Heart Health Alert: Shortness of Breath and Fatigue

Heart disease is a leading cause of death and disability worldwide. It can affect anyone, regardless of age, gender, or lifestyle. However, some people may have a higher risk of developing heart disease due to factors such as high blood pressure, high cholesterol, high blood sugar, smoking, obesity, or family history. These factors can damage the heart and blood vessels, leading to symptoms such as chest pain, shortness of breath, palpitations, fatigue, or dizziness.

In this article, you will learn about:

  • Heart Disease and Its Close Connection to the Three Highs
  • Three Common Factors Leading to Chest Pain, Shortness of Breath, and Palpitations
  • How is Heart Disease Diagnosed? What are the Common Examination Procedures?
    • Resting Electrocardiogram (ECG)
    • X-ray Examination
    • Exercise Electrocardiogram
    • 4-Hour Holter Monitoring
    • Echocardiography
    • Myocardial Perfusion Imaging
    • Coronary CT Angiography
    • Cardiac Catheterization
  • Frequently Asked Questions
    • What is the difference between angina and a heart attack?
    • How can I lower my blood pressure, cholesterol, and blood sugar levels?
    • What are some healthy foods for the heart?

Table of Contents

Heart Disease and Its Close Connection to the Three Highs

Many seniors suffer from chronic conditions, and chronic heart disease is closely related to high blood pressure, high cholesterol, and high blood sugar. Monitoring one’s health becomes a common concern for everyone in an aging society. According to the World Health Organization, cardiovascular diseases are the leading cause of death globally, accounting for nearly 18 million deaths in 2019. Among the risk factors for developing heart disease, the three highs are the most prevalent and modifiable. High blood pressure, also known as hypertension, can damage the walls of the arteries and increase the workload of the heart. High cholesterol, also known as hyperlipidemia, can cause fatty deposits to build up in the arteries and reduce blood flow to the heart. High blood sugar, also known as diabetes, can impair the function of the blood vessels and the nerves that control the heart. These three conditions can interact and worsen each other, leading to serious complications such as stroke, heart failure, and kidney disease. Therefore, it is important to keep the three highs under control and prevent or delay the onset of heart disease.

Three Common Factors Leading to Chest Pain, Shortness of Breath, and Palpitations:

Chest pain, shortness of breath, and palpitations are some of the common symptoms of heart disease. They can indicate different types of problems affecting the heart and its function. Here are three common factors that can cause these symptoms:

  • Issues with inadequate oxygen supply to the heart: The heart is a muscle that needs a constant supply of oxygen-rich blood to function properly. When the oxygen supply is reduced or interrupted, the heart may not be able to pump enough blood to the rest of the body. This can cause irregular heart rhythms, also known as arrhythmias, which can result in insufficient oxygen delivery to the organs and tissues. Some of the causes of inadequate oxygen supply to the heart include coronary artery disease, anemia, lung disease, and sleep apnea. Some of the signs of arrhythmias include chest pain, shortness of breath, dizziness, fainting, and palpitations.
  • Narrowing of the coronary arteries: The coronary arteries are the blood vessels that supply oxygen and nutrients to the heart muscle. When these arteries become narrowed or blocked by plaque, a condition known as atherosclerosis, the blood flow to the heart can be reduced or stopped. This can cause angina, a type of chest pain that occurs when the heart does not get enough oxygen. Angina can be triggered by physical exertion, emotional stress, cold weather, or eating a large meal. If the plaque ruptures and forms a blood clot, it can completely block the artery and cause a heart attack, also known as acute myocardial infarction. A heart attack is a medical emergency that can damage or destroy part of the heart muscle. Some of the signs of a heart attack include chest pain, shortness of breath, nausea, vomiting, sweating, and pain in the arm, jaw, or back.
  • Abnormal heart valve conditions: The heart has four valves that open and close to regulate the flow of blood through the chambers of the heart. When these valves become damaged or diseased, they can affect the efficiency and function of the heart. Some of the common heart valve conditions include stenosis, which is the narrowing of the valve opening that restricts blood flow; regurgitation, which is the leakage of blood back through the valve that causes the heart to work harder; and prolapse, which is the bulging of the valve leaflets that prevents the valve from closing properly. Some of the causes of heart valve conditions include congenital defects, rheumatic fever, infections, aging, and other heart diseases. Some of the signs of heart valve conditions include chest pain, shortness of breath, fatigue, swelling, and palpitations.

How is heart disease diagnosed? What are the common examination procedures?

Heart disease is a broad term that covers various conditions that affect the heart and blood vessels, such as coronary artery disease, arrhythmia, heart valve disease, and heart failure. To diagnose heart disease, your doctor will perform a series of tests and evaluations based on your symptoms, risk factors, and medical history. Some of the common examination procedures for heart disease are:

Resting Electrocardiogram (ECG):

A resting ECG is a quick and painless test that records the electrical signals in the heart. It can show if the heart is beating too fast or too slow, if there is any damage to the heart muscle or valves, or if there is any blockage or narrowing of the coronary arteries. A resting ECG is usually the first test done for people who have chest pain, shortness of breath, palpitations, or other signs of heart problems. However, a normal resting ECG does not rule out heart disease, as some conditions may not show up at rest.

X-ray Examination:

An X-ray examination is a simple and safe test that uses radiation to create images of the chest and lungs. It can help detect signs of heart enlargement, aortic arch widening, pulmonary edema, or other lung diseases that may affect the heart function. An X-ray examination is often done for people who have shortness of breath, cough, or fever, as well as for people who have a history of heart disease or risk factors such as high blood pressure, diabetes, or smoking.

Exercise Electrocardiogram:

An exercise ECG is a test that monitors the heart’s electrical activity during physical activity, such as walking on a treadmill or riding a stationary bike. It can show how the heart responds to stress and whether it gets enough oxygen and blood flow during exercise. An exercise ECG can help diagnose coronary artery disease, which is the most common cause of heart disease and heart attacks. It can also help assess the severity of the disease and the effectiveness of treatment. An exercise ECG is usually done for people who have chest pain or other symptoms that worsen with exertion, or for people who have a normal resting ECG but are at high risk of heart disease.

4-Hour Holter Monitoring: A Useful Tool for Detecting Heart Rhythm Disorders

Primarily used to detect arrhythmias. Arrhythmias are mostly related to heart valve problems. If individuals frequently feel sharp pain during heart contractions or experience palpitations, this test may be scheduled.

Echocardiography:

Mainly used to observe heart structure, contraction function, valve conditions, etc. Echocardiography is a non-invasive test that uses sound waves to create images of the heart. The sound waves are emitted by a device called a transducer, which is placed on the chest or inserted into the esophagus. The sound waves bounce off the heart and are captured by the transducer, creating a moving picture of the heart on a monitor. Echocardiography can show the size, shape, and movement of the heart chambers and valves, as well as the blood flow through the heart and the major vessels. Abnormalities, such as mitral valve prolapse, aortic stenosis, or coronary artery disease, can be seen through echocardiography, providing clues about heart function and possible causes of symptoms. Echocardiography can also measure the ejection fraction, which is the percentage of blood pumped out of the heart with each beat. A normal ejection fraction is between 50% and 70%, and a lower value may indicate heart failure or cardiomyopathy.

Myocardial Perfusion Imaging:

If an elderly person is unable to undergo exercise ECG testing, a myocardial perfusion scan may be arranged. This test can assess the blood flow to the heart muscle and detect any areas of reduced or blocked blood supply, which may indicate coronary artery disease or a previous heart attack. By injecting a small amount of radioactive isotopes and then imaging blood flow in the heart, this test can observe if there are issues such as inadequate blood supply or ischemia. The radioactive isotopes are taken up by the heart cells in proportion to the blood flow, and they emit gamma rays that are detected by a special camera. The images are then processed by a computer to create a map of the heart, showing the areas of normal, reduced, or absent blood flow. The test can be done at rest or after exercise or medication to stimulate the heart, and the results can help the doctor determine the best treatment options for the patient.

Coronary CT Angiography:

Coronary CT angiography is a non-invasive imaging technique that uses a special X-ray machine called a multi-detector CT scanner to capture detailed pictures of the heart and its blood vessels. The scanner is synchronized with an electrocardiogram, which records the electrical activity of the heart, to ensure that the images are clear and accurate. By injecting a contrast dye into the bloodstream, the scanner can highlight any narrow or blocked areas in the coronary arteries, which supply oxygen-rich blood to the heart muscle. Coronary CT angiography can also show the thickness and calcification of the artery walls, which are indicators of atherosclerosis, or plaque buildup. Coronary CT angiography is a useful test for diagnosing coronary artery disease, especially in patients who have intermediate risk factors or inconclusive results from other tests. However, this test is usually not covered by the national health insurance and requires self-payment. The cost may vary depending on the hospital and the type of scanner used.

Cardiac Catheterization:

Cardiac catheterization is an invasive procedure that allows doctors to directly examine the heart and its blood vessels. It involves inserting a thin, flexible tube called a catheter into a large artery or vein, usually in the groin, arm, or neck, and guiding it to the heart using X-ray images. Once the catheter reaches the heart, different tests can be performed, such as measuring the blood pressure and oxygen levels in the heart chambers, injecting a contrast dye to visualize the coronary arteries and the heart valves, and taking a small sample of heart tissue for biopsy. Cardiac catheterization can also be used to treat some heart conditions, such as opening up a narrowed or blocked coronary artery with a balloon or a stent, repairing a defective heart valve, or closing a hole in the heart wall. Cardiac catheterization is usually reserved for patients who have severe or unstable symptoms that cannot be relieved by medication, or who have a high likelihood of having significant coronary artery disease based on other tests. Cardiac catheterization is a relatively safe procedure, but it carries some risks, such as bleeding, infection, allergic reaction, heart attack, stroke, or kidney damage. Therefore, it should only be performed by experienced cardiologists in well-equipped facilities.

Frequently Asked Questions

What is the difference between angina and a heart attack?

Angina and heart attack are both conditions that affect the blood flow to the heart muscle, but they have different causes and symptoms. Angina is a type of chest pain or discomfort that occurs when the heart does not get enough oxygen-rich blood. It is usually triggered by physical or emotional stress, and it often goes away with rest or medication. Angina is not a heart attack, but it can be a warning sign of an underlying heart problem that needs attention. A heart attack, on the other hand, is a medical emergency that occurs when a blood clot blocks one of the coronary arteries that supply blood to the heart. This causes permanent damage to the heart muscle, and can be fatal if not treated quickly. The symptoms of a heart attack may include severe chest pain, shortness of breath, nausea, sweating, and weakness. Unlike angina, the pain of a heart attack does not go away with rest or medication, and it may last for more than 15 minutes. If you suspect that you or someone else is having a heart attack, call 911 or your local emergency number immediately.

How can I lower my blood pressure, cholesterol, and blood sugar levels?

High blood pressure, high cholesterol, and high blood sugar are common risk factors for heart disease and stroke. They can damage the blood vessels and the heart, and increase the chances of developing atherosclerosis, which is the buildup of fatty deposits in the arteries. To lower your blood pressure, cholesterol, and blood sugar levels, you need to make some lifestyle changes, such as:

  • Eating a healthy diet that is low in salt, saturated fat, trans fat, and added sugars, and high in fruits, vegetables, whole grains, lean protein, and healthy fats.
  • Exercising regularly, at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week, or a combination of both.
  • Maintaining a healthy weight, or losing weight if you are overweight or obese.
  • Quitting smoking, or avoiding exposure to secondhand smoke.
  • Limiting alcohol intake, no more than one drink per day for women and two drinks per day for men.
  • Managing stress, by practicing relaxation techniques, such as deep breathing, meditation, yoga, or tai chi.
  • Taking medications as prescribed by your doctor, if lifestyle changes are not enough to control your blood pressure, cholesterol, or blood sugar levels.

It is important to monitor your blood pressure, cholesterol, and blood sugar levels regularly, and to consult your doctor if you have any questions or concerns.

What are some healthy foods for the heart?

Some foods that are good for your heart include:

Food Benefits
Oatmeal It contains soluble fiber, which can lower cholesterol and prevent plaque buildup in the arteries.
Salmon It is rich in omega-3 fatty acids, which can lower triglycerides, reduce inflammation, and improve blood vessel function.
Berries They are packed with antioxidants, which can protect the cells from oxidative stress and prevent damage to the blood vessels and the heart.
Nuts They are a good source of unsaturated fats, protein, fiber, and minerals, which can lower cholesterol, blood pressure, and blood sugar levels.
Dark chocolate It contains flavonoids, which can improve blood flow, lower blood pressure, and prevent blood clots.

However, moderation is key, as eating too much of any food can have negative effects on your health. Aim for a balanced and varied diet that meets your nutritional needs and preferences.

References

  • American Heart Association. (2020). Angina (Chest Pain). 
  • American Heart Association. (2020). How to Help Prevent Heart Disease At Any Age. 
  • Harvard Health Publishing. (2019). 11 foods that lower cholesterol. 
  • Mayo Clinic. (2019). Heart attack. 
  • WebMD. (2020). 15 Foods That Are Good for Your Heart. 

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