How is coronary heart disease diagnosed?

There are a number of ways to diagnose coronary heart disease. Your physician will probably use a number to make a definitive diagnosis.

A coronary angiogram uses a dye inserted into your arteries and an x-ray to see how the blood flows through your heart. The picture taken, the angiogram, will show any atherosclerosis.

Another test is an electrocardiogram.  This test records the electrical activity of your heart.  An electrocardiogram measures the rate and regularity of heartbeats, the size and position of the heart chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart. It is a non-invasive procedure.

  What is the connection between high blood pressure (hypertension) and heart disease?

Blood moving through your arteries pushes against the arterial walls; this force is measured as blood pressure.

High blood pressure (hypertension) occurs when very small arteries (arterioles) tighten.  Your heart has to work harder to pump blood through the smaller space and the pressure inside the vessels grows.  The constant excess pressure on the artery walls weakens them making them more susceptible to atherosclerosis.

  How do the symptoms of heart attack differ between men and women?

The symptoms of heart attack in a man are intense chest pain, pain in the left arm or jaw and difficulty breathing.

A woman may have some of the same symptoms, but her pain may be more diffuse, spreading to the shoulders, neck, arms, abdomen and even her back. A woman may experience pain more like indigestion. The pain may not be consistent. There may not be pain but unexplained anxiety, nausea, dizziness, palpitations and cold sweat. A woman’s heart attack may have been preceded by unexplained fatigue.

Women also tend to have more severe first heart attacks that more frequently lead to death, compared to men.

  How are smoking and heart disease linked?

Smoking damages the lining of blood vessels, increases fatty deposits in the arteries, increases blood clotting, adversely affects blood lipid levels, and promotes coronary artery spasm. Nicotine accelerates the heart rate and raises blood pressure.

  What symptoms suggest that I might be having a heart attack?

The major symptoms are chest discomfort, often a heavy feeling in the center of the chest, shortness of breath, nausea, sweating, dizziness and a feeling of impending doom. Many people, however, do not have typical symptoms. They may feel jaw discomfort, arm pain, severe weakness or worsening fatigue doing activities that previously were very easy to perform. If you experience any of these symptoms, get help quickly. Call 911 if these symptoms are sudden, recurrent, severe or persistent. Contact your doctor if you have brief symptoms, even if you feel better. Preventing a heart attack before it happens is far better than treating the consequences of heart damage.

  What are the risk factors of heart disease?

Some pre-existing personal conditions as well as certain lifestyle choices can contribute to your level of risk for heart disease. High blood pressure, high blood cholesterol, cigarette smoking, diabetes and obesity can all increase a person's risk of heart disease.

 Will my child be considered for a heart and/or lung transplant?

In a small number of children with severe heart problems, the doctors may discuss the possibility of a heart and/or lung transplant. There are many important aspects to the doctors' decision to recommend a transplant. This procedure cannot be guaranteed as a long-term cure. The family will require extensive counselling before the decision is made. The hospital has a transplant co-ordinator who works with the cardiologist and surgeon. Together they provide detailed information on the heart and/or lung transplant. The family will be provided with time for full discussion with the transplant team.

  Can there be complications from heart surgery?

Complications from surgery may arise, but with improvements in technology, in surgical procedures and with more surgery being performed at a younger age, the risk of complications is continually being reduced.

The possible complications are related to the specific type of surgery being performed and they vary widely depending on the nature of the problem which requires surgery.

Your child's cardiologist and cardiac surgeon will discuss this subject with you prior to surgery.

  How common are congenital heart problems?

Abnormalities of the heart are present in nearly 10 in every 1,000 babies born. Some of these are mild and cause no significant disturbance to heart function. In many cases, such minor problems need no treatment and do not affect the life or the health of the child. More serious abnormalities are present in about five of these ten individuals with congenital heart problems.

The total frequency of all birth defects affecting different parts of the body is quite high. Some abnormality occurs in about 25 in every 1,000 babies born. This, however, includes many minor abnormalities.