Heart disease has many causes, however, we will discuss those causes of heart disease most commonly seen at the Medical Examiners Office.

Coronary artery disease, also known as atherosclerosis, or arteriosclerosis is the leading cause of death in the United States. It is commonly referred to as a heart attack. The coronary arteries supply the heart muscle, or myocardium, with blood. Blockage of one or several coronary arteries will prevent the necessary blood flow to the heart which can lead to sudden death. The blockage occurs from the build-up of plaque, which are deposits of fat-like substances, cholesterol, calcium and other cellular waste products in the inner lining of the artery. Consider a water pipe in your home through which water flows freely. Any material that adheres to the pipe will cause other materials to get caught in this same area. Eventually, you may have enough of a build-up to narrow the pipe's circumference, or lumen. If left untreated, you will have a clog with no flow of water beyond the obstruction. Which artery and where within an artery a plaque will develop varies with each person.

Approximately 30 percent to 40 percent of heart attacks occur without the person suffering any signs or symptoms prior to death. These symptoms include:

• chest pain
• shortness of breath or difficulty breathing
• sweating or cold sweats
• dizziness
• nausea
• paleness
• palpitations (fast heart rate)
• pain in the arms
• back or neck
• prolonged burning feeling in the chest often confused with heartburn.

If you have any of these symptoms, take an aspirin and call an ambulance immediately. If your doctor has prescribed medication for you to take in case of chest pains, then do so.

Although a person may never have any of the above symptoms, the following risk factors place a person in danger of having a heart attack:

• A diet rich in fat
• Smoking
• High blood pressure
• No regular aerobic exercise
• High blood cholesterol
• Overweight
• Obesity
• Diabetes
• Family history of heart disease, high blood pressure or diabetes
• Stress
• Increased alcohol intake

Coronary artery disease is a slow, progressive disease that can even begin in childhood. In some people the disease may progress rapidly in their early 30's or 40's, while in others it may not become threatening until the later decades. About 4 out of 5 people who die of coronary artery disease are 65 or older. At older ages, women who suffer a heart attack are more likely than men to die. Nevertheless, men have a greater risk than women of having a heart attack, and men also have heart attacks earlier in life.

For a detailed explanation of how the risk factors contribute to the development of coronary artery disease visit the American Heart Association's web site.

Hypertension , or hypertensive heart disease is the medical term for high blood pressure. A blood pressure of approximately 120 / 80 is considered optimum and can fluctuate to about 140 / 90. The first number represents the systolic pressure and is the number recorded while the heart is beating. The second number represents the diastolic number and is the number recorded while the heart is resting between beats. The goal is to maintain your blood pressure within the limits previously described. While high blood pressure is certainly undesirable and can lead to stroke, heart attack and other problems, low blood pressure can also indicate a medical problem. A person can have high blood pressure and have no symptoms. Some diseases can cause high blood pressure. There are two types of hypertension: essential and secondary. The cause of essential hypertension is generally unknown. The cause of secondary hypertension is a recognizable underlying disease state.

High blood pressure is harmful because it causes the heart to work harder than normal and this tends to enlarge the heart and eventually weaken it. In addition, the arteries of the heart can become hardened and less elastic over time. This damage to the arteries leads to a decrease in the amount of blood that all of the body's organs need. Certain factors increase the chance that a person will have hypertension such as:

• Heredity
• Race, i.e., African-Americans are more likely to have high blood pressure than Caucasians
• Males, until age 55, then women have the same risk as men and after age 75 women are more likely than men to develop hypertension
• Salt
• Overweight and obesity
• Inactive lifestyle
• Heavy alcohol consumption
• Oral contraceptives and certain other medications
• Diabetes, gout and kidney disease tends to increase hypertension
• High-risk pregnancies

Your doctor can prescribed medication to help lower your blood pressure, if you are one of the many Americans that has this condition. A diet rich in fruits, vegetables, fat-free and low-fat dairy products are essential in order to reduce blood pressure. Medication, along with a healthy diet and lifestyle changes can help reduce your blood pressure and decrease your risk of heart attack, stroke and death.

For additional topics of interest, log on to Florida Department of Health