Arrhythmogenic right ventricular dysplasia (ARVD) is a disease where fatty tissue replaces the heart muscle. This causes irregular heart rhythms which could lead to the heart becoming weaker over some time. Usually, this is a genetic disease that is diagnosed between 10 and 50 years of age. Generally, ARVD affects more of the right ventricle, while in some cases the left ventricle could also be impacted. As the condition progresses, the irregular heart rhythm causes blood to not be pumped to the rest of the body as needed. So, it causes fluid buildup in the lungs and/or soft tissues. The condition could eventually lead to heart failure too.

Symptoms of ARVD:

The symptoms of ARVD include, but are not limited to:

• Dizziness and/or fainting.
• Difficulty breathing.
• Persistent cough.
• Chest pain.
• Heart palpitations.
• Fatigue.
• Swelling in the legs and other areas.

Diagnosis:

Since this is a genetic condition family history plays a role in the diagnosis along with other clinical tests. While the condition is difficult to diagnose, the cardiologist would recommend the following tests to help with the diagnosis:

• Electrocardiogram (ECG), helps in analysing the heart rhythm. The doctor might recommend continuous portable ECG monitoring to understand the heart rhythm over a period. Signal-average ECG helps to assess the potential for irregular heart rhythms.
• Echocardiogram (Echo) helps to understand the heart motion and the blood flow in the heart
• Cardiac MRI helps to understand the heart anatomy better
• Angiography, with catheterization
• Heart biopsy if the cardiologist wants to examine the heart in more detail
• Electrophysiology studies are used to analyse the heart rhythm in more detail

Treatment:

Based on the severity of the disease, your doctor could prescribe any or a combination of the following medications:

• Beta-blockers to control your heartbeat and rhythms.
• Antiarrhythmic medicines to help prevent abnormal heart rhythms.
• Diuretics to reduce swelling or oedema.
• Medicines such as ACE inhibitors to reduce the workload of the heart.
• Blood thinners (anticoagulants) to prevent blood clots.

Several people with ARVD require an ICD – implantable cardioverter-defibrillator. This is an electronic device that is attached to the heart. It helps to treat life-threatening arrhythmias by using electric shocks. In a nutshell, this device prevents sudden death in people with ARVD.

People with ARVD are also recommended lifestyle changes to cope with and manage the condition.

• Avoid or limit heavy physical activity.
• You will need to get treated for other heart conditions.
• Quit smoking, and other substances. Reduce your alcohol and caffeine intake.
• Improve your diet, keep your weight under control.
• You will need to monitor your symptoms carefully.

Amyloidosis is a condition marked by protein (amyloid) build up in organs such as kidneys, heart, liver, spleen, stomach, nervous system, or intestines. When the buildup happens in the heart, it is referred to as cardiac amyloidosis.

Sometimes amyloidosis could develop into a form of cancer.

Symptoms of Amyloidosis:

Depending on the organ that is affected, the symptoms of amyloidosis could vary. Some of the symptoms are:

• Irregular heartbeat.
• Diarrhoea alternating with constipation.
• Difficulty swallowing.
• Dizziness or feeling faint.
• Loss of weight.
• Numbness or tingling in the hands or feet.
• Fatigue.
• Shortness of breath.
• Skin changes.
• Swelling of the ankles and legs.
• Weakness.
• Enlarged liver
• Enlarged tongue.

Cardiac amyloidosis could be a life-threatening condition. The first symptom of cardiac amyloidosis is difficulty in breathing, and shortness of breath even with mild activity. The protein buildup causes less blood to be pumped with every heartbeat. It could also cause irregular heartbeats or arrhythmia.

The cause of amyloidosis is not known. The disease often starts at the bone marrow – when the bone marrow produces antibodies that that body break down, it causes a buildup of amyloid. While the cause is unknown there are a few risk factors for amyloidosis, which include:

• Age above 50 years.
• Preexisting chronic infection or inflammatory disease.
• Family history of amyloidosis.
• Patient has multiple myeloma.
• Kidney disease requiring dialysis for more than 5 years.

Diagnosis:

Clinical tests such as blood and urine tests reveal excess protein in the body. But to diagnose amyloidosis correctly, a sample tissue needs to be analysed under the microscope. Sometimes this is done as an outpatient, and sometimes this is done with hospitalisation.

Treatment:

While there is no cure for amyloidosis (unless it is caused by an underlying disease), medication could help manage the symptoms such as reducing inflammation and pain and arrhythmia. However, diet and lifestyle changes could also help manage the disease. A well-planned nutritionally sound diet could help in managing the symptoms of this condition.

Tumours that originate in the heart could be both benign or malignant. But, since the heart is an important organ, even a benign tumour could be dangerous. The tumour could involve the sheath of the tissue that covers the heart (Epicardium), the muscles of the heart wall (Myocardium), or the membrane that lines the cavities of the heart (Endocardium). A tumour that may originate in the heart is usually rare.

Benign tumours that originate in the heart include:

• Myxoma – Occurs inside the cavities of the heart.
• Rhabdomyomas – Develops in the myocardium or the endocardium.Most of these occur in children or infants.
  
• Fibromas – Also develop in the myocardium or the endocardium.
  
• Pericardial cysts, and.
• Lipomas.

Malignant heart tumours can originate from any heart tissue, and they mostly occur in children.

• Angiosarcomas – usually starts in the right side of the heart.
• Fibrosarcomas.
• Rhabdomyosarcomas.
• Liposarcomas.

Symptoms of Cardiac Tumours:

The symptoms of cardiac tumours could be similar to the symptoms of other heart conditions making it harder to diagnose. If a person with a malignanttumourin any other part of the body has heart symptoms, then it is a sign that the tumour has spread to the heart.

Symptoms of cardiac tumours(benign and malignant – myxoma, fibroma, and rhabomyomas) that originate in the heart include:

• Embolism – fragments of the tumour breaks away into the blood steam and causes blockage or clots.
• Blockages in the blood flow.
• Symptoms similar to bacterial endocarditis, collagen-vascular disease and clinically undetectable malignancies.
• Rapid heart beats.
• Enlargement of the heart.
• Heart murmurs.

Myxomas are usually genetic and tend to run in the family.

Diagnosis:

Myxomas is usually diagnosed using the following tests:

• Echocardiogram (Echo) helps to understand the heart motion and the blood flow in the heart.
• Cardiac MRI helps to understand the heart anatomy better.
• Cardiac catheterization/ angiogram.
• Biopsy.
• Gated pool scintigraphy.
• Computer tomography.
• Angiocardiography.

Treatment:

Benign tumours of the heart are treated by surgically removing them. For malignant tumours, a combination of surgery, radiation, and chemotherapy is employed to treat, and manage symptoms.

Cardiomyopathy is marked by the difficulty of the heart to pump blood to the rest of the body, owing to the disease affecting the heart muscle. This could potentially lead to heart failure.

Symptoms of Cardiomyopathy:

Initially, the disease presents itself with no symptoms. However, as the disease progresses symptoms start shown up which include:

• Shortness of breath with exertion or even at rest
• Swelling of the legs, ankles, and feet
• Bloating of the abdomen
• Cough while lying down
• Fatigue and tiredness
• Rapid heartbeats
• Chest discomfort or pressure
• Dizziness, lightheadedness, and fainting

Types of Cardiomyopathy:

• Dilated cardiomyopathy is a type of cardiomyopathy, where the left ventricle or the heart’s main pumping chamber gets enlarged and cannot effectively pump blood out of the heart This type of cardiomyopathy is most common among middle-aged men and is the most common cause of heart attack.
• Hypertrophic cardiomyopathy is marked by abnormal thickening of the heart muscle, particularly affecting the left ventricle. This thickening makes it harder for the heart to work properly. This condition can affect people of any age but is more severe when diagnosed in childhood. This type of cardiomyopathy is mostly linked to genetic causes.
• Restrictive cardiomyopathy makes the heart muscle rigid, and less elastic. This mostly affects older people. While there is no known cause of this specific condition, it can be linked to disease in some other part of the body.
• Unclassified cardiomyopathy

Causes:

The cause of cardiomyopathy is now clearly known, however, there could be contributing factors such as:

• Long-term high blood pressure
• Heart tissue damage from a heart attack
• Chronic rapid heart rate
• Heart valve problems
• Obesity, thyroid disease or diabetes
• Vitamin or mineral deficiencies, such as vitamin B-1
• Complications during pregnancy
• Alcohol abuse
• Use of substances such as cocaine, amphetamines or anabolic steroids
• Use of some chemotherapy drugs and radiation to treat cancer
• Certain infections, especially those that inflame the heart
• Iron buildup in the heart muscle
• A condition that causes inflammation and can cause lumps of cells to grow in the heart and other organs (sarcoidosis)
• A disorder that causes the buildup of abnormal proteins (amyloidosis)
• Connective tissue disorders

Diagnosis:

To confirm a diagnosis, apart from recording the symptoms and family history, the doctor may ask for the following clinical examinations:

• Electrocardiogram (ECG), helps in analysing the heart rhythm. The doctor might recommend continuous portable ECG monitoring to understand the heart rhythm over a period. Signal-average ECG helps to assess the potential for irregular heart rhythms.
• Echocardiogram (Echo) helps to understand the heart motion and the blood flow in the heart.
• Cardiac MRI helps to understand the heart anatomy better
• Chest X-ray
• Treadmill stress test.
• Cardiac catheterization
• Coronary angiogram
• Cardiac CT scan
• Blood tests: To check kidney, thyroid, and liver function, and/or a blood test to measure the B-type natriuretic peptide (BNP), which might rise in the heart if there is heart failure.
• Genetic testing or screening

Treatment:

Most treatment for cardiomyopathy is to manage the symptoms. Medication is given to improve the pumping of the heart, improve blood flow, slow down the heart rate, and to remove excess fluid from your body.

Sometimes, certain devices are implanted in the body to improve the heart’s function, such as:

• Implantable cardioverter-defibrillator (ICD) which monitors the heart rhythm and controls abnormal rhythms.
• Ventricular assist device (VAD) which helps better blood circulation in the heart.
• Pacemaker, which uses electrical impulses to control arrhythmias.

At times, open-heart surgery is employed to remove part of the thickened heart muscle wall to improve blood flow through the heart.

Some non-surgical procedures are also used to treat the symptoms of cardiomyopathy:

• Septal ablation – A small portion of the thickened heart muscle is destroyed to allow blood to flow through the area.
• Radiofrequency ablation – This is used to treat abnormal heart rhythms by using long, flexible tubes (catheters) through your blood vessels to your heart. Electrodes at the catheter tips transmit energy to damage a small part of the abnormal heart tissue that is causing the abnormal heart rhythm.

Chemotherapy-related Cardiomyopathy

Chemotherapy has significantly contributed to better cancer survival rates. However, cardiotoxicity is one of the long-term side effects of chemotherapy. This cardiotoxicity has contributed to left ventricular systolic dysfunction. Certain specific medications have shown to contributing towards this form of cardiomyopathy.

Certain heart defects or abnormalities are present since birth. Such conditions are called congenital heart defects. Often, these conditions have no cause. At times they could be inherited, and at other times they could have developed in the foetus if the woman is exposed to certain radiation, or toxic substances during pregnancy.

Some of these conditions resolve on their own over time, while some need intervention in the form of surgery or medication. Most children with congenital heart diseases/ defects grow up to have fulfilling lives.

However, the presence of these conditions increases the risk of heart failure, heart valve problems, endocarditis, and atrial fibrillation.

Lifestyle

Adults with congenital heart defects need to focus on maintaining a heart-healthy lifestyle to not develop any complications.

• Eat a nutritionally balanced diet.
• If you are taking medications, maintain the routine, and plan regular health check-ups.
• Exercise, and maintain an active lifestyle.
• Manage your weight.
• Don’t smoke.
• Monitor your blood pressure, cholesterol, and sugar, and keep them within control.
• Check with your doctor about vaccines and get the recommended ones.

Endocarditis

Your congenital heart defect could increase the risk of an infection in your heart – this is called endocarditis. This infection is mostly caused by bacteria in the mouth. So, it is important to take good care of your teeth and discuss dental procedures in detail with your dentist. Often, it is recommended to take antibiotics before any procedure.

Pregnancy

Both men and women with a congenital heart defect need to discuss and understand the risk of passing this heart defect to their offspring before planning a pregnancy. Women who have the defect also need to understand the risk that pregnancy could pose owing to the condition.

Most adults with congenital heart defects lead normal lives with regular jobs and the capacity for an active lifestyle. However, they need to monitor their symptoms regularly to avoid any complications.

The pericardium is the membrane that surrounds the heart. It keeps the heart in place and ensures it works properly. An inflammation of this membrane is called Pericarditis. The pericardium is made of an inner, and outer layer, with fluid in between the two which keeps the layers apart. Pericardium could be caused by several conditions including infection, an autoimmune disorder (such as rheumatoid arthritis), chest injury, cancer, HIV, kidney failure, tuberculosis, heart surgery, inflammation after a heart attack, and medical treatments such as radiation in the chest.

Symptoms:

• Sharp, piercing chest pain on the centre or the left side of the chest. This kind of pain gets better when you lean forward or sit straight up
• Chest pain behind the breastbone, under the collarbone, neck, and left shoulder
• Fever
• Fatigue
• Coughing
• Breathing difficulty
• Pain while swallowing
• Palpitations

Diagnosis:

Your doctor can recognize pericarditis by listening to the heart for the sound of the outer layer of the pericardium rubbing against the inner layer. Another method is to check for pulsus paradoxus – where the blood pressure drops when you take a deep breath.

Apart from these clinical examinations, and heart history, the doctor will also recommend the following tests:

• Electrocardiogram (ECG)
• Echocardiogram
• Chest x-ray
• Cardiac CT and/or MRI Scans
• Blood tests

Treatment:

While the doctor may prescribe medication to reduce the inflammation, the larger goal of treatment is to eliminate the root cause of the disease itself. Sometimes if the condition progresses, then doctors could recommend the removal of the excess fluid around the heart, or surgery.

Coronary artery disease is marked by the damage of the major blood vessels that supply blood to the heart. Often this happens due to cholesterol-containing deposits in the arteries. The coronary arteries supply blood, oxygen, and nutrients to the heart. The blockage due to these deposits decreases the blood flow to the heart. A complete blockage could cause a heart attack.

This is one of the heart diseases which develops over time. A good lifestyle and diet could play a huge role in preventing this disease.

Symptoms:

• Chest pain: Chest pain particularly in the middle or the left side of the chest, also called angina.
• Breathing difficulty and fatigue
• Heart attack. A full blockage of the coronary artery will cause a heart attack.

Causes:

Coronary artery disease is caused by damage to the inner layer of the artery. This damage is caused by several factors including smoking, high cholesterol, insulin resistance, sedentary lifestyle, and high blood pressure.

Diagnosis:

Apart from clinical examination, family history, and blood tests, your doctor would recommend any or a combination of these tests:

• Electrocardiogram (ECG)
• Echocardiogram
• Exercise stress test
• Nuclear stress test
• Cardiac catheterization and angiogram
• Cardiac CT scan

Treatment:

There are various medications to treat coronary artery disease. They are a combination of drugs to reduce cholesterol, blood-thinning medications, beta-blockers, and medicines to reduce blood pressure.

Based on how far the disease has progressed, other surgical procedures could also be employed for treatment.

• Angioplasty and Stent Placement: Your cardiologist will insert a catheter into the artery and insert a deflated balloon to the narrowed area. The balloon is inflated to compress the deposits along the walls of the artery. A stent is usually placed to keep the dilated artery open.
• Coronary Artery Bypass Surgery: In this open-heart surgery, the surgeon bypasses the blocked arteries to allow the blood to flow around the narrowed arteries.

Lifestyle:

Apart from medical treatment, you need to make several lifestyle changes to manage coronary artery disease.

• Quit smoking
• Eat a nutritionally-balanced diet
• Stay active
• Lose weight if needed
• Reduce stress

Heart failure is a condition where the heart muscle does not pump enough blood. In Diastolic Heart Failure, the left ventricle of the heart cannot fill fully.

Symptoms:

• Shortness of breath
• Fatigue, weakness, and tiredness
• Swelling in the legs, ankle, and feet

Causes:

With age, the heart muscles start becoming stiff. Diastolic heart failure is more common with older people. The causes of diastolic heart failure include:

• High blood pressure
• Coronary Artery Disease
• Other diseases such as Diabetes

Diagnosis:

To diagnose diastolic heart failure, your doctor will examine you to understand symptoms and understand your medical history, and the family medical history. Additionally, the doctor will also recommend the following tests:

• Blood tests
• Electrocardiogram (ECG)
• Echocardiogram
• Chest X-ray
• Stress test

Treatment:

For diastolic heart failure, doctors often prescribe a combination of medicines including beta-blockers, diuretics (water pills), and medicines to increase the strength of the heart muscle. If the condition has progressed, then other surgical options are also recommended:

• Ventricular Assist Device: This implanted mechanical device pumps blood from the lower ventricles of the heart to the rest of the body.
• Bypass surgery: If blocked arteries are contributing to heart failure, then your cardiologist may recommend a bypass surgery
• Heart Transplant: If medications or other surgeries don’t help, then a heart transplant is imminent for a patient with this condition.

Dilated cardiomyopathy is marked by the heart’s inability to contract. Typically, this starts in the left lower ventricle of the heart, which progresses to the right lower ventricle, and the upper ventricles. As it progresses, the heart’s capacity to pump blood severely reduces, which causes fluid accumulation in the lungs, and in the body, which is referred to as heart failure.

Causes:

This is a fairly rare condition that has different causes. Some of these causes are:

• Infections such as HIV
• Autoimmune disease
• Alcohol abuse, substance use, exposure to heavy metals, and certain chemotherapy medicines
• Diseases of the thyroid, or diabetes
• High blood pressure
• Irregular heart rhythms
• Coronary artery disease
• Heart valve problems
• Nutritional problems
• Pregnancy
• Muscular dystrophy

Symptoms:

TThe symptoms of dilated cardiomyopathy include:

• Shortness of breath
• Fatigue and weakness
• Swelling in the legs, and ankles
• Cough
• Heart rhythm problems
• Dizziness

Diagnosis:

TApart from examining the clinical symptoms, and understanding heart history, the following tests help in diagnosing dilated cardiomyopathy.

• Echocardiogram
• Electrocardiogram (ECG)
• Chest X-ray
• Exercise testing

Treatment:

TApart from focusing on treating the root cause behind the condition, your doctor would prescribe the following medications to address dilated cardiomyopathy:

• Diuretics to reduce swelling
• Beta-blockers to reduce the heart’s workload
• ACE inhibitors to help the heart pump better
• Blood thinners (anticoagulants) to prevent blood clots
• Medicines to help prevent heart rhythm problems

You should also make lifestyle changes such as exercising, shifting to a heart-healthy diet, and reducing salt intake to manage your condition.

Familial cardiomyopathy of Familial dilated cardiomyopathy causes the heart to not be able to contract. This affects the heart’s ability to pump and consequently impacts the amount of blood flowing through the body.

Familial cardiomyopathy occurs due to underlying genetic abnormalities in the heart muscle. The heart contracts and expands every time it beats. With this disorder, the heart is unable to contract, and thereby not able to pump out enough blood.

While there are several causes for dilated cardiomyopathy, gene abnormalities are one such cause or risk factor. There are several genes which when mutated cause cardiomyopathy. Most of the inherited genes require only one gene mutation to develop a high risk of this condition.

Symptoms:

• Shortness of breath.
• Fatigue and weakness.
• Swelling in the legs, and ankles.
• Cough.
• Heart rhythm problems.
• Dizziness.

Diagnosis:

While your doctor may recommend a combination of ECG, echocardiogram, chest X-ray, and exercise testing to diagnose you with dilated cardiomyopathy, for this particular type of cardiomyopathy genetic testing, and screening is also required.

If someone in your family has been diagnosed with familial cardiomyopathy, all first-degree relatives (siblings, children, and parents) need to be screened for the same. If other first-degree relatives are also diagnosed with the condition, then other relatives may also require screening.

While there is no single genetic test to comprehensively test for familial cardiomyopathy, based on symptoms the genetic testing team will be able to recommend appropriate genetic tests to diagnose the gene mutation.

Treatment:

• Diuretics to reduce swelling.
• Beta-blockers to reduce the heart’s workload .
  
• ACE inhibitors to help the heart pump better.
• Blood thinners (anticoagulants) to prevent blood clots.
• Medicines to help prevent heart rhythm problems.

You should also make lifestyle changes such as exercising, shifting to a heart-healthy diet, and reducing salt intake to manage your condition.

The heart muscle pumps blood to different parts of the body, and with heart failure, this particular action does not happen appropriately. At times, the heart does not relax, and hence unable to pump blood properly. This causes fluid build-up in the lungs. This is also called congestive heart failure.

Causes:

Heart failure has several causes including:

• Heart valve disease.
• High blood pressure.
• Infections such as endocarditis.
• A past heart attack.
• Coronary artery disease.
• Cardiomyopathy.
• Congenital heart diseases.
• Arrhythmia.
• Long-term chronic lung disease.
• A reaction to medicines such as those used for chemotherapy.
• Anaemia and too much blood loss.
• Diabetes.
• Obstructive sleep apnea.
• Alcohol and drug abuse.
• Some viral infections.

Symptoms:

The symptoms of heart failure are overlapping with several other conditions and could be confusing. It is best to seek a cardiologist to analyse this further. Common symptoms of heart failure include:

• Shortness of breath: At rest, during exercise, or while lying down.
• Weight gain due to fluid retention.
• Swelling (oedema) in the legs, and ankles.
• Fatigue and weakness.
• Loss of appetite, and nausea.
• Persistent cough.

Diagnosis:

To diagnose heart failure, a combination of the following tests is used:

• BNP testing. B-type natriuretic peptide (BNP) hormone is released from the heart ventricles during heart failure. Checking this level acts as a quick assessment for heart failure. Higher BNP levels indicate the extent of heart failure. This is measured from a blood sample.
• Chest X-ray .
• Echocardiogram.
• Electrocardiogram (ECG).
• Cardiac MRI.

Treatment:

It is important to treat the cause of heart failure to address it. If heart failure caused by a heart valve problem, then you will need a corresponding intervention. Similarly, if an infection has caused heart failure, then your medical team will address the infection while treating other symptoms.

Several types of medicines are used to treat heart failure including:

• ACE inhibitors to lower blood pressure.
• Angiotensin receptor blockers (ARB) to relax blood vessels, and to reduce stress on the heart.
• Angiotensin receptor-neprilysin inhibitors (ARNIs) to promote salt, and water loss.
• Sinus node I-f channel blocker to lower the heart rate.
• Diuretics to reduce the fluid build-up in the body.
• Vasodilators to reduce the workload on the heart.
• Digitalis to help the heart beat better.
• Antiarrhythmics to keep a normal heart rhythm.
• Beta-blockers to help the heart pump better over time.
• Aldosterone blockers to reduce sodium and water retention.
• Statins or PCKS9 inhibitors to lower the amount of bad cholesterol in the body.

Procedures:

• Angioplasty removes the blockages in the heart if that is the cause of heart failure.
• If a narrowed heart valve is the reason for heart failure, heart valve replacement is done to address it. This is usually an open-heart surgery.
• A pacemaker is an implantable device that restores a normal heart rate.
• An ICD is implanted to fix the heart’s rhythm.
• VAD (Ventricular Assisted Device) is a mechanical pump that pumps blood from the lower chambers of the heart to the rest of the body.
• Heart transplant is the final treatment option for whom medications, and other surgeries have not worked.

The heart valves ensure that blood keeps moving in one direction. Sometimes one or two of the valves don’t work causing heart valve defects, and corresponding problems. The heart has four valves:

• Tricuspid valve: Present in between the right atrium and the right ventricle.
• Pulmonary valve: Located between the right ventricle and the pulmonary artery.
• Mitral valve: Placed between the left atrium and the left ventricle.
• Aortic valve: Present between the left ventricle and the aorta.

As the heart beats, or contracts and relaxes, the valves open and close to allow the heart to flow in and out of the ventricles alternatively. Heart valve problems could occur due to either one of the following conditions:

• Leakage of the valve (regurgitation): If the valve does not close properly, the blood flows backward through the valve. This reduces blood flow and can lead to overload in the heart.
• Narrowing of the valve (stenosis): If the valve opening becomes narrow, the blood flow out of the ventricles becomes less. So, the heart works harder to pump more blood and to push the blood out of the valve.

Both of these conditions could happen together, and more than one valve could be affected too. The effects of heart valve diseases could be serious. It causes heart failure, arrhythmia, heart attack, or even death.

Causes:

• Heart attack.
• Coronary heart disease.
• Endocarditis, or heart valve infection.
• Congenital valve defects.
• Sexually transmitted infections such as syphilis.
• Changes in the heart valve structure due to aging.
• Radiation therapy aimed at the chest area (to treat cancer).
• Myxomatous Degeneration – An inherited connective tissue disorder that weakens the heart valve tissue .
• Some medications.

Symptoms:

The most common symptoms of heart valve disorders are:

• Chest pain.
• Palpitations.
• Fatigue.
• Dizziness or fainting.
• Low or high blood pressure, (depends on the type of valve disease).
• Breathing difficulty, and shortness of breath at rest or with activity.
• Pain in the belly (happens due to an enlarged liver).
• Swelling in the legs.

Diagnosis:

Your cardiologist would be able to detect heart valve disease using the stethoscope. They might hear abnormal sounds via the stethoscope indicating regurgitation or stenosis. Your cardiologist will further diagnose this with a combination of the following tests:

• Electrocardiogram (ECG ) .
• Echocardiogram (echo).
• Transesophageal echocardiogram (TEE) to see a clearer picture of the valves without the ribs or the lungs.
• Chest X-ray.
• Cardiac catheterization and angiography.
• Cardiac MRI and CT Scan.

Treatment:

Based on the extent of the defect or disease, the treatment plan also varies.

• Medication: Medicines help in relieving the symptoms of the disorder. A combination of beta-blockers, calcium blockers, help to control the rhythm of the heart. Diuretics reduced swelling by removing excess water from the body. However, you need other procedures to fix the defect in the valve.
• Surgery: Your valve is repaired or replaced based on the extent of the damage. Replacement valves are either biologic valves (made from animal tissue, or donated human tissue) or mechanical valves (made from artificial materials such as metal, plastic)
• Transcatheter procedures are minimally invasive procedures to replace the heart valve.
• To repair the mitral valve, a clip can be used to reduce the amount of blood leaking.
• Balloon valvuloplasty: A catheter is inserted into the blood vessel and directed towards the valve. When the catheter reaches the narrow part of the valve, a balloon is inflated to push the walls and to stretch the valve open. This is done only to treat stenosis.
• TAVR (transcatheter aortic valve replacement): This non-surgical procedure delivers a fully collapsible valve to the site of the misfunctioning valve using a catheter. This procedure is currently employed only to treat aortic stenosis.

Haemochromatosis is a condition which causes you to absorb too much iron from the food you eat. This excess iron gets stored in your organs especially in the liver, heart, and pancreas. This could lead to heart problems, liver disease, and diabetes.

This is typically an inherited condition, although several people who inherit it lead normal lives. In about 10% of people, this condition leads to tissue or organ damage.

Symptoms:

Some people with haemochromatosis do not exhibit any symptoms. Often people start showing symptoms in mid-life. In the case of women, they show symptoms closer to menopause when they start losing blood due to menstruation. The symptoms of the condition include:

• Joint pain
• Pain in the abdomen
• Tiredness and weakness
• Diabetes
• Loss of sex drive, and/or impotence
• Heart failure
• Liver failure
• Memory fog

Diagnosis:

Since the symptoms of haemochromatosis are fairly common, most people don’t get diagnosed with these symptoms. Often while testing for other conditions, or when a family member is diagnosed, this might show up.

Haemochromatosis is diagnosed by the following blood tests:

• Serum transferrin saturation. Transferrin is a protein that carries iron in your blood. This test measures the amount of protein that is bound to transferrin. A value higher than 45 percent is too high.
• Serum ferritin. This test gives an indication of the amount of protein stored in the liver. Usually if serum transferrin saturation shows a high percentage, your doctor would recommend this test.

Your doctor may recommend the following tests after these blood tests to confirm the diagnosis.

• Liver function teststo identify liver damage.
• MRIto measure the iron overload in the liver.
• Genetic testing to identify the gene mutations that have contributed to this disorder.
• Liver biopsy to check for the extent of liver damage.

Treatment:

To manage haemochromatosis, your doctor will recommend blood removal on a regular basis similar to donating blood. The aim is to keep the iron levels in your body within limits, and removing blood contributes towards that aim. The amount of blood removed, and the frequency of it depends on your age, other health conditions, and the extent of your condition.

Hypertensive cardiomyopathy is a complication following hypertension or high blood pressure. In this condition, the heart is unable to relax after a contraction. Over time the left ventricle becomes stiff and is unable to handle the volume of blood. Over time fluid buildup in other parts of the body, predominantly the lungs.

This could also lead to heart failure and sudden death.

Symptoms:

• Shortness of breath while lying down, or with activity.
• Chest pain.
• Fainting or dizziness.
• Palpitations.
• Fatigue.
• Swelling in the legs and feet.
• Abnormal heart rhythms (Arrhythmia).

Diagnosis:

Hypertensive cardiomyopathy is diagnosed with a combination of the following diagnostic tests:

• Electrocardiogram (ECG)
• Echocardiogram (Echo)
• Stress echocardiogram
• Continuous portable electrocardiogram monitoring.
• Other tests including MRI, cardiac catheterisation, and/or angiography
• Genetic testing

Treatment:

Treatment options include:

• Medication: Beta-blockers, and calcium-blockers help treat shortness of breath by improving blood flow. Some medicines prevent abnormal heart rhythms. Anticoagulants or blood thinners help the flow of blood.
• Implantable cardioverter defibrillator (ICD) is an implanted device that monitors the heart rhythms and prevents abnormal rhythms. Apart from these medical procedures, your doctor will also recommend lifestyle changes to manage the condition.

Hypertrophic cardiomyopathy is marked by the thickening of the heart muscle – the wall between the left and the right ventricle of the heart’s lower chamber thickens, thereby partially blocking the blood flow from the heart to the rest of the body.

The thickened wall causes the left ventricle to become very stiff, and over time causes fluid buildup in the lungs. While many people with hypertrophic cardiomyopathy lead normal lives, in some cases this condition could progress and cause stroke, heart rhythm problems, heart failure, and even sudden death.

This is typically a genetic disorder that shows up during adolescence or early adulthood.

Symptoms:

The symptoms of hypertrophic cardiomyopathy include:

• Shortness of breath while lying down, or with activity.
• Chest pain.
• Fainting or dizziness.
• Palpitations.
• Fatigue.
• Swelling in the legs and feet.
• Abnormal heart rhythms (Arrhythmia).

Diagnosis:

Hypertrophic cardiomyopathy is diagnosed with a combination of the following diagnostic tests:

• Electrocardiogram (ECG).
• Echocardiogram (Echo).
• Stress echocardiogram.
• Continuous portable electrocardiogram monitoring.
• Other tests including MRI, cardiac catheterisation, and/or angiography.
• Genetic testing.

Treatment:

The treatment for hypertrophic cardiomyopathy depends on your symptoms. Treatment options include:

• Medication: Beta-blockers, and calcium-blockers help treat shortness of breath by improving blood flow. Some medicines prevent abnormal heart rhythms. Anticoagulants or blood thinners help the flow of blood.
• Surgery: Septal myectomy removes a portion of the septal wall to fill more blood in the ventricle so that more blood is pumped to the body.
• Alcohol septal ablation is a procedure where pure alcohol is injected into specific blood vessels to destroy the segment that is blocking the blood flow.
• Implantable cardioverter defibrillator (ICD) is an implanted device that monitors the heart rhythms and prevents abnormal rhythms. Apart from these medical procedures, your doctor will also recommend lifestyle changes such as staying hydrated and restricting heavy physical activity such as competitive sports, weight lifting, or sprinting.

Ischemic cardiomyopathy is marked by the heart’s inability to contract. This specific type of disease is caused by coronary artery disease or heart attack.

Typically, this disease starts in the left lower ventricle of the heart, which progresses to the right lower ventricle, and the upper ventricles. As it progresses, the heart’s capacity to pump blood severely reduces, which causes fluid accumulation in the lungs, and in the body, which is referred to as heart failure.

Symptoms:

• Shortness of breath.
• Fatigue and weakness.
• Swelling in the legs, and ankles.
• Cough.
• Heart rhythm problems.
• Dizziness.

Diagnosis:

Apart from examining the clinical symptoms, and understanding heart history, the following tests help in diagnosing ischemic cardiomyopathy.

• Echocardiogram.
• Electrocardiogram (ECG).
• Chest X-ray.
• Exercise testing.

Treatment:

Apart from focusing on treating the root cause behind the condition, your doctor would prescribe the following medications to address dilated cardiomyopathy:

• Diuretics to reduce swelling.
• Beta-blockers to reduce the heart’s workload.
• ACE inhibitors to help the heart pump better.
• Blood thinners (anticoagulants) to prevent blood clots.
• Medicines to help prevent heart rhythm problems.

You should also make lifestyle changes such as exercising, shifting to a heart-healthy diet, and reducing salt intake to manage your condition.

Myocarditis is marked by the inflammation of the heart muscle. Typically, is happens as a result of an infection such as diphtheria, tuberculosis, or rheumatic fever. It may also happen owing to the damage of the heart due to some toxins, or autoimmune condition. As the condition progresses, it weakens the heart, and the rest of the body does not get enough oxygen. Severe myocarditis could lead to a stroke, heart attack, arrhythmia, or heart failure.

Symptoms:

The early stages of myocarditis present no symptoms. As the disease progresses, you see signs and symptoms including:

• Chest pain
• Abnormal heart rhythms.
• Breathlessness and Shortness of breath, at rest or during activity.
• Swelling of your legs, ankles, and feet.
• Fatigue.
• Signs of a viral infection, such as a headache, body aches, joint pain, fever, sore throat or diarrhoea.

Diagnosis:

With an early diagnosis, you can prevent long term heart damage. Your doctor may recommend any or a combination of the following tests to diagnose myocarditis.

• Electrocardiogram (ECG)
• Chest X-ray.
• Cardiac MRI.
• Echocardiogram.
• Blood tests to measure white and red blood cell counts, and to detect antibodies against viruses or other organisms. Blood tests can also assess levels of certain enzymes that indicate damage to the heart muscle.
• Cardiac catheterisation and endomyocardial biopsy: After the catherisation, a small sample of the heart tissue is extracted to analyse in the lab for inflammation or infection.

Treatment:

• Medication: Medicines such as beta-blockers help control arrhythmia, and treat heart failure. ACE inhibitors allow blood to flow easily, diuretics reduce fluid retention in the body.
• Intra-aortic balloon pump: In some severe cases, doctors place a balloon in the main artery with the help of a catheter send through a blood vessel in the leg. As the balloon inflates and deflates it increases the blood flow.
• Extracorporeal membrane oxygenation (ECMO) provides oxygen to the body through a membrane that removes carbon dioxide and adds oxygen to the blood.
• Ventricular assist device is a mechanical pump that is implanted to help with better blood circulation in the heart.

Your doctor may also recommend lifestyle changes such as restricting physical activity especially competitive sports and rest until you are in a position to restart a more active life.

Non-compaction cardiomyopathy or left ventricular non-compaction cardiomyopathy is marked by the muscular wall of the left ventricle appearing spongy. The non-compacted left ventricles cause channels to form in the heart muscle called trabeculations.

Over time the non-compaction affects the heart’s capacity to pump blood to the rest of the body. And, the trabeculations affect the electrical signalling of the heart.

Causes:

This is typically a genetic condition that develops before birth. Sometimes people could also develop this condition after birth. This particular condition happens when the normal development of the heart is affected in the embryo stage. It is caused by a gene mutation, i.e., it is inherited from a parent.

Symptoms:

Everyone with this condition does not necessarily show symptoms. Symptoms also vary from person to person. Symptoms include:

• Shortness of breath
• Fatigue
• Dizziness or lightheadedness, and/or fainting
• Palpitations
• Swelling of legs, ankles, and feet

Diagnosis:

This condition is diagnosed by comparing the non-compacted heart muscle to the compacted heart muscle, and by identifying the number of trabeculations. Your doctor will also try to understand your family's medical and heart history. Diagnostic tests include:

• Electrocardiogram (ECG)
• Echocardiogram

Treatment:

Treatment is focused on managing symptoms, improving the heart’s function, and monitoring of the condition in the long term. Based on the symptoms you show, treatment options include:

• Medication: Beta-blockers, and calcium-blockers help treat shortness of breath by improving blood flow. Some medicines prevent abnormal heart rhythms. Anticoagulants or blood thinners help the flow of blood. Diuretics reduce the fluid buildup in the body.
• Implantable cardioverter defibrillator (ICD) is an implanted device that monitors the heart rhythms and prevents abnormal rhythms. Apart from these medical procedures, your doctor will also recommend lifestyle changes to manage the condition.
• Pacemaker: This implantable device restores the normal heart rhythm.

Postpartum cardiomyopathy is a rare form of heart disease that occurs between the last month of pregnancy up to five months after birth. Cardiomyopathy is a disease of the heart muscle. In this specific case, the chambers of the heart enlarge, the muscle weakens, and with every contraction lesser blood flows out of the left ventricle of the heart. Over time, with this condition, lesser blood flows in the entire body.

Causes:

The causes of this disease are connected to diet, lifestyle, preexisting medical conditions, and genetics. The risk factors for this condition include:

• Smoking
• Obesity
• Women with preexisting heart diseases such as myocarditis
• Poor nourishment
• Alcohol abuse

Symptoms:

• Tiredness
• Palpitations
• Shortness of breath – with activity or while lying down
• Swelling of the legs, and ankles
• Increased nighttime urination

Diagnosis:

Your doctor will examine with a stethoscope to look for fluid in the lungs, or abnormal heartbeats. The doctor may also recommend any of the following diagnostic tests:

• Echocardiogram
• Electrocardiogram (ECG)
• Chest X-ray
• Exercise testing
• Blood tests to assess kidney, liver, and thyroid function, and haemoglobin count.

Treatment:

• Medication: Your doctor may prescribe ACE inhibitors to help the heart work more efficiently. Beta-Blockers are used to fix the heart rhythm, and diuretics remove excess fluid from the body. Anticoagulants or blood thinners help in free blood flow in the body.
• Diet and lifestyle: Your doctor may put you on a low-salt diet. You will need to quit smoking and reduce alcohol intake.

Pulmonary hypertension is marked by increased blood pressure in the blood vessels of the lungs. This is caused by the narrowing of the arteries that carry blood between the heart and the lungs. While this is a rare condition, it could lead to failure of the right ventricle of the heart.

This condition is idiopathic or has no known cause. Sometimes this could be affected by your genes that you are born with.

Symptoms:

Some of the symptoms of pulmonary hypertension are:

• Shortness of breath.
• Reduced exercise capacity.
• Chest pain.
• Fatigue, and weakness.
• Dizziness and/or fainting.
• Dry cough.
• Swelling in the legs, and ankles.
• Palpitations.

Diagnosis:

To evaluate pulmonary hypertension, you need to consult a cardiologist along with a pulmonologist. The following tests help the medical team diagnose the condition:

• Cardiac catheterization.
• Electrocardiogram (ECG).
• Echocardiogram.
• Chest x-ray .
• Cardiac CT scan.
• Pulmonary function test.
• Perfusion lung scan.
• Blood tests.

Treatment:

Based on the progression of the disorder, the kind of treatment varies. A few options for treating pulmonary hypertension are:

• Medications: Some medications help control the symptoms of the disorder to manage everyday living. Anticoagulantsor blood thinners help the blood flow more freely. Diuretics reduce the fluid buildup in the body. Some medicines help lower the blood pressure in the lungs..
• Rehabilitation: A focused pulmonary physiotherapy programme helps in addressing the symptoms of this disorder while maintaining good health in the long term. .
• Lifestyle changes: A focused exercise and diet regimen could help support treatment and lower your risk of complications. You should quit smoking and consider getting annual pneumonia and flu vaccines..
• Oxygen therapy: In advanced cases, with severe difficulty in breathing, you might need additional oxygen which is connected to an external oxygen tank.
• Hospitalisation: Certain symptoms need in-hospital care to ease them. Sometimes medicines are provided intravenously to reduce blood pressure..
• Organ transplant: If none of the medical or surgical treatments work, you may need a lung or a heart-lung transplant. .

Restrictive cardiomyopathy is marked by the heart muscles getting stiff over time. The heart squeezes well but is unable to relax, which causes fluid build-up in the other organs including the lungs. This also increases blood pressure in the ventricles and eventually affects the amount of blood pumped out from the heart. This is a rare form of cardiomyopathy which can affect someone at any age.

Eventually, this condition leads to heart failure.

Causes:

Several other health conditions cause restrictive cardiomyopathy.

• Amyloidosis: This condition, where an abnormal buildup of protein happens in organs and tissues is the most common cause of restrictive cardiomyopathy.
• Hemochromatosis: This condition causes a buildup on iron in your organs.
• Sarcoidosis: Sarcoidosis causes scarring of the heart.
• Eosinophilic endomyocardial disease: This is caused by some lymphomas, tumours, or parasitic disease.
• Scleroderma: This disease is marked by the hardening of the tissues in the body.
• Radiation-induced heart disease: This is induced by radiation treatment employed to treat cancer.
• Certain rare genetic conditions.

Symptoms:

• Shortness of breath with activity or while lying down
• Fatigue, weakness and/ or dizziness
• Swelling in the body, especially in the legs
• Cough
• Arrhythmia, abnormal heart rhythms

Diagnosis:

Apart from a clinical exam, and details family history, your doctor may ask for a combination of the following diagnostic tests.

• Electrocardiogram (ECG)
• Echocardiogram
• Continuous portable ECG monitoring
• Chest X-ray
• Blood tests
• Exercise testing
• Cardiac MRI
• Heart biopsy
• Cardiac catheterization with angiography

Treatment:

Since restrictive cardiomyopathy is caused by an underlying disease, your doctor will focus on treating the underlying disease, while also working with you to ease the symptoms of restrictive cardiomyopathy.

• Medication: Diuretics reduce the fluid buildup in the body. Beta-blockers help improves the efficiency of the heart, and ACE inhibitors help the heart pump better. Blood thinners help in the free flow of the blood.
• Lifestyle changes: A heart-healthy diet with reduced salt helps in managing the condition better. Quit smoking, reduce your intake of alcohol, and work with your doctor to identify the right exercise regimen for you. Monitor your symptoms, and keep a watch on weight gain because it would indicate fluid buildup.
• eart transplant: If medical intervention, and treating the underlying disease does not help, then you might need a heart transplant.

Inflammation in the lungs is called pulmonary sarcoidosis. This condition causes small lumps of inflammatory cells in the lungs. Sometimes, they heal and go away on their own. If they don’t heal it leads to pulmonary fibrosis. This causes difficulty in breathing. Eventually from chronic inflammation, bronchiectasis occurs where the airways thicken and widen.

There is no known cause for pulmonary sarcoidosis. Some bacteria or viruses could trigger this condition. In some cases, few chemicals could also trigger this. Experts also say that there could be a hereditary component to this condition.

Symptoms:

Often people with sarcoidosis may not present any symptoms in the initial stages. When the signs and symptoms start showing up, it could be different for every person:

• Shortness of breath.
• Persistent cough.
• Chest pain and/or wheezing.
• Extreme fatigue.
• Fever.
• Pain in the joints and bones.
• Weight loss.
• Night sweats.
• Inflammation of the eyes and pain or burning sensation. Blurred vision, and light sensitivity.
• Skin rashes, and color changes on face, arms, or shins.

Diagnosis:

Your doctors may recommend a combination of the following diagnostic tests if they suspect this condition:

• Chest X-ray.
• CT scan.
• Pulmonary function tests.
• Blood tests.
• Bronchoscopy: A bronchoscope, which is a long thin tube with a light at the end of it, is put down the throat into the lungs. The doctor can view the main airway of the lungs through this and evaluate the problem.
• Bronchoalveolar lavage: A sterile saline solution is put into the lungs using the bronchoscope. This solution is then suctioned out, and the cells in the saline are examined to find infection or inflammation.
• Lung biopsy.

Treatment:

• Edication: Medication can help relieve symptoms and improve lung function. Steroids help reduce inflammation.
• Rehab: Your doctor will place you on a rehab programme focused on diet, exercise, and education about monitoring the condition.
• Oxygen therapy: In severe cases, oxygen therapy may be needed to support breathing.

Heart failure is a condition where the heart muscle does not pump enough blood. In Systolic Heart Failure, the left ventricle cannot contract, thereby causing a pumping problem.

Causes:

There are several different causes and contributors to systolic heart failure. Some of them include:

• High blood pressure
• Coronary Artery Disease
• Cardiomyopathy
• Aortic stenosis
• Viral myocarditis
• Arrhythmia

Symptoms:

• Shortness of breath
• Fatigue, weakness, and tiredness
• Swelling in the legs, ankle, and feet
• Chest pain
• Irregular heartbeat
• Persistent cough

Diagnosis:

To diagnose systolic heart failure, your doctor will recommend the following tests:

• Blood tests
• Electrocardiogram (ECG)
• Echocardiogram
• Chest X-ray
• Stress test
• Cardiac CT scan
• Myocardial biopsy

Treatment:

For systolic heart failure, doctors often prescribe a combination of medicines including beta-blockers, diuretics (water pills), and medicines to increase the strength of the heart muscle. If the condition has progressed, then other surgical options are also recommended:

• Ventricular Assist Device: This implanted mechanical device pumps blood from the lower ventricles of the heart to the rest of the body.
• Bypass surgery: If blocked arteries are contributing to heart failure, then your cardiologist may recommend a bypass surgery
• VAD (Ventricular Assist Device): The VAD is a mechanical pump that is implanted to pump blood from the lower chambers of the heart.
• Heart Transplant: If medications or other surgeries don’t help, then a heart transplant is imminent for a patient with this condition.

Ventricular Tachycardia (VT) is marked by rapid heartbeats. Typically, it starts in the lower chambers of the heart. This condition could sometimes be life-threatening. The condition is specifically defined as three or more heartbeats in a row at more than 100 beats per minute. This fast heartbeat does not give the heart enough time to fill up with blood, and thereby affects blood flow to the entire body. Ventricular Tachycardia could occur in a normal healthy heart as well. It could also occur as a result of previous heart disease. This condition could be life-threatening when it occurs for someone with heart disease.

You are at a higher risk of Ventricular Tachycardia if you have any of the following conditions:

• Abnormal heart valves.
• Cardiomyopathy.
• Heart failure.
• Coronary artery disease.
• Past heart attack.
• Sarcoidosis.
• Long QT syndrome or Brugadasyndrome.

Causes:

There are two common ways in which Ventricular Tachycardia occurs.

• Reentry: An abnormal heart circuit is triggered within the lower chambers
• Automaticity: An abnormal ventricular muscle gets activated by itself.

Symptoms:

• Dizziness and/or fainting
• Chest pain
• Breathing difficulty
• Palpitations or persistent rapid heartbeat
• Tightness in the neck

Diagnosis:

Your doctor will need to understand your heart rhythm to diagnose ventricular tachycardia. So, your cardiologist might ask for an ECG, and/or a stress test. Sometimes, they may monitor your heartbeat continuously in a hospital using a procedure called telemetry. Implantable loop recorders could also be used to monitor your heartbeats over longer periods.

Treatment:

• If you do not have any underlying heart condition, and the VT does not last for a long time, you do not require treatment. However, if you experience unmanageable symptoms, your doctor may prescribe medicines to control the heart rhythm.
• Implantable Cardiac Defibrillator (ICD): An ICD is an implantable device that can prevent abnormal heart rhythms. For those with sustained VT, this could be recommended.
• Catheter ablation: Sometimes your doctor might recommend this treatment, where radiofrequency energy is used to destroy the tissue that causes the abnormal heartbeat.