Common heart problems explained

Here’s our guide to some of the most common heart problems, and what might happen if the heart isn’t working as well as it should.

Cardiovascular disease

This is an umbrella term for a collection of diseases that affect the heart and circulatory system and is the most common cause of premature death in the UK. Cardiovascular disease is also the most common cause of death in the UK.

One of the most common is coronary heart disease, which is when fatty deposits gradually build up on the walls of your coronary arteries.

There are many lifestyle choices that contribute to coronary heart disease. The biggest risk factors are smoking, a diet that’s high in fat, salt and sugar, and a lack of physical exercise. You’re also at greater risk if you’re overweight or obese, or have underlying health issues such as high blood pressure, high cholesterol, diabetes or a family history of heart disease. It becomes more likely as you get older, and it’s also more common in certain ethnic groups such as South Asians.

Angina is a symptom of coronary heart disease and occurs when your arteries narrow so much that they can’t deliver enough oxygen to your heart. Angina can also be triggered by physical exertion, emotional upset, cold weather or a heavy meal.

Coronary heart disease can lead to a heart attack, or myocardial infarction. This happens when a piece of the fatty build-up inside the artery ulcerates and causes a blood clot, blocking the artery and starving the heart of blood and oxygen.

Symptoms include central chest pain that spreads to the arms, neck or jaw, often with breathlessness, sweating and nausea. Some symptoms are mild, such as a sense of heaviness or tightening in the chest, or similar to a bad attack of indigestion. A heart attack is a medical emergency, so always dial 999 if you have concerns about yourself or someone else.

In some cases, a heart attack causes a life-threatening disturbance to the rhythms of the heart, known as a cardiac arrest. The heart stops pumping so no blood can circulate around the body, which can cause irreparable organ damage within three to four minutes.

A person in cardiac arrest will lose consciousness and stop breathing almost instantly. However, prompt cardiopulmonary resuscitation (CPR) can reduce the risk of permanent organ damage, and the rhythm of the heart can sometimes be corrected by using a defibrillator to administer an electric shock through the chest wall.

Rhythmic disturbances

Sometimes the heart beats with an abnormal rhythm, known as arrhythmia.

The most common form is atrial fibrillation, and occurs when the electrical impulses in the heart become disordered. This makes the heart beat very fast and irregularly.

Symptoms include palpitations, breathlessness and faintness, although some people have no obvious signs.

Age is the most common cause of atrial fibrillation, with five per cent of over-65s affected. Other causes include coronary heart disease, disease of the valves in the heart, high blood pressure, an overactive thyroid gland and lung infections. It can also occur after heart or lung surgery, binge drinking or years of heavy drinking. It is important to try and return the heart to its normal rhythm and a variety of treatments are available.

Atrial fibrillation can cause complications such as angina and stroke. So the first step is to determine whether it’s a sign of underlying heart disease or other disease. In some cases, rhythmic disturbances can lead to heart block, where the heart beats irregularly or more slowly than usual, sometimes stopping for brief periods, affecting the efficiency of the heart in pumping blood around the body.

Often, heart block causes only mild symptoms, such as dizziness or the feeling of a “missed beat”. However, complete or “third-degree” heart block can have serious complications such as a heart attack. In this case, you may be fitted with a pacemaker, which regulates the heartbeat again.

Congenital heart disease

Congenital heart disease is an abnormality of the heart that a person has had since birth. There are many different types of defect and it affects about seven pregnancies in every thousand.

Sometimes it is discovered during a routine antenatal ultrasound scan. All pregnant women should be offered an anomaly scan at around 16 to 20 weeks, to check for organ abnormalities, including the heart.

In some cases, congenital heart disease may not be detected until after the birth. Some babies have symptoms such as blue fingers, toes and lips, while others have no outward symptoms. This is why newborns are examined after birth and again at six weeks, to check for warning signs. For a minority, it is not apparent until later in childhood, or adulthood.

The causes of congenital heart disease are not always obvious. Usually, it occurs when something goes wrong in the early development of the fetus. This may be due to faulty genes, chromosomal abnormalities, a problem with the mother’s health or drinking, smoking or drug use in pregnancy. Often, however, no cause is apparent.

Treatment depends on the type of the problem and its severity. Some children with mild disease don’t need treatment but in other cases, medication or surgery may be required.

The majority of babies with congenital heart disease respond well to treatment and grow up to live a normal adult life. However, some people do have ongoing physical issues and limitations, and certain procedures or events, such as giving birth or having a general anaesthetic, are riskier for people with congenital heart disease. A specialist adult congenital heart disease clinic will be able to provide regular checkups and ongoing support and advice.

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