Cardiophaty: what is it? How do you deal with it?
The term “cardiophaty” refers to all diseases affecting the heart, altering normal blood circulation and causing – consequently – important repercussions on the health of the patient, who may suffer from limitations in carrying out daily activities
Pathologies that develop to the detriment of the heart valves (stenosis or insufficiency), congenital malformations and all pathologies that can alter the function of the heart pump belong to the category of heart disease.
Based on the origin, cardiophaties can be divided into congenital and acquired.
Congenital cardiophaty
Congenital heart disease is present in the patient from birth.
Some of these, of particular seriousness, require timely intervention to surgically correct the heart defects of the child within a few hours of his birth; others, on the other hand – most – only appear later and a good part of these resolve spontaneously, without medical intervention.
Congenital cardiophaties can be divided into heart disease with cyanosis and heart disease without cyanosis
Cardiophaties with cyanosis are the most serious and complex to treat, generally due to a derivation that circulates the blood in the arterial system without first passing it through the lungs, to be re-oxygenated as it should.
Cardiophaties with cyanosis include tetralogy of Fallot (blue disease), tricuspid ethresia, hypoplastic left heart syndrome, and Ebstein anomaly.
Heart disease without cyanosis is instead due to stenosis of the cardiac or aortic vessels or to impaired intracardiac communication.
Heart diseases without cyanosis include simple and localized coarctation of the aorta, vascular rings, aortic arch hypoplasia, congenital aortic stenosis, congenital mitral stenosis, and congenital mitral regurgitation.
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Acquired cardiophaty
Acquired cardiophaty is not present in the patient from birth but manifests itself throughout life.
Among these we find hypertensive heart disease caused by arterial hypertension; ischemic heart disease caused by ischemia due to stenosis of the coronary arteries; valvular heart disease caused by alterations of one of the heart valves; chronic cor pulmonale due to a pulmonary problem whose effects are also manifested at the cardiac level; myocardial disease and diseases of the pericardium, the membrane that surrounds the heart.
What are the causes of cardiophaty?
The causes depend on the type of heart disease the patient has.
If it is a congenital heart disease, its development is attributable to genetic causes or to the mother’s exposure – before or during the gestation period – to environmental factors adverse to the development of a healthy fetus: alcohol or drug abuse, drugs, smoking, radiation or infectious diseases contracted by the mother during the first months of pregnancy.
Another possible cause of the development of congenital heart disease is diabetes mellitus.
The causes of heart disease acquired during an individual’s life can be very varied.
Heart disease can be the result of viral or bacterial infections, rheumatic diseases, tumors, poisoning or severe kidney failure.
There are various risk factors that contribute to the development of heart disease, including obesity, diabetes, hypertension and an unhealthy lifestyle.
Cardiophaty: the symptoms
Congenital heart disease can manifest itself – as mentioned – with a cyanotic color of the skin of the newborn, a symptom of a lack of correct oxygenation of the blood.
On auscultation, heart disease can be identified by recognizing the characteristics of the heart murmur.
The murmur is not always an alarm bell, it could simply indicate a tiring adaptation of the newborn to extrauterine life.
Acquired heart disease, despite being different in typology and cause, has rather similar symptoms: dyspnoea, i.e. difficulty breathing both at rest and under exertion; air hunger; chest pain following an increased demand for blood by the body (physical activity, cold, etc …); swelling and water retention in the lower limbs; palpitations.
Diagnose cardiophaty
With regard to congenital heart disease in the neonatal age, the diagnosis will be made at birth.
If this presents obvious signs of cyanosis, cardiac auscultation will be performed immediately.
If the newborn does not have cyanosis, auscultation will still be performed, as part of the neonatal visit necessary to ascertain the good health of the newborn.
If a murmur is present, the doctor will detect it and perform the necessary diagnostic investigations.
The diagnosis of acquired heart disease occurs when an adult patient recognizes some of the symptoms described above and decides to entrust himself to the care of a cardiologist.
During the visit, the patient will be subjected to an accurate anamnesis, necessary to direct the professional’s diagnostic suspicion towards one heart disease rather than another.
The information that will be requested from you are: family medical history, personal medical history, habits, lifestyle and assessment of any risk factors.
Immediately afterwards, the cardiologist will perform a careful cardiac auscultation; in this way he will be able to detect any signs of heart disease.
Auscultation – however – is not sufficient for the formulation of a precise diagnosis: it will be necessary to perform some specific tests including the electrocardiogram to highlight abnormalities in the heart rhythm; echocardiography to identify alterations to the cardiac structure; cardiac ultrasound with Doppler for measuring the speed with which the blood flow passes through the valves of the heart, so as to highlight any stenosis or insufficiencies.
Only after having obtained the results of these specialist tests, the doctor will have all the elements necessary to provide a correct diagnosis, so as to be able to set the correct therapy to follow.
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Cardiophaty: the most appropriate therapy
As we have seen, the development of heart disease in adulthood largely depends on the presence of risk factors.
A correct therapeutic path will therefore begin with the elimination of bad habits that could cause the disease to arise and slow down or prevent its healing.
It is necessary to avoid smoking, excess alcohol, keep your weight under control, avoid a sedentary lifestyle, practice regular physical activity.
Depending on the severity of the clinical picture and the diagnosis made by the cardiologist, the correct therapy could be either pharmacological or – in the most serious cases – surgical.
Pharmacological therapy for the treatment of heart disease is aimed at treating the main triggering cause: hypertension.
Diuretic drugs, ACE inhibitors, beta-blockers and sartans are the most suitable for the treatment of hypertension as this determines, in the long run, important effects on the walls of the arteries.
In cases of more serious heart disease – or in cases of congenital heart disease that does not regress spontaneously – it may be necessary to resort to surgical therapy with angioplasty (with or without implantation of metal stents) or with the creation of aorto-coronary bypass .
Cardiophaty: how to prevent its formation?
If heart disease is congenital, as the word itself suggests, it comes from genetic causes and there is no way to prevent its occurrence.
The risk of developing acquired heart disease, on the other hand, can be reduced by leading a healthy, active life and following a controlled diet.
Avoid or limit preserved, pickled, canned foods, salty snacks, snacks, sausages, cheeses and sweets, preferring instead fresh foods, raw or cooked seasonal fruit and vegetables, fibers, whole grains, oily fish and steamed or grilled cooking .
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