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Cardiovascular disease: prevalence, symptoms and diagnosis

Cardiovascular disease:

Prevalence

Cardiovascular disease (CVD) is a main cause of ill health and premature death in the UK at present.

Coronary Heart disease (CHD)

Coronary Heart Disease is the most common form of CVD in the UK, with approximately 275,000 heart attacks reported every year and an estimated 1.4 million people suffer annually from angina - a common symptom of coronary heart disease.

Stroke

In the UK, someone has a stroke every five minutes. They are more common among those over the age of 65, but can happen at any age. Strokes are the leading cause of disability in the UK, and the third most common cause of death, (after cancer and Coronary Heart Disease).

Peripheral Vascular Disease (PVD)

It is difficult to assess the prevalence of PVD as many patients may not have symptoms to begin with or may have unusual symptoms.

At present it is suggested to affect approximately 3% of the population under the age of 60 years and over 70% of the population over the age of 75 years.

Symptoms

Coronary Heart disease (CHD)

Angina is a symptom of coronary heart disease caused by congestion in the major blood vessels of the heart, and can cause a mild, uncomfortable feeling similar to indigestion. In severe cases, angina causes a feeling of extreme pressure on the chest, breathlessness, trapped air and belching. Angina is usually triggered by physical exercise or stressful situations.

If the arteries become completely blocked, a heart attack will occur. Heart attacks usually present with pain or pressure in the chest often radiating down the arm, across the shoulders and up the neck. People experiencing a heart attack will often feel nauseous, short of breath, dizzy and appear pale in colour.

Heart attacks can cause permanent damage to the heart muscle, and can sometimes be fatal if they are not treated immediately.

Some people with coronary heart disease may have heart palpitations. This is when you become aware of the heart beating irregularly or harder than normal.

Heart failure can occur in people with coronary heart disease. Heart failure is when the heart gradually gets too weak to pump blood around the body and eventually stops all together. Often fluid will build up in the lungs, making it increasingly difficult to breathe.

Stroke

The symptoms of a stroke will depend upon the part of the brain that has been affected, and the extent of the damage caused.

The symptoms of a stroke therefore vary from person to person.

Symptoms usually come on suddenly, and can include: weakness or numbness on one side of the body or face, loss of speech and co-ordination, confusion, severe headache and loss of consciousness.

Symptoms of the stroke can often improve after a few weeks with treatment and rehibilitation when the swelling around the damaged part of the brain goes down, however many people are left with some degree of disability after a stroke.

Peripheral Vascular disease (PVD)

The typical symptom of PVD is pain which develops in one or both calves during exercise. It is due to narrowing of the femoral artery - the most common site for PVD to develop.

During exercise, muscles need extra oxygen, delivered through the blood. The narrowed artery cannot deliver the extra blood required, and so pain occurs from the oxygen-starved muscles.

If an artery higher "upstream" is narrowed, such as the iliac artery or aorta, then pain may develop in the thighs or buttocks.

If the blood supply to the legs becomes worse it may result in the development of sores or ulcers on the legs and feet, and eventually may lead to death of tissue.

In extreme cases, part or all of the affected limb may have to be amputated, but this is often preventable.

Diagnosis

Coronary Heart Disease (CHD)

Diagnosis of coronary heart disease can be made using several different tests including:

ECG

A test called an ECG (electro-cardiogram) will be carried out to determine whether a heart attack has occurred, what type of heart attack it was and which part of the heart is damaged.

An ECG also determines how fast your heart is beating and whether it's beating in a regular rhythm or not.

Angiogram

An angiogram will show any plaque (fatty deposits) that have built up, causing the arteries to get narrower or blocking the blood supply.

A flexible tube is inserted into an artery in the groin, upper leg, upper arm, or under arm area, and pushed through to the coronary arteries using a thin wire. A dark coloured dye is then run through the arteries and an x-ray is taken which will show up any blockages

Blood test

A blood test can be used to find out the level of cholesterol in the blood. As cholesterol levels tend to vary, the test will usually be repeated again on different days and at different times to find an average level.

LDL cholesterol is known as “bad cholesterol” and is linked to the development of atherosclerosis (the development of fatty plaques which cause narrowing of blood vessels and impaired blood flow) and subsequently increased risk of CVD.

The ideal level for LDL is <3.4mmol/l in a healthy individual (and less then 2mmol/l if at risk of CVD).

HDL cholesterol is known as “good cholesterol” and helps to lower “bad cholesterol” levels in the blood.

The ideal level of HDL in a healthy individual is >0.91mmol/l (and greater than 1mmol/l if at risk of CVD).

The ideal level for total cholesterol levels in a healthy individual should be below 5mmol/l (and below 4mmol/l if at risk of CVD).

Lifestyle

Lifestyle factors such as diet, exercise, alcohol intake, weight and smoking are very important and will be taken into account when the risk of coronary heart disease is determined.

Stroke

People suspected of having a stroke will need to be admitted to hospital for tests including:

  • Brain scan (CT scan or MRI scan) – to determine the type of stroke and where the bleeding has happened.
  • Ultrasound - to look at the arteries in the neck
  • Chest X-ray and Electrocardiogram (ECG) – to check for heart or lung problems that may have caused the stroke
  • Blood Tests – to identify possible causes of the stroke

Peripheral Vascular Disease (PVD)

Peripheral vascular disease can be diagnosed by comparing blood pressures taken above and below the point of pain.

The area below the pain (downstream from the obstruction) will have a much lower or undetectable blood pressure reading.

Imaging techniques and angiography can also be used for diagnosis.

 

For more information on cardiovascular disease why not visit NHS direct.

Cardiovascular disease:
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