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Cardiovascular Disease

Key Facts:

  • Cardiovascular diseases (CVDs) are the leading cause of death globally.

  • An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.

  • Over three quarters of CVD deaths take place in low- and middle-income countries.

  • Out of the 17 million premature deaths (under the age of 70) due to non-communicable diseases in 2019, 38% were caused by CVDs.
  • Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.

  • It is important to detect cardiovascular disease as early as possible so that management with counselling and medicines can begin.

 

What are cardiovascular diseases?

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. They include:

  • Coronary heart disease – a disease of the blood vessels supplying the heart muscle which includes stable angina, unstable angina, myocardial infarction (heart attack)

  • Cerebrovascular disease – a disease of the blood vessels supplying the brain which includes ischemic and hemorrhagic strokes

  • Reripheral arterial disease – a disease of blood vessels supplying the arms and legs which includes arterial ulcers

  • Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;

  • Congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth; and

  • Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

  • Abnormal heart rhythms, or arrhythmias – Improper beating of the heart, whether irregular, too fast or too slow. Cardiac arrhythmia occurs when electrical impulses in the heart don't work properly. There may be no symptoms. Alternatively, symptoms may include a fluttering in the chest, chest pain, fainting or dizziness. it includes supraventricular arrhythmias, ventricular arrhythmias, Bradyarrhythmias.

  • Aorta disease and Marfan syndrome – Disorders of the aorta-the main artery that supplies blood from the heart-can be extremely life threatening. Aneurysms, tears in the inner lining, and ulcers are types of aortic disease that require treatment.

  • Heart failure –   A chronic condition in which the heart doesn't pump blood as well as it should. Heart failure can occur if the heart cannot pump (systolic) or fill (diastolic) adequately. Symptoms include shortness of breath, fatigue, swollen legs and rapid heartbeat. Treatments can include eating less salt, limiting fluid intake and taking prescription medication. In some cases, a defibrillator or pacemaker may be implanted.

  • Heart muscle disease (cardiomyopathy) – An acquired or hereditary disease of heart muscle, this condition makes it hard for the heart to deliver blood to the body, and can lead to heart failure. Symptoms include breathlessness, swollen legs and feet and a bloated stomach.

  • Pericardial disease – Pericardial disease affects the pericardium, which is the flexible two-layered sac that envelops the heart including pericarditis and pericardial effusion.

  • Hypertension Usually hypertension is defined as blood pressure >/= 140/90, and is considered severe if the pressure is >/= 180/110. High blood pressure often has no symptoms. Over time, if untreated, it can cause health conditions, such as heart disease and stroke. Eating a healthier diet with less salt, exercising regularly and taking medication can help lower blood pressure.

 

Heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Strokes can be caused by bleeding from a blood vessel in the brain or from blood clots.
 

What are the risk factors for cardiovascular disease?
The most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of heart attack, stroke, heart failure and other complications.


Cessation of tobacco use, reduction of salt in the diet, eating more fruit and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. Health policies that create conducive environments for making healthy choices affordable and available are essential for motivating people to adopt and sustain healthy behaviours.


There are also a number of underlying determinants of CVDs. These are a reflection of the major forces driving social, economic and cultural change – globalization, urbanization and population ageing. Other determinants of CVDs include poverty, stress and hereditary factors.
 

In addition, drug treatment of hypertension, diabetes and high blood lipids are necessary to reduce cardiovascular risk and prevent heart attacks and strokes among people with these conditions.


What are common symptoms of cardiovascular diseases?
 

Symptoms of heart attacks and strokes
Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke may be the first sign of underlying disease. Symptoms of a heart attack include:

  • Pain or discomfort in the center of the chest; and/or

  • Pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.

 

In addition, the person may experience difficulty in breathing or shortness of breath; nausea or vomiting; light-headedness or faintness; a cold sweat; and turning pale. Women are more likely than men to have shortness of breath, nausea, vomiting, and back or jaw pain.


The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one side of the body. Other symptoms include sudden onset of:

  • Numbness of the face, arm, or leg, especially on one side of the body;

  • Confusion, difficulty speaking or understanding speech;

  • Difficulty seeing with one or both eyes;

  • Difficulty walking, dizziness and/or loss of balance or coordination;headache with no known cause; and/or

  • Fainting or unconsciousness.


People experiencing these symptoms should seek medical care immediately.


Symptoms of blockages in peripheral blood vessels throughout your body:

  • Pain or cramps in your legs when you walk.

  • Leg sores that aren’t healing.

  • Cool or red skin on your legs.

  • Swelling in your legs.

  • Numbness in your face or a limb. This may be on only one side of your body.

  • Difficulty with talking, seeing or walking.

How is cardiovascular disease diagnosed?

Your healthcare provider will perform a physical exam and ask questions about your symptoms, personal health and family health history. They may also order tests to help diagnose cardiovascular disease.

 

What tests might I have for cardiovascular disease?

Some common tests to diagnose cardiovascular disease include:

  • Blood work measures substances that indicate cardiovascular health, such as cholesterol, blood sugar levels and specific proteins. A provider can use a blood test to check for blood clotting issues as well.

  • Ankle brachial index (ABI) compares the blood pressure in your ankles and arms to diagnose peripheral artery disease.

  • Electrocardiogram (EKG) records your heart’s electrical activity.

  • Ambulatory monitoring uses wearable devices that track your heart rhythm and rates.

  • Echocardiogram uses sound waves to create an image of your heartbeat and blood flow.

  • Ultrasound uses sound waves to check blood flow in your legs or neck.

  • Cardiac computerized tomography (CT) uses X-rays and computer processing to create 3D images of your heart and blood vessels.

  • Cardiac magnetic resonance imaging (MRI) uses magnets and radio waves to create highly detailed images of your heart.

  • MR angiogram or CT angiogram uses an MRI or CT, respectively, to see blood vessels in your legs, head and neck.

  • Stress tests analyze how physical activity affects your heart in a controlled setting, using exercise or medications, to determine how your heart responds. This type of test can involve EKGs and/or imaging tests.

  • Cardiac catheterization uses a catheter (thin, hollow tube) to measure pressure and blood flow in your heart.

 

How is cardiovascular disease treated?

Treatment plans can vary depending on your symptoms and the type of cardiovascular disease you have. Cardiovascular disease treatment may include:

  • Lifestyle changes: Examples include changing your diet, increasing your aerobic activity and quitting smoking or tobacco products (including vaping).

  • Medications: Your healthcare provider may prescribe medications to help manage cardiovascular disease. Medication type will depend on what kind of cardiovascular disease you have.

  • Procedures or surgeries: If medications aren’t enough, your healthcare provider may use certain procedures or surgeries to treat your cardiovascular disease. Examples include stents in your heart or leg arteries, minimally invasive heart surgery, open-heart surgery, ablations or cardioversion.

  • Cardiac rehabilitation: You may need a monitored exercise program to help your heart get stronger.

  • Active surveillance: You may need careful monitoring over time without medications or procedures/surgeries.

Prevention

How can I prevent cardiovascular disease?


You can't prevent some types of cardiovascular disease, such as congenital heart disease. But lifestyle changes can reduce your risk of many types of cardiovascular disease.


You can reduce your cardiovascular risks by:

  • Avoiding all tobacco products.

  • Managing other health conditions, such as Type 2 diabetes, high cholesterol or high blood pressure.

  • Achieving and maintaining a healthy weight.

  • Eating a diet low in saturated fat and sodium.

  • Exercising at least 30 to 60 minutes per day on most days.

  • Reducing and managing stress.

 

Outlook / Prognosis

What is the outlook for people with cardiovascular disease?

  • Many people enjoy a high quality of life and can manage their cardiovascular disease with the help of their healthcare team. Your chances for a positive outcome are higher if you engage in your healthcare and follow your provider’s treatment plan. It’s important to take medications exactly as prescribed.

 

Does cardiovascular disease increase my risk of other conditions?

Untreated cardiovascular disease can lead to serious complications.

If you have cardiovascular disease, you may have a higher risk of:

  •  Heart attack.

  • Stroke.

  • Acute limb ischemia (sudden blockage in your leg arteries).

  •  Aortic dissection.

  • Sudden cardiac death.

 

Living With

When Should I See My Healthcare Provider?

Cardiovascular disease is often easier to treat when healthcare providers catch it early. That’s why it’s important to see a primary care provider every year. They can detect cardiovascular issues before symptoms start. If you have any signs of cardiovascular disease, you should see your provider immediately.

Call +256 709 756 635 or seek emergency medical attention if you experience sudden:

  • Chest pain, pressure, heaviness or discomfort, especially with exertion.

  • Fainting (syncope).

  • Severe shortness of breath, especially if it’s new or progressive.

  • Pain or numbness in your arms/legs.

  • Ripping or tearing back pain.

 

A note from Pan Medical Services Kampala.

Cardiovascular diseases are conditions that affect your heart and blood vessels. Without appropriate treatment, heart disease can lead to heart attacks or strokes. You can make lifestyle changes or take medications to manage cardiovascular disease. Earlier diagnosis can help with effective treatment. Many people live a full and active life with a cardiovascular disease.

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