[The Heart] [Heart Disease - The basics] [Tests for Heart Disease] [Open Heart Surgery] [Congenital Heart Defects]
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Now you know what a wonderful and complex organ the heart is. { If you don't, read the first part of this article ! }
In such a complex structure, every part must work together, normally, for the heart to be "normal". If even one part of the heart does not do it's job well, the other parts will be harmed. And this causes HEART DISEASE.
Diseases can affect different parts of the heart. They can damage the VALVES - and this results in VALVULAR heart disease. The CORONARY ARTERIES, that supply energy to the heart itself, may be abnormal - causing CORONARY heart disease. There may be defects in the normal growth and development of the heart even before a child is born, and many different parts of the heart may be abnormal. This group of diseases is known as CONGENITAL heart disease - or more commonly "birth defects". Sometimes, the heart muscle itself becomes weak and cannot pump blood effectively. This is called CARDIOMYOPATHY.
VALVULAR HEART DISEASE may affect any one or more of the FOUR valves in the heart - the mitral, aortic, tricuspid and pulmonary valves. The valves are meant to direct blood flow within the heart and arteries in one direction alone. When they are damaged, one of two things may happen. The valve may become narrow, and "block" the normal flow of blood. This is called valve STENOSIS. Or it may get "leaky" and allow blood to flow back into the chamber it came from. Then it is called valve REGURGITATION (or INCOMPETENCE). Rarely, the same valve may become both "blocked" and "leaky" !
Many different conditions cause valve disease. In India, where I live, a deadly disease called RHEUMATIC FEVER affects children and young adults. Over a period of time, usually five or more years, it slowly destroys the heart valves and produces valvular heart disease. Fortunately, in Western countries, rheumatic fever is almost fully eradicated. Other causes of valve disease are congenital (birth defects), old age (which causes "degeneration" and hardening of the valve leafs), Marfan's disease (a disorder of collagen, which is the scaffolding of the body), coronary artery disease, infective endocarditis (an infection of the inner lining of the heart and arteries by bacteria) and many more.
CORONARY ARTERY DISEASE is perhaps the heart disorder that almost everyone has atleast heard of. Someone you know has had either a "heart-attack" or a "bypass operation". Coronary artery disease, as the name implies, is a disorder of the small "feeder" arteries of the heart muscle - the coronary arteries. It is also called ISCHEMIC heart disease. Ischemia (pronounced "is-kee-mee-aah") means a decrease in blood flow.
When "fat" (also called cholesterol) collects in the wall of the coronary artery, it narrows the central passage through which blood flows to the heart. When the narrowing becomes severe, enough blood cannot flow through the artery across the "block" to serve the heart's needs. The heart lets you know this by producing chest pain (ANGINA), and by working less efficiently. Among the many causes of coronary artery disease, the most important are stress, smoking, eating fatty foods, a sedentary lifestyle, obesity and the added presence of diseases like high blood pressure and diabetes. Coronary heart disease is also partly "genetic" - that is, it runs in families, with more than one person being affected.
CONGENITAL HEART DISEASE is - to me atleast - the most fascinating kind of heart defect. Even before birth, as the child is growing inside his or her mother, changes occur which cause an abnormal development of the heart. Depending on the time at which this change happens, a bewildering array of abnormalities may be seen. Some of these may be so severe that the child may not be able to live, or needs early and major operations to help it survive. Some may permit almost normal life, and come to be detected accidentally much later.
Although much has been said about the causes of congenital heart disease - or birth defects - only some have been found. For instance, the use of certain medicines, or an attack of some infections in the mother can affect the growing child resulting in heart defects. GENES are a kind of "information package" inside the cell, which tells the cell what to do, how to grow and develop. It is also thought that an aberration in these genes can cause congenital heart disease.
CARDIOMYOPATHY is yet another kind of heart disease in which the muscle of the heart itself is weak. Again, there are many conditions and diseases that cause cardiomyopathy.
In a very brief and general way, I have tried to tell you about the different kinds of heart disease. In medicine, nothing is quite SIMPLE, and what I have given you is a very elemental description, which I hope will stimulate your interest in this wonderful organ and its abnormalities. Perhaps, one of you young people reading this will be as fascinated as I once was, and decide to become a doctor and specialize in heart diseases and their cure. That will be the highest tribute that I can get for my work here !
By the way, if you DO decide to become one, wouldn't you like to know what you will be called ? Well, if you become a doctor who detects heart disease, and treats it with medicines, but not by operations, you will be called a CARDIOLOGIST. Then, there are doctors who treat some other heart defects by operation. They are called CARDIAC SURGEONS. I am one of them ! And now, there is another kind of doctor who attempts to cure heart disease, not by medicines, and not by surgery, but by using special tubes called catheters threaded into the arteries and into the heart. They are called INTERVENTIONAL CARDIOLOGISTS.
The future, however, will perhaps see the evolution of yet another breed of doctors. There would be some who will attempt to cure heart ailments by preventing, or even reversing changes in the genes - the MOLECULAR BIOLOGISTS. And once again we are becoming aware of the importance of the old maxim "PREVENTION IS BETTER THAN CURE". Some doctors try to prevent illness by telling their patients to avoid the things that cause it. They are called PREVENTIVE CARDIOLOGISTS.
So the field is wide open. Pick your choice, work hard and become one. The exciting world of heart disease is your's to conquer !
I hope you enjoyed reading this piece as much as I did writing it !
Let me know what you think about it. Fill in my "Self-Assessment Form". Or just E-Mail me at "sivaraj@giasmd01.vsnl.net.in".
