Condition: Terminology
This page provides definitions of commonly used terms and cardiovascular conditions.
Cardiovascular disease (CVD), also known as heart disease, is a general term for a variety of conditions (such as those noted below) that affect the heart and blood vessels, that can lead to serious health implications such as heart attack and death. CVD is one of the leading causes of death in Canada and worldwide (University of Ottawa Heart Institute, 2011).
Atherosclerosis: A buildup of plaque (consisting of substances such as cholesterol) over time, which hardens and narrows the arteries to various parts of the body such that blood flow is slowed or blocked. A restriction of blood flow to the brain can cause a stroke. Poor blood flow to the arms or legs is called peripheral artery disease (PAD), while a poor blood flow to the heart is called coronary artery disease (CAD) and can cause angina or heart attack. Atherosclerosis is caused by a combination of genetic and lifestyle factors, and may start at an early age.
Angina: Pain or pressure in the middle of the chest, that may spread up to the arms, neck, or jaw, with a shortness of breath, sweating, or nausea. This pain generally diminishes when resting or with nitroglycerin medication. Due to a buildup of plaque on the coronary arteries to the heart, causing poor blood flow and a reduction in oxygen (University of Ottawa Heart Institute, 2011).
Unstable Angina: A change in pattern of chest pain, occurring more frequently, with less exercise, or lasting longer than usual. Due to a sudden opening of plaque in the artery, and although blood forms a clot over the cracked plaque, the clot causes a narrowing in the artery. (University of Ottawa Heart Institute, 2011).
Canadian Cardiovascular Society Angina Class:
Class Criteria
CCS 0 Asymptomatic
CCS I Ordinary physical activity such as walking or climbing stairs does not cause angina. Angina with strenuous, rapid or prolonged exertion at work or recreation.
CCS II Slight limitation of ordinary activity. Walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, or in a cold, or in a wind, or under emotional stress, or during the few hours after awakening. Walking more than two blocks on the level and climbing more than one flight of stairs at a normal pace and in normal conditions.
CCS III Marked limitation of ordinary physical activity. Walking one or two blocks on the level or climbing one flight of stairs in normal conditions at a normal pace.
CCS IV-A Inability to carry out any physical activity without discomfort. Anginal syndrome may be present at rest. Patient admitted to hospital and becomes relatively asymptomatic with aggressive medical therapy and may be managed on outpatient basis.
CCS IV-B Inability to carry out any physical activity without discomfort. Anginal syndrome may be present at rest. Patient admitted to hospital continues to experience angina on maximal medical therapy and cannot be safely discharged home, but does not require IV nitroglycerin.
CCS IV-C Inability to carry out any physical activity without discomfort. Anginal syndrome may be present at rest. Patient admitted to hospital continues to experience angina on maximal medical therapy, including IV nitroglycerin, fails to control symptoms or there is hemodynamic instability.
CCS IV-D Shock
Heart Attack (Myocardial Infarction): When the heart does not receive enough oxygen for more than 20 minutes, a part of the heart muscle dies, and some permanent damage occurs. Blood tests and an electrocardiogram (ECG) confirm that a heart attack has occurred.Depending on the area of the heart involved, and the degree of damage, medical treatment varies. Larger heart attacks are called ST-elevation myocardial infarctions (STEMI), and require immediate treatment with clot dissolving drugs or opening the artery with balloon angioplasty and stents. (University of Ottawa Heart Institute, 2011).
Heart Damage: Depending on the heart attack, the amount and severity of damage to heart muscle will occur. This damage can be measured the strength of the heart, looking at pumping strength and the heart valves, such as a MUGA or a ventriculogram, commonly done during an angiogram. (University of Ottawa Heart Institute, 2011).
Congestive Heart Failure (CHF): A disease process that progressively weakens the myocardium, causing unsteady increase in the end-diastolic and end-systolic volumes. As a result, the heart has difficulty pumping blood through the body and congestion and edema (collection of blood and fluid in areas of the body) can result. (Saunders, 2001).
a common condition that develops after the heart becomes damaged or weakened by diseases of the heart including heart attacks and other medical conditions. HF occurs when the pumping action of your heart is not strong enough to move blood around, especially during increased activity or under stress. In addition, the heart muscle may not relax properly to accommodate the flow of blood back from the lungs to the heart. These abnormalities in heart function can cause fluid to back up in your lungs and in other parts of your body such as your ankles. The congestion in your lungs and lack of oxygen may make you feel tired and short of breath. Sometimes the fluid in your lungs can accumulate to the point where it can cause a life-threatening condition called acute pulmonary edema, requiring emergency treatment (Heart and Stroke Foundation, 2013).
CHF is classified using the New York Heart Association (NYHA) Functional Classification (New York Heart Association Functional Classification, n.d.)
Class Criteria
I No symptoms and no limitations in ordinary physical activity
II Mild symptoms and slight limitation during ordinary activity. Comfortable at rest.
III Marked limitations in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.
IV Severe limitations. Experiences symptoms even while at rest. Any activity leads to increase discomfort.
Other Commonly Used Terms Related to Cardiovascular Disease
Atrial Fibrillation (A-Fib): A condition involving an irregular heart rhythm (arrhythmia). It is the most common type of arrhythmia, affecting approximately 350,000 Canadians. Generally, the risk of developing AF increases with age and with other risk factors such as diabetes, high blood pressure, and underlying heart disease. One of the main complications of atrial fibrillation is stroke. (Heart and Stroke Foundation, 2014).
Atrial tacycardia (A-Tach):
a) A rapidly firing focus which may originate from either atria, usually warranting medical therapy or complex catheter ablation. b) A supraventricular tachycardia (SVT) that does not require the atrioventricular (AV) junction, accessory pathways, or ventricular tissue for its initiation and maintenance. It occurs in persons with normal hearts and in those with structurally abnormal hearts, including individuals with congenital heart disease (particularly after surgery for repair or correction of congenital or valvular heart disease). In patients with structurally normal hearts, atrial tachycardia is associated with a low mortality rate. Patients with underlying structural heart disease, congenital heart disease, or lung disease are less likely to be able to tolerate this rhythm disturbance. (Budzikowski, 2014).
Cardiomyopathy: diseases of cardiac muscle
Cardiac dysrhythmias: abnormalities of heart rhythm
Cerebrovascular disease: disease of blood vessels that supply blood to the brain such as stroke.
Congenital heart disease: heart structure malformations existing at birth.
Cor pulmonale: a failure at the right side of the heart with respiratory system involvement
Endocarditis: Inflammation of the inner layer of the heart, the endocardium. The structures most commonly involved are the heart valves.
Hypertensive heart disease: diseases of the heart secondary to high blood pressure
Myocarditis: inflammation of the myocardium, the muscular part of the heart.
Peripheral arterial disease: disease of blood vessels that supply blood to the arms and legs.
Rheumatic heart disease: heart muscles and valves damage due to rheumatic fever caused by streptococcal bacteria infections
References
Budzikowski, A.S. (2014). Atrial Tachycardia. Retrieved from http://emedicine.medscape.com/article/151456-overview
Heart and Stroke Foundation (2014). Atrial Fibrilation- Be pulse Aware. Retrieved from http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.5052135/k.2C86/Heart_disease__Atrial_fibrillation.htm
New York Heart Association Functional Classification (n.d.). http://www.sciencedaily.com/encyclopedia/new_york_heart_association_functional_classification
Saunders, W.B. (2001). AACN procedure manual for critical care. 4th edition.
University of Ottawa Heart Institute (2011). About Heart Disease. Coronary Artery Disease, A guide for Patients and Families, p. 2,3.