodge in the artery and produce a heart attack, which deprives the heart of oxygen. There is a range of treatments available for CAD, including medication, angioplasty and heart surgery. Lifestyle changes involving diet and exercise also are important to stemming progression of CAD.

Heart murmurs and valve abnormalities

Many people have heart murmurs—extra heart sounds that a physician can hear with a stethoscope—but only some of them require treatment. Similarly, heart valve problems don’t always cause symptoms, which may include wheezing, coughing or shortness of breath; difficulty breathing when lying down; unexplained weight gain; weakness or fatigue; and swollen ankles or feet. For heart murmurs and valve problems that merit closer attention, we can provide diagnostic services and monitor your condition over time. When necessary, we will specify treatment, including medication, valve repair or valve replacement.

Heart failure

A diagnosis of heart failure means the heart is not pumping as effectively as it should. As a result, fluid tends to gather in the lower extremities (legs and ankles) or in the lungs. The condition may cause other symptoms, such as weakness and shortness of breath and coughing on exertion. Heart failure usually is caused by another heart problem, such as coronary artery disease, a heart attack, high blood pressure or valve disease. There are two types: where the heart’s pumping function is weakened and where the pumping function is normal, but a mechanical problem in the heart leads to heart failure. With good care management, most people with heart failure can avoid hospitalization and live well with this condition.

Heart rhythm abnormalities (arrhythmias)

A change in the pace or pattern of the heartbeat is called an arrhythmia. There are various types, and many don’t interfere with life. However, some arrhythmias require testing to determine if treatment is necessary. Atrial fibrillation, the most common cardiac arrhythmia, is associated with a risk for stroke. For many patients, medication is effective at regulating the heart’s rhythm. But other arrhythmias, including those that produce either an abnormally slow or very fast pulse, can be life-threatening. Through careful examination and testing in an electrophysiology lab, we can determine if a device-based therapy, such as a pacemaker or implantable defibrillator, is needed.

Vascular disease

Similar to coronary artery disease (CAD), blood vessels distant from the heart also can become blocked. In fact, people who have been diagnosed with CAD are at risk for developing vascular disease, often referred to as peripheral artery disease (PAD). If you have leg pain when walking that disappears when you are at rest, you may have PAD in your legs and should be evaluated. If you have neurologic symptoms or have had a transcient ischemic attack (TIA, also known as a “mini-stroke”), your carotid arteries, which carry blood to the brain, may be blocked. Treatments for vascular disease include medications, procedures to open the blocked blood vessels and bypass surgery that provides a route for blood around the blockage.

Adult congenital heart disease

Congenital heart defects occur while the fetus is developing and may or may not cause symptoms at the time of birth. The most common congenital heart disorders that affect adults are valve defects, atrial and ventricular septal defects and patent foramen ovale (known as “hole in the heart”). As a result of breakthroughs in pediatric heart surgery, many individuals live healthy lives despite being born with a congenital heart condition. However, even those who had successful surgery should be seen by a cardiologist throughout their adult years.

Risk factor modification

Many people have a combination of risk factors that should be aggressively managed with the goal of preventing the development of heart disease. The main risk factors are:

High blood pressure: You should aim for a healthy blood pressure—no higher than 120/70. Once your blood pressure reaches 140/90, treatment is typically recommended. Over time, high blood pressure can damage the blood vessels, so it is important to bring it under control. There are many effective medications, but you can help keep your blood pressure down by losing weight, eating a low-fat and low-sodium diet, exercising and limiting alcohol intake.

High cholesterol: High levels of LDL cholesterol—“bad” cholesterol—is known to increase the amount of plaque in the arteries. Low levels of HDL—“good” cholesterol—is also unhealthy. The American Heart Association’s LDL cholesterol goals are based on an individual’s cardiac risk factors (Diane: please highlight the following 3 lines):

• Low risk – goal is less than 160 mg/dl
• Moderate risk – goal is less than 130 mg/dl
• High risk – goal is less than 100 mg/dl

Diabetes: The high blood sugar associated with diabetes can damage blood vessels throughout the body, which can lead to the development of plaque. One-third of those with diabetes have coronary artery disease.

Obesity: Those who are 20 percent or more above their target weight are at increased risk of developing cardiovascular disease—by 46 percent in men and 64 percent in women. In addition to putting a strain on the heart, being overweight makes it difficult to control high blood pressure, high cholesterol and diabetes.