What is the pathogenesis of heart disease, especially rheumatic heart disease?
What is the pathogenesis of heart disease, especially rheumatic heart disease?
Introduction
Despite the easy access to information about heart diseases and various conditions, most people are unaware of factual information. This causes confusion about recognizing symptoms, or choosing the best recommended approach to treatment or management of conditions. Here is a good look at the pathogenesis of heart disease and the manner in which certain conditions can be proactively prevented.
What is the main cause of ischemic heart disease?
Atherosclerosis is considered as one of the main reasons for ischemic heart disease. Atherosclerosis also happens to be one of the main contributors when studying the pathogenesis of heart disease. This refers to a condition where fatty deposits, accumulate on the walls of the coronary arteries. This buildup of plaque narrows the arteries and hardens it, significantly affecting flow of blood to the heart muscle. Here is an outline of the condition and related information.
- Atherosclerosis – the restricted flow of blood through the coronary arteries, decreases the oxygen and nutrients delivered to the heart muscle.
- Coronary Artery Disease – causes symptoms pain in the chest, known as angina and, causes heart attacks when atherosclerosis is severe.
- Risk factors – are primarily due to one of the following conditions or a combination of many conditions. For instance, high blood pressure causes damage to the arterial walls, increasing risk of plaque buildup. High cholesterol levels increase risk of plaque buildup, while smoking causes considerable damage to the blood vessels which result in buildup of plaques.
Other risk factors include high blood sugar levels that aggravate or speed up atherosclerosis. Obesity, physical inactivity are other contributors, through increased risk of high blood pressure, high cholesterol, and diabetes.
People with a family history of heart disease are also at increased risk due to possible inherited conditions. The best way to learn of this risk of inherited conditions or congenital conditions is through advanced genetic testing facilities that are presently available in Tamil Nadu. Simple tests based on saliva and blood samples offer detailed information about possible future risk of heart disease due to genetic reasons.
Is it true that rheumatic heart disease is caused by rheumatic fever?
Yes, rheumatic heart disease is linked to rheumatic fever, the inflammatory disease that develops after strep throat infections. There is a possible and clear pathway from rheumatic fever to RHD, and is part of the study results of pathogenesis of heart disease. It typically begins with an initial infection of strep throat or scarlet fever. When the condition is improperly treated, or left untreated, it may trigger an autoimmune response in the body, causing rheumatic fever. The person may experience symptoms such as fever, pain in the joints, outbreak of rashes on the skin, and inflammation of the heart.
Following this, the body’s immune system erroneously attacks its own tissues, especially the heart valves. When there are multiple episodes of rheumatic fever, this causes chronic inflammation and scarring of the heart valves. This brings about long-term damage and dysfunction of the heart valves and results in narrowing of the valve or leakage from the valve. This triggers symptoms such as heart murmurs, difficulty breathing, and possible heart failure.
Is rheumatic heart disease autoimmune in nature?
Yes, rheumatic heart disease is considered as autoimmune in nature. As outlined above about the pathogenesis of heart disease, an autoimmune response is set off, due to a cross-reaction with the streptococcal bacteria. This response impacts the heart valves, mistakenly identifying it as foreign bodies.
Is it true that coronary heart disease is due to high cholesterol?
Various reasons cause or contribute to coronary heart disease, and high cholesterol levels is a significant risk factor, as seen in pathogenesis of heart disease. Here is a detailed look at the progression from high cholesterol levels to development of CHD:
- Atherosclerosis – A person with high levels of cholesterol, especially low-density lipoprotein will end up with buildup of fatty deposits on the walls of coronary arteries. This causes narrowing of the arteries and hardening, which greatly decreases the flow of blood to the heart muscle. The functioning of the heart depends to a great extent on the oxygen and nutrient rich blood supply. When this is reduced, the heart’s functioning is considerably affected.
LDL cholesterol carries cholesterol to tissues, and the excess LDL cholesterol is deposited in the arteries, causing plaque formation. Gradually, this plaque accumulates, narrowing the arteries, impacting flow of blood and oxygen.
When flow of blood is restricted, it causes chest pain, also known as angina, difficulty breathing, and other symptoms. When the blockage is severe it may result in a heart attack. This occurs when the plaque ruptures, resulting in formation of blood clots that completely block the artery, resulting in a heart attack.
- Different types of cholesterol
- Low-density lipoprotein, also known as LDL is the “bad” cholesterol, and high levels of LDL result in plaque buildup.
- High-density lipoprotein, also known as HDL is the “good” cholesterol, as HDL removes LDL cholesterol from the blood. The LDL is moved through the blood stream to the liver, from where it is flushed out of the body.
Quick summary of rheumatic heart disease
As seen earlier, rheumatic heart disease is caused by rheumatic fever, owing to untreated strep throat infection or scarlet fever. As part of information about pathogenesis of heart disease, RHD refers to commonly affected vales like the mitral and aortic valves which suffer the most damage. The damage is typically valve stenosis or regurgitation affecting blood flow and causing the following symptoms.
- Pain in the chest.
- Difficulty breathing.
- Overall tiredness.
- Swelling in the feet.
- Heart murmurs.
- Pain in the joints.
- Outbreak of rashes.
- Fever.
Diagnosis is usually on the basis of medical history, physical examination, and tests such as echocardiography and imaging tests. The condition can be managed through medicines, that are intended to control inflammation and prevent further damage. Wherever necessary, surgical intervention may be undertaken, such as valve repair or valve replacement.
An effective method of treatment is timely management of strep throat infection using antibiotics. RHD belongs to the category of chronic conditions as it is known to cause long-term damage to heart valves. This may necessitate continuous management and monitoring to avoid complications.
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Education: Bachelor of Pharmacy (B.Pharm) from the Tata Institute of Social Sciences (TISS), Mumbai Experience: Agarwal is a seasoned pharmacist with over 7 years of experience in the pharmaceutical field. She has worked in various settings, including hospital pharmacies and community clinics, where she has excelled in medication management, patient counseling, and clinical support. Agarwal is known for her expertise in drug therapy optimization and patient safety. In addition to her practical experience, she contributes to health journalism, focusing on pharmaceutical advancements and health policy, and is involved in research projects aimed at improving medication practices and health outcomes. is known for her expertise in drug therapy optimization and patient safety. In addition to her practical experience, she contributes to health journalism, focusing on pharmaceutical advancements and health policy, and is involved in research projects aimed at improving medication practices and health outcomes.