Heart Attack: Atherosclerosis that occurs in the coronary arteries can deprive the heart of oxygen-rich blood until the affected area of the heart literally dies, causing a myocardial infarction (heart attack), sometimes leading to cardiac arrest (stopped heartbeat) that often results in death. Heart attacks are responsible for about 500,000 deaths annually in the U.S., and there are an estimated 1,500,000 new and recurrent cases every year. Often, a diminished blood supply to the heart exhibits few symptoms until the blockage is so great that a heart attack results. But while a heart attack may appear to come on suddenly, it often begins with years of physical neglect, such as a poor diet and lack of exercise. Genetic predisposition can also be a crucial factor.

Coronary Stenosis: In coronary occlusion, arteries that course over the surface of, and penetrate into, the heart muscle become narrowed so that blood flow through them is restricted. The heart muscle stops receiving adequate amounts of oxygen and nutrients and a person develops angina. This means the heart muscle’s pumping capacity has been exceeded. Coronary stenosis is commonly caused by atherosclerosis, the buildup of plaque and clogging in the arteries that can lead to heart attacks.

Angina: Angina (discomfort, heaviness, or pressure in the chest or throat) can result when there are lesions in the coronary arteries or valves of the heart. These lesions diminish the supply of oxygenated blood to the heart muscle, causing discomfort to radiate from the throat or chest to the shoulder and down the left arm, in some cases.

“Silent angina” is a form of angina that manifests without discomfort, other than shortness of breath, numbness in the arm, dizziness, or other vague symptoms caused by overexertion or emotional stress. About 50% of all people with coronary stenosis develop silent angina. Often, their first awareness of having heart disease is when they have a sudden heart attack. Overall, however, angina is a warning sign that there are problems with the heart, but is not necessarily a precursor of a heart attack if appropriate treatment is initiated.

Congestive Heart Failure: Congestive heart failure (cardiomyopathy) is failure of the heart muscle. The heart becomes congested with blood and dangerously weakened. Congestive heart failure is most commonly caused by coronary stenosis or occlusion and heart attacks. Repeated heart attacks can damage large sections of the heart muscle, so that there is not enough heart muscle left intact to pump blood out of the heart. Cardiomyopathy can also be caused by viral infections that damage the heart muscle. As the pressure and volume of blood inside the heart’s pumping chamber increases, additional pressure is placed on arteries and veins in the lungs, resulting in fluid leaks into the lungs and the start of the cardiomyopathy process. A typical sign of congestive heart failure is shortness of breath, either with minimal exertion or when lying down at night.

Stroke: Twenty-five percent of the blood pumped from the heart goes to the brain and, if the blood flow to a part of the brain is interrupted for any reason, the affected brain cells are deprived of oxygen and die, resulting in a stroke, the third leading cause of death in the U.S.9 Stroke can lead to loss of speech, physical movement, or eyesight, depending on the area of the brain affected. Of the 500,000 Americans who suffer a stroke every year, nearly two-thirds become handicapped. There are currently over two million people in the U.S. disabled by stroke.

Atherosclerosis of the cerebral arteries can affect blood flow to the brain and increase the risk of stroke. A stroke can also result from a blood clot that has formed in a narrowed cerebral artery or as a result of a clot formed elsewhere in the body, usually in the heart or arteries of the neck, and carried in the bloodstream to the head as a thromboembolus. Other causes include a blood vessel that ruptures or hemorrhages, causing blood to spill into the brain, not only damaging the brain cells directly, but resulting in further damage to brain tissue due to lack of oxygen when the blood supply is interrupted. Strokes have also been associated with inherited disorders, birth defects, and certain rare blood diseases.