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Heart disease is a generic term that indicates that the heart is not functioning normally.Babies are sometimes born with heart disease. This is known as congenital heart disease. When people develop heart disease later, it is called acquired heart disease. Most heart disease is acquired. Diseases such as coronary artery disease and rheumatic heart disease are examples of acquired heart disease. The most common types of acquired heart diseases are:

• Coronary Artery Disease (or CAD) – This is a disease within the blood vessels that deliver blood to the heart muscle. If these blood vessels get very narrow, or if they become occluded, blood will not flow through them normally. Since less blood is supplied to the heart muscle the muscle cannot contract at normal capacity. The heart muscle will become sick and weak(ischemic). The heart muscle may even die if blood flow stops completely(this is what occurs in a heart attack). Blocked arteries in the heart are often the result of injury associated with smoking, high cholesterol, high blood pressure, diabetes and some inherited traits from parents. All of these factors damage the lining (endothelium) of the heart’s blood vessels and cause them to become narrowed or even blocked completely. The narrowed areas often have calcium and cholesterol deposits called plaques. Plaques can suddenly rupture or break open and cause a sudden blockage of a blood vessel. This is a frequent cause of heart attacks and strokes.
• Congestive Heart Failure ( or CHF) – This is a condition that indicates that the heart is not pumping at normally. Two common causes of congestive heart failure are a weakened heart muscle and the other is abnormal heart valves. The valves may not let too little blood through because they are too narrowed. Or the valve may have a “leak” and let blood flow the wrong direction in the heart. If the heart valves do not close or open normally, the heart muscle performs excess work and it will become fatigued.
• Abnormal Heart Rhythms – The electrical activity in the heart controls the heart muscle contraction. Heart rhythm problems or arrhythmias may make the heart beat too quickly or too slowly. Very abnormal heart rhythms may make the heart be unable to pump blood. The heart needs a normal rhythm to pump the blood efficiently. When the rhythm is too fast the heart may not have time for blood to fill the chambers, so there is too little blood moving forwards through the heart with each contraction of the heart. When the heart rate is too slow, there may not be enough contractions of the heart to provide enough blood to the rest of the body for its basic needs.

Some patients can have heart disease and yet not feel sick. Most people with heart disease have some symptoms such as those listed below

• Breathing difficulty–blood and fluid can back up into the lungs making the lungs “wet” or fluid filled
• Pains in chest–the heart muscle is ischemic (not getting enough flow to keep it contracting)
• Swelling in feet or legs–blood can backing up in the lower body and cause fluid buildup
• Palpitations or extra heart beats (the patient has the feeling that the heart is beating too fast, too hard, or is not regular)
• Feeling weak or fatigued because the body and brain are getting too little blood to supply them with oxygen.
• Cyanosis (blueish color of skin) which means that too little oxygen is attached to hemoglobin in the bloodstream to supply the cells in the body. Hemoglobin without oxygen attached has a blue color.

Heart disease in the United States is the biggest killer of both men and women. For example, heart disease causes 40% the deaths in the United States, which is more than all kinds of cancer put together. There are many things that a patient can do to decrease their risk of heart disease. Some of the factors that may be modified include:

• Stop Smoking–smoking is toxic to your arteries and the injury to them contributes to the narrowing of the arteries.
  
• High LDL, or “bad” cholesterol and low HDL, or “good” cholesterol–drugs and diet can help modify these
• Uncontrolled hypertension (high blood pressure)-weight loss exercise and medication help to treat hypertesion
• Physical inactivity–activiy is good for your heart and brain. Cholesterol and diabetes are improved. The heart muscle strengthens
• Obesity (more than 20% over one’s ideal body weight). Weight loss will improve cholesterol, diabetes and blood pressure
• Uncontrolled diabetes. High blood sugar is bad for your arteries and needs to be controlled.
• High C-reactive protein. An elevated C-reactive protein indicates that your arteries are inflamed making them more likely to develop plaques and clots in them. Aspirin is probably helpful in reducing this inflammation. All of the other things such as sensible diet, exercise, stopping smoking and weight loss are also helpful in lowering C-reactive protein, which means that the arteries are less inflamed and irritated. The result of lowering your C-reactive protein is that your arteries are less likely to get a clot in them and thus a heart attack or stroke is less likely.
• Uncontrolled stress and anger–Try to lower your stress level through relaxing activities, meditation, exercise and getting plenty of rest. Anger and anxiety are associated with the release of substances such as epinephrine in your body that raise your blood pressure and make your heart work too hard.

Congenital heart disease is a term that refers to types of heart disease that are present at birth (congenital). Congenital heart disease includes a numerous conditions. The formation of the heart structures before birth can be abnormal. As an example, when a part of the aorta (the main artery that comes from the heart) is narrowed that is called coarctation of the aorta. Other problems include things like “holes inside the heart” which allows the blood to flow abnormally inside the heart chambers. Still other congenital heart problems are caused by abnormal heart valves. Most congenital heart problems are discovered at birth, but other times the problems may not be detected until the person is an adult. Some of the more common congenital heart problems that may require surgical treatment include:

• aortic valve stenosis
• Tetralogy of Fallot
• hypoplastic left heart syndrome
• atrial septal defects
• ventricular septal defects
  
• coarctation of the aorta
• pulmonary valve stenosis
• single ventricle conditions
• total anomalous pulmonary venous return
• transposition of the great arteries
• vascular rings around the aorta

Surgical and cardiac catheterization procedures are generally required to deal with these conditions. Some of the conditions require immediate surgery after the patient is born while others are less serious and surgery can be delayed.