The heart is often considered the most important organ in the body. In Bermuda the Bermuda Heart Foundation and the Ministry of Health devote February to public awareness on the importance of maintaining a healthy heart. This week Body & Soul's Cathy Stovell, an anatomy and physiology student, explains in simple terms some of the most common heart conditions affecting Bermudians.

Coronary Artery Disease

When excessive amounts of fats are circulating in the blood, the arteries can accumulate them as deposits called plaques. Healthy arteries are smooth and elastic. Arteries with lots of plaque become rigid and their walls lose their smoothness. The plaque build-up is called atherosclerosis and causes vessels to narrow or become obstructed. Coronary artery disease results as atherosclerotic plaque fills the hollow of the arteries and obstructs blood flow to the heart. This results in reduced oxygen and nutrients to the heart tissue.

Angina pectoris

Angina pain is a term familiar to most of us although most of us have not experienced it. It's a term we hear often if we watch movies or TV. Certainly every hospital drama, soap opera and TV detective show has featured a character suffering an angina attack.

Angina is the pain felt in cardiac muscle. It happens when blood supply to heart muscle is reduced. The pain is temporary and if blood flow is restored, little permanent change or damage results.

In most cases, angina pectoris results from blockages or restrictions in the arteries bringing blood to the heart. These arteries may be narrowed due to cholesterol build-up on their inner walls and may also be hardened. The reduced blood flow means less oxygen gets to heart muscle. The heart will try to compensate for a while but this causes a build-up of lactic acid in cardiac muscle. Pain receptors are stimulated by the lactic acid causing angina pain.

Angina is often associated with exercise. This is because during exercise the increased pumping activity of the heart requires more oxygen, and the narrowed blood vessels cannot supply it.

Angina pectoris is characterised by deep middle-chest pain, often described as heaviness, pressure or moderately severe pain. It is often mistaken for indigestion and may radiate to the neck, lower jaw, left arm and left shoulder.

Myocardial Infarction

Literally translated this means death of cardiac muscle — death of heart muscle. It happens when the heart or a portion of the heart, has been deprived of oxygen for a prolonged period. Although each case is unique, typically if blood supply can resume within 20 minutes, no permanent damage to the cells of the heart will occur. If, however, the lack of oxygen lasts longer, cell death results.

The most common cause of myocardial infarction is a blockage in an artery servicing the heart. Because the artery is blocked oxygen is unable to reach the heart and cells die. A blood clot usually forms the blockage in the narrowed arteries of people who suffer atherosclerosis.

Congestive Heart failure

Congestive heart failure is the mechanical inability of the heart to pump blood effectively. The result is a decrease in blood circulation, which forces blood to back-up and oxygen supply to decrease in muscle and lung tissues. High blood pressure, advanced age, malnutrition, chronic infections, toxins and severe anaemia are some of the common causes of heart failure.

Sources: Anatomy & Physiology Seeley, Stevens, Tate 7th Edition Disease & Disorders Lippincott Williams & Wilkins 2nd Edition