Heart Conditions

Angina

Angina is a heart-related symptom, typically felt as a tight or squeezing sensation in the chest. Some patients might experience overt pain in the chest, but for many patients, the sensation is not so severe that it will cause pain. The discomfort may be felt anywhere between the upper abdomen to the lower face (jaw, neck, throat, ears), and including the arms. Angina might be accompanied with shortness of breath.

Angina occurs when the supply of oxygen-rich blood to the heart is inadequate to meet the metabolic demands of the heart. The most common cause for angina is atherosclerotic coronary artery disease, a build-up of fatty deposits inside the arteries that supply blood to the heart. Other conditions can also cause angina e.g. narrowing of the aortic valve (known as aortic stenosis), severe anaemia, or an overactive thyroid gland.

Angina usually occurs with physical exertion or emotional excitement or emotional upset. The discomfort often resolves within 10 minutes of ceasing physical activity. However, symptoms that persist longer can indicate a more serious situation and it is recommended that you seek immediate medical attention if this occurs.

The onset of angina is an indication of a serious heart condition. If you develop these symptoms, you should see your GP and seek further investigation and treatment. Your GP can arrange for you to have appropriate tests, which could include blood tests and an electrocardiogram (ECG). 

Your GP may also refer you to Heart Centre St John of God to have an exercise stress test and to seek a cardiologist opinion. Your cardiologist might recommend that you undergo a special test called a coronary angiogram, to determine the extent of your coronary artery disease. The angiogram will also help decide if you will benefit with coronary stenting or coronary artery bypass graft surgery. 

Coronary Artery Disease

Atherosclerosis literally means “hardening of the arteries” and occurs as a result of thickening of the walls of an artery from a build up of fatty deposits. These fatty deposits are also known as plaques. 

Atherosclerosis can occur in many different arteries, but when this occurs in the arteries that supply oxygen-rich blood to the heart, it is known as coronary artery disease.

Coronary artery disease may be present for decades without causing any symptoms or signs of the condition. A number of conditions can increase the risk of developing atherosclerosis: tobacco smoking, high blood cholesterol levels, high blood pressure (hypertension), and diabetes.

When plaque causes severe narrowing of a coronary artery, you might develop symptoms of angina. Coronary plaque can also lead to heart attack.

Heart Failure

The heart is a specialised muscle that pumps blood throughout the body. Heart failure is present when the heart is no longer able to function as effectively as normal. Conditions that weaken the pumping action of the heart lead to systolic heart failure, whereas conditions that result in the heart not relaxing lead to diastolic heart failure.

There are many medical conditions that can lead to heart failure. Some of these are due to problems within the heart itself (e.g. coronary artery disease, valvular heart disease, and arrhythmias) and some are the result of other medical conditions (e.g. an overactive thyroid gland, infections, side-effects of drugs such as cancer chemotherapy).

The most frequent symptoms of heart failure include shortness of breath, lack of exercise capacity, becoming easily fatigued and tired, and swelling of the legs). However, these symptoms are present in many other illnesses, so if you have any of theses symptoms, it does not always indicate heart failure.

You should visit your GP if you develop any of these symptoms, so that a cause for your symptoms can be determined. Your GP can arrange appropriate blood tests and chest x-ray. 

Your GP might also refer you to Heart Centre St John of God for echocardiogram and cardiologist assessment. Your cardiologist might recommend further specialised tests (e.g. coronary angiogram), depending on the likely cause of your heart failure.

Heart Murmur

A heart murmur is an extra sound or noise that is heard arising from the flow of blood through the various heart valves and chambers. Heart murmurs are often caused by turbulence of blood flowing across a heart valve that is either narrowed or leaking. The loudness of the murmur does not usually indicate the severity of the valve narrowing or leakiness. Sometimes, a murmur can be present without any abnormal valve function; these are known as innocent flow murmurs.

If a heart murmur is detected, your GP might refer you to Heart Centre St John of God to have an echocardiogram. Your cardiologist might recommend further specialised tests (e.g. cardiac catheterisation) if the condition is severe or causing symptoms.

Palpitations & Arrhythmia

If you feel your heart beating, this is called palpitations. Palpitations may be felt as missed beats or extra heartbeats, an irregular heart rhythm, feeling your heart racing, or feeling a fluttering sensation in your chest.

There are many normal situations where you might feel your heartbeat, for example during heavy physical exertion, when frightened, or when emotionally excited.

Palpitations may also develop as a result of a heart rhythm disorder, called an arrhythmia. There are different types or arrhythmia; some of these may just cause uncomfortable palpitations, whereas others might cause more serious problems.

You should see your GP if you develop palpitations, so that the underlying cause can be assessed. Initial appropriate tests, including blood tests and electrocardiogram (ECG) can be arranged.

Your GP might also refer you to Heart Centre St John of God for a Holter moniter and echocardiogram, and referral for a cardiologist opinion. Your cardiologist might recommend that you undergo an electrophysiological study to determine the precise nature of the arrhythmia. This electrophysiological study will also help to decide if catheter ablation is appropriate.