The heart beats about one hundred thousand times a day. When this rhythm is disrupted or the muscle weakens, the consequences affect the entire body. Understanding the major groups of heart diseases allows for earlier detection of warning signs and action on modifiable risk factors such as tobacco, cholesterol, or high blood pressure.
Inflammatory heart diseases: myocarditis, pericarditis, endocarditis
Before discussing blocked arteries or damaged valves, we must focus on a group of less publicized conditions: cardiac inflammations. They affect different structures of the heart, and their causes vary widely.
Myocarditis refers to inflammation of the heart muscle itself. It is often triggered by viral infections. The patient experiences unusual fatigue, sometimes chest pain, and the diagnosis often involves a cardiac MRI.
Pericarditis, on the other hand, concerns the envelope surrounding the heart (the pericardium). The typical pain increases when lying down and decreases when sitting forward. Finally, endocarditis affects the inner wall of the heart and the valves. It most often results from a bacterial infection that settles on a previously weakened valve.
These three diseases are distinct entities from coronary heart disease or arrhythmias. Their common point: prompt management limits damage to the heart muscle.
Coronary heart disease and myocardial infarction
Have you ever heard of a “heart attack”? The exact medical term is myocardial infarction. It occurs when a coronary artery, which supplies blood to the heart muscle, suddenly becomes blocked.
Before this emergency, there are often years of silent coronary disease. Cholesterol plaques gradually deposit on the walls of the arteries. This process, called atherosclerosis, gradually reduces blood flow. As long as the narrowing remains moderate, the heart compensates. When the plaque ruptures, a clot forms and blocks the flow: this is the infarction.
To better understand the different heart diseases and how they relate to each other, it is useful to remember that coronary disease represents, according to WHO, the leading cause of cardiovascular mortality worldwide, alongside stroke.
Among the major risk factors for this condition:
- Tobacco, which accelerates the formation of atheromatous plaques and promotes arterial spasms
- High blood pressure, which subjects the walls of the arteries to excessive pressure over the years
- High cholesterol levels, particularly LDL cholesterol, which directly contributes to fat deposits in the coronary arteries
- Physical inactivity and a diet rich in salt, sugar, and saturated fats
Cardiomyopathies: when the heart muscle deforms
Cardiomyopathies form a group often absent from public lists. They directly affect the heart muscle, regardless of a problem with an artery or valve.
Dilated cardiomyopathy is the most common. The left ventricle enlarges and loses its contraction strength. The heart pumps less efficiently, leading to shortness of breath, fatigue, and water retention.
The hypertrophic form works in the opposite way: the heart wall thickens abnormally, hindering the filling of the chambers. It has a strong genetic component and can cause sudden deaths in young individuals, including athletes.
There are also restrictive and arrhythmogenic forms, which are rarer. Some cardiomyopathies are hereditary, while others are acquired after an infection, toxic exposure (alcohol, certain chemotherapy drugs), or a systemic disease. The classifications of the American Heart Association and the European Society of Cardiology distinguish these different origins to tailor treatment.
Valvular diseases and heart rhythm disorders
The heart has four valves that open and close with each beat to direct blood in the right direction. When a valve no longer opens properly (stenosis) or does not close tightly (insufficiency), it is referred to as valvular disease.
A concrete example: aortic stenosis. The aortic valve, located between the left ventricle and the aorta, calcifies with age. The heart has to work harder to eject blood. Symptoms appear late: shortness of breath during exertion, discomfort, chest pain. An early detected valvular disease can be monitored before requiring surgery or valve replacement.
Heart rhythm disorders (arrhythmias) form another distinct group. The heart beats too fast (tachycardia), too slowly (bradycardia), or irregularly. Atrial fibrillation is the most common arrhythmia. It increases the risk of stroke because blood stagnates in the atria and can form clots.
Congenital heart diseases and high blood pressure
Not all heart diseases are acquired over a lifetime. Congenital heart diseases are present from birth. They result from an abnormal formation of the heart during fetal life: communication between two chambers that should not exist, poorly formed valve, mispositioned vessel.
Some are benign and close spontaneously in the first months. Others require cardiac surgery in the neonatal period. Advances in surgery and interventional cardiology now allow the majority of these patients to reach adulthood, but lifelong cardiological follow-up remains necessary.
High blood pressure, on the other hand, is sometimes considered a cardiovascular disease in its own right and sometimes as a cross-cutting risk factor. Consistently high blood pressure damages the arteries, heart, and kidneys. It promotes heart failure, stroke, and coronary disease. Its silent nature makes it particularly dangerous: most hypertensive individuals experience no symptoms for years.
Remembering these major groups (coronary diseases, cardiomyopathies, valvular diseases, arrhythmias, cardiac inflammations, congenital heart diseases, hypertension) helps to understand that a “heart disease” encompasses very different realities. Early detection, control of modifiable risk factors, and regular medical follow-up remain the most effective levers to protect cardiovascular health.