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Heart Function FAQ

How does the heart work?

The heart is a hallow pump that receives deoxygenated blood from the body, that is pumped into the right side, flowing through the tricuspid valve, pulmonary valve and then up to the lungs where the blood receives fresh oxygen and then pumped out through the pulmonary veins, to the left side of the heart, flowing through the mitral valve then through aortic valve into the left side via the aorta to the rest of the body to supply rich oxygenated blood to keep our body functioning in a healthy way. Without oxygen our body would not be able to function well.

What are the RISK factors for developing heart disease (coronary artery disease – CAD)?

The risk factors for heart disease are and not limited to:

-Age – with age we develop medical conditions that can narrow our blood arteries making flow of oxygen rich blood difficult

-Family history – genetics play a role

-Elevated Cholesterol levels: often called – Hypercholesterolemia or hyperlipidemia refers to levels of cholesterol in the blood that are higher than normal.

-Hypertension: Defined as the pressure within our arteries, the working and resting pressures, the first number is the working pressure as the blood is pumped out from the heart and the second number is the resting pressure when heart is at rest. High blood pressure is defined as usually above 140/90, aim for numbers that are lower than these to stay healthy.

-Diabetes: A disease that negatively affects the metabolism of glucose (sugar) and causes changes in blood vessels that if untreated, may lead to circulation issues such as the development of coronary artery disease, blindness and other health issues. Keeping your sugar levels near to normal with diet, medications and exercise play an important role in prevention

-Smoking: Can cause changes in blood vessels that untreated could lead to circulation issues. STOP smoking is the key to promote a healthy lifestyle.

-Alcohol: Can cause damage to the pumping ability of the heart leading to congestion such as congestive cardiac failure often called heart failure these terms are interchange and mean the same.

-Inactivity: Sedentary life style not participating in activity can lead to an elevated BMI (Body mass index), i.e. overweight which adds extra strain to the heart. Thirty minutes of exercise daily is recommended, and keeps the health care provider away? (Should we put this sentence in).

-Depression: Associated with heart attacks – talk to your health care provider they can help

Talk to your health care provider about your risks and how you can play a role in reducing your risk of developing coronary artery disease, and thus reduce your chances of developing angina or heart attack by simply modify your risk factors.

What is coronary artery (heart) disease?

Coronary artery disease/heart disease is a disease of the coronary arteries (blood vessels) that feed the heart muscle. If narrowed, this results in a reduction of oxygen rich blood to the heart muscle, resulting in angina (chest pain on exertion due to partial narrowing) or heart attack if the artery is not treated or completely blocked with no blood flow to that particular area if not treated immediately. Narrowing of the coronary arteries may be related to your individual cardiac risk factors.

What are some of the typical symptoms of coronary artery disease?

The person will develop symptoms such as but not limited to chest pain/pressure that occurs on activity or rest, may extend to arms often described as tightness, discomfort, pressure, heaviness, burning or crushing chest pain and very individualised, not the typical symptoms you see on TV, with the person clutching their chest and collapsing. Other symptoms may include shortness of breath, nausea, vomiting, breaking out in a sweat, palpitations or dizziness. Becoming weak and pale are other features. Getting to the ER is important so treatment can be started immediately, if you suspect you are having symptoms of a heart attack, CALL 911. Do not drive yourself to the hospital.

How is coronary artery disease diagnosed and treated?

Seeing your health care provider is essential for regular physical appointments to promote healthy styles that manage your cardiac risk factors before symptoms occur. Your symptoms once assessed and if CAD is suspected, you will be refereed for cardiac testing, be it an electrocardiogram (ECG), stress test, echocardiogram and blood tests if necessary. A referral will be made to see a cardiologist. If the diagnosis is clear or highly suspected you will be advised to go to the nearest Emergency Room.

What is a heart attack?

A "heart-attack" is a blockage in one of the arteries (coronary) that feeds your heart muscle with blood rich in oxygen, over time or due to risk factors these arteries become narrow and finally block, with loss of part of the heart muscle due to a severe decrease in blood supply, leading to permanent damage loss of some of the pumping action.

Getting treatment is vital and can result in less damage or no damage. Call 911 and do not drive to the hospital.

What is Angina?

Angina is · Pain or discomfort which occurs when the heart does not receive adequate blood flow to maintain a constant flow of oxygen to the heart muscle. Angina may be experienced in the chest, neck, jaw, arms, shoulder or back. No permanent damage is done to the heart. Usually occurs with activity and is often relieved with rest or the use of nitroglycerin spray. It becomes unstable when it occurs at rest and requires urgent attention.

Treatment of CAD

After the diagnosis of your condition, you may typically start at least 3-5 medications if your condition allows, these medications protect your heart by preventing excessive clotting and keeping the oxygen rich blood flowing through your arteries and reducing some of the pressures in your heart and blood vessels. Treatment is individuated – speak to your health care provider. Some of the typical medications are:

1. Antiplatelet medications possibly two to keep the blood flowing through the coronary arteries

2. Angiotension converting agents or similar agents if ordered by your doctor

3. Beta blockers to protect your heart and reduce your heart rate

4. Cholesterol lower medications even if you have a normal cholesterol they are used to protect your blood vessels

5. You may be given a prescription for nitroglycerin - very individualised discuss with your health care provider. Should only be taken if prescribed as instructed and only used in the event of typical cardiac chest pain and if the pain is not relieved within defined period of time as instructed, you should call an ambulance. Nitroglycerin dilates the coronary arteries and should be used in caution post angioplasty.

6. An angiogram will be performed, if necessary to assess for blockages and treatment will consist of re-opening the artery by the means of angioplasty often with stents or surgical treatment such as cardiac bypass surgery which bypasses the narrowed arteries improving blood flow to the heart muscle.

What do Troponin levels means?

Troponins are proteins that are released when the heart muscle is exposed to stress and deprived of oxygen resulting in an elevated troponin which is a biochemical marker indicating that the heart muscle does not like the current stress that is occurring, and leaks out into the blood circulation. Troponin are likely to be elevated in conditions such as angina or heart attack, as normally our blood does not contain troponin markers. There can also be other causes – speak to your health care provider for more information.


What does nitroglycerin do?

Nitroglycerin is a drug that has been used for many years to relieve symptoms of angina. It works by dilating or opening up the coronary arteries that are partially blocked. It can relieve symptoms of angina within a few minutes. If you have to take nitroglycerin more frequently than usual, it may be a sign that coronary artery disease is advancing and you should seek medical advice in that case.

Can exercise really make your heart stronger?

Exercise has huge benefits. It reduces blood pressure and increases HDL, or good cholesterol. It improves the effectiveness of our blood vessels in the heart and in the rest of the body and can actual go smaller blood vessels which can act as a protective barrier. Exercise makes it less likely that you will have a heart attack and if you do have a heart attack, it's likely that it will be less severe. In addition, exercise is a very important component of any weight-loss program. Sign up for cardiac rehabilitation can be very beneficial in playing a role in your recovery or prevention of heart disease.

What is congestive heart failure?

Congestive heart failure is a condition where the heart does not pump normally. The heart is unable to fill or empty as previously. It does not mean that your heart is failing and going to stop. It just can’t cope with the normal flow of blood through the arteries and veins because the pumping or squeezing of the heard is reduced, and it becomes congested. This can be due to the heart muscle becoming weak because of heart attacks, virus, alcohol or valves that are not opening or closing properly. Or the heart muscle is unable to fill properly or relax and becomes stiff, making it hard to pump, one cause can be but not limited to, long standing high blood pressure. Typical symptoms include and not limited to are feelings of fatigue, shortness of breath, due to the left side not working well. Or developing swelling of lower limbs due to right side not working well.

Medications can relieve these symptoms of congestion, by preventing the heart from being stressed by over activation of the natural stress hormones which can be toxic and protecting and stabilising the pumping ability of the heart.

Typically some of the medications include

-ACEI/ARB/ARNI – help to pump the heart

-Beta blocker: Slow down the heart rate

-Diuretics – water pill

-MRA – prevent salt reabsorption

These drugs are all disease modifying medications that help to relive the symptoms of heart failure.

Congestive heart failure – what you can do

Being aware of what your symptoms are catching them early just like a diabetic.

-Watching for any sudden weight gain 2 – 3lbs in 24 hours or 5lbs in a week

-Increased shortness of breath

-Cough when lying flat

-Swelling of ankles

-Limiting your fluid intake to 6 – 8 cups a day 1.5 to 2.0 litres a day

-Limiting salt to less than a ¼ teaspoon a day i.e. 2.0 grams – avoid packaged foods contain a lot of hidden salt, watch when eating out and look out for MSG

Know what to do if these symptoms occur – speak to your health care provider in regards to your individualised plan.

Southlake Regional Health Centre
596 Davis Drive, Newmarket, Ontario   L3Y 2P9
Tel: 905-895-4521   |   TTY: 905-952-3062
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