Heart Diseases: Complete Overview with Treatments

1. Coronary Artery Disease (CAD) / Ischemic Heart Disease

• Stable angina - chest pain on exertion that resolves with rest
• Unstable angina - chest pain at rest or with minimal effort (medical emergency)
• Acute Myocardial Infarction (Heart Attack) - complete blockage causing heart muscle death
• Silent ischemia - ischemia without symptoms

• Lifestyle changes: low-salt/low-fat diet, exercise, smoking cessation
• Medications: aspirin, clopidogrel, statins (atorvastatin, rosuvastatin), beta-blockers (bisoprolol, metoprolol), nitrates (glyceryl trinitrate), ACE inhibitors, PCSK9 inhibitors (evolocumab)
• Procedures: Percutaneous Coronary Intervention (PCI/angioplasty + stent), Coronary Artery Bypass Graft (CABG) surgery
• Cardiac rehabilitation

2. Heart Failure (HF)

• HFrEF - Heart failure with reduced ejection fraction (systolic HF, EF <40%)
• HFpEF - Heart failure with preserved ejection fraction (diastolic HF, EF ≥50%)
• HFmrEF - Heart failure with mildly reduced EF (40-49%)
• Acute (decompensated) heart failure
• Chronic heart failure

• ACE inhibitors (enalapril, ramipril) or ARBs (sacubitril/valsartan - ARNI)
• Beta-blockers (carvedilol, bisoprolol, metoprolol succinate)
• Mineralocorticoid receptor antagonists (spironolactone, eplerenone)
• SGLT2 inhibitors (dapagliflozin, empagliflozin) - now standard of care
• Diuretics (furosemide) for fluid overload
• Devices: Cardiac Resynchronization Therapy (CRT), Implantable Cardioverter-Defibrillator (ICD)
• Heart transplant (end-stage)
• Mechanical circulatory support (LVAD - left ventricular assist device)

3. Arrhythmias (Abnormal Heart Rhythms)

• Atrial Fibrillation (AFib) - most common sustained arrhythmia; irregular, rapid atrial activity
• Atrial Flutter
• Supraventricular Tachycardia (SVT) - rapid heart rate from above the ventricles
• Ventricular Tachycardia (VT) - rapid rhythm from the ventricles; potentially fatal
• Ventricular Fibrillation (VF) - chaotic ventricular activity; cardiac arrest
• Bradycardia - heart rate too slow (<60 bpm)
• Heart block (AV block) - 1st, 2nd (Mobitz I/II), 3rd degree
• Sick Sinus Syndrome
• Wolff-Parkinson-White (WPW) Syndrome
• Long QT Syndrome
• Brugada Syndrome

• Rate control (beta-blockers, calcium channel blockers, digoxin)
• Rhythm control (antiarrhythmics: amiodarone, flecainide, sotalol)
• Anticoagulation for AFib (warfarin, dabigatran, rivaroxaban, apixaban) to prevent stroke
• Cardioversion (electrical or chemical)
• Catheter ablation (radiofrequency or cryoablation)
• Pacemaker implantation (for bradycardia, heart block)
• ICD implantation (for VT/VF prevention)
• Defibrillation (emergency for VF/VT)

4. Valvular Heart Disease

• Aortic Stenosis - narrowing of aortic valve
• Aortic Regurgitation (Insufficiency) - leaking aortic valve
• Mitral Stenosis - commonly from rheumatic fever
• Mitral Regurgitation - leaking mitral valve
• Mitral Valve Prolapse (MVP)
• Tricuspid Stenosis / Regurgitation
• Pulmonary Stenosis / Regurgitation

• Medical management: diuretics, ACE inhibitors, anticoagulation
• Surgical valve repair or replacement (mechanical or bioprosthetic valve)
• Transcatheter Aortic Valve Replacement (TAVR) - minimally invasive
• Transcatheter edge-to-edge repair (MitraClip) for mitral regurgitation
• Balloon valvuloplasty (for mitral/pulmonary stenosis)

5. Cardiomyopathy

• Dilated Cardiomyopathy (DCM) - enlarged, weakened heart; most common type
• Hypertrophic Cardiomyopathy (HCM) - abnormal thickening of the heart muscle; leading cause of sudden cardiac death in young athletes
• Restrictive Cardiomyopathy - stiff heart muscle (seen in amyloidosis, sarcoidosis)
• Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) - fatty/fibrous replacement of RV muscle
• Stress Cardiomyopathy (Takotsubo / "Broken Heart Syndrome")
• Peripartum Cardiomyopathy
• Alcoholic Cardiomyopathy
• Ischemic Cardiomyopathy

• HCM: beta-blockers, calcium channel blockers, mavacamten (new cardiac myosin inhibitor), septal myectomy surgery, alcohol septal ablation, ICD
• DCM: same as heart failure medications (ACE inhibitors, beta-blockers, SGLT2i, diuretics)
• Restrictive: treat underlying cause (e.g., tafamidis for cardiac amyloidosis)
• Takotsubo: supportive care, usually self-resolving
• Heart transplant for end-stage disease

6. Congenital Heart Disease (CHD)

• Atrial Septal Defect (ASD) - hole between upper chambers
• Ventricular Septal Defect (VSD) - hole between lower chambers (most common CHD)
• Patent Ductus Arteriosus (PDA) - persistent fetal vessel connecting aorta and pulmonary artery
• Tetralogy of Fallot (ToF) - 4-component defect; most common cyanotic CHD
• Transposition of the Great Arteries (TGA)
• Coarctation of the Aorta
• Pulmonary Stenosis / Atresia
• Tricuspid Atresia
• Ebstein Anomaly
• Hypoplastic Left Heart Syndrome (HLHS)
• Atrioventricular Septal Defect (AVSD) - common in Down syndrome

• Watchful waiting for small defects that close spontaneously (small VSD, ASD)
• Medications: indomethacin or ibuprofen to close PDA; prostaglandins to keep PDA open
• Catheter-based procedures: device closure of ASD/VSD/PDA
• Surgical repair (open-heart surgery)
• Palliative procedures (e.g., Blalock-Taussig shunt, Fontan procedure for single ventricle hearts)
• Heart transplant for HLHS and other inoperable defects

7. Pericardial Disease

• Acute Pericarditis - inflammation of the pericardium (viral, bacterial, autoimmune)
• Constrictive Pericarditis - chronic scarring/stiffening of the pericardium
• Pericardial Effusion - fluid accumulation around the heart
• Cardiac Tamponade - life-threatening compression of the heart by fluid

• NSAIDs (ibuprofen, aspirin) + colchicine for acute pericarditis
• Corticosteroids for refractory/autoimmune cases
• Pericardiocentesis (needle drainage) for effusion/tamponade
• Pericardiectomy (surgical removal of pericardium) for constrictive pericarditis

8. Hypertensive Heart Disease

• Antihypertensives: ACE inhibitors, ARBs, calcium channel blockers, thiazide diuretics, beta-blockers
• Lifestyle modification
• Treat complications (heart failure, arrhythmia)

9. Infective Endocarditis

• Prolonged IV antibiotics (4-6 weeks): penicillin, oxacillin, vancomycin, gentamicin (organism-directed)
• Surgical valve repair or replacement for complicated cases (large vegetations, heart failure, abscess)

10. Rheumatic Heart Disease

• Penicillin prophylaxis to prevent recurrent strep infections
• Medical management of valvular disease
• Surgical or transcatheter valve repair/replacement

11. Aortic Diseases

• Aortic Aneurysm - dilation of the aorta (abdominal or thoracic)
• Aortic Dissection - tear in the aortic wall (Type A/B)

• Blood pressure control (beta-blockers, ACE inhibitors)
• Endovascular stent-graft (EVAR/TEVAR)
• Emergency surgery for Type A dissection or ruptured aneurysm

12. Pulmonary Heart Disease

• Cor Pulmonale - right heart failure caused by lung disease (COPD, pulmonary fibrosis)
• Pulmonary Arterial Hypertension (PAH)

• PAH: phosphodiesterase-5 inhibitors (sildenafil, tadalafil), endothelin receptor antagonists (bosentan, ambrisentan), prostacyclins (epoprostenol)
• Treat underlying lung disease
• Oxygen therapy, diuretics

13. Cardiac Tumors

• Atrial Myxoma - most common primary cardiac tumor (benign, in left atrium)
• Lipoma, Fibroma, Rhabdomyoma
• Metastatic tumors (secondary tumors more common than primary)

• Surgical excision for myxoma and symptomatic benign tumors
• Chemotherapy/radiation for malignant tumors

Summary Table

Note: This is a medical overview for educational purposes. All diagnoses and treatments must be determined by a qualified physician based on individual patient assessment.