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How Heart Disease Works & What Causes It | Dr. Andy Galpin

Andy GalpinSeptember 11, 202611m
In a Nutshell

Heart disease stems from blocked coronary arteries causing tissue death (myocardial infarction), electrical firing problems triggering cardiac arrest through ventricular fibrillation, or chronic high blood pressure inducing vessel stiffening and cardiac fibrosis. Genetic conditions like hypertrophic cardiomyopathy and Wolf-Parkinson-White syndrome create structural or electrical vulnerabilities that can cause sudden death, especially during exertion. Atrial fibrillation poses stroke risk through clot formation, while early screening and blood pressure control are key to preventing long-term cardiac damage.

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If vessels that supply blood to the heart become blocked or damaged, a myocardial infarction results. When oxygen and nutrients are blocked to heart tissue, the heart becomes hypoxic and stops contracting. This leads to necrosis or death if severe enough because the heart cannot pump blood throughout the body. The health of the coronary arteries themselves is the first priority.

Firing issues involve the electrical signal that causes heart contraction. Cardiac arrest occurs when the heart stops firing and contracting due to electrical conductivity problems rather than oxygen delivery blockage. Ventricular fibrillation (Vfib) is the most deadly form where the ventricles misfire. The ventricles flutter instead of contracting strongly, relaxing, and refilling with blood. This prevents adequate blood output and causes blood to be shot into chambers in the wrong direction because valves open and close at incorrect times.

Atrial fibrillation (Afib) is much more common than ventricular fibrillation and less dangerous. Many people have Afib without knowing it or with minimal concern. Athletes who are sidelined for heart issues often have Afib that gets checked by a cardiologist and cleared for return to sport. However, Afib becomes dangerous when blood pools in the atria, forms clots, and these clots can move to the ventricles and be pushed into the system, potentially causing stroke.

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