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By Mayo Clinic staff Chambers and valves of the heart Development of atherosclerosis How the heart works To understand

heart disease, it helps to know how the heart works. Your heart is a pump. It s a muscular or!an about the si"e of your fist and located sli!htly left of center in your chest. Your heart is divided into the ri!ht and the left side. The division protects o#y!en$rich blood from mi#in! with o#y!en$poor blood. %#y!en$poor blood returns to the heart after circulatin! throu!h your body. The ri!ht side of the heart, composed of the ri!ht atrium and ventricle, collects and pumps blood to the lun!s throu!h the pulmonary arteries. The lun!s refresh the blood with a new supply of o#y!en, makin! it turn red. %#y!en$rich blood then enters the left side of the heart, composed of the left atrium and ventricle, and is pumped throu!h the aorta to supply tissues throu!hout the body with o#y!en and nutrients. &our valves within your heart keep your blood movin! the ri!ht way. The tricuspid, mitral, pulmonary and aortic valves open only one way and only when pushed on. 'ach valve opens and closes once per heartbeat ( or about once every second while you re at rest. ) beatin! heart contracts and rela#es. Contraction is called systole, and rela#ation is called diastole. Durin! systole, your ventricles contract, forcin! blood into the vessels !oin! to your lun!s and body ( much like ketchup bein! forced out of a s*uee"e bottle. The ri!ht ventricle contracts a little bit before the

left ventricle does. Your ventricles then rela# durin! diastole and are filled with blood comin! from the upper chambers, the left and ri!ht atria. The cycle then starts over a!ain. Your heart also has electrical wirin!, which keeps it beatin!. 'lectrical impulses be!in hi!h in the ri!ht atrium and travel throu!h speciali"ed pathways to the ventricles, deliverin! the si!nal to pump. The conduction system keeps your heart beatin! in a coordinated and normal rhythm, which in turn keeps blood circulatin!. The continuous e#chan!e of o#y!en$rich blood with o#y!en$poor blood is what keeps you alive. The causes of heart disease vary by type of heart disease. Causes of cardiovascular disease +hile cardiovascular disease can refer to many different types of heart or blood vessel problems, the term is often used to mean dama!e caused to your heart or blood vessels by atherosclerosis ,ath$ur$oh$skluh$-%+$sis., a buildup of fatty pla*ues in your arteries. This is a disease that affects your arteries. )rteries are blood vessels that carry o#y!en and nutrients from your heart to the rest of your body. /ealthy arteries are fle#ible and stron!. %ver time, however, too much pressure in your arteries can make the walls thick and stiff ( sometimes restrictin! blood flow to your or!ans and tissues. This process is called hardenin! of the arteries ,arteriosclerosis.. )therosclerosis is the most common form of this disorder. )therosclerosis is also the most common cause of cardiovascular disease, and it s often caused by an unhealthy diet, lack of e#ercise, bein! overwei!ht and smokin!. )ll of these are ma0or risk factors for developin! atherosclerosis and, in turn, cardiovascular disease. Causes of heart arrhythmia Common causes of abnormal heart rhythms ,arrhythmias., or conditions that can lead to arrhythmias include1

/eart defects you re born with ,con!enital heart defects. Coronary artery disease /i!h blood pressure Diabetes 2mokin! '#cessive use of alcohol or caffeine Dru! abuse 2tress 2ome over$the$counter medications, prescription medications, dietary supplements and herbal remedies 3alvular heart disease In a healthy person with a normal, healthy heart, it s unlikely for a fatal arrhythmia to develop without some outside tri!!er, such as an electrical shock or the use of ille!al dru!s. That s primarily because a healthy person s heart is free from any abnormal conditions that cause an arrhythmia, such as an area of scarred tissue. /owever, in a heart that s diseased or deformed, the heart s electrical impulses may not properly start or travel throu!h the heart, makin! arrhythmias more likely to develop. Causes of heart defects /eart defects usually develop while a baby is still in the womb. )bout a month after conception, the heart be!ins to develop. It s at this point that heart defects can be!in to form. 2ome medical conditions, medications and !enes may play a role in causin! heart defects. /eart defects can also develop in adults. )s you a!e, your heart s structure can chan!e, causin! a heart defect.

Causes of cardiomyopathy The e#act cause of cardiomyopathy, a thickenin! or enlar!in! of the heart muscle, is unknown. There are three types of cardiomyopathy1

Dilated cardiomyopathy. This is the most common type of cardiomyopathy. In this disorder, your heart s main pumpin! chamber ( the left ventricle ( becomes enlar!ed ,dilated., its pumpin! ability becomes less forceful, and blood doesn t flow as easily throu!h the heart. Hypertrophic cardiomyopathy. This type involves abnormal !rowth or thickenin! of your heart muscle, particularly affectin! the muscle of your heart s main pumpin! chamber. )s thickenin! occurs, the heart tends to stiffen and the si"e of the pumpin! chamber may shrink, interferin! with your heart s ability to deliver blood to your body. Restrictive cardiomyopathy. The heart muscle in people with restrictive cardiomyopathy becomes stiff and less elastic, meanin! the heart can t properly e#pand and fill with blood between heartbeats. It s the least common type of cardiomyopathy and can occur for no known reason. Causes of heart infection /eart infections, such as pericarditis, endocarditis and myocarditis, are caused when an irritant, such as a bacterium, virus or chemical, reaches your heart muscle. The most common causes of heart infections include1 Bacteria. 'ndocarditis can be caused by a number of bacteria enterin! your bloodstream. The bacteria can enter your bloodstream throu!h everyday activities, such as eatin! or brushin! your teeth, especially if you have poor oral health. Myocarditis can also be caused by a tick$borne bacterium that is responsible for 4yme disease.

Viruses. /eart infections can be caused by viruses, includin! some that cause influen"a ,co#sackievirus B and adenovirus., a rash called fifth disease ,human parvovirus B56., !astrointestinal infections ,echovirus., mononucleosis ,'pstein$ Barr virus. and 7erman measles ,rubella.. 3iruses associated with se#ually transmitted infections also can travel to the heart muscle and cause an infection. Parasites. )mon! the parasites that can cause heart infections are Trypanosoma cru"i, to#oplasma, and some that are transmitted by insects and can cause a condition called Cha!as disease. Medications that may cause an allergic or to ic reaction. These include antibiotics, such as penicillin and sulfonamide dru!s, as well as some ille!al substances, such as cocaine. The needles used to administer medications or ille!al dru!s also can transmit viruses or bacteria that can cause heart infections. !ther diseases. These include lupus, connective tissue disorders, inflammation of blood vessels ,vasculitis. and rare inflammatory conditions, such as +e!ener s !ranulomatosis. Causes of valvular heart disease There are many causes of diseases of your heart valves. &our valves within your heart keep blood flowin! in the ri!ht direction. You may be born with valvular disease, or the valves may be dama!ed by such conditions as rheumatic fever, infections ,infectious endocarditis., connective tissue disorders, and certain medications or radiation treatments for cancer.

Risk factors By Mayo Clinic staff /eart disease risk factors include1

"our age. 2imply !ettin! older increases your risk of dama!ed and narrowed arteries and weakened or thickened heart muscle, which contribute to heart disease. "our se . Men are !enerally at !reater risk of heart disease. /owever, the risk for a woman increases after menopause. #amily history. ) family history of heart disease increases your risk of coronary artery disease, especially if a parent developed it at an early a!e ,before a!e 88 for a male relative, such as your brother or father, and 98 for a female relative, such as your mother or sister.. $moking. :icotine constricts your blood vessels, and carbon mono#ide can dama!e their inner linin!, makin! them more susceptible to atherosclerosis. /eart attacks are more common in smokers than in nonsmokers. Poor diet. ) diet that s hi!h in fat, salt and cholesterol can contribute to the development of heart disease. High %lood pressure. ;ncontrolled hi!h blood pressure can result in hardenin! and thickenin! of your arteries, narrowin! the vessels throu!h which blood flows. High %lood cholesterol levels. /i!h levels of cholesterol in your blood can increase the risk of formation of pla*ues and atherosclerosis. <la*ues can be caused by a hi!h level of low$ density lipoprotein ,4D4. cholesterol, known as =bad= cholesterol, or a low level of hi!h$density lipoprotein ,/D4. cholesterol, known as =!ood= cholesterol. Dia%etes. Diabetes increases your risk of heart disease. Both conditions share similar risk factors, such as obesity and hi!h blood pressure. !%esity. '#cess wei!ht typically worsens other risk factors. Physical inactivity. 4ack of e#ercise also is associated with many forms of heart disease and some of its other risk factors, as well.

High stress. ;nrelieved stress in your life may dama!e your arteries as well as worsen other risk factors for heart disease. Poor hygiene. :ot re!ularly washin! your hands and failure to establish other habits that can help prevent viral or bacterial infections can put you at risk of heart infections, especially if you already have an underlyin! heart condition. <oor dental health also may contribute to heart disease. Complications By Mayo Clinic staff Complications of heart disease include1

Heart failure. %ne of the most common complications of heart disease is heart failure. /eart failure occurs when your heart can t pump enou!h blood to meet your body s needs. %ver time, the heart can no lon!er keep up with the normal demands placed on it. The ventricles may become stiff and don t fill properly between beats. )lso, the heart muscle may weaken, and the ventricles stretch ,dilate. to the point that the heart can t pump blood efficiently throu!hout your body. /eart failure can result from many forms of heart disease, includin! heart defects, cardiovascular disease, valvular heart disease, heart infections or cardiomyopathy. Heart attack. Coronary artery disease can cause a heart attack. /eart attacks usually occur when a blood clot blocks the flow of blood throu!h a coronary artery ( a blood vessel that feeds blood to a part of the heart muscle. Interrupted blood flow to your heart can dama!e or destroy a part of the heart muscle. $troke. Cardiovascular disease may cause an ischemic stroke, which happens when the arteries to your brain are narrowed or blocked and too little blood reaches your brain. ) stroke is a medical emer!ency ( brain tissue be!ins to die within 0ust a few minutes of a stroke.

&neurysm. Cardiovascular disease can also cause an aneurysm, a serious complication that can occur anywhere in your body. )n aneurysm is a bul!e in the wall of your artery. If an aneurysm bursts, you may face life$threatenin! internal bleedin!. )lthou!h this is usually a sudden, catastrophic event, a slow leak is possible. If a blood clot within an aneurysm dislod!es, it may block an artery at another point downstream. Peripheral artery disease. The same atherosclerosis that can lead to coronary artery disease can also lead to peripheral artery disease ,<)D.. +hen you develop peripheral artery disease, your e#tremities ( usually your le!s ( don t receive enou!h blood flow to keep up with demand. This causes symptoms, most notably le! pain when walkin! ,claudication.. $udden cardiac arrest. 2udden cardiac arrest is the sudden, une#pected loss of heart function, breathin! and consciousness. 2udden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumpin! action and causes blood to stop flowin! to the rest of your body. 2udden cardiac arrest almost always occurs in the conte#t of other underlyin! heart problems, particularly coronary artery disease. 2udden cardiac arrest is a medical emer!ency. If not treated immediately, it is fatal, resultin! in sudden cardiac death.