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67

Introduction

We will talk about heart function , anatomy and ..

In this article we want to lessen our chance for having heart attack . Some factors
that increase the risk of having heart attack are our family history , smoking , high
blood pressure , cholesterol , diabetes ,
physical inactivity and
By controlling these factors we can reduce
our chance for having heart diseases
.Accompany us to show you the style and
how affective are these .

We have many kind of heart diseases . We can treat our heart diseases by three ways
Having a healthy diet
Make changes in your lifestyle
Undergo some surgeries
We will talk about these topics in our arteries .

68

Anatomy of heart
Physiology heart
Expression of the problem
Necessity of the prblem

69

Anatomy of heart
The humans heart is under the breast bone and its the
size of a clenched fist. And most of it contains the heart
muscle. The heart wall is made of three layers that are
the inner layer (endocardium) and the central layer
(endocardium) and external (pericardium).
The inner layer is made of epithelial tissue that covers
the atrium and ventricle cavity. The middle layer is a
thick layer of muscle and its the contractile potion of
heart and outer layer is a connective tissue that makes
pericardium.

Pericardium:
is the outer layer of the heart wall that is made of continuous tissue covered by
epithelium and its also known as visceral pericardium.

Myocardial:
Its the middle layer of heart muscle. This layer is located in Espantanqualsely .
That is in muscle fiber and allows the heart to contract.

Endocardium:
Is the inner layer of heart that cover lines of the heart cavity and its composed of
epithelial tissue and connective tissue.

Blood vessels
Blood vessels are the tubes that carry blood to the body. Some of them take the blood
out of heart. These are called arteries. The aorta is the largest artery in the blood that
takes the oxygen-rich blood out of the left ventricle. These blood vessels are divided
into branches that each of them go to brain, hands, legs, and all of other organs of
body except lungs. And the other big arteries take pure blood oxygen from the right
ventricle to the lungs. The arteries have thick, strong and elastic walls.

70

Their walls have smooth muscle cells that can change the size of blood vessels, so the
arteries can be wider or closed. When you get red or you are pale, this is because the
tiny blood vessels in your skin expand or contact. Blood passes through the arteries
with sever contraction of the ventricles. Pulse, is wave power during the elastic walls
of the arteries. When the heart beats you can feel beat where a vessel is close to the
skin. Your doctor usually feels beat in your neck, your temples or any other place
where vessels are near the bodys surface.
The blood returns by veins to the heart. These blood vessels are thinner and less
elastic than arteries. Blood is current in the veins very quiet and with a little pressure.
For this reason it may be found pocket-like valves in some veins. Especially in the
hands and feet. Valves prevent blood from
flowing in the wrong direction. The largest
veins, take the low oxygenated blood from
many organs of the body to the right atrium.
Another large vein, take the oxygen-rich blood
from the lungs to the corridor. Arteries take
blood from the heart to all body parts. The
veins collect blood and return to the heart.
How blood passes from arteries to veins? This
secret did not solve until the scientists did not
start to study by microscope. One of them
found the answer of this problem when he was examining lung of a frog under a
microscope. He discovered that blood vessels with these walls connect arteries to
veins. These and oxygen from blood to tissue cells that are resting close to capillaries
is easy. At the same time, carbon dioxide, and additional cellular tissue, can easily
cross the blood as blood flows in the veins

Cavities of the heart

The heart has four cavities, two atria and two ventricular that is divided into two
parts, left and right by ventricular and atrial walls. The right side of heart contains
blood without oxygen. And left side of heart contains the oxygenated blood. Right
ventricular is foremost cavity of the heart. And left atrial is the most rear cavity of the
heart. The lowest cavity is the left ventricle. The right atrium is located on the right

71

side of heart. The veins that shed into the right atrium include: large upper vein, large
lower vein, and coronary sinus. Right atrium, receives the venous blood from the
upper and lower vein and coronary sinus and pump it into the right ventricle. The
right atrium is larger than the left atrium but its walls are thinner. The right atrium
consists of two parts, the main cavity and the mumps. The main cavity or sinus vein is
located at the rear of the right atrium. This section of the corridor is similar vessels.
Right mumps is a small cone cavity along the right atrium and inside of that is uneven
by shoulder muscle Vessels and heart valves: atrioventricular _ ventricular valves as
a way admit blood from atria to ventricles and close. These valves consist of two
inertial valve (mitral) between the left atrium and left ventricle and tricuspid valve
between the right atrium and right ventricle. These valves are lacking in muscle tissue
and direction of blood flow open or close them. The valves are connected to the inner
lining of the heart muscle pumps by strings. At the beginning of the aorta and
pulmonary artery the trays valves are seen. These valves are opened when entering
the blood in the arteries and prevent blood to return from the arteries into ventricles.
The most anterior part of the heart is the right ventricle, that receives blood from the
right atrium and it pumps oxygenated blood to the lungs. The right ventricle is a

72

triangular section that is made of Esternokstal surface and small part of

diaphragmatic surface of the heart. The interior space of right ventricle is divided into
two parts: input and output. The space is located below the tricuspid valve is the input
section.

Tricuspid valve adjusts blood flow between the right atrium and right ventricle.The
output section of right ventricle is a cone-shaped space that is located at the top of
theventricular and under lung tray valve that is called arterial con . The left atrium
makes a large part of the base and posterior of the heart. The left atrium receives the
oxygenated blood by four lung veins and it pumps through the mitral valve into the left
ventricle. This cavity is slightly smaller than the right atrium but the thickness of it
wall is greater. And like the left atrium has two parts of main cavity and left mumps.
The main cavity of the posterior is left atrium. And it has straight walls and four
pulmonary veins enter into this cavity. Mumps makes the anterior part of left atrium.
And it is longer and narrower than the right mumps. And the inner surface of left
mumps like right mumps has shoulder muscles. The left ventricle makes the major part
of the left side of the heart. And is stronger than right ventricle and gets the pumped
blood and sends to the other parts of the body. The left ventricle like right ventricle
has trabecular muscles and papillary muscles. But is lacking a curved bar.
73

Physiology
The physiology of heart contains two main parts

Systole
During systole , cardiac muscle tissue is contracting to push blood out of the champer .

Diastole
During diastole ,the cardiac muscle cells relax to allow the champer to feel with blood .
Blood pressure increases in the major arteries during ventricle systole and decrease
during ventricle diastole .
Diastole

Systole

The cardiac cycle

The cardiac cycle includes all of the events that take place during heartbeat . There are
three phases to the cardiac cycle.

Atrial systole
During the atrial systole phase of the cardiac cycle , the atria contract and push the
blood in to the ventricles . To facilitate this filling the atrium ventricle ( AV ) valves

74

stay open and the semilunar valves stay closed to keep atrial atrial blood from reentering the heart . The atrial are much smaller than the valves , so they fill only about
25% of the ventricles during this phase .The ventricles remain in diastole during this
phase .

Ventricle systole
During ventricle systole ,the ventricles contract to puish blood in to aorta and
pulmonary trunk. The pressure of the ventricle forces the semilunar valves to open avd
the AV vaves to close . This arrangement of valves allows for blood flow from the
ventricles in to arteries . The cardiac muscles of the atria repolarize and enter the state
of diastole during this phase .

Relaxation phase
During the relaxation phase , all 4 champers of the heart rate in diastole as blood pours
in to the heart from veins . The ventricle fill about 75% capacity during this phase and
will be completely filled only after the atria enter aystole . The cardiac muscle cells of
the ventricle repolaries during this phase to prepare for the next round of
depolarization and contraction . During this phase the AV valves open to allow blood to
flow freely in to ventricles while the semilunare valves close to prevent the regurgitation
of blood from the great arteries in to the ventricles .

75

Expression of the problem

As a result of physical inactivity and having wrong habits in eating , most of the
indivituals arent healty . This number is going to incrase and It means that instead of
preventing them , we help the risk factors to create . If you oay attention to the people
who are living near you , you can understand that most of them has some problems such
as high blood oressure , diabetes and . About 96% of people in the world has one of
these factors and just 4% doesnt have these factors ( healthy).Most of them dye
because they dont know what should they eat to prevent their ailmentsHeart diseases
are one of the normall happenings in the world which kills millions of the peple . By
studying the related subjects , Iknow my duty to apprise the treatment of heart diseases
to my dears .

76

Ncessity of the problem

Humans heart is one of the essential for continuing our living . So we can say that
taking care of our heart is our duties . Most of the people are busy and doesnt pay
attention to their health.For example they may have the risk factors because they
dont know the complecations they dont take it seriouse until the symptoms of heart
attack or heart failure starts .

This article can be addressed for these important things . unhealthy heart can cause
other problems too like making the mind smaller . This can create Amnesia . So taking
care of heart is really essential

77

Heart diseases
The ailments of the heart
Risk factors that create heart diseases

78

Heart diseases
Heart disease is a broad term used to describe a range of diseases that affect your
heartThe various diseases that fall under the umbrella of heart disease include
diseases of yourblood vessels, such as coronary artery disease; heart rhythm
problems (arrhythmias);heart infections; and heart defects you're born with
(congenital heart defects). The term "heart disease" is often used interchangeably
with cardiovascular disease." Cardiovasculardisease generally refers to conditions
that involve narrowed or blocked blood vessels thatcan lead to a heart attack, chest
pain (angina) or stroke. Other heart conditions, such as infections and conditions
that affect your heart's muscle, valves or beating rhythm, alsoare considered forms of
heart disease. Many forms of heart disease can be prevented or treated with healthy
lifestyle choices. Most of the time heart arrhythmias start suddenly .Hear beating

austhma Angina and downfall pressure syncope are the symptoms

ofArrhythmias tha usually appears and disappears speedly . So having pain in chest
or Austhmatic in patients feeling that just appears during activities is one of the
clear symptoms in cardiac patients . On the other hand this topic developing these
symptomsduring resting and disappearing during activities is the happening that
seems In organci patients rarely . Heart diseases are so normal among people that
most of them are familiarwith its symptoms . so we are going to be more familiar

79

with heart diseases and it symptoms .

Heart Defection :
Serious congenital heart defects defects you're born with usually become evide
soon after birth. Heart defect symptoms could include: Pale gray or blue skin color
Swelling in the legs, abdomen or areas around the eyesShortness of breath during
feedings . congenital heart defects are often not diagnosed until later in childhood
or even during adulthood. Signs and symptoms of congenital heart defects that usually
aren't immediately life-threatenin include:
Easily becoming short of breath during exercise or activity
Easily tiring during exercise or activity
Built-up fluid in the heart or lungs

What is Cardiovascular Disease (Heart Disease)?

Cardiovascular disease is caused by narrowed, blocked or stiffened blood vessels
that prevent your heart, brain or other parts of your body from receiving enough
blood. Cardiovascular disease symptoms can include:Chest pain (angina) Shortness
of breath Pain, numbness, weakness or coldness in your legs or arms, the blood
vessels in those parts of your body are narrowed You might not be diagnosed with
cardiovascular disease until your condition worsens to the point that you have a
heart attack,angina,stroke or heart failure. It's important to watch for
80

cardiovascular symptoms and discuss anyconcerns with your doctor.Cardiovascular

disease can sometimes be found early with regular visits to your doctor.

Heart attack
Heart attack, also known as myocardial infarction, is a condition where the supply of
oxygen-richblood to the heart muscle gets suddenly blocked. As a result, the heart
muscle gets damaged andstop functioning . Medically, the damage to the heart is
known as infarction. The oxygen-richblood is a food for the heart muscle. It nourishes
the muscle and keeps it healthy. The blood is supplied to the heart by coronary
arteries. When these arteries get suddenly clogged with a blood clot that is big
enough to hamper the blood flow . It occurs when the flow of blood to the
heartsuddenly gets blocked that in turn causes breathing trouble and discomfort in
chest . Most of the people ignore such minute pain and discomfort but the fact
remains that such an attack is known to be a silent killer of both men and women. It is
good to know that science and technology hasintroduced many ways to save lives and
prevent disabilities. Accessibility to modern technologies ofheart disease treatment
has now become easy and convenient. However, to enjoy this kind of availability, an
individual has to be cautious and take the required treatment immediately after the
symptoms occur. To make it work the best way, it is very important that people should
know the signs and symptoms of heart attack. For many people, the first symptom of

81

heart disease is a heartattack. That means everyone should know how to identify the
symptoms of a heart attack and how to get immediate medical help.Ideally, treatment
should start within 1 hour of the first symptoms.Recognizing the warning signs and
getting help quickly can save your life .

Stroke:
An ischemic stroke (the most common type) happens when a blood vessel that feeds
the brain gets blocked,usually from a blood clot. When the blood supply to a part of
the brain is shut off, brain cells will die. The result will be the inability to carry out
some of the previous functions as before like walking or talking. A hemorrhagic
stroke occurs when a blood vessel within the brain bursts.The most likely cause is
uncontrolled hypertension. Some effects of stroke are permanent if too many brain
cells die after a stroke due to lack of blood and oxygen to the brain. These cells are
never replaced. The good news is that some brain cells don't die they're only
temporarily out of order. Injured cells can repair themselves. Over time, as the repair
take place, some body functioning improves. Also, other brain cells may take control
of those areas that were injured. In this way, strength may improve, speech may get
better and memory may improve.

Coronary heart disease

Coronary heart diseases is the narrowing or blockage of the coronary arteries,
usually caused by atherosclerosis. Atherosclerosis (sometimes called hardening or
82

clogging of the arteries) is the buildup of cholesterol and fatty deposits (called
plaques) on the inner walls of the arteries. These plaques can restrict blood flow to
the heart muscle by physically clogging the artery or by causing abnormal artery tone
and function. Without an adequate blood supply, the heart becomes starved of oxygen
and the vital nutrients it needs to work properly. This can cause chest pain called
angina .

Angina
More than 6 million of the people in the world live with angina, which is chest pain
or discomfort that occurs when the heart muscle is not getting enough blood. The
inadequate blood flow is caused by narrowed coronary arteries, due to an
accumulation of plaque. A bout of angina is not a heart attack, but it means that
youre more likely to have a heart attack than someone who doesnt have Angina
.There are two kinds of Angina:

Stable angina
It has a recognizable pattern. It may feel like pressure or a squeezing pain in your
chest. The pain may also occur in your shoulders, arms, neck, jaw, or back. It may
also feel like indigestion. Stable angina pain is generally brought on by some kind of
exertion or strain (such as climbing stairs or experiencing emotional (stress) , and it
is usually relieved by rest or medicine.

83

Unstable angina
It is more serious than stable angina. Occurring at any time, unstable angina often
reflects a change in a previously stable pattern of angina. Episodes of unstable angina
are usually more frequent , painful, and longer lasting than bouts of stable angina,
and are less often relieved by rest or medicine . Unstable angina is a sign that you
may have a heart attack very soon. The symptoms are the same as if you are having a
heart attack.

Heart failure
This doesn't mean that the heart stops beating. Heart failure, sometimes called
congestiveheart failure. it as a life treating condition which means the heart isn't
pumping blood aswell as it should. The heart keeps working, but the body's need for
blood and oxygen isn't being met. Heart failure can get worse if it's not treated. High
blood pressure is the leading cause of congestive heart failure .In the United States
heart disease and diabetes are also major underlying causes of heart failure.
People who have had a heart attack are at high risk of developing this condition.

Arrhythmias
Many factors can contribute to Arrhythmias , including heart disease s high blood
pressure , diabetes smoking, heavy alcohol use, an electrolyte imbalance, drug
abuse,and stress. This is an abnormal rhythm of the heart. There are various types of
arrhythmias. The heart can beat too slow, too fast or irregularly. Bradycardia is when
84

the heart rate is less than 60 beats per minute.Tachycardia is when the heart rate is
more than 100 beats per minute. An arrhythmia can affect how well the heart works.
The heart may not be able to pump enough blood to meet the body's needs . A
common type of arrhythmia is called atrial fibrillation, a disorder

affecting 2.2

million Americans. It is more common in older people and those with certain inborn
heart problems Atrial fibrillation occurs when the heart s two upper chambers (the
atria) quiver instead of beating normally . Blood isnt pumped completely out of these
chambers, making it more likely to pool and clot. If a clot leaves the heart and
becomes lodged in an artery in the brain, a stroke result . About 15 percent of strokes
occur in people with atrial fibrillation. Another type of arrhythmia called ventricular
fibrillation occurs when the lower heart chambers (the ventricles) quiver, preventing
the heart from effectively pumping blood. This is the most dangerous type of heart
rhythm disturbanceTo prevent collapse and sudden cardiac death, it is vital to get
immediate emergency medical .
Symptoms of arrhythmias include :
-Fast or slow heart beat
-Skipping beats
-Chest pain
-Shortness of breath
-Sweating

Valvulare heart diseases

Valvular heart disease is any disease of one or more of the valves of the heart . Righ
t heart disease will involve the pulmonary and tricuspid valves. The more usual left

85

heart disease involve the aortic and mitral valves. Rheumatic fever has been a long
known cause of valvular heart disease and is usually called rheumatic heart disease;
the common complication of thiis a thickening and consequent stenosis (narrowing)
of the mitral valve.

You and Your Doctor: A Healthy Partnership

Your doctor can be an important partner inhelping you manage heart disease. He or
she may already have spoken with you about yourheart disease risk factors, but if
not, be sure to ask about how to control all of them to help prevent future problems
Here are some tips for establishing good,
clear communication withyour doctor.

Speak up
Tell your doctor that you want to keep your
heart disease from getting worse and
would like help in achieving that goal. Ask
questions about your chances of having a
first heart attack or a repeat heart attack,
your risk of other heart complications, and
ways to lower those risks. If you havent
done so already, ask for tests that will

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determine your personal risk factors.

Be open.
When your doctor asks you questions,
answer them as honestly and fully as you can. While certain topics may seem quite
personal, discussing them openly can help your doctor work with you more effectively
to manage your heart condition.

Keep it simple.
If you dont understand something your doctor says, ask for an explanation in plain
language. Be especially sure you understand how to make the lifestyle changes your
doctor recommends,as well as why and how to take each medication youre given. If
youre worried aboutunderstanding what the doctor says or if you have trouble
hearing, bring a friend or relative with you to your appointment. You may want to ask
that person to write down the doctors instructions for you.

Risk factors
Smoking
On their box is written that , Health warning ; Smoking is a
main cause of lungcancer , lun disease of heart and artery
diseases .Smoking or using tobacco of any kind is one of the
most significant risk factors for developing heart disease.

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Chemicals in tobacco can damage your heart and blood vessels, leading to
narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead
to a heart attack. If you live or work with others, your secondhand smoke can
cause them numerous health problems, including a higher risk of heart attackeven
if they dont smoke themselves. By the same token, if you have heart disease and live
or work with someone who smokes, your own risk of heart attack goes up
considerably. Smoking putsstress on the heart in many ways. The nicotine in cigarette
constricts the coronary arteries, which raises blood pre s s u re and forces the heart
to work hard e r. Smoking alscarbon raise monoxide levels and reduces oxygen
levels in the blood. Its a double whammy : Smoking both increases the heart s need
for oxygen and restricts the amount of oxygen it receive.There is simply no safe way to
smoke. Low-tar and low-nicotine cigarettes do not lessen the risks of a heart attack.
The only safe and healthful course is not to smoke at all. Women who smoke and take
birth control pills are at greater risk of having a heart attack or stroke than are those
who don't do either because both smoking and taking birth control pills increase the
riks of blood clots. When it comes to heart disease prevention, no amount of smoking
is safe. But the more you smoke, the greater your risk. Smokeless tobacco and low-tar
and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke. Even
so-called social smoking smoking only while at a bar or restaurant with friends is
dangerous and increases the risk of heart disease. The good news is that quitting

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smoking will immediately and significanty reduce your risk of further heart disease
complications. After a few days, once nicotine and carbon monoxide are cleared from
your body, your blood pre ssure will go down and the leves of oxygen and carbon
monoxide in your blood can return to normal . Within 1 year after quitting, your
blood flow and breathing will be improved and your coughing and shortness ofbreath
will be reduce .

High blood presure

High blood pressure, also known as hypertension, is another major risk factor for
heart disease and heart attack. For those who already have heart disease, high blood
pressure raises heart attack risk even higher. Hypertension also raises the risks of
stroke, congestive heart failure, and kidney disease. Blood pressure is the amount of
force exerted by the blood against the walls of the arteries. Everyone has to have
some blood pressure, so that blood can get to all of the bodys organs. Blood pressure
is usually expressed as two numbers, such as 120/80, and is measured in millimeters
of mercury (mmHg)

Systole pressure
When your heart beats, it contracts and pushes blood through the arteries to the rest
of your body. This force creates pressure on the arteries. This is called systolic blood
pressure. A normal systolic blood pressure is below 120. A systolic blood pressure of
120 to 139 means you have prehypertension, or borderline high blood pressure. Even
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people with prehypertension are at a higher risk of developing heart disease. A

systolic blood pressure number of 140 orhigher is considered to be hypertension, or
high blood pressure.

Diastole pressure
The diastolic blood pressure number or the bottom number
indicates the pressure in the arteries when the heart rests
between beats. A normal diastolic blood pressure
number is less than 80. A diastolic blood pressure
between 80 and 89 indicates prehypertension. A diastolic blood pressure number of
90 or higher is considered to be hypertension or high blood pressure.

High blood cholesterol

The higher your blood cholesterol level, the greater your risk of having a heart attack
Because you have heart disease, your heart attack risk is already high, which means
it is especially important to lower your cholesterol level. If you have diabetes as well
as heartdisease, your heart attack risk rises still higher. If you have both diseases, it
is extremely important to take steps to keep both your cholesterol and your diabetes
under control. Studieshave proven that lowering cholesterol in people with heart
disease reduces the risks for heart attack and death from heart disease and can
actually prolong life.
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How Cholesterol Causes Heart Problems

The body needs cholesterol to function normally. However, your body makes all the
cholesterol it needs. Over time, extra cholesterol and fat circulating in the blood build
up in the walls of the arteries that supply blood to the heart. This buildup, called
plaque, makes the arteries narrower and narrower. If enough oxygen-rich blood
cannot reach your heart, you may suffer chest pain, or angina. If the blood supply to
a portion of the heart is completely cut off, the result is a heart attack. This usually
happens when a cholesterolrich plaque bursts, releasing the cholesterol into the
bloodstream and causing a blood clot to form over the plaque.

Types of Cholesterol
Cholesterol travels in the blood in packages of fat (lipid) and protein called
lipoproteins. Cholesterol packaged in low-density lipoprotein (LDL) is often called
bad cholesterol, because too high a level of LDL in your blood can lead to
blockages in your arteries. Another type of cholesterol is high-density lipoprotein
(HDL) known as good cholesterol. Thats because HDL helps to remove
cholesterol from the body, preventing it from building up in your arteries.

Over weight or obesity

If you have heart disease and are overweight or obese (extremely overweight), your
risks of heart attack and other heart complications rise sharply . This is true even if
you have no othe risk factors. Being overweight or obese also increases your chances
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of developing other major risk factors for heart disease and heart attack, such as
diabetes, high blood pressure, and high blood cholesterol. Overall, obese people are
more likely to die of heart disease than normal-weight individuals. The bottom line:
Maintaining a healthy weight is a necessary part of controlling heart disease.

Diabetes
If you have diabetes, you have about the same high risk for heart attack as someone
who has heart disease itself. Those who have heart disease and diabetes have an even
higher risk for heart attack than those who have either heart disease or diabetes
alone. Up to three-quarters of those who have diabetes die of some type of heart or
blood vessel disease. However, if you have diabetes, there is much you can do to
prevent the complications of this condition. The type of diabetes that most commonly
develops in adulthood is called type 2 diabetes. In this type of diabetes, the pancreas
makes insulin but the body cannot use it properly and gradually loses the ability to
produce it. Type 2 diabetes is a serious disease. Diabetes can also lead to nerve
damage, difficulties in fighting infection, and delayed wound healing. A major risk
factor for type 2 diabetes is overweight, especially having extra weight around the
waist. Other risk factors include physical inactivity and a family history of diabetes.
Women who have had diabetes during pregnancy (gestational diabetes), or who gave
birth to a baby weighing more than 9 pounds, are also more likely to develop type 2

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diabetes in later life. Symptoms of diabetes may include fatigue, nausea

frequenurination, unusual thirst, weight loss, blurred vision, frequent infections, and
slow healing of sore s . But type 2 diabetes develops gradually and sometimes has no
symptoms. In fact, nearly 6 million Americans who have this serious disease are not
aware of it. Even if you have no symptoms, if you are overweight or have an other risk
factors for type 2 diabetes, ask your doctor about getting tested for it. You have
diabetes if your fasting blood glucose level is 126 mg/dL or higher. If you have
diabetes, controlling your blood glucose (blood sugar) levels will help to prevent
complications. Because diabetes is strongly linked with heart disease and heart
attack, you must manage your diabetes very care fully . It is also especially important
to control your blood pressure and cholesterol levels. Recommended levels of blood
pressure and than for most others. Not smoking, getting regular physical activity, and
taking aspirin daily (if your doctor recommends it) also are important ways to
prevent heart disease complications if you have diabeteSome people do not yet have
diabetes, but are at high risk for developing the disease. About 40 percent of
Americans aged 4074 have a condition known as prediabetes, where blood glucose
levels are higher than normal but not yet in the diabetic range. Prediabetes is defined
as a fasting blood glucose level of 100125 mg/dL. If you have heart disease and also
have prediabetes, it is extremely important to improve your blood glucose levels in
order to prevent the development of diabetes. The good news: A recent study shows

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that many people with prediabetes can prevent or delay diabetes by eating a lower fat
lower calorie diet and getting 30 minutes of moderate physical activity at least 5 days
per week.

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Theory
Treatment for risk factors
Getting help for a heart attack
What should we eat to prevent complications ?

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Theoreis

Nutrition can be affective for treating heart diseases .

Physical inactivity and the bad habits in eating can cause heart diseases .

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Treatments for risk factors

High blood pressure

Changing your lifestyle

If your blood pressure is not too high, you may be able to control it entirely by losing
weight if you are overweight, getting regular physical activity, limiting the salt in
your food, cutting down on alcohol, and changing your eating habits. A special eating
plan called DASH can help to lower blood pressure. DASH stands for Dietary
Approaches to Stop Hypertension. The DASH eating plan emphasizes fruits,
vegetables, whole-grain foods, and low-fat dairy products. It is rich in magnesium,
potassium, calcium, protein, and fiber, but low in saturated fat, trans fat, total fat, and
cholesterol. (Trans fat is a harmful type of dietary fat that forms when vegetable oil is
hardened.) The diet also limits red meat, sweets, and sugar-containing beverages.

Major sources of saturated fat include:

- Red meat
-Dairy product
-Coconut and palm oils

Sources of trans fat include:

-fried fast foods
-Deep Bakery products
- Packaged snack foods
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-Margarines
-Cracker
If you follow the DASH eating plan and also consume less sodium, you are likely to
reduce your blood pressure even more . Sodium is a substance that affects blood
pressure. It is the main ingredient in salt and is found in many processed foods, such
as soups ,convenience meals, some breads and cereals, and salted snacks.

Taking medication.
If your blood pressure remains high even after you make lifestyle changes, your
doctor willprobably prescribe medicine. Depending on your health needs, your
doctor may prescribemedication from the start, along with changes in your living
habits. One recent study found that diuretics (water pills) work better than newer
drugs to treat high blood pressure in many people.Other research shows that using a
diuretic can reduce the risk of death from heart and bloodvessel diseases, especially
among people with diabetes. Talk with your doctor about making one of your high
blood pressure medications a diuretic. Keep in mind that lifestyle changes will help
the medicine work more effectively. In fact, if you are successful with the changes
you make in your daily habits , you may be able to gradually reduce amount of
medication you take. Taking medicine to lower blood pressure can reduce your risk of
heart attack, stroke, congestive heart failure, and kidney disease. Be sure to take your
blood pressure medicine exactly as your doctor has prescribed it. Before you leave
your physicians office, make sure you understand the amount of medicine you are
supposed to take each day, and the specific times of day you should be taking it. If you
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take a drug and notice any uncomfortable side effects, ask your doctor about
changing the dosage or switching another type of medicine .

How To Lower Your LDL

There are two main ways to lower your LDL cholesterolthrough lifestyle changes
alone, or through lifestyle changes combined with medication. As explained before,
doctors now have the option to recommend cholestero l medication, as well as
lifestyle changes, to high-risk patients at lower LDL levels than previously advised

Lifestyle changes
One important treatment approach is called TLC, which stands for Therapeutic
Lifestyle Changes. This treatment helps to reduce LDL cholesterol through a diet that
is low in saturated fat (the main dietary culprit that raises blood cholesterol), trans
fat, and dietary cholesterol, as well as through regular physical activity and weight
management. Everyone who needs to lower LDL cholesterol should use this TLC
program. Maintaining a healthy weight and getting regular physical activity are
especially important for people who have metabolic syndrome. Adopt the TLC
approach and youll lower your chances of having a heart attack and other heart
disease complications. Both the TLC eating plan and DASH eating plan recommend
foods that are lower in saturated fats, trans fats, and cholesterol, such as vegetables
and fruits, whole grains, low-fat milk products; and lean meats, fish, or poultry. The
TLC plan simply puts more emphasis on decreasing saturated fat, trans fat, and
cholesterol to lower blood cholesterol levels.
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Medication
If your LDL level is above your goal, your doctor will prescribe medications at the
same time you are making lifestyle changes. If you do need medication, be sure to use
it along with the TLC approach. This will keep the dose of medicine as low as
possible, and will lower your risk in other ways as well. You will also need to control
all of your other heart disease risk factors,including high blood pressure, diabetes,
and smoking .

Control your obesity

Step 1: Get your number.

Take a look on previous page . Youll see that your weight in relation to your height
gives you a number called a body mass index (BMI). A BMI from 18.5 to 24.9
indicates a normal weight. A person with a BMI from 25 to 29.9 is overweight, while
someone with a BMI of 30 or higher is obese. Those in the overweight and obese
categories have a higher risk of heart attack and other heart disease complications.
The higher your BMI, the greater your risk.

Step 2: Take out a tape measure.

The second step is to take your waist measurement. For women, a waist measurement
of over 35 inches increases the risk of heart attack, as well as the risks of high blood
pressure, diabetes, and other serious health conditions. For men, a waist
measurement of more than 40 inches raises these risks. To measure your waist
correctly, stand and place a tape measure around your middle, just above your
hipbones. Measure your waist just after you breathe out. Once youve taken these
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steps - found out your BMI and taken your waist measurement - you can use the
information to decide whether you need to take off pounds. While you should talk with
your doctor about whether you should lose weight, keep these guidelines in mind:If
you have heart disease and are overweight or obese, you should lose weight If you
have heart disease and a high waist measurement (over 35 inches for a woman; over
40 inches for a man), you should lose weight.
If you have two or more risk factors for heart disease and are overweight or obese,
you should lose weight. If your weight and waist measurement are in the normal
range, keep them that way! Avoid becoming overweight or adding extra inches
around your middle.

Lose a Little, Win a Lot

If you need to lose weight, heres some good news: A small weight lossjust 5 to 10
percent of your current weightcan help to lower the risks of heart attack and other
serious medical disorders. The best way to take off pounds is to do so gradually, by
getting more physical activity and eating a balanced diet that is lower in calories and
fat. For some people at very high risk, medication also may be necessary. To develop
a weight-loss or weight-maintenance program that works well for you, consult with
your doctor, registered dietitian, or qualified nutritionist.

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Cure Yourselves With Vegetables & Fruits

Eggs:
Eggs are profitable for our bodies more than we can
imagine, as it can prevent the heart diseases. Eggs are
the greatest sources for Protein, Lipids and Vitamins.
According to the nutrition experts this food also has a
strong Anti-Oxidant which helps preventing the heart
diseases. Yoke also, has two
kinds of Amine Acid named Tryptophan and Tyrosine that both have Anti-Oxidant
virtue.

Watermelon
This fruit is a source of strong Anti-Oxidants like Vitamins C & A; the daily usage of
this fruit prevents the body from heart diseases. Watermelons Nitric Acid reduces the
blood pressure. Its a great source of Potassium which is effective in controlling the
blood pressure.

Muskmelon:
This fruit is the main source for the Vitamins which can prevent the heart diseases.
Muskmelon, in addition to having Vitamins C & A has other nutritive values like
Potassium, Folate, Fiber, and Magnesium.

Red pepper:
Red pepper can cause reducing the Cholesterol of blood and prevent breaking and
repelling of it from body. Plants are reducers of Diabeteswhich are one of the heart
diseases factors.Many of plants are useful for reducing the blood pressure like
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Fenugreek and Galga.Fenugreek is a pea plant and can reduce the Cholesterol,
blood fat, blood pressure and blood sugar.
Galga is also a pea plant. Reducing the blood pressure in people with Diabetes TypeB
is one of its benefits. Also the plants like Onion and Garlic are reducers of
Cholesterol. But Garlic is more effective.
If these plants get used constantly, the
blood sugar will be reduced. Other plants
like: Carrots, Pomegranate, Coriander,
White mulberry, Sumac, Pumpkin etc. are
also useful.One of the fruits that cause
reducing the blood sugar is grapes while
most of people think it increases blood
sugar as its sweet.But It has Fructose which wont cause increasing the blood sugar.

Reducing The Bloods Cholesterol

People who have high Blood Cholesterol mustnt use foods with lots of Protein like
eggs and other foods like them and they should use foods with high Fiber instead.
Because liquid Fibers can help reducing Cholesterol. They should use fruits like
Oranges, Carrots, Pears, Beans, Cabbage specially Soya and dried fruits.

Tomatoes
Baked Tomato has the same benefits as Estatin for people with high Cholesterol or
Blood Pressure. Estatin is used for reducing the Blood Cholesterol and Blood
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Pressure which both cause the heart diseases. Tomato has lots of Anti-Oxidant and
prevents the heart attack and cerebral apoplexy. Also is useful protecting heart.

Carrots
Carrots are very important sources of Beta-carotene and Fibers
which can prevent cancers and heart attacks. The Cholesterol of 5
people between 25 till 41 years old who used 30 gr. Carrot per day
was measured.
After 3 weeks it was controlled again and it was relieved that its
reduced. As Cholesterolis an important factor in heart diseases try to include it in
your diet. A group of Swish researches have recently found even better reasons for

Using vegetables for treatment

They relieved that vegetables are effective in reducing heart attacks and Blood
Cholesterols. Researches show that people, who use vegetables at least 6 times a
week, are less involved in heart attacks.
During over 5 years researchers compared the meal of 287 women between 32 till 69
years old who were suffering from heart diseases with others and a huge difference
between people who tend to use Carrots and people who dont, was found.
So people who used Carrots were less in danger of heart diseases.
Finally, We can prevent from heart problems with using Fruits and Vegetables.

Vegetables Remedy
Heart: Spinach is amplifier of heart;use it with your meal.

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Smelling pennyroyal strengthens heart.

Pennyroyal is regulates heart movements.
Onions prevent blood from clotting, so its suitable for some heart diseases.
For heart diseases put onion in oven or on fire then use it as plaster for your sole.
Cress is good for blood vessels.
Leek causes consolidating of heart muscles, besides try to drink less tea.
Green tea prevents from heart attack; Cucumbers are useful for heart muscles.
The syrup of sweet basils seed is useful for heart.
People who suffer from heart diseases should allocate two meals in a week to eat
mashed potatoes baked in oven or fire.
For consolidating heart use Catoot tea after meal and use cabbage with your meal.

Angina
Allow 5 gr. Spinach seed to draw in 200 gr. CC boiling water, drink it 3 times a day
for 7 days.
Vessels Tighten:
Allocate Cress and Spinach& Onion in your diet.
Sorrel and Parsley soups are also useful.

Heart Attack
Use light tea and remember Sweet Basils prevent from heart attack.
For preventing heart attack use steamed chicory 3 cups a day, which is allowed to
draw in 200 CC boiling water for 20 minutes.

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Cholesterol
Eat lettuce salad before meal. Use dill seed with yogurt and drink steamed dill seed
after meal.
Eating Green pepper causes reducing the bloods fat.

Diabetes
Allocate Spinach in your diet as well as eggplants. Also try to use Onion.
Notice: People with very low blood sugar must try not to use onion.

Origins Clog:
Using of extract: If you suffer from vessels obstruction, theres no reason for
operating. You only need to drink a half glass of this syrup:
How to make: Mix 30 garlic seed with 5 limes in a mixer then mix it with one liter
water and boil it. (Attention: Boil it once) after it got cold strain it, then pour t in a
glass and keep it in refrigerator.

Usage:
Drink this liquid 30 CC before or after main meals. After 3 weeks constant using,
youll feel freshness in your whole body! And the vessels clogs will be cured.
Remember, you should stop using it after three weeks, for seven days and then try it
for another three weeks. You should repeat this cheap effective remedy every year.
Using this syrup no one will notice the smell of Garlic.
Curative strengths of Garlic and Lime show themselves after using clearly. People

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with vessels clogs and high Cholesterol can sleep relax every night and exercise every
day. Because their disease is solved! As the final suggestion: for removing the Garlics
skin easily, put them in a bowl full of water and then the skins will be easily removed!

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Teatments for heart diseases

Recovery well after heart attack
The result

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Diagnosing coronary heart disease

If your doctor feels you are at risk of CHD, they may carry out a risk assessment. This
involves asking about your medical and family history, your lifestyle and taking a
blood test.. Further tests may be needed to confirm a diagnosis of CHD, including:
Electrocardiogram stress test (or treadmill test or exercise ECG )
Nuclear scan
Echocardiography
Echocardiography
Ventriculogram
Intracoronary ultrasound
Carotid doppler ultrasound
Electron-beam computed
Magnetic resonance imaging (MRI)

What are these tests?

Electrocardiogram
(ECG or EKG) makes a graph of the hearts electrical activity as it beats. This test
can show abnormal heartbeats, heart muscle damage, blood flow problems in the
coronary arteries, and heart enlargement.

Stress test (or treadmill test or exercise ECG)

records the heart s electrical activity during exercise, usually on a treadmill or
exercise bike. If you are unable to exercise due to arthritis or another health
condition, a stress test can be done without exercise Instead, you can take a medicine
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that increases blood flow to the heart muscle and shows whether there are any
problems in that flow.

Nuclear scan
shows the working of the heart muscle as blood flows through the heart . A small
amount of radioactivematerial is injected into a vein, usually in the arm, and a
camera records how much is taken up by the heart muscle.

Echocardiography
changes sound waves into pictures that show the heart s size, shape, and movement
The sound waves also can be used to see how much blood is pumped out by the heart
when it contracts.

Coronary angiography (or angiogram or arteriography)

shows an x ray of blood flow problems and blockages in the coronary arteries. A thin,
flexible tube called a catheter is threaded through an artery of an arm or leg up into
the heart. A dye is then injected into the tube, allowing the heart and blood vessels to
be filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Ventriculogram
is frequently a part of the x-ray dye test described before. It is used to get a picture of
the hearts main pumping chamber, typically the left ventricle.

Intracoronary ultrasound
uses a catheter that measures blood flow. It creates a picture of the coronary arteries
that shows the thickness and other features of the artery wall. This lets the doctor see
blood flow and any blockages. In addition, several new, highly sensitive screening
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tests have been developed. Ask your doctor about these tests:

Carotid doppler ultrasound

uses sound waves to detect blockages and narrowing of the carotid artery in the neck,
both of which can signal an increased risk for heart attack or stroke.

Electron-beam computed tomograph

is a superfast scan that provides a snapshot of the calcium buildup in your coronary
arteries.

Magnetic resonance imaging (MRI)

Is a scan using magnets and computers to create high-quality images of the heart s
structure and functioning. It is often used to evaluate congenital heart disease. The
test can also detect severe blockages in coronary arteries in people who are having
unstable angina or a heart attack, thereb allowing immediate treatment to restore
blood flow to the heart.

Treating coronary heart disease

Although coronary heart disease cannot be cured, treatment can help manage the
symptoms and reduce the chances of problems such as heart attacks.We can treat our
ailment in two ways , such as making some changes in our life , medicines . Making
changes in our lifestyle .
The goals of treatment are to:
Relieve symptoms
Lower the risk of blood clots forming. (Blood clots can cause a heart attack.)
Widen plaque-clogged coronary (heart) arteries.
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Prevent CHD complications.

Lifestyle changes
Quit smoking
Follow a health y diet
Physical activities
Maintain a healthy weight
As we said in heart factors is one of the main factors for develop heart diseases .
So try to quit .

Follow a healthy diet

A healthy diet is an important part of a healthy
lifestyle. A healthy diet includes a
variety of vegetables and fruits. These foods can
be fresh, canned, frozen, or dried.
A good rule is to try to fill half of your plate
with vegetables and fruits. A healthy diet
also includes whole grains, fat-free or low fat
dairy products, and protein foods, such
as meats, poultry without skin, seafood,
processed soy products, nuts, seeds, beans,
and peas. Choose and prepare foods with little sodium (salt). Too much salt can raise
your risk for high blood pressure. Try to avoid foods and drinks that are high in
added sugars. For example, drink water instead of sugary drinks, like soda. Try to

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avoid foods and drinks that are high in added sugars Also, try to limit the amount of
solid fats and refined grains that you eat. Solid fats are saturated fat and trans fatty
acids. Refined grains come from processing whole grains, which results in a loss of
nutrients .

Physical activities
Many of us put off getting regular physical activityand then put it off some more .
But to protect our hearts, we must keep moving. For people with heart disease,
physical inactivity greatly incre ases the risk of worsened disease. Lack of physical
activity also contributes to other heart disease risk factors, such as high blood
pressure , diabetes, and overweight. Fortunately, research shows that as little as 30
minutes of moderate-intensity physical activity on most and preferably all days of the
week helps to protect heart health. This level of activity can reduce your risk of heart
disease complications, as well as lessen your chances of having a stroke, high blood
pressure, diabetes, colon cancer, and other serious medical disorders . Examples of
moderate activity are taking a brisk walk, light weightlifting, dancing, raking leaves,
washing a car, housecleaning, or gardening. If you prefer, you can divide your 30minute activity into shorter periods of at least 10 minutes each. If you have heart
disease or another type of heart problem, be sure to see your doctor before starting a
program of regular physical activity.

Maintain a healthy weight

Overweight and Obesity
If you have heart disease and are overweight or obese (extremely overweight), your
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risks of heart attack and other heart complications rise sharply . This is true even if
you have no other risk factors. Being overweight or obese also increases your
chances of developing other major risk factors for heart disease and heart attack,
such as diabetes, high blood pressure, and high blood cholesterol. Overall, obese
people are more likely to die of heart disease than normal weight individuals. The
bottom line: Maintaining a healthy weight is a necessary part of controlling heart
disease.

Medicines
Some medications may be used to treat a risk
factor for heart disease complications,
such as high blood pressure or high blood
cholesterol. Others may be prescribed to
prevent or relieve the symptoms of heart disease.
If you do take medicine, its important to keep up your heart healthy lifestyle because
healthy daily habits willkeep your dose of medicine as low as possible. Medications
that are commonly prescribed for people with heart disease include:

ACE inhibitors
stop the body from producing a chemical that current weightcan relieve mild cases
of sleep apnea. Other self-help treatments include quitting smoking and avoiding
alcohol and sleeping pills. Sleeping on your side rather than on your back also may
help. Some people benefit from a mechanical device that helps to maintain a regular
breathing pattern by increasing air pressure through the nasal passages. For very
serious cases, surgery may be needed.
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Menopausal Hormone Therapy

Until recently, it was thought that menopausal hormone therapy could lower the risks
of heart attack and stroke for women with heart disease. But research now shows that
women with heart disease should not take this.

Medication.
Menopausal hormone therapy can involve the use of an estrogen-plus-progestin
medicine or an estrogen-alone medicine. Studies on each type of medicine show that:
Estrogen-plus-progestin medication increases the risk of heart attack during the
first few years of use, also increases the risks of stroke, blood clots, and breast cancer.
they make your heart work harder.
Estrogen-only medication increases the risks of stroke and venous thrombosis (a
blood clot that usually occurs in one of the deep veins of the legs). Estrogen-only
medicine will not prevent heart attacks. If you have heart disease and are currently
taking or considering taking menopausal hormone therapy, talk with your doctor
about safer medicines for controlling heart disease, for preventing osteoporosis,
and/or for relieving menopausal symptoms.

C-Reactive Protein (CRP)

An elevated level of this blood protein is a sign of inflammation Studies indicate that
people with low CRP levels tend to have a slower progression of heart disease as well
as fewer heart attacks and deaths from heart disease, than those with higher levels of
the protein. Whether CRP plays a role in causing heart disease is notin the feet and
ankles.
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Nitrates
relax blood vessels and are used to treat chest pain. Nitrates in different forms can
be used to relieve the pain of an angina attack, to prevent an expected episode, or to
reduce the number of attacks that occur by using the medicine regularly on a longterm basis.The most commonly used nitrate for angina is nitro Nitroglycerin

Managing Angina
Angina is chest pain or discomfort caused by a temporary lack of oxygen to the heart
muscle. If you have this condition, its important to manage it well in order to prevent
a heart attack and other complications. Here is what you need to know:

Try to avoid triggers.

Anything that makes the heart work harder can cause angina pain. Common triggers
include certain types of physical activity, emotional stress, cold weather, eating a big
meal, high blood pressure, overweight, and cigarette smoking. With the exception o
f regular, routine physical activity avoid as many of these triggers as you can . Be
especially careful to avoid combining triggers, such as going out in cold weather
right after eating a heavy meal. You should also avoid heavy lifting and holding your
breath when pulling or lifting, since they make your heart work harder.

Exercise safely.
Certain kinds of exercise can bring on an angina episode. But other, gentler forms of
physical activity can actually help to improve your heart health. Getting regular
physical activity is a vital part of living well with angina. Talk with your doctor about
a safe program of physical activity for you. Participating in a cardiac rehabilitation
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program is another good way to establish a safe and healthful exercise regimen.

Keep an angina diary.

It is important to recognize changes in your angina pattern, including changes in the
frequency, length, and severity of episodes. Whenever you notice a change, report it
to your doctor right away. To help you keep track of changes, it can help to keep an
angina diary. Using an ordinary notebook, jot down a record of the following
narrows blood vessels. They are used to treat high blood pressure and damaged heart
muscle. ACE inhibitors may reduce the risks of a future heart attack and heart
failure. They also can prevent kidney damage in some people with diabetes.

Anticoaulgants
decrease the ability of the blood to clot, and therefore help to prevent clots from
forming in your arteries and blocking blood flow. (These medicines are sometimes
called blood thinners, though they do not actually thin the blood.) Anticoagulants will
not dissolve clots that have already formed, but they may prevent the clots from
becoming larger and causing more serious problems.

Antiplatelet
They are medications that stop blood particles called platelets from clumping
together to form harmful clots. These medications may be given to people who have
had a heart attack, have angina, or who experience chest pain after an angioplasty
procedure. Aspirin is one type of antiplatelet medicine.

Beta blockers
slow the heart rate and allow it to beat with less force. They are used to treat high
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blood pressure and some arrhythmias (abnormal heart rhythms), and to prevent a
repeat heart attack. They can also delay or prevent the development of angina.

Calcium-channel blockers
relax blood vessels. They are used to treat high blood pressure, angina, and some
arrhythmias.

Cholesterol-lowering drugs
Are usually used to decrease LDL, or bad cholesterol, levels in the blood.
Sometimes they are also used to increase HDL, or good cholesterol, and to lower
triglycerides. Commonly used cholesterol-lowering medications include statins, bile
acid sequestrants, niacin, fibrates, and cholesterol-absorption inhibitors.

Digitalis
Makes the heart contract harder and is used when the heart cant pump strongly
enough on its own. It also slows down some fast heart rhythms.

Diuretics
(water pills) decrease fluid buildup in the body and are very effective in treating high
blood pressure. In addition, new research suggests that diuretics can help to prevent
stroke, heart attack, and heart failure. For those who already have heart failure,
diuretics can help to reduce fluid buildup in the lungs and swelling.

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Keep your medicine handy.

If you are taking nitroglycerin for angina, it is important to keep it with you at all
times. The bottles are very small and can easily be carried in a purse or pocket. Also,
be sure to keep the medicine in its original bottle. Get your prescription refilled every
6 months, even if you havent used up all of the tablets.In the next chapter we will be
more familiar to this topic .

Procedure
Stent Placement
A stent is a tiny wire mesh tube that
is used to prop open an artery. A
stent iscommonly used along with
angioplasty and/or plaque removal.
In this procedure, astent is placed
over a balloon catheter and then
moved into the area of the blockage.When the balloon is inflated, the stent expands
and locks into place, holding open theartery. The stent remains in the artery
permanently, improving blood flow to the heart muscle and relieving chest pain. A
stent reduces the chances that an artery will narrow again after an angioplasty and/or
plaque removal. Newer types of stents are coated with medication that is slowly
released and helps to keep theblood vessel from closing up again. Stenting may be
particularly beneficial for women. In a large study of heart attack patients, women

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who received a stent were less likely to suffer a major heart complication during the
following year, and also less likely to need a repeat procedure than those who
receivedballoon angioplasty without stenting.

Coronary Bypass Surgery

Bypass surgery is often chosen when artery blockages are hard to reach or are too
extensive for angioplasty. In this procedure, the surgeon takes a piece of blood vessel
from the leg or chest and then attaches it to the heart artery both above and below
the narrowed area. This procedure creates a new route, or bypass, around the
blockage. Afterward, the blood can use this new pathway to flow freely to the heart
muscle, thereby reducing the risk of a heart attack. In some cases, more than one
bypass is necessary. For most operations, the patient is connected to a heart-lung
machine that delivers oxygen to the blood and circulates blood throughout the body
so that the heart can be temporarily stopped while the bypass is made. When the
surgery is finished, the heart is restarted. A person who undergoes bypass surgery
usually stays in The date and time of your discomfort, and how long it lasted .
The trigger or triggers that brought on an episode
The type and severity of discomfort
What action you took that relieved your angina

Coronary Angioplasty, or Balloon Angioplasty

In this procedure, a thin tube called a catheter is threaded through an artery into the
narrowed heart vessel. The catheter has a tiny balloon at its tip, which is repeatedly
inflated and deflated to open and stretch the artery. Then the balloon is deflated and
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the catheter removed. This process improves blood flow, reducing chest pain and
helping to prevent a heart attack.Compared with coronary bypass surgery , the
advantages of angioplasty are that the procedure is less invasive, the patient receives
local anesthesia only, and the recovery period is shorter . The disadvantage is that in
some cases, the artery closes up again. If this happens, you will need a second
angioplasty or bypass surgery In most cases, coronary angioplasty is a planned
procedure. But it is also used as an emergency treatment during a heart attack to
quickly open a blocked coronary artery. The procedure minimizes damage during a
heart attack and restores blood flow to the heart muscle.

Plaque Removal
Plaque is the buildup of cholesterol, fat, and other substances in an arterys inner
lining. Several procedures have been developed to remove harmful plaque from
arteries.
Most heart attacks involve discomfort in the center of the chest that lasts for more
than a few minutes. It may feel like uncomfortable pressure, squeezing, fullness, or
pain. The discomfort can be mild or severe, and it may come and go.
Chest discomfort.
Discomfort in other areas of the upper body,
including one or both arms, the back, neck, jaw, or stomach.
Shortness of breath.
This symptom may occur with or without chest discomfort
Other signs include nausea,
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light-headedness, or breaking out in a cold sweat.

Get Help Quickly

If you think that you or someone else may be having a heart attack, you must act
quickly to prevent disability or death, and to get the most benefit from current
treatments. Wait no more than a few minutes5 at mostbefore calling to emergency
.symptoms last up to 5 minutes. If your symptoms stop completely in less than 5
minutes, you should still call your doctor right away. You must also act at once
because hospitals have clot-dissolving medicines and other artery -opening treatments
that can stop a heart attack if given quickly. These treatments work best when
givenwithin the first hour after a heart attack starts. When you get to the hospital,
dont be afraid to speak up for what you needor bring someone who can speak up
for you. Ask for tests that can determine if you are having a heart attack. Commonly
given initial tests include an electrocardiogram (EKG or ECG) and a cardiac blood
test (to check for heart damage). You have the right to be thoroughly examined for a
possible heart attack. If you are having a heart attack, you have the right to immediate
treatment to help stop the attack .and the hospital for about a week, and then
continues to recuperate for several weeks at home. Two recently developed types of
bypass surgery do not require use of the heart-lung machine They are:.

Off-pump coronary bypass.

In this procedure, the heart is kept beating and just the portion of the heart with the
affected artery is held still while the bypass graft is sewn into place. While more study
is needed on this approach, recent research suggests that this type of bypass surgery
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may have fewer complications than conventional bypass surgery, particularly for
overweight and elderly patients.

Minimally invasive coronary artery bypass.

This procedure is intended for use only when one or two arteries will be bypassed.
Also performed while the heart is still beating, the surgery uses a combination of
small holes in the chest and a small incision madedirectly over the artery to be
bypassed. The surgeon usually detaches an artery from inside the chest wall and
reattaches it to the clogged artery furthest away from the blockage. This operation
usually has a shorter recovery time than conventional bypass surgery.

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Recovery well after heart attack

Having a heart attack or a heart procedure can be a frightening and upsetting
experience. It is difficult to discoveroften suddenly that your body isnt working
the way it should, and to be plunged into an unfamiliar world of hospitals and
high-tech procedures. But its important to know that millions of people have survived
a heart attack, recovered fully, and gone on to resume active, normal lives. Likewise,
most people who undergo heart surgery recover well andreturn to their usual
activities.
Many surgery patients eventually feel healthier than they did before their procedure .
The time it takes to get back to normalwill depend on many factors, including your
age and general health . If you have had a
heart attack, the pace of recovery will also
depend on the severity of the attack.
If you have undergone surgery, recovery
time will depend partly on the type of
procedure you had. But whatever your
situation, there is much youcan do to
improve your health and prevent
complications following a heart attack or major
heart procedure.

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The first step:

Give yourself permission to recover. You and your body have been through a lot, and
it will take some time to feel like yourself again . Expect to feel quite tired at first, and
to gradually regain your strength and energy . While individual needs vary,
following are some overall tips for recovering well from a heart attack or heart
surgery.

Your First Weeks at Home

When you first arrive home from the hospital, youll need to get a lot of rest so that
your heart can begin to heal. It is very important to eat healthfully and to get enough
sleep. Take the medications your doctor has prescribed for you. Avoid heavy yard
work, house cleaning, or other projects that require a lot of energy. Also refrain from
physical activity in very hot or cold weather. Ask family and friends to help out with
chores, childcare, and other activities that may be difficult to take care of during your
first weeks at home. At the same time, it is important to get up and move around as
you begin to recover. Your heart is a muscle that needs be exercised though very
gently at first. Pace yourself. Allow plenty of time for each thing you do during the
day, from getting out of bed to taking a shower to preparing a simple breakfast. Rest
between activities, and whenever you feel tired. Ask your doctor for a list of guidelines
for activity during your first few weeks at home. Your doctor will want to check your
progress 1 to 4 weeks after you leave the hospital. During your first follow up visit,
your doctor will check your weight and blood pressure, make any needed changes in
your medicines, perform necessary tests, and check how your recovery is progressing
overall. Use this opportunity to ask any questions you may have about safe or unsafe

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activities, medicines, lifestyle changes, or any other issues that concern you. You may
want to write down your questions beforehand. For some situations and questions, it
is best to call your doctor right away rather than wait for your next appointment.

Call promptly if:

-You have symptoms related to your original heart disease, as trouble breathing,
chest pain, weakness, or an irregular heartbeat.
- You notice side effects after starting a new heart medicine.
- Youve been given a prescription for a condition other than heart disease. It is
important to find out whether its safe to take other medicines along with your heart
drugs.
- Youve recently had heart surgery or another kind of medical treatment and you
notice symptoms that your doctor has warned you about.

Cardiac Rehabilitation
Your doctor may recommend cardiac rehabilitation (rehab) to help you recover from
a heart attack or heart surgery. This is a total program for heart health that includes
exercise training, education on heart healthy living, and counseling to reduce stress
and help you return to an active life. Getting involved in a cardiac rehab program is
an excellent idea. A recent study showed that people who participated in cardiac
rehab were 50 percent more likely to survive 3 years after a heart attack than those
who didnt participate. Cardiac rehab can help to strengthen your heart, reduce the
risks of a future heart attack, and return you as quickly as possible to your normal
daily activities. Almost everyone with heart disease can benefit from some kind of
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cardiac rehabilitation. No one is too old or too young to benefit. Women are helped by
cardiac rehab as much as men are.

Getting Started
Cardiac rehab often begins in the hospital after a heart attack or heart surgery, with
very gentle physical activity and counseling on adjusting to life at home. Once you
leave the hospital, you can continue to participate in cardiac rehab on an outpatient
basis. Outpatient programs may be located at your hospital, in a medical center, or in
a community facility such as a YMCA. Some people continue cardiac rehabilitation at
home. Regardless of the location, your cardiac rehab teamwhich may include
doctors, nurses, exercise specialists, dietitians and counselorswill help you to
create a safe exercise plan, as well as provide information and encouragement to
control your risk factors. You will need your doctors approval to get started in
cardiac rehab . But not all doctors bring up the topic with their heart patients,
especially women. Research indicates that women are only about half as likely as
men to participate in cardiac rehab programs. This is worrisome, because
nonparticipation increases the risk of having second and often fatal heart attacks. So
be sure to tell your doctor or nurse that youre interested in cardiac rehabilitation.
Talk with them about your specific needs and preferences, and ask for a referral that
is a good fit for you.

How To Choose a Cardiac Rehab Program

Cardiac rehab programs vary in the types of services they offer and emphasize.
Choose one that makes exercise training a priority . Studies show that people who
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participate in an exercise-based program are less likely to have a future heart attack
or major heart surgery, and are less apt to die of any heart-related cause than those
who dont join a program that emphasizes exercise. When choosing a cardiac rehab
program, also look for one that:
- Offers a wide range of services, including education and counseling.
- Offers services at a time and place that are convenient for you.
- Offers services that meet your specific needs and preferences.
For example, if youre overweight, look for a plan that provides help for weight loss.
-Is supervised by a team of health care professionals.
-Is affordable. Your insurance may cover the cost of some cardiac rehab services, but
not others . Find out what will be covered and for how long, so youll know from the
start what your out-of-pocket costs will be.

What Youll Do in a Cardiac Rehab Program Get moving.

Exercise training will help you learn to safely participate in physical activity,
strengthen your muscles, and improve your stamina. If youve recently gotten out of
the hospital, you may beworried that exercise will bring on another heart attack or
other heart crisis. In fact, physical activity can help prevent future heart problems.
Your rehab team will help you develop a program that is safe and effective for you.
Some programs make use of equipment such as a treadmill for walking, stationary
bikes, and light weights, and youll be shown how to use this equipment to get the
most benefit. Other programs offer low-impact aerobics classes and other group
exercise activities. In most programs, your heart rate and blood pressure will be
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monitored while you move. As your heart and body become stronger, you will
gradually increase your physical activity. Eventually, after you become familiar with
the program, you can continue it at a fitness center or at home.

Learn new heart healthy habits

In your cardiac rehab program, youll also learn about controlling your personal risk
factors for heart attack and other heart complications, and how to create new,
healthier habits. Controlling risk factors is a very important part of your recovery.
Depending on your personal needs, you may learn to:
- Quit smoking if youre a smoker.
- Manage related health conditions such as diabetes and high blood pressure.
- Eat a healthy, low-saturated fat, low-cholesterol diet.
-Control your weight.
- Manage stress.

Get counseling and support.

A good cardiac rehab program will help you learn to cope with the challenges of
adjusting to a new lifestyle ,as well as address any concerns you may have about the
future. Youll also be offered help in dealing with the emotional ups and downs that
many people experience following a heart attack or heart surgery. Many programs
offer classes in stress management, as well individual counseling, group support ,
both .

Getting the Most Out of Cardiac Rehab

Youll benefit most from your cardiac rehab program by becoming as actively
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involved in it as possible. Think of yourself as the most important member of your

recovery teambecause you are . Join with health care professionals in designing
or adjusting services to best meet your needs. Show up for exercise, education, and
supportsession . Ask questions. Report any changes in your feelings or symptoms.
Finally, be sure to complete the program. Even if you feel that you already have a
handle on how to recover, keep in mind that your needs will continue to change
throughout the recovery process. Your cardiac rehab team can help you respond to
those changing needs, and thereby continue to help you improve your heart health. So
stick with the program!

Getting Your Life Back

As you begin to recover from a heart attack or heart procedure, you may naturally
wonder when you can return to your usual activities, including work, sexual activity,
driving, and travel. Most people can safely return to most of their normal activities
within a few weeks, as long as they do not have chest pain or other complications.
While you should ask your doctor when you can return to each of your usual
activities, here are some general guidelines:

Work
Most people are able to return to their usual work within several weeks. Your doctor
may ask you to take tests to find out if you can do the kind of job you did before.
While most individualscan continue their customary work with no problems, some
people choose to change jobs or reduce their hours to lighten the load on their heart.
Counselors at cardiac rehab program s may be able to provide support and resources
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for those considering a job change.

Driving
can usually begin within a week for most patients, if allowed by State law. Each State
has its own regulations for driving a motor vehicle following a serious illness, so
contact your States Department of Motor Vehicles for guidelines. People with
complications or chest pain should not drive until their symptoms have been stable for
a few weeks.

Travel.
Once your doctor tells you its safe for you to travel, keep these tips in mind:
- Keep your medications in your purse or carry-on luggage so they will be easily
available when you need them.
- Pack light so that you can lift your luggage without strain. At the airport, train, or
bus station, use a pull-cart to cut down on lifting. If possible, get help from a porter.
- Allow more time than usual to catch your flight, train, or bus. Who needs the extra
stress?
- Walk around at least every 2 hours during trips . While sitting, flex your feet
frequently and do other simple exercises to increase blood flow in your legs and
prevent blood clots.
Check with your doctor before traveling to locations at high altitudes (greater than
6,000 feet)
or places where the temperature will be either very hot or very cold. When you first
arrive, give yourself a chance to rest. Remember, each persons recovery process is
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different. Dont try to guess when you can return to normal activities. Always ask your
doctor first.

Coping With Your Feelings

Anyone who has had a heart attack or has undergone heart surgery knows that it can
be an upsetting experience. Youve just come through a major health crisis, and your
usual life has been disrupted Afterward, its normal to experience a wide range of
feelings. You may feel some relief. But you may also feel worried, angry, or depressed.
It may be reassuring to know that these reactions are very common, and that most
difficult feelings pass within a fewweeks. Here are some things to remember:

Take 1 day at a time

Try not to think too much about next week or next month. Do what you can do today.
Enjoy small pleasures: a walk in your neighborhood, a conversation with a loved
one, a snuggle with a pet, or a good meal.

Share your concerns.

Talk with family members and friends about your feelings and concerns, and ask for
support. Be sure to ask for the kind of support you need. (For example, if you want a
sympathetic ear rather than advice, gently let your loved ones know.) Be sure to give
family members time to say what they feel and need,too. Supportive relationships may
actually help to lengthen life aftera heart attack.

Get support from veterans.

Whether youve had a heart attack or gone through heart surgery, consider joining a
support group for people who have shared your experience. Groups for heart patients
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can provide emotional support as well as help you develop new ways of handling
everyday challenges.

Keep moving.
Regular physical activity not only helps to reduce the risk of future heart problem ,
but also helps to relieve anxiety, depression, and other difficult feelings. Any regular
physical activityeven gentle walkingcan help to lift your mood.

Seek help for depression.

Up to 20 percent of heart disease patients battle serious depression, and many more
suffer milder cases of the blues. If you find yourself feeling very sad or
discouraged for more than a week or so, be sure to let your doctor know. Counseling
and/or medication can often be very helpful. Seeking help is very important, not only
because you deserve to enjoy life as fully as possible, but also because heart patients
who are successfully treated for depression are less likely to have future serious heart
problems .

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