Heart disease: Symptoms & treatment

Around 25% of all deaths in the UK are due to heart and circulatory diseases, so it makes sense to arm yourself with the facts.

Every 8 minutes, someone in the UK dies from heart disease.¹

Now that seems like a shockingly high number, decades after heart disease was actually discovered, so what can be done to help prevent heart disease?

What is heart disease?

Let’s start at the very beginning: your heart will beat around 2.5 billion times over your lifetime.²

Its job is to pump blood around your body, which also transports oxygen, nutrients, hormones and essential substances to your organs, muscles, bones and other tissues, and carries away waste products.³

Heart disease is the name given to a number of conditions that affect this system. Heart and circulatory diseases – also called cardiovascular diseases – refer to problems with the heart and circulation – and include:⁴

1. Coronary Heart Disease: angina or heart attack
2. Congenital heart disease
3. Stroke
4. Vascular dementia
5. Diabetes

Coronary Heart Disease (CHD) is the most common form of cardiovascular disease. It’s also known simply as ‘heart disease’.

Summary

• Heart disease is the overall name that’s given to describe a number of conditions that affect the way your heart works
• Heart and circulatory diseases are referred to as being cardiovascular diseases
• Coronary Heart Disease (CHD) or ‘heart disease’ is the most common form of cardiovascular disease

Different types of heart disease

There are several different types of heart disease, which have different symptoms and various different ways to treat them. They include:

1. Ischaemic heart disease

This is another name for Coronary Heart Disease or coronary artery disease.

2. Coronary Heart Disease/CHD

CHD happens when the coronary arteries become narrow due to a build-up of fatty material within their walls.

These arteries are responsible for supplying your heart muscle with oxygen-rich blood, but over time, they get so clogged up that they’re prevented from getting enough oxygen-rich blood to your heart.⁵

3. Congenital heart disease

Is a general term that’s used to describe a range of birth defects that impact the way the heart works.

The term ‘congenital’ means the condition is present from birth.

Congenital heart disease is one of the most common types of birth defect, affecting up to 8 in every 1,000 babies born in the UK.⁶

There is no one single cause of this form of heart disease however, it’s believed certain things have been identified as increasing the risk of it.

They include, Down’s Syndrome and chromosome defects, and women having an infection (e.g. Rubella), smoking, drinking or having poorly-controlled diabetes while pregnant.

4. Rheumatic heart disease

Rheumatic heart disease is when the heart valves have been permanently damaged by rheumatic fever.

This heart valve damage may start shortly after untreated or under-treated streptococcal infection, such as strep throat or scarlet fever.

An immune response causes an inflammatory condition in the body, which can result in ongoing valve damage.⁷

This form of heart disease is caused by rheumatic fever, an inflammatory disease that affects connective tissues, especially in the heart, joints, skin and brain.

The heart valves become inflamed and scarred over time. And this can result in the valve narrowing or leaking, making it more difficult for the heart to work properly.

5. Hypertensive heart disease

Hypertensive heart disease is the main cause of death associated with high blood pressure.

It refers to a group of disorders that includes heart failure, ischemic heart disease, and left ventricular hypertrophy (excessive thickening of the heart muscle).

Hypertensive heart disease is most commonly treated by reducing blood pressure levels, usually by taking medication. ⁸

6. Structural heart disease

This is caused by having an abnormal heart structure, which applies to the valves, walls, muscles or blood vessels near the heart.

It can be present at birth (congenital) or develop after birth due to factors, including infection.

Because this form of heart disease is caused by a heart defect, on-going medical care, and potentially surgery, is usually needed for people who have it throughout their entire life.⁹

7. Heart valve disease

The human heart has four valves that work together to make sure blood is pumped around the body in the proper direction.

Heart valve disease can occur when one or more of your four heart valves doesn’t work properly.

This form of heart disease tends to be caused by the valve flaps becoming thicker, which prevents the valve from fully opening.

Leaking valves, which cause blood to flow back into the heart, are also a common contributor, as well as atresia, a congenital absence of a valve opening.¹⁰

8. Endocarditis

Is an infection or condition that impacts the inner membrane that divides the chambers and valves of the heart or endocardium.

Similar symptoms to other cardiovascular diseases are experienced, such as fever, breathlessness, feeling tired, swollen abdomen and legs, changes in heartbeat, chronic cough and an unusual rash.¹¹

9. Dilated cardiomyopathy

This form of heart disease is caused by weakened heart muscles, also referred to as dilated cardiomyopathy.

Early-stage dilated cardiomyopathy doesn’t tend to involve many symptoms.

However, as it develops symptoms include tiredness, fainting, irregular heartbeats that can feel like fluttering or quick pounds in the chest, swollen limbs, and general shortness of breath.¹²

Summary

• There are several different types of heart disease, which have different symptoms and are treated in different ways
• Coronary Heart Disease (CHD) and ischaemic heart disease are the same thing and happens when the coronary arteries become narrow due to a build-up of fatty material within their walls
• Other types of heart disease include: rheumatic, hypertensive and congenital heart disease

What causes heart disease?

The main cause of CHD is atherosclerosis – when fatty deposits, also known as plaques, build up in the arteries supplying the heart.

These deposits can start to restrict blood flow to the heart and trigger angina, which usually makes your chest feel uncomfortable or painful.¹³

If a plaque breaks off (a blood clot) and completely blocks the artery, it can cause a heart attack.¹⁴

Plaques are made up of cholesterol, fatty substances and minerals.

They can build up inside an artery if the inner lining has been damaged by smoking, high cholesterol or high blood pressure.¹⁵

You may be more likely to develop CHD if you have specific risk factors, such as:^16,17

1. Smoking heart disease – nicotine and carbon monoxide from the smoke puts your heart under strain to work faster.
2. Obesity and heart disease – puts added strain on your body, your heart included, and is usually caused by not eating a healthy and balanced diet, which can lead to your arteries getting blocked up with fatty deposits.
3. Family history of CHD
4. High blood pressure – also referred to as hypertension, high blood pressure puts strain on your heart and can lead to CHD.
5. High cholesterol – which is a fat made by the liver from the saturated fat in your diet, can clog up your arteries.
6. Your age – the risk increases around the age of 45 in men and 55 in women.
7. Lack of exercise – not being active can lead to fatty deposits building up in your arteries, which may lead to a heart attack over time.
8. Diabetes – high blood sugar levels can damage artery walls. It can also lead to heart diseases because it may cause the lining of blood vessels to become thicker, restricting blood flow.
9. Poor diet – eating too much fatty and sugary food can lead to you becoming overweight, as well as developing diabetes – both of which are heart disease culprits. What’s more, unhealthy eating can result in your arteries becoming clogged up with fatty deposits.
10. Alcohol heart disease – according to the British Heart Foundation, there’s a link between regularly drinking too much alcohol and having high blood pressure. Over time, high blood pressure (hypertension) puts strain on the heart and can lead to cardiovascular disease, increasing your risk of having a heart attack or stroke.¹⁸

Summary

• The main cause of CHD is atherosclerosis, which develops when fatty deposits, also known as plaques, build up in the arteries supplying the heart
• There are certain factors that can lead to people being at an increased risk of getting heart disease
• These factors include: smoking; being obese; having diabetes; drinking alcohol on a regular basis; eating an unhealthy diet and not exercising regularly

How do I know if I have heart disease?

Unless you’ve had angina or a heart attack, CHD is usually suspected by your GP during an assessment.

If your doctor thinks you may be at risk, they’ll ask you questions about your lifestyle and medical history, and may ask you to take tests, such as a cholesterol test or electrocardiogram (ECG).¹⁹

You may also be offered a risk assessment as part of an NHS Health Check – available to all adults over the age of 40 in England and Scotland – or you can ask your GP for an assessment if you’re worried about heart disease.

Are men or women more at risk of heart disease?

CHD actually kills more than twice as many women in the UK every year than breast cancer.²⁰

The hormone, oestrogen, helps protect women from heart disease, but after menopause, declining levels can raise your risk.

However, many women don’t recognise the symptoms of heart disease, and they’re less likely to seek medical attention until it may be too late.

Rather than the typical ‘soap opera’-style chest grab that men experience during a heart attack, women are more likely to experience:²¹

1. Shortness of breath
2. Pain in the neck, jaw or upper back
3. Pain in one or both arms
4. Nausea or vomiting
5. Abdominal discomfort
6. Sweating
7. Feeling dizzy or lightheaded

A 2003 study led by the University of Arkansas found that only 30% of women experienced chest pain before an attack.

Unusual tiredness was the most common early symptom before the attack, followed by sleep problems.²²

If you develop any of these symptoms, seek medical help right away.

Summary

• Your GP can determine if you have or are at risk of developing heart disease by exploring your medical history and lifestyle, as well as carrying out a cholesterol test or electrocardiogram (ECG)
• Over 40s are usually offered a heart disease risk assessment as part of their NHS Health Check
• CHD kills more than twice as many women in the UK every year than breast cancer. The hormone, oestrogen, helps protect women from heart disease, but post-menopause, declining oestrogen levels can lead to an increased risk of developing heart disease

Heart disease treatment

CHD can be managed with a combination of lifestyle changes, medication and surgery, if necessary.

Most medicines are aimed at reducing cholesterol and your blood pressure, making your blood less likely to clot (‘thinning’ the blood), and helping to improve blood flow by widening your arteries.²³

If you haven’t already, stopping smoking is the single best thing you can do to help your heart health.²⁴

Your GP can refer you to a nurse or counsellor, who can help you quit and prescribe medication or Nicotine Replacement Therapy (NRT) to help make it easier.

10 ways to prevent heart disease

A healthy lifestyle is one of the best ways to protect yourself against CHD. You can do this by:²⁵

1. Following a Mediterranean Diet

An increasing number of studies show the Mediterranean diet is good for heart health, thanks to large amounts of oily fish, fresh fruit and vegetables and olive oil, and fewer meat and dairy products.

2. Exercising regularly

Not only will it help you lose weight, which in turn reduces your risk of diabetes and high blood pressure, exercise is good for your heart muscle, like all muscles in the body.

3.  Reducing the amount you drink

Too much alcohol can raise your blood pressure and lead to weight gain, so try to drink no more than 14 units a week.

4. Swapping saturated fats for unsaturated

Too much saturated fat raises cholesterol levels, but swapping cakes, cream and butter for avocados, nuts and seeds and vegetable oils can raise levels of ‘good’ cholesterol in the blood and help you maintain a healthy weight.

5. Reducing your salt intake

 Aim for no more than 6g a day (about a teaspoon) because high salt intake has been linked to high blood pressure.

6. Getting enough omega-3s

Studies show that omega-3 fatty acids can reduce blood pressure and help maintain healthy arteries.

7. Limiting your alcohol intake

It’s best for your heart, and overall health, to enjoy alcohol in moderation. Not only can drinking too much alcohol increase your blood pressure, it can also make you put on weight over time due to the extra calories.

Both of these factors can increase your risk of developing heart disease. Ideally, men should have no more than 2 alcoholic drinks a day, and women, no more than 1.²⁶

8. Not smoking

Smoking raises your blood pressure and puts you at a higher risk of having a heart attack or stroke.

If you can’t cut it out altogether right away, cutting back is just as crucial because it can help reduce your risk of getting heart disease.²⁷

Handpicked content: They key to quitting smoking

9. Managing your stress levels

Stress can raise your blood pressure, while feeling extremely stressed can potentially trigger a heart attack.

What’s more, some people choose to handle their stress by snacking, drinking alcohol and smoking – which can all contribute to heart disease.²⁸

10. Getting plenty of sleep

Not getting enough sleep every night can lead to people developing high blood pressure and diabetes and becoming obese - all things that can increase your risk of heart disease.

Most adults need between 7 and 9 hours of sleep a night.²⁹

Handpicked content: Guide to sleeping better – 34 natural sleeping remedies

Summary

• CHD can be managed with a combination of lifestyle changes, medication, and surgery, if required
• Leading a healthy lifestyle is the best way to protect yourself against developing heart disease
• This includes eating a healthy, balanced diet, exercising regularly, eating saturated fats instead of unsaturated fats, reducing how much alcohol you drink, quitting smoking and eating less salt, alongside many more things…

When to see your GP

Speak to your GP if you are experiencing any signs or symptoms of heart disease; the main ones being chest pain, shortness of breath or fainting.³⁰

Fortunately, heart disease is something that can be picked up early on, so if you have concerns relating to your heart health, speak to your GP about them sooner rather than later.

If heart disease runs in your family, and you are concerned about developing it too, speak to your GP about the measures you can take to reduce your heart disease risk.

Takeaway

Heart disease is incredibly common, but there are plenty of things you can do to take care of your heart, as well as the rest of your body, and help reduce the risk of you developing some form of heart disease at some point in your life.

We can all easily implement many of the daily measures. 

For instance, we can make sure we drink less alcohol, exercise more, and put the right vitamins and nutrients into our body every day by steering clear of processed and fatty food.

Last updated: 8 October 2021