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Some specific diseases of the heart include cardiomyopathy, congenital heart disease, heart valve defects, myocardial infarcation (heart attack), problems of the pericardium, and arrhythmias. If any of these diseases cause the heart to lose its ability to pump blood effectively, the patient is said to have heart failure. Because poor pumping ability often results in an accumulation of fluid in the tissues and lungs, it is often called congestive heart failure.
Cardiomyopathy is a disease of the heart muscle with multiple causes and is the number one reason people undergo heart transplants. Categorized by the type of muscle damage, there are three general types of cardiomyopathy: dilated, hypertrophic, and restrictive. Dilated cardiomyopathy refers to the enlargement of the heart that is a response to the overall myocardial weakness. Many problems can cause dilated cardiomyopathy, including viral infections, excessive alcohol intake, and myocarditis (inflammation of the heart).
Hypertrophic cardiomyopathy is an abnormal over-growth of the heart muscle. An inherited disease, the overgrown muscle blocks the movement of blood both
Congenital heart disease is caused by defects of the heart present at birth. Defects can be relatively mild and asymptomatic to severe and life-threatening. Some more common problems are abnormally formed blood vessels that block blood flow, malformed heart valves, incorrect connections between arteries, veins, and the heart, or defects in the atrial or ventricular septa. The most common congenital heart defect is a combination of four problems called the teralogy of Fallot. With this problem the ventricular septum is incomplete, there is an obstruction to blood flow beneath the pulmonary artery, the aorta is shifted rightward, and the right ventricular wall is thickened.
Any of the hearts valves can obstruct blood flow if they are too stiff (stenosis) or don't close properly and allow blood to leak (regurgitation). Valve problems can cause congestive heart failure or heart enlargement, which can lead to angina or heart arrhythmias. Causes of valve disease include congenital defects, calcium deposits, and infections, such as endocarditis (a bacterial infection of the endocardium, the lining of the heart). Severe valve problems can be treated by removal of the diseased valve and replacement with an artificial valve.
A myocardial infarction (heart attack) is death of heart tissue due to the sudden lack of blood flow from the coronary arteries. Doctors believe the most common cause of the blockage is a blood clot that formed at a rupture of an atherosclerotic plaque that has broken loose. The results of the heart attack are dependent on the amount of heart tissue that is damaged. With less than 10% of the heart affected, there is a reduction in the ability of the heart to pump blood, but a normal lifestyle can often be maintained. At 25%, enlargement of the heart and heart failure is a common result. If 40% or more of the heart is damaged, shock or death usually occurs.
Pericarditis is inflammation of the pericardium, usually caused by a viral infection. Although this disease can cause sharp, piercing chest pain, it is usually self-limiting and ordinarily does not lead to further problems. Pericardial effusion is a collection of fluid around the heart in the pericardial sac. If the fluid amount is great enough, it can reduce the heart's ability to expand and receive blood, reducing its efficiency. This condition is known as cardiac tamponade. A final condition of the pericardium is pericardial constriction, an abnormal inflexibility of the pericardial membrane. Some types of pericarditis often result in this problem. If the inflexible membrane causes heart failure, it can be removed surgically.
Arrhythmias are abnormal heartbeats. Very broadly, arrhythmias can be classified into four different types: conduction system abnormalities, abnormally slow, abnormally fast, and irregular. Conduction system abnormalities are seen using electrocardiography units and do not directly cause an outwardly altered heartbeat. An example is some heart blocks, where the electrical signal adopts alternative paths in the heart to avoid nonconductive tissue.
Slow heartbeat (brachycardia) is the most common cause for the implantation of a pacemaker and can be caused by problems with the autonomic nervous system, the SA node, or the conduction system. Abnormally fast heartbeats (tachychardia) can be atrial flutter, the presence of an extra, abnormal pathway for electrical conduction in the heart, or ventricular tachychardia (V tach). Some common irregular heartbeats include extra beats (extrasystoles) and atrial fibrillation, where the atria stop having effective contractions and beat chaotically at several hundred times per minute.
Author Info: Michelle L. Johnson M.S., J.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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