Heart disease
Heart disease has the potential to cause
permanent disability and is a leading cause of death.
Introduction
Types of heart disease
Symptoms and signs
Risk factors
Statistics
Legal background
Rehabilitation
Leaflets and factsheets
Web links
Get more help
Introduction
Heart disease is a general term used to describe a number of
acute (short-term) and chronic (long-term) medical conditions that
affect the heart. Heart disease is common in the general
population, including those of working age, and is the biggest
cause of death in the UK. Although heart disease can have genetic
causes, lifestyle choices have a large impact on its
likelihood.
Medical emergencies such as a heart attack or cardiac arrest can
be life-threatening, so it’s sensible to consider what you would do
if one of your employees or visitors suffered one. The chances of
surviving a heart arrest or heart attack are increased if emergency
treatment is given as soon as possible. If the person becomes
unconscious, use cardiopulmonary resuscitation (CPR) or a
defibrillator.
Cardiac arrest, also known as cardiopulmonary arrest, happens
when the heart stops pumping blood around the body. As a result,
the person becomes unconscious and can’t breathe normally.
Immediate CPR and/or defibrillation are needed for survival.
Heart attack, also known as myocardial infarction or acute
coronary syndrome, happens when the blood supply to a part of the
heart muscle is suddenly cut off due to a blood clot, causing
severe injury or death of the heart muscle. A heart attack can
cause chest pain, pain in the arms or other parts of the body,
shortness of breath, nausea and anxiety. Immediate medical
assistance should be sought (call 999 in the UK, or 112 from your
mobile phone and throughout Europe).
Types of heart disease
There are many types of heart disease. The main conditions
include the following (in alphabetical order).
• Cardiac
arrhythmia, such as
atrial fibrillation, is an irregular heartbeat. The heart can
beat too slowly, too fast or with an abnormal rhythm. There are
various types of arrhythmia. Most are harmless but some can be
life-threatening.
• Cardiomyopathy
is a disease of the heart muscle. It affects people of all ages and
is usually inherited. The heart muscle becomes enlarged, thick or
rigid, affecting its ability to pump blood.
• Congenital
heart disease is a problem with the heart’s structure and
function that is present at birth. It affects about 1 in every 145
births.
• Coronary
heart disease (also known as ischaemic heart disease) is the
most common type of heart disease and is the leading cause of
death. Plaque builds up inside the blood vessels of the heart,
obstructing the supply of oxygen-rich blood to the heart muscle.
Coronary heart disease causes around 94,000 deaths in the UK each
year. Angina
is a symptom of coronary heart disease and affects about 2 million
people in the UK.
• Heart
failure is a serious condition but is usually secondary to
other heart conditions. It affects about 900,000 people in
the UK. It is a condition in which the heart loses its ability to
pump blood efficiently through the body. In other words, it can’t
pump enough blood to meet the body’s needs.
• Heart
valve disease occurs if one or more of the valves in heart
doesn't work properly, resulting in extra strain on the heart,
causing the heart to pump less efficiently.
• Hypertensive
heart disease is caused by high blood pressure. As the heart
pumps against this pressure, it has to work harder, resulting in
other heart abnormalities and dysfunctions.
• Inflammatory heart
disease is an inflammation of the heart muscles due to an
infection that is usually caused by bacteria, a virus or from an
internal abnormality, such as autoimmune disorder. There are three
main types of inflammatory heart disease:
pericarditis,
endocarditis and myocarditis.
• Marfan
syndrome is a rare connective tissue disorder. Like other parts
of the body, it affects blood vessels, causing damage to the
heart.
Symptoms and signs
Symptoms vary widely depending on the severity and type of heart
condition. The same heart condition may develop differently in
different people. Typical symptoms include:
• chest pain or chest discomfort
• pressure or pain in the arms, neck, jaw or stomach
• fatigue
• breathlessness
• irregular heartbeat
• dizziness
• numbness and tingling
• nausea
• pale, sweaty skin
• loss of consciousness.
Refer to the Types of heart
disease section for specific symptoms associated with each
condition.
In the event of a heart attack or cardiac arrest, immediate
medical attention (eg calling 999 or 112, CPR, defibrillation) is
essential. Typical heart attack symptoms include:
• pre-attack – pain in the chest, shoulder, neck and arms;
anxiety; breathlessness; unusual fatigue; indigestion
• during the attack – tightness and severe chest pains; severe
pressure and pain in the arms, neck, jaw and stomach; shortness of
breath; pale and/or sweaty skin; fast heartbeat; sudden fatigue;
dizziness; nausea or vomiting; swelling or pain in the legs.
Risk factors
The best treatment for heart disease is prevention. A healthy
diet and regular exercise in everyday life reduces the risk of
heart disease. The main
risk factors for heart disease include smoking, age, genetic
history, ethnicity, high blood cholesterol, high blood pressure,
obesity and diabetes. Other risk factors include poor diet, lack of
exercise, excessive alcohol consumption, stress, extreme
temperatures and possibly excessive noise.
Statistics
Diseases of the heart and circulatory system (cardiovascular
disease) account for almost 191,000 deaths in the UK and an
estimated 17 million worldwide each year. Around 1 million men and
nearly 500,000 women currently living in the UK have had a heart
attack and around one in five men and one in seven women die from
coronary heart disease.
Legal background
The law places duties on the employer to assess risks posed to
their workers and, where necessary, to take action to safeguard
health and safety, including health surveillance if
appropriate.
The Health and
Safety at Work etc Act 1974 requires employers to secure the
health, safety and welfare of employees at work. This includes
providing a safe place of work, safe systems of work, information
and training.
The Management of Health and Safety at Work Regulations 1999 (as
amended) require suitable and sufficient assessments of health
and safety risks, especially for those with known health
conditions, to be carried out.
The
Workplace (Health, Safety and Welfare) Regulations 1992 require
employers to provide adequate welfare for their employees.
The
Health and Safety (First-Aid) Regulations 1981 require
employers to provide adequate and appropriate first-aid equipment
and facilities, making sure that employees receive immediate
attention if they are taken ill or are injured at work.
The Equality Act
2010 imposes a duty on employers to make reasonable adjustments
and provide legal defence against discrimination on the grounds of
disability, including disability relating to a heart disease.
Rehabilitation
If an employee is suffering from an ongoing heart condition or
has suffered a heart attack recently, it may be necessary to make
some reasonable
adjustments, such as changes to their working pattern, changes
to a workstation or location, or time off to attend medical
appointments. If the employee has been off sick for some time due
to their heart condition, the employer might need to arrange a
phased return to work once they’ve recovered. The employer should
discuss any issues with the individual once they’re well enough and
before they return to work, perhaps with the help of an
occupational health adviser. Some of the leaflets and links in the
following section provide more detailed information.
Leaflets and factsheets
Web links
• Absence
management toolkit for line managers from the HSE and
CIPD
• Angina
from the British Heart Foundation
• Can
you recognise a heart attack? quiz tool from the American Heart
Association
• Coronary
heart disease information on
symptoms,
causes and
prevention from the NHS
• Driving
a guide from the British Heart Foundation
• Employment
of workers with cardiac disease from the University of
Manchester
• Health
and wellbeing self-check tool from Investors in People
(requires registration)
• Healthy
workplace from Heart Research UK
• Heart
and vascular health & prevention Cleveland Clinic
(USA)
• Heart assessment tools to measure the risk of heart disease
from the
American Heart Association and
BUPA
• Heart
disease and work from the Hinchingbrooke Health Care NHS
Trust
• Know
the risks information on heart disease risk factors from the
Heart Foundation (Australia)
• Managing
sickness absence and return to work from the HSE
• NHS
health check from NHS Choices
• Pericarditis
symptoms, causes and diagnosis from BUPA
• Coronary
heart disease: prevention from the NHS Choices
• Smoking
and heart disease from the British Heart Foundation
• Some
case studies on returning to work, from Healthtalkonline
• The
atlas of heart disease and stroke from the World Health
organisation
• Risk factors
linked with heart disease from Heart Research UK
• Improve
employee health and well-being from Business Link
• Women
and heart disease guidance from NHS Choices.
•
Women
and heart disease guidance from NHS Choices.
Get more help
The following organisations offer help and advice:
• Action on Smoking and Health campaigns
to tackle the problem of smoking and smoking-related diseases, and
provides information on quitting or cutting down
• Arrhythmia Alliance is
a registered charity promoting better understanding, diagnosis,
treatment and quality of life for individuals with cardiac
arrhythmias
• Atrial Fibrillation
Association provides information, support and access to
innovative treatments for atrial fibrillation
• British Heart Foundation offers a
comprehensive website describing the links between heart disease
and smoking, alcohol, physical exercise, diet, stress and high
blood pressure
• Chest, Heart and Stroke Scotland
offers support, advice and information for patients, family members
and carers
• Grown Up Congenital Heart Patients
Association provides support, information and advice for people
with congenital heart conditions
• Health and Safety Executive
provides access to workplace health and safety information,
guidance and expert advice
• Health for Work Adviceline is
a free service to help employers quickly and effectively address
the issue of employee ill health, minimise the impact of staff
illness, and provide essential support to staff with physical or
mental health issues
• HEART UK is an organisation
committed to preventing ill health and deaths caused by high
cholesterol and cardiovascular diseases
• Marfan Association UK
provides advice and information for those affected by Marfan
syndrome and their families
• National Institute for Health and
Clinical Excellence provides patients, health professionals and
the general public with guidance on current best practice
• NHS 24 helpline led by nurses,
providing confidential healthcare advice and information in
Scotland
• NHS Choices confidential
healthcare advice and information service to promote health and
wellbeing
• Royal Association for Disability and
Rehabilitation promotes education, welfare and integration into
the community for disabled people
• The Blood Pressure Association
campaigns and provides information on lowering blood pressure to
prevent heart attacks
• The British Cardiac Patients
Association provides support, reassurance and practical advice
to patients, their families and carers
• The British Heart Valve Society
improves the care of patients with heart valve disease by
increasing knowledge and understanding through education, training,
research and published articles
• The
Cardiomyopathy Association provides support and
easy-to-understand information on the different types of
cardiomyopathy
• The
Equality and Human Rights Commission acts as a source of
information and advice, and tackles discrimination at various
levels
• Workplace Health
provides a free, no-obligation service – in partnership with the
Health and Safety Executive – that provides practical advice on
workplace health and safety.
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Developed in partnership with:
Dr Bob Jefferson FFOM CMIOSH Newcastle University