Common Diseases & Conditions
High Blood Pressure
Chest pain is one of the most common reasons people call for emergency medical help.
Fortunately, chest pain doesn't always signal a heart attack. Often chest pain is
unrelated to any heart problem. Even so it is important not to ignore it, and to
seek a medical evaluation as quickly as possible.
There are many possible causes of chest pain. Some causes are mildly inconvenient,
while other causes are serious, even life-threatening. Any organ or tissue in your
chest can be the source of pain, including your heart, lungs, esophagus, muscles,
ribs, tendons or nerves. Angina is one type of heart-related chest pain. This pain
occurs because your heart is not getting enough blood and oxygen. Angina pain can
be similar to the pain of a heart attack.
Other causes of chest pain include:
- Asthma, which is generally accompanied by shortness of breath, wheezing, or cough.
- Pneumonia, a blood clot to the lung (pulmonary embolism), the collapse of a small
area of a lung (pneumothorax), or inflammation of the lining around the lung (pleurisy).
In these cases, the chest pain often worsens when you take a deep breath or cough
and usually feels sharp. Strain or inflammation of the muscles and tendons between
- Anxiety and rapid breathing.
- Chest pain can also be related to problems with your digestive system. These include
stomach ulcer, gallbladder disease, gallstones, indigestion, heartburn, or gastroesophageal
reflux (when acid from your stomach backs up into your esophagus).
- Ulcer pain burns if your stomach is empty and feels better with food. Gallbladder
pain often gets worse after a meal, especially a fatty meal.
Hypertension, or high blood pressure, is defined as a repeatedly elevated blood
pressure exceeding 130 over 80 mmHg -- a systolic pressure above 130 with a diastolic
pressure above 80.
When you have high blood pressure, or hypertension, the force of blood against your
artery walls is too strong. High blood pressure can damage your arteries, heart,
and kidneys and lead to atherosclerosis and stroke. Hypertension is called a "silent
killer'' because it does not cause symptoms unless it is severely high and, without
your knowing it, causes major organ damage if not treated.
In most cases, a doctor may not be able to pinpoint the exact cause of your high
blood pressure. But several factors are known to increase blood pressure, including
obesity, heavy alcohol use, family history of high blood pressure, high salt intake
and aging. A sedentary lifestyle, stress, low potassium intake, low calcium intake
and resistance to insulin may also cause your blood pressure to rise.
Hypertension is treated with regular aerobic exercise, weight reduction (if overweight), salt restriction and medications.
Heart attacks result from blood vessel disease in the heart. Coronary heart disease
(CHD), sometimes referred to as coronary artery disease (CAD), is a more general
name for heart attack (and angina).
A heart attack (or myocardial infarction) occurs when the blood supply to part of
the heart muscle itself (the myocardium) is severely reduced or stopped. This occurs
when one of the coronary arteries (the arteries that supply blood to the heart muscle)
is blocked by an obstruction, often plaque due to atherosclerosis. A heart attack
also can be caused by a blood clot lodged in a coronary artery. Such an event is
sometimes called a coronary thrombosis or coronary occlusion.
If the blood supply is cut off drastically or for a long time, muscle cells suffer
irreversible injury and die. Disability or death can result, depending on how much
heart muscle is damaged.
Sometimes a coronary artery temporarily contracts or goes into spasm. When this
happens, the artery narrows and blood flow to part of the heart muscle decreases
or even stops. What causes a spasm is unclear, but it can occur in normal blood
vessels as well as vessels partially blocked by atherosclerosis. If a spasm is severe,
a heart attack may result.
An arrhythmia occurs when the heart's regular rhythm changes - it may speed up or
slow down, and it may beat irregularly. In North America, about 5 million people
get arrhythmias, most over the age of 50.
Some also have heart disease, but many don't. In the vast majority of cases, the
arrhythmia by itself isn't life threatening, but may predispose someone to a number
of problems such as a stroke. There are many different types of arrhythmias and
their significance and consequences are varied.
The normal beating of the heart is controlled by electrical signals sent from a
particular segment of heart muscle tissue called the sinus node. This natural pacemaker
is located near the top of the right atrium. The heart is divided into four chambers:
two atria on top, and two ventricles underneath. The job of the atria is to fill
the ventricles with blood, which then do the heavy work of pumping it through the
rest of the body. In a normal heartbeat, an electrical pulse travels down the muscle
tissue, activating the ventricles a split-second after the atria. In arrhythmias,
there's a problem with this signal. There are many different kinds of arrhythmias,
but those that affect the ventricles are generally more serious than arrhythmias
of the atria.
High blood cholesterol is one of the four major risk factors for coronary heart
disease (cigarette smoking, high blood pressure, and sedentary lifestyle are the
High blood cholesterol occurs when there is too much cholesterol in your blood.
Your cholesterol level is determined partly by your genetic makeup and the saturated
fat and cholesterol in the foods you eat. Even if you didn't eat any cholesterol,
your body would manufacture enough for its needs.
The risk of developing coronary heart disease increases as your blood cholesterol
level rises. This is why it is so important that everyone over age 20 should have
their blood cholesterol level measured every five years.
The following breakdown can help you see how the results of your total blood cholesterol tests relate to your risk of developing coronary heart disease:
- Desirable: Less than 200 mg/dl
- Borderline High: 200 to 239 mg/dl
- High: 240 mg/dl and above
If your blood cholesterol is 240 mg/dl or greater, you have more than twice the
risk of someone whose cholesterol is 200 mg/dl, and you need medical attention and
Lowering your total cholesterol levels will reduce your chance of suffering a heart
attack or stroke, or dying of heart disease. If you have had a heart attack, keeping
your cholesterol under control is especially important.
Managing your diet and weight, and increasing your physical activity can help bring
low-density lipoprotein (LDL) cholesterol down to normal levels.
Heart failure affects nearly 5 million Americans, including approximately 550,000
newly diagnosed heart failure patients each year. It is the leading cause of hospitalization
in people older than 65.
Heart failure does not mean the heart has stopped working; rather, it means that
the heart's pumping power is weaker than normal. With heart failure, blood moves
through the heart and body at a slower rate, and pressure in the heart increases.
As a result, the heart cannot pump enough oxygen and nutrients to meet the body's
The chambers of the heart respond by stretching to hold more blood to pump through
the body or by becoming more stiff and thickened. This helps to keep the blood moving
for a short while, but in time, the heart muscle walls weaken and are unable to
pump as strongly. As a result, the kidneys often respond by causing the body to
retain water and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs
or other organs, the body becomes congested, a condition called congestive heart
Heart failure is caused by many conditions that damage the heart muscle, including
coronary artery disease, heart attack, cardiomyopathy and conditions that overwork
the heart, such as valve disease, kidney disease and congenital heart defects.
Most strokes are caused by a blockage in an artery that carries blood to the brain.
Within minutes, brain cells begin to die. This can cause that part of the brain
to be damaged, and you may lose control of a function that is controlled by that
part of the brain. For example, you could lose the use of an arm or leg, or the
ability to speak. The damage can be temporary or permanent, partial or complete.
Doctors have found that if you get treatment right away after symptoms start, there
is a better chance of getting the blood moving to your brain, and less chance of
There are two kinds of stroke. The more common kind, called ischemic stroke, is
caused by a blood clot that blocks or plugs a blood vessel in the brain. The other
kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds
into the brain.
"Mini-strokes," or transient ischemic attacks (TIAs), occur when the blood supply
to the brain is briefly interrupted.
- Sudden numbness or weakness of the face, arm or leg (especially on one side of the
- Sudden confusion, trouble speaking or understanding speech
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
- If you have any of these symptoms, you must get to a hospital quickly to begin treatment.
- Arteriosclerosis (hardening of the arteries)
- Uncontrolled diabetes
- High blood pressure
- High cholesterol level
- Previous transient ischemic attack (TIA)
- Heart disease
- Carotid artery disease (the artery that carries blood to your brain)
- Control your blood pressure
- Avoid foods that are high in fat and cholesterol, and eat less sodium to lower your
cholesterol and blood pressure
- If you have diabetes, keep your blood sugar level under control
- Limit how much alcohol you drink.
- Quit smoking. If you don't smoke, don't start.