As a cardiologist, Dr. Allen Amorn diagnoses and manages a variety of cardiac related disorders and diseases. For patients that have not seen a cardiologist in the past or had any cardiac issues, it may be confusing as to what sorts of issues patients see their cardiologist for and exactly what gives rise to these disorders. Dr. Amorn outlines a few of the most common reasons he has patients referred to him.
Congestive Heart Failure
Commonly known as heart failure, this condition is the inability of the heart to pump blood effectively and efficiently to the rest of the body. Patients often will present with symptoms such as shortness of breath, weakness, generalized edema, decreased exercise tolerance, and sometimes cough up foamy pink mucus. Heart failure most commonly occurs in the setting of other diseases that have weakened the heart, or caused stiffening, leaving the heart not as compliant and struggles to properly pump.
Coronary artery disease is the most common cause of heart failure as decreased blood flow supplying the heart leads to a weaker heart and can lead to heart attacks that cause heart failure. High blood pressure is another leading cause of CHF; overtime, the heart becomes stiffer and weaker after pumping against higher pressure than what the body is normally capable of.
Dr. Allen Amorn states that other causes of CHF include cardiomyopathies-damage to the muscular portion of the heart from genetic causes, or environmental such as drugs, alcohol, and sometimes prolonged use of some medications, faulty heart valves that cause increased pressures and overload, and myocarditis which can occur in the context of viral illnesses.
Coronary Artery Disease and Heart Attacks
Coronary artery disease is a process in which the major arteries that supply the heart with oxygen and nutrients become diseased, and most of the times this is in the form of plaques that cause decreased blood flow due to stenosis/narrowing. Overtime, the plaque builds up and the stenosis becomes more significant, sometimes lead to 100% blockage of the artery, and significant enough blockage can cause a heart attack due to the muscles of the heart not receiving oxygen.
There are multiple factors that can lead to damage of the coronary arteries, according to Dr. Allen Amorn the top contributors are: smoking, high cholesterol, diabetes, and hypertension. Initial damage to the inner lining of the arteries predispose them to inflammation and makes it easier for cholesterol to stick to the vessel. Dr. Allen Amorn explains that overtime, cholesterol and other debris build the plaque and begin to occlude the vessel. If a portion of the plaque ends up breaking off, platelets may end up clotting blood in the area, further causing increased blockage.
Smoking can directly damage the vessel through chemical damage, but also indirectly through raised blood pressure. High blood pressures cause stiffening and narrowing of the arteries.
Similar to coronary artery disease, arteries throughout the body can become clogged by atherosclerosis/plaque buildup, known as peripheral arterial disease. If it occurs in the carotids, it can lead to stroke as the brain can become deprived of oxygen very quickly, just as the heart does in a heart attack.
In your limbs, atherosclerosis can lead to cramps and pain, skin color changes, numbness, and in severe cases amputation. Aneurysms can also be seen, which can be caused by environmental factors such as smoking, hypertension and diabetes, while genetic causes such as connective tissue disorders can also play a role.
These are a group of disorders that cause interruptions to the electrical activity of the heart leading to irregular heart rhythms, either in the form of increased heart rate, uncoordinated heart beating, or irregular heartbeats. Dr. Allen Amorn is trained in electrophysiology, and arrhythmias are a major component of his practice. Patients may experience symptoms of chest pain, shortness of breath, fatigue, palpitations, lightheadedness, or even fainting.
As mentioned, arrhythmias are caused by irregularities in the electrical activity of the heart due to conduction issues, extra electrical pathways that the heart uses, other heart diseases, infections, or even medications. At baseline, the SA node and AV node controls the heart, along with a network of electrical pathways including purkinje fibers and the bundle of His.
In normal electrical activity, the atria and ventricles contract in unison and in beat to the electrical activity being sent, but in arrhythmias, they may beat out of sync with one beating much faster than the other, or they may beat in sync but irregularly. Dr. Allen Amorn explains that doctors make use of EKGs to watch the electrical activity of the heart and to figure out what type of arrhythmia a patient may have to treat accordingly.