OVERVIEW

What is the cardiovascular system?

The heart is a powerful muscular pump that propels blood into major blood vessels through myocardial contractions, delivering blood throughout the body via an extensive vascular network. The heart and blood vessels together constitute the cardiovascular system.

What are the major categories of cardiovascular diseases?

• Congenital heart diseases: such as atrial septal defect, tetralogy of Fallot, etc.
• Heart diseases secondary to other conditions: such as hypertensive heart disease, rheumatic heart disease, hyperthyroid heart disease, cor pulmonale, etc.
• Coronary atherosclerotic heart disease (coronary heart disease): including angina pectoris, myocardial infarction, etc.
• Valvular heart diseases: such as mitral stenosis, aortic regurgitation, etc.
• Pericardial diseases: such as pericarditis, etc.
• Endocardial diseases: such as infective endocarditis, etc.
• Major vascular diseases: such as aortic aneurysm, aortic dissection, etc.
• Hypertension
• Cardiomyopathies: such as myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, etc.
• Arrhythmias: including atrial premature beats (APB), atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), ventricular premature beats (VPB), ventricular tachycardia (VT), etc.

SYMPTOMS

What are the common symptoms of cardiovascular system diseases?

• Chest discomfort such as chest pain and tightness;
• Palpitations;
• Shortness of breath and difficulty breathing;
• Blackouts (sudden vision loss) and fainting.

CAUSES

What are the common causes of cardiovascular system diseases?

Smoking, alcoholism, obesity, hypertension, diabetes, hyperlipidemia, rheumatic diseases, hyperthyroidism, anemia, viral infections, etc. are all common causes of cardiovascular system diseases.

DIAGNOSIS

What are the common tests for cardiovascular system diseases?

• Electrocardiogram (ECG) and Holter monitoring: Can determine heart rate (beats per minute) and rhythm (whether the heartbeat is regular), and detect arrhythmias, myocardial ischemia, etc.
• Echocardiography: Can assess the structure and function of the pericardium, heart, and major artery origins, detecting congenital heart disease, pericardial effusion, abnormal myocardial motion, valvular heart disease, and abnormal pulmonary artery pressure.
• Treadmill stress test: Increases cardiac workload through exercise to observe ECG changes during physical activity, evaluating the degree of coronary artery insufficiency.
• Coronary CTA and angiography: Can identify severe coronary artery stenosis affecting myocardial blood supply.
• Cardiac MRI perfusion: Evaluates myocardial blood flow, tissue characteristics, and contractile function.

##What is coronary angiography in cardiovascular disease testing?
Coronary angiography involves puncturing a superficial artery (femoral artery in the groin or radial artery in the wrist), advancing a catheter through the artery to the coronary artery openings, and injecting contrast dye to visualize the coronary arteries under X-ray, assessing the severity of coronary artery stenosis.

Coronary angiography is used to diagnose coronary heart disease and evaluate its severity.

TREATMENT

What does PCI refer to in cardiovascular diseases?

Percutaneous coronary intervention (PCI) involves puncturing a superficial artery (such as the femoral artery in the groin or the radial artery in the wrist) and guiding a catheter through the artery to the coronary arteries of the heart. A stent is then placed via the catheter into the severely narrowed section of the coronary artery, expanded to restore normal vessel diameter and blood flow, and ensure adequate myocardial blood supply.

PCI is used to treat coronary artery disease (CAD) patients with severe coronary stenosis. Some acute myocardial infarction patients can be saved if they arrive at the hospital in time for PCI treatment. Suitability for PCI must be assessed by a professional cardiologist.

What is coronary artery bypass grafting (CABG) in cardiovascular diseases?

Coronary artery bypass grafting (CABG), performed by cardiac surgeons, requires open-chest surgery.

The surgeon uses a suitable blood vessel from another part of the patient's body as a "graft vessel," connecting one end to the aorta and the other end beyond a severely narrowed or blocked segment of a coronary artery. This allows blood to bypass the blockage and reach the heart muscle.

CABG is suitable for patients with severe coronary artery stenosis who are not candidates for PCI due to extensive or complex blockages.

What is radiofrequency ablation in cardiovascular diseases?

Radiofrequency ablation involves puncturing a suitable blood vessel and guiding an electrode catheter to a specific area of the heart. Radiofrequency energy is then applied to destroy abnormal heart tissue responsible for irregular electrical signals.

This procedure is used to treat certain rapid heart rhythm disorders, such as atrial fibrillation.

What is pacemaker implantation in cardiovascular diseases?

Pacemaker implantation involves placing a small device under the skin that sends electrical impulses to regulate the heartbeat. It is used for patients with severe or irreversible sinus node dysfunction (e.g., sinus arrest) or conduction disorders (e.g., third-degree atrioventricular block).

What is ICD implantation in cardiovascular diseases?

An implantable cardioverter-defibrillator (ICD) combines pacing and defibrillation functions. Typically implanted in the left chest, it detects severe ventricular arrhythmias (e.g., ventricular tachycardia, ventricular flutter, or fibrillation) and delivers electrical shocks to restore normal rhythm, protecting the patient's life.

ICDs are used for patients with recurrent, life-threatening ventricular arrhythmias.

What is the role of aspirin in cardiovascular diseases?

Aspirin has multiple effects, but its primary role in cardiovascular disease is inhibiting platelet aggregation. It is commonly used to treat coronary artery disease and prevent recurrent myocardial infarction.

Common side effects include allergies, gastrointestinal ulcers, bleeding, and liver or kidney damage at high doses. It should be taken after meals or with antacids. Seek medical attention if symptoms like abdominal pain, black stools, or unusual bleeding occur.

What is the role of warfarin in cardiovascular diseases?

Warfarin inhibits vitamin K-dependent clotting factor synthesis in the liver, acting as an anticoagulant. It is used to prevent and treat thromboembolic diseases.

Common side effects include bleeding (e.g., nosebleeds, gum bleeding, bruising). Liver or kidney damage may occur but usually resolves after discontinuation. Avoid grapefruit juice and maintain a consistent vitamin K intake. Regular blood tests are needed to adjust dosage.

What is the role of statins in cardiovascular diseases?

Common statins include atorvastatin, rosuvastatin, lovastatin, simvastatin, and pravastatin.

Statins lower cholesterol and stabilize arterial plaques. They improve lipid profiles (reducing LDL and increasing HDL) in hyperlipidemia patients and reduce the risk of acute cardiovascular events in CAD and cerebrovascular disease patients.

Side effects may include liver dysfunction and muscle pain (rhabdomyolysis). Regular liver and muscle enzyme tests are necessary.

What are the common types of antihypertensive drugs for cardiovascular diseases?

Antihypertensives are classified into five main categories: diuretics, beta-blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin II receptor blockers (ARBs). The choice depends on individual conditions, so patients should use them under medical supervision.

What is the role of beta-blockers in cardiovascular diseases?

Common beta-blockers include propranolol, metoprolol, and atenolol.

They slow heart rate, dilate blood vessels, lower blood pressure, and relieve angina. They are used for hypertension, rapid arrhythmias, angina, and chronic heart failure.

Side effects include hypotension, bradycardia, hypoglycemia, and bronchospasm. Avoid use in patients with asthma, severe bradycardia, or advanced heart block.

What is the role of ACE inhibitors in cardiovascular diseases?

Common ACEIs include captopril, enalapril, cilazapril, benazepril, perindopril, and ramipril.

ACEIs dilate blood vessels, reduce vascular resistance, improve coronary blood flow, and prevent heart remodeling. They treat hypertension, myocardial infarction, and heart failure.

Side effects include dry cough and hypotension. Patients intolerant to cough may switch to ARBs.

What is the role of ARBs in cardiovascular diseases?

Common ARBs include losartan, irbesartan, valsartan, and telmisartan.

ARBs lower blood pressure, reverse left ventricular hypertrophy, protect against diabetes, reduce proteinuria, and prevent atrial fibrillation. They are used for hypertensive patients with diabetes or kidney damage, as well as chronic heart failure.

Side effects are rare but may include headache and hyperkalemia. Dosage adjustment or drug change may be needed if intolerable.

DIET & LIFESTYLE

Precautions for daily life can be found in the respective disease sections.

PREVENTION

How to prevent cardiovascular diseases?

• Maintain a healthy lifestyle, including: quitting smoking, limiting alcohol, maintaining a slim figure, eating a low-salt, low-fat, and low-sugar diet, exercising moderately, avoiding chronic sleep deprivation, and learning to relieve psychological stress.

• Actively manage chronic conditions that can lead to cardiovascular diseases, such as hypertension, diabetes, hyperthyroidism, and anemia.

• Schedule regular health check-ups to detect early signs of cardiovascular diseases and intervene promptly, preventing worsening conditions and increasing treatment difficulty.