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5. What can go wrong with my heart?

Various things can go wrong with your heart:


  • A problem with the pump: the muscle might become weak (thin) or too thick (hypertrophy);
  • Damage to your valves: they might become narrow or develop leaks;
  • Your coronary arteries might become narrowed or blocked; or
  • The ‘electrics’ might fail: they might short circuit and go too fast or too slow or alternate between fast and slow.


More than one thing can happen at once and one problem can lead to another. This course will explain that there is plenty that you can do to prevent or deal with the problems that occur.

The heart may also be faulty from birth. This condition is known as congenital (present at birth, by chance) heart disease and can occasionally be inherited (passed on from your parents through your genes).

Question: I am 46 and sometimes feel odd sensations in my chest. Are these to do with my heart? How will I know if I have a heart problem?

Answer: The main symptoms people get are:


  • Chest pain;
  • Breathlessness;
  • Palpitations;
  • Blackouts (less commonly).


If your heart muscle weakens, then you may feel tired or ‘washed out’, feeling as though you have heavy legs or thinking everything is an effort. Of course, there may be other causes for these symptoms and your doctor will be able to sort them out.

Question: What is the commonest heart problem for me to watch out for?

Answer: Coronary artery disease (hardening or narrowing of the arteries to the heart) is the most common problem. The next chapters deal with each condition in turn, describing what the problem is and what treatment is available.

Question: What is the pericardium?

Answer: The heart is covered by a thin, silky-smooth lining called the pericardium (peri-car-dee-um). It is known as the pericardial sac. Sometimes it becomes inflamed and, instead of being silky, it becomes more like sandpaper and, if the heart rubs against it, it will be painful.

Fluid can accumulate in the sac compressing the heart (pericardial effusion) leading to breathlessness and a low blood pressure. If necessary, the fluid can be removed under a local anaesthetic to give instant relief. Inflammation of the pericardium is known as pericarditis.



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