Cardiology

Cardiovascular diseases

Cardiovascular disease is the world’s number one cause of death⁽⁹⁾

Thromboembolic heart diseases

Thromboembolic heart diseases are responsible for the formation of blood clots in the heart chamber.

When this clot is ejected into the general circulation, it can cause embolism and stroke in the most severe cases⁽¹⁾. Thromboembolic heart diseases often come with a mechanical disturbance of the intracardiac blood flow.

Thromboembolic heart disease is the second most common cause of stroke⁽¹⁾.

Some of the most common etiologies include:

Rhythm disorders (essentially complete arrhythmia by atrial fibrillation, more rarely atrial disease, flutter)
Mitral stenosis, especially narrowing, even in the absence of associated atrial fibrillation, and mitral valve prolapse
Myocardial infarction with left ventricular thrombus formation in contact with a recent or old infarction, with extensive ventricular hypokinesia or akinesia, or on left ventricular aneurysm (at a distance from the acute phase)
Congenital heart diseases⁽¹⁾…

Thromboembolic heart diseases can be effectively prevented by rapid diagnosis of the heart defect⁽¹⁾.

Deep vein thrombosis (DVT) and pulmonary embolism (PE)

Phlebitis, or deep vein thrombosis, is a circulation disorder caused by the formation of a blood clot in a deep vein of a limb. Phlebitis can cause a pulmonary embolism⁽²⁾.

Venous thromboembolic disease (METV) is a common disease: annual incidence in France estimated at 1 to 2 cases per 1000 inhabitants (between 50 and 100,000 phlebitis and 40,000 pulmonary embolisms)⁽²⁾⁽³¹⁾.
The annual incidence of venous thromboembolism increases with age⁽²⁾.

Deep vein thrombosis (DVT):

Venous thrombosis is the formation of a blood clot (thrombus) within the venous network. It usually occurs in the lower limbs, totally or partially blocking the blood circulation⁽³⁾.
DVT often causes no symptoms, but it must be treated because it can sometimes lead to serious complications, such as pulmonary embolism, which causes 10 to 20,000 deaths each year in France⁽³⁾.

Pulmonary Embolism (PE):

Pulmonary embolism is the obstruction of a pulmonary artery or one of its branches, usually by a blood clot. It causes damage to the affected lung and the injured part can no longer supply oxygen to the body⁽⁴⁾.
The clot forms during phlebitis or venous thrombosis (usually in the legs). It detaches from the wall of the vein and rises with the blood in the venous circulation to the heart. During its contractions, the right ventricle of the heart propels the clot into the pulmonary arteries. The blood clot travels through thinner and thinner arteries, where it eventually becomes blocked, causing a pulmonary embolism⁽⁴⁾.
The severity of pulmonary embolism depends on the extent of the part of the lung damaged by the blocked artery and/or the person’s cardiac or respiratory condition prior to the onset of embolism⁽⁴⁾.
Pulmonary embolism can cause severe hypoxemia (decrease of oxygen in the blood) and affects the right ventricle of the heart (heart failure)⁽⁴⁾.

Deep vein thrombosis causes 10 to 20,000 deaths each year in France⁽³⁾.

High blood pressure is the most common cardiovascular disease.⁽⁵⁾

Heart failure affects 2.3% of the French adult population and 10% of people over 70.⁽⁸⁾

High blood pressure (hypertension)

High blood pressure (hypertension) is the most common chronic disease in France.

It constitutes, when it is not controlled, one of the main causes of cardiovascular, cerebrovascular or neurodegenerative complications (myocardial infarction, stroke, Alzheimer’s disease…). With few symptoms, it usually appears with age, often accompanied by excess weight. ^(5-6)

Hypertension means excessive pressure in the arteries. It accelerates the aging of the heart and arteries. The work of the heart muscle is increased due to the stronger pressure to which it is subjected. It will therefore grow, become less efficient and exhaust itself⁽⁵⁾.

We talk about high blood pressure when⁽⁶⁾:

– Systolic pressure ≥ 140 mmHg
– Diastolic pressure ≥ 90 mmHg

High blood pressure is the most common cardiovascular disease, and is even the first chronic pathology in France. It is estimated that one in three adults is affected.
Its incidence increases with age: it would thus concern less than 10% of 18–34 year olds against more than 65% after 65 years⁽⁶⁾.

If high blood pressure cannot be cured, it can be treated very well if diagnosed⁽⁵⁾. Indeed, hypertension being most often “silent”, many people are unaware that they are affected. In France, if 10 million hypertensives are treated, it is estimated that 5 million people have untreated hypertension⁽⁵⁾.

High blood pressure increases the risk of stroke, ischemic heart disease (angina pectoris, myocardial infarction), lower limb arterial disease (narrowing of the arteries that supply blood to the legs) and chronic renal failure that may eventually require dialysis⁽⁶⁾.
In addition, blood pressure indirectly increases the activity of the heart to maintain constant blood flow that can eventually develop into heart failure(6).

Healthy diet measures, combined with drug treatment, are most often used to control blood pressure⁽⁶⁾.

Edema of cardiac, renal or hepatic origin

Edema is swelling due to the abnormal presence of fluid in the tissues of the body.

It is a disease that usually starts slowly, but its onset can also be abrupt in some cases. Edema can be a sign of a serious illness. Its causes include certain medications, allergies, diseases, etc.⁽⁷⁾

Although edema may be due to many primitive causes, its general mechanism is the intratisular accumulation of fluids⁽⁷⁾.

Some possible causes of edema:

Heart failure
Hepatic impairment
Cirrhosis
Kidney disease or kidney damage. Damage to the glomeruli can lead to nephrotic syndrome. Glomeruli are renal capillaries that filter waste and excess fluid in the blood.

Heart failure

Heart failure is the inability of the heart muscle to normally propel blood through the body.

It can occur in the evolution of myocardial infarction, angina, high blood pressure… Its frequency increases with age.⁽⁸⁾

The heart of a patient with heart failure has lost muscle strength and normal contraction capacity; it no longer pumps enough blood to allow the organs to receive enough oxygen and nutrients, essential to their proper functioning⁽⁸⁾.

In France, heart failure affects 2.3% of the French adult population and 10% of people over 70, or more than one million people⁽⁸⁾.
Heart failure is a major cause of death in France regardless of age. It was directly or indirectly responsible for more than 70 000 deaths⁽⁸⁾.

There are several possible causes for heart failure:

Ischemic heart disease (myocardial infarction, angina pectoris), which is the main cause of heart failure⁽⁸⁾.
High blood pressure (i.e. too high blood pressure), which is the second leading cause of heart failure⁽⁸⁾.
Heart rhythm disorders, including atrial fibrillation, heart valve abnormalities and heart muscle diseases that are rarer causes⁽⁸⁾.

References

1. JFR 2010 – Accidents ischémiques cérébraux d’origine cardiaque et aortique : des diagnostics à ne pas méconnaître (accessed 2022-01-28)
2. INSERM: Thrombose veineuse (accessed 2022-01-28)
3. Collège des Enseignants de Pneumologie (2017) (accessed 2022-01-28)
4. AMELI: Embolie pulmonaire (accessed 2022-01-28)
5. Fédération Française de Cardiologie : l’hypertension artérielle (accessed 2022-01-28)
6. INSERM: l’hypertension artérielle (accessed 2022-01-28)
7. INFORMATION HOSPITALIERE : Œdème (accessed 2022-01-28)
8. AMELI: l’insuffisance cardiaque (accessed 2022-01-28)
9. Lindstrom M, DeCleene N, Dorsey H, Fuster V, Johnson CO, LeGrand KE, et al. Global Burden of Cardiovascular Diseases and Risks Collaboration, 1990–2021. J Am Coll Cardiol. 2022

JUV-FRA-202408-0211, 09/2024