Cardiovascular disease is a general term for any condition that affects the heart or blood vessels. Common types of cardiovascular disease include: Coronary artery disease – narrowing or blockage of the arteries that supply the heart, which can lead to chest pain or heart attack. Heart failure – when the heart can’t pump blood effectively. Arrhythmias – abnormal heart rhythms. Stroke – damage to the brain caused by blocked or burst blood vessels. Peripheral artery disease – narrowing of arteries in the legs or arms. Heart valve problems – issues with valves that control blood flow through the heart. Risk factors: High blood pressure High cholesterol Smoking Diabetes Obesity Family history of heart disease Are older (your risk increases as you get older)

Heart failure refers to the heart failing to pump efficiently. There are many diseases that cause this including cardiovascular disease, high blood pressure, viral infections, alcohol, and diseases affecting the valves of the heart. When the heart is inefficient a number of symptoms occur depending on the cause and severity of the condition. The main symptoms are tiredness, breathlessness on exertion or lying flat, and ankle swelling. Doctors often refer to oedema, which means fluid retention usually in your feet or lungs as a result of the heart not pumping efficiently. Tests looking for possible causes of heart failure include: Chest x-ray, Electrocardiogram (ECG), Echocardiogram (Cardiac ultrasound), Angiogram. You are likely to be given several medications over time, started and monitored by your cardiologist and GP. These include medication to control the amount of fluid that builds up (diuretics), medication to protect your heart and slow it down as well as to thin your blood. You will often be referred to a dietitian or given advice about restricting the amount of fluid and salt you take as this can contribute to symptoms.

Heart rhythm refers to the electrical source that is driving the heart rate and whether or not it is regular or irregular. Heart rhythm can be affected by a number of conditions. Some common terms Sinus rhythm is the normal rhythm Arrhythmia means abnormal rhythm Fibrillation means irregular rhythm or quivering of one part of the heart Bradycardia means slow heart rate Tachycardia means fast heart rate Paroxysmal means the arrhythmia comes and goes Tachycardia The most common form of this is atrial fibrillation. This is where the heart rhythm is irregular and often too fast. Symptoms include fatigue, palpitations (where you are aware of your heart racing or pounding), dizziness and breathlessness. Other tachycardias include supraventricular tachycardia (SVT) or ventricular tachycardia (VT). These have similar symptoms as atrial fibrillation but can also cause you to lose consciousness (faint). Bradycardia The most common form of this is called heart block. This is because messages from the electrical generator of the heart don't get through efficiently to the rest of the heart and hence it goes very slowly or can pause. Symptoms of the heart going too slowly include feeling tired, breathless or fainting. Tests Tests to diagnose what sort of arrhythmia you have include an electrocardiogram (ECG) and an ambulatory ECG (Holter monitor or Event recorder). Treatment Most treatments for tachycardias consist of medication to stop the abnormal rhythm or make it slower if and when it occurs. Atrial fibrillation, if you have other problems, can increase your risk of stroke so blood-thinning medication is often used as well. If you have bradycardia, you may be referred to the surgeons for a pacemaker. This is a small operation where a battery powered device is placed under the skin with wires that lead to your heart and provide it with electrical stimulation to prevent it from going too slowly. You can't feel it doing this but will be aware of a small flat lump under your skin just below your collar bone.

Your heart consists of four chambers that receive and send blood to the lungs and body. Disorders affecting valves can either cause stenosis (a narrowing) or regurgitation (leakage after the valve has closed). Depending on what valve is involved and how severe the damage is it may result in symptoms of heart failure, as it makes the heart pump inefficiently. Suspicion of a heart valve problem is usually picked up by your doctor when they listen to your heart and hear a murmur. A murmur is heard with the stethoscope and is turbulence of blood flow that occurs through a narrowed or leaky valve. Not all heart murmurs mean serious problems but are best investigated further. The echocardiogram is the main test to diagnose what valve is involved and how severe it is. Treatment depends on the type and severity of the valve lesion. You may simply be monitored over years to see if anything changes. Some conditions require medication to thin the blood or treat any complicating heart problems. You may be referred to a heart surgeon for consideration of a valve replacement or dilatation of a narrowed valve.

This is a test used to measure your blood pressure over a 24-hour period while you go about your normal daily activities and during sleep. You wear a small portable device connected to a cuff on your arm, that provides many readings throughout the day and night.

Angina is a pain, usually in the chest, that occurs when the arteries that supply blood to the heart become narrowed and are unable to keep up with the heart muscles’ demand for oxygen and energy. Typical angina chest pain is a heavy sensation in the chest associated with shortness of breath. It sometimes radiates to the arms and can make you feel like being sick, dizzy or sweaty. Angina is a warning sign of underlying heart disease and means there may be a higher risk of heart attack or stroke.

This is a condition where the arteries (the blood vessels that carry oxygen-rich blood from the heart to the rest of the body) become narrowed due to a build-up of fatty deposits, cholesterol, calcium, and other substances. This build-up is called plaque. Over time, plaque can cause the arteries to harden which can lead to heart attacks, stroke and other complications.

A cardiac MRI is a special scan that uses large magnets and radio waves to create detailed pictures of the heart. It shows both the structure and function of the heart, including the heart muscle, the chambers and valves and blood flow through the heart and major vessels. It can be particularly useful in patients who have had prior heart attacks, heart muscle disease, valvular diseases and congenital abnormalities.

Cardiac nuclear testing is a type of heart scan in which a small amount of radioactive tracer is injected into a vein and a special camera used to see how well blood is flowing to your heart muscle. This test will show any areas of the heart muscle with reduced blood flow or that are scarred from a past heart attack, and how well the heart pumps blood.

This is a special type of CT (computed tomography) scan that takes detailed 3D pictures of the coronary arteries — the blood vessels that supply the heart. It shows whether they are narrowed or blocked. In the procedure, a contrast dye is injected into a vein to make the arteries visible. You then lie on a table that slides into the CT scanner, which takes rapid X-ray images of your heart.

Percutaneous coronary intervention (PCI), or angioplasty, is a procedure designed to reduce or remove blockages in the coronary arteries (arteries supplying the heart with oxygen). The purpose of a PCI is to restore blood flow to the coronary arteries and ensure the heart is adequately supplied with oxygen. This may reduce or eliminate angina and can restore blood flow in the event of a heart attack. During this procedure, a specially designed catheter with a small balloon tip is guided to the point of narrowing in the artery. Once in place, the balloon is inflated to open the artery and stretch the artery to increase blood flow to the heart. A stent, a small stainless steel mesh tube, can also be inserted at this time to function as scaffolding and give a coronary artery support. A balloon catheter is used to insert the stent into the narrowed coronary artery. Once in place, the balloon is inflated and the stent expands to the size of the artery and holds it open. The balloon is then deflated and removed, and the stent stays in place permanently.

This refers to narrowing of the arteries that supply blood to the heart muscle, usually due to atherosclerosis (plaque build-up). Narrowed arteries are unable to keep up with the demand needed to supply the heart muscle with blood, which can cause damage to the muscle if prolonged. The most common symptom of this problem is chest pain that occurs when you exert yourself (angina). Typical angina chest pain is a heavy sensation in your chest associated with shortness of breath. It sometimes radiates to your arms and can make you feel like being sick, dizzy or sweaty. Treatment consists of medication to protect the heart and its blood vessels. You will be given advice on diet changes that can protect the heart as well as stop smoking programmes. Depending on test results you may have procedures offered to surgically correct the narrowed blood vessels.

Echocardiography (or cardiac ultrasound) is a test that uses high frequency sound waves to generate pictures of your heart. During the test, you generally lie on your back, gel is applied to your skin and a technician then moves the small, plastic transducer over your chest. The test is painless and can take from 10 minutes to an hour. The machine then develops images of your heart which are seen on a monitor. This is referred to as an echocardiogram. Echocardiography can help in the diagnosis of many heart problems including cardiovascular disease, previous heart attacks, valve disorders, weakened heart muscle, holes between heart chambers, fluid around the heart (pericardial effusion). If doctors are looking for evidence of coronary artery disease, they may perform variations of this test which include: Exercise echocardiography - compares how your heart works when stressed by exercise versus when it is at rest. The ultrasound is conducted before you exercise and immediately after you stop. Either a stationary bicycle or standard treadmill is used. Dobutamine stress echocardiography - if you’re unable to exercise for the above test, you might be given medication to simulate the effects of exercise. During this test, an echocardiogram initially is performed when you’re at rest. Then dobutamine is given to you via a needle into a vein in your arm. Its effect is to make your heart work harder and faster just like with exercise. After it has taken effect, the echocardiogram is repeated. The effect wears off very quickly.

An ECG is a recording of your heart's electrical activity. Electrode patches are attached to your skin to measure the electrical impulses given off by your heart. The result is a trace that can be read by a doctor. It can give information of previous heart attacks or problems with the heart rhythm. Ambulatory ECG - this can be performed with a Holter monitor which monitors your heart for rhythm abnormalities during normal activity for an uninterrupted 24-hour period. During the test, electrodes attached to your chest are connected to a portable recorder - about the size of a paperback book - that's attached to your belt or hung from a shoulder strap. Another form of ambulatory ECG test is an Event recorder which covers 1-2 weeks. You wear a monitor (much smaller than a Holter monitor) and if you have any symptoms, such as dizziness, you press a button on a recording device which saves the recording of your heart rhythm made in the minutes leading up to and during your symptoms. Because you can wear this for a longer period of time it has a higher rate of catching your abnormal rhythm.

A Holter monitor monitors your heart for rhythm abnormalities during normal activity for an uninterrupted 24-hour period. During the test, electrodes attached to your chest are connected to a portable recorder - about the size of a paperback book - that's attached to your belt or hung from a shoulder strap.

An ECG done when you are resting may be normal even when you have cardiovascular disease. During an exercise ECG the heart is made to work harder so that if there is any narrowing of the blood vessels resulting in poor blood supply it is more likely to be picked up on the tracing as your heart goes faster. For this test you have to work harder which involves walking on a treadmill while your heart is monitored. The treadmill gets faster with time but you can stop at anytime. This test is supervised and interpreted by a doctor as you go. This test is used to see if you have any evidence of cardiovascular disease and can give the doctor some idea as to how severe it might be so as to direct further tests and possible treatment.

This is a special CT scan that measures the amount of calcium in the walls of the coronary arteries (the arteries that supply blood to the heart). Calcium in the arteries is a sign of atherosclerosis (plaque build-up), which can increase the risk of heart attacks. The scan calculates a calcium score, with higher scores usually indicating a higher risk of heart attacks. It can be useful to assess the risk of heart disease in people who don’t have symptoms and to help decide whether preventative treatments are needed.

Cardioversion is a procedure used to restore a normal heart rhythm in people with certain types of abnormal heartbeats (arrhythmias), such as atrial fibrillation or atrial flutter. There are two main types: Electrical cardioversion in which a controlled electric shock is delivered through pads on the chest. Pharmacological (or chemical) cardioversion uses medications to try to return the heart to a normal rhythm.

Hypertension (or high blood pressure) is a common disorder in which the pressure of blood in the arteries is persistently raised. Hypertension is classified as either primary or secondary; in most cases it is primary which means there is no clear underlying medical cause whereas secondary hypertension is caused by other medical conditions that affect the heart, kidneys, arteries or endocrine system. If left untreated hypertension can increase the risk of stroke, heart failure, heart attack, kidney failure or vascular disease.