For nearly a century, diseases of the heart have been the No. 1 cause of death in America, claiming more lives each year than all forms of cancer combined.
Heart disease encompasses a wide variety of ailments of the heart and blood vessels. But when people say “heart disease,” what they often mean is coronary artery disease—by far the most prevalent life-threatening heart condition. The underlying problem, atherosclerosis, stems from the gradual buildup of cholesterol-laden plaque inside the arteries. Stiff, narrow coronary arteries can set the stage for a heart attack.
In the United States, someone dies from a heart attack or other cardiovascular problem approximately every 40 seconds. Damage from a heart attack can trigger a dangerous heart rhythm disorder (arrhythmia) or may weaken the heart’s muscle, leaving it unable to pump blood effectively, a condition known as heart failure. It can also cause cardiac arrest, in which the heart suddenly stops beating, usually because scarring of the heart muscle or insufficient blood flow produces an abrupt electrical disturbance.
In addition to harming the heart, atherosclerosis can damage arteries throughout the body, leading to a painful leg condition called peripheral artery disease. If plaque damages the body’s largest artery, the aorta, the vessel may weaken and swell, creating a dangerous aneurysm.
Despite this dire picture, there’s reason for hope. Since 1999, deaths from heart disease have fallen by about a third. Some of the credit goes to more timely treatment and improvements in medications and procedures. But lifestyle changes that help prevent or slow heart disease are also playing a role. That’s good news: it means your everyday choices can make a real difference in your heart’s health. If you’re like most people, you have control over at least one major risk factor for heart trouble, such as lack of exercise, high blood pressure, cigarette smoking, or high cholesterol.
This report begins with a description of how a healthy heart works. The chapters that follow provide overviews of various conditions that affect the heart, including rare disorders that occur before birth and infections that damage the valves or muscles of the heart. You’ll find information about causes, symptoms, diagnosis, and treatment for each one. When relevant, we’ve included additional prevention and screening advice for specific cardiovascular problems and the conditions that place you at risk for them. The special section, “Lifestyle habits that help your heart,” outlines various strategies that can help you prevent heart disease or at least slow its progression.
Deepak L. Bhatt, M.D., M.P.H.