Congenital disorder manifests in newborn, and characterized by poor feeding, blue discoloration, cough and breathing difficulty. Coronary diseases present as severe chest pain, palpitation, sweating, anxiety, fear, and syncope. Rheumatic diseases present with sore throat, pain in joints, chest pain, breathlessness and rash. Valvular heart diseases present with complaints such as dyspnea, leg swelling, cough, fever, dizziness and chest pain [6].

• Weakness

  Hypertensive heart disease Aneurysm An aneurysm is a bulge or weakness in the wall of a blood vessel. Aneurysms can enlarge over time and may be life threatening if they rupture. [world-heart-federation.org]

  Coronary artery disease or high blood pressure can, over time, leave the heart too stiff or weak to fill and pump properly. [medicalnewstoday.com]

  These include pain in the jaw, neck or back; pain in the arms or shoulder; chest pain; lightheadedness or weakness; and shortness of breath, Phillips said. Heart disease symptoms may differ for men and women, according to the Mayo Clinic. [livescience.com]

  Loss of heart tissue due to a blockage can cause symptoms such as chest pain, shortness of breath, weakness, and even death. [onhealth.com]

  Your heart may get too weak to pump well. There are many possible causes of the disease, including genetic heart conditions, reactions to certain drugs or toxins (such as alcohol), and infections from a virus. [webmd.com]

• Fatigue

  However, ordinary physical activity such as walking causes some breathlessness, fatigue, or palpitations. [patient.info]

  Men are more likely to have chest pain, while women are more likely to have shortness of breath, nausea and extreme fatigue. A number of factors play a role in heart disease risk. [livescience.com]

  It is important to know about the associated symptoms including shortness of breath, sweating, nausea, vomiting, and indigestion, as well as malaise or fatigue. The circumstances surrounding the symptoms are also important. [medicinenet.com]

  (stretched and thinned muscle) Hypertrophic (thickened heart muscle) Restrictive (rare problem where the heart muscle does not stretch normally so the chambers do not fill with blood properly) Signs and Symptoms of Cardiomyopathy Shortness of breath Fatigue [onhealth.com]

• Weight Gain

  Won’t I gain weight if I quit smoking? Four out of five people who quit smoking gain a small amount of weight. The average is about five pounds. Some of this weight gain is due to a temporary increase in appetite caused by nicotine withdrawal. [wvdhhr.org]

  One is its well-known links to weight gain and cavities. The other is that sugar delivers “empty calories” — calories unaccompanied by fiber, vitamins, minerals, and other nutrients. [health.harvard.edu]

  "Although most people experience stress from jobs and major life events, African Americans are more likely to have persistent economic stress and to face concerns about maintaining their health, including preventing weight gain and managing chronic conditions [news-medical.net]

  Symptoms of heart defects in children can include pale gray or blue skin (cyanosis), swelling in the legs, abdomen or around the eyes, and shortness of breath during feeding in infants (causing poor weight gain), according to the Mayo Clinic. [livescience.com]

  gain Preventing CVD A healthy lifestyle can lower your risk of CVD. [nhs.uk]

• Cough

  Valvular heart diseases present with complaints such as breathlessness, leg swelling, cough, fever, dizziness and chest pain. [symptoma.com]

  The symptoms of a heart attack include a strong pain or tightness in the centre of the chest, shortage of breath, coughing and a strong feeling of anxiety. If you, or someone else, appear to be having a heart attack call 999 for medical help. [diabetes.co.uk]

  ACE inhibitors commonly cause a persistent cough; diuretics are linked to increased risk of diabetes; beta blockers are associated with increased likelihood of stroke; calcium channel blockers may increase risk of heart attack and breast cancer; and ARBs [drfuhrman.com]

  Know These Heart Attack Symptoms Arrhythmias Cough Heartburn Loss of appetite Malaise Such symptoms in women cause delays in diagnosis if the symptoms are not considered as possible signs of heart disease. [onhealth.com]

  Potential side effects include a dry cough, high potassium levels in your blood, dizziness, fatigue, headaches, and losing your sense of taste. [verywell.com]

• Dyspnea

  The symptoms of heart disease range from dyspnea, chest pain and syncope to symptoms of cardiac shock like cold extremities, hypotension, confusion, and multiple organ failure. [symptoma.com]

  It may be a good choice for you if you have severe heart disease and you're experiencing distressing symptoms that are difficult to control, such as: Chest pain ( angina ) even when you're resting Shortness of breath ( dyspnea ) even when you're resting [verywell.com]

• Nausea

  By midweek, she was experiencing nausea, vomiting, and diarrhea. She had heartburn. [scarymommy.com]

  Men are more likely to have chest pain, while women are more likely to have shortness of breath, nausea and extreme fatigue. A number of factors play a role in heart disease risk. [livescience.com]

  Potential side effects include headaches, dizziness, nausea, constipation, diarrhea, indigestion, abdominal pain, nosebleeds, and bruising easily. [verywell.com]

• Vomiting

  By midweek, she was experiencing nausea, vomiting, and diarrhea. She had heartburn. [scarymommy.com]

  In addition the person may experience difficulty in breathing or shortness of breath; feeling sick or vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale. [who.int]

  It is important to know about the associated symptoms including shortness of breath, sweating, nausea, vomiting, and indigestion, as well as malaise or fatigue. The circumstances surrounding the symptoms are also important. [medicinenet.com]

  Many women also experience nausea, vomiting, or a feeling similar to indigestion, as Larko did. [theatlantic.com]

  Symptoms and numbers The most common warning signs of a heart attack are discomfort (sometimes pain) in the chest; lightheadedness, nausea or vomiting; pain in the jaw, neck or back; discomfort in the arm or shoulder; and shortness of breath. [cnn.com]

• Chest Pain

  Coronary diseases present as severe chest pain, palpitation, sweating, anxiety, fear, and syncope. Rheumatic diseases present with sore throat, pain in joints, chest pain, breathlessness and rash. [symptoma.com]

  The patient, who had a history of hypertension presented with chest pain and shortness of breath to the emergency department. She was diagnosed with ischaemic heart disease (IHD) and had hypertension as one of the coronary risk factor. [ncbi.nlm.nih.gov]

  These include pain in the jaw, neck or back; pain in the arms or shoulder; chest pain; lightheadedness or weakness; and shortness of breath, Phillips said. Heart disease symptoms may differ for men and women, according to the Mayo Clinic. [livescience.com]

  […] and/or heartburn (some women may present with these as their predominant symptoms instead of chest pain) Weakness Heart Attack Symptoms in Women Although some women present with symptoms of chest pain, a large number of women will not present with chest [onhealth.com]

  Angina (say: an-JY-nuh): people with angina feel a pain in the chest that means the heart isn't getting enough blood. Heart attack: when a blood clot or other blockage cuts blood flow to a part of the heart. [kidshealth.org]

• Tachycardia

  We present the case of a girl without heart disease admitted at our PICU due to an influenza A acute respiratory distress syndrome, who suffered a paroxysmal supraventricular tachycardia (PSVT) twelve hours after DEX progressive withdrawal was completed [ncbi.nlm.nih.gov]

  Tachycardia may be managed by carotid massage or adenosine if origin is supraventricular or beta blockers, verepamil, digoxin or lidocaine if origin is ventricular or nodal. [symptoma.com]

  Tachycardia, or a heart rate that’s too fast, refers to a heart rate of more than 100 beats per minute. An arrhythmia can affect how well your heart works. [heart.org]

• Heart Murmur

  Topics under Heart Disease Abnormal Electrocardiogram (0 drugs) Arrhythmia (198 drugs in 25 topics) Cardiomyopathy (9 drugs in 6 topics) Endocarditis (82 drugs in 3 topics) Heart Murmur (0 drugs) Hemopericardium (0 drugs in 2 topics) Ischemic Heart Disease [drugs.com]

  […] of the heart and thoracic aorta (1884) ‎ (20 F) F ► Framingham Heart Study ‎ (4 F) H ► Heart aneurysms ‎ (4 C, 9 F) ► Heart failure ‎ (5 C, 9 F) ► Heart murmurs ‎ (7 F) ► Heart rupture ‎ (11 F) I ► Inflammatory heart diseases ‎ (5 C, 1 F) ► Ischemic [commons.wikimedia.org]

• Cyanosis

  Symptoms of heart defects in children can include pale gray or blue skin (cyanosis), swelling in the legs, abdomen or around the eyes, and shortness of breath during feeding in infants (causing poor weight gain), according to the Mayo Clinic. [livescience.com]

  Systemic complications of cyanosis in adults with congenital heart disease. Hematologic derangements renal function, and urate metabolism. Cardiol Clin, 11 (1993), pp. 689-699 [175] P. Engelfriet, E. Boersma, E. Oechslin, J. Tijssen, M.A. [revportcardiol.org]

• Anxiety Disorder

  Even after adjusting for a wide range of factors – personal (e.g. age, gender, education levels, ethnicity, immigrant status, marital status); health conditions (e.g. diabetes, arthritis, hypertension, mood and anxiety disorders); health behavior (e.g [ehstoday.com]

• Irritability

  Studies have shown that if stress makes you angry or irritable, you're more likely to have heart disease or a heart attack. [apa.org]

  This mixture contains more than 4,000 substances, more than 40 of which are known to cause cancer in humans or animals and many of which are strong irritants. [wvdhhr.org]

• Insomnia

  Sleep disorders such as sleep disordered breathing and insomnia, as well as particularly short duration of sleep or particularly long duration of sleep, have been found to be associated with a higher cardiometabolic risk. [en.wikipedia.org]

• Agitation

  Why car horns, planes and sirens might be bad for your heart Lindsey Bever The roar of a jet plane, the rumble of a big rig, that shrill scream from the siren of a speeding emergency vehicle: The common but loud noises that keep you awake at night and agitate [chicagotribune.com]

The diagnosis can be done by physical examination and investigations. In each and every case, ECG should be done. Echocardiography is important investigation which shows anatomical defects, valvular defects, and defects in pericardial space. It also asseses the pathophysiological condition of blood flow, valvular function, myocardial contraction and cardiac function like output and stoke volume.

Cardiac catheterization is important to diagnose diseases of valves and function of ventricles. Angiography detects stenoses in coronary circulation, and is also important to be done before angioplasty or stenting. It is also done to measure pulmonary artery pressure, and cardiac output. Blood pool imaging establishes left ventricular ejection fraction. Myocardial perfusion scans measure perfusion of myocardium at rest and at stress [7]. Laboratory investigations like biochemical markers, troponin or Anti-streptolysin O (ASO) titer could be advised as required.

Blood pressure is kept under control by diet modification and antihypertensive drugs like diuretics and beta blockers. If there is suspected or diagnosed ischemia, it requires treatment with oxygen, sublingual nitroglycerine, centrally acting analgesics like morphine and platelet inhibitors like aspirin or clopidogrel.

If ECG shows abnormal rhythm, anti-arrhythmic drugs like lidocaine, amiodarone, are indicated. In worst situations, patient may need resuscitation with defibrillation.

Bradycardia is managed by atropine. Tachycardia may be managed by carotid massage or adenosine if origin is supraventricular or beta blockers, verepamil, digoxin or lidocaine if origin is ventricular or nodal [8].

Surgical interventions are required in certain conditions like internal pacemaker for heart block, angioplasty or stent placement for coronary diseases, valvuloplasty or valve replacement in valvular defects and septoplasty for septal defects.

Congenital and acquired valvular defects have poor prognosis, and require regular follow up to asses function, secondary infection and rejection. Prognosis of other conditions like coronary diseases and conduction disorders is good with pharmacological and surgical management. Further recurrence of underlying conditions like atherosclerosis and thromboembolism could be prevented by control of obesity, diet, diabetes, lipids and changing lifestyle [5].

Diseases of conduction can be due to myocardial infarction, sick sinus syndrome, hypothermia or fever, hypothyroidism and hyperthyroidism, pheochromocytoma and drugs like beta blocker and digoxin. Coronary heart diseases are due to atherosclerotic plaques in coronary vessels with superimposed changes, and increased workload to the heart like in case of exertion [2].

Valvular defects could be congenital or acquired secondary to conditions like rheumatic disease. The valvular condition could also be senile or due to calcification like in the case of aortic stenosis or may be due to infective endocarditis or due to trauma in the case of aortic regurgitation. Myocardial diseases are secondary to viral infection or other conditions. Pericardium can be infected by virus or mycobacterium.

In 2008, 17.3 million people died from cardiovascular diseases, accounting for total of 30% deaths. Out of this 7.3 million died because of coronary heart disease. High blood pressure, obesity, tobacco use and diabetes are associated risk factors. 9.4 million cases are attributed to high blood pressure. It is expected that there will be increasing incidence and prevalence of heart diseases [3].

In congenital conditions, there might be anatomical defect resulting in altered hemodynamics, either pressure overload or volume overload, altered oxygenation of blood and which might further lead to infections.

Coronary heart diseases are precipitated as a result of superimposed changes in established atheromatous plaques resulting in unfulfilled oxygen need to heart muscles resulting in ischemic changes or infarct. This can lead to death of cardiac muscle.

Diseases of conduction can be due to myocardial infarction, sick sinus syndrome, hypothyroidism and hyperthyroidism, pheochromocytoma and drugs like beta blocker and digoxin. Myocarditis is secondary to viral or rarely bacterial infection.

Pericardium can be infected by virus or mycobacterium, and may result in fluid accumulation in pericardial space [4].

Except congenital diseases, other diseases are preventable by control of risk factors like obesity, smoking, blood pressure, diet control, life style changes and infections [9].

The symptoms of heart disease range from dyspnea, chest pain and syncope to symptoms of cardiac shock like cold extremities, hypotension, confusion, and multiple organ failure. Heart diseases can be diagnosed by electrocardiography (ECG), echocardiography, X-ray, cardiac catheterization or myocardial perfusion imaging. Heart conditions are treated with medications and surgical interventions like pacemakers, percutaneous coronary intervention and coronary artery bypass graft [1].

• Definition: Heart diseases can be congenital or acquired. Acquired heart diseases can due to hereditary predisposition, infection or due to risky life style.
• Symptoms: Congenital disorder manifests in newborn and children characterized by poor feeding, blue discoloration, cough and breathing difficulty. Coronary diseases presents as severe chest pain, feeling of heart beats, sweating, anxiety, fear and dizziness. Rheumatic diseases present with sore throat, pain in the joint, chest pain, breathlessness and rash. Valvular heart diseases present with complaints such as breathlessness, leg swelling, cough, fever, dizziness and chest pain.
• Diagnosis: The diagnosis can be made by clinical history, presenting complaints, various signs and symptoms, and investigations like ECG, echocardiography, angiography, angioplasty, myocardial perfusion scan and cardiac catheterization depending on specific cardiac condition.
• Treatment: Congenital defects requires surgery most of the time. Acquired defects can be treated medically or surgically [10].

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