Editing Cardiology (section)

== Heart disorders ==
{{Main|List of heart disorders}}

Cardiology is concerned with the normal functionality of the heart and the deviation from a healthy heart. Many disorders involve the heart itself, but some are outside of the heart and in the vascular system. Collectively, the two are jointly termed the cardiovascular system, and diseases of one part tend to affect the other.

=== Coronary artery disease ===
{{Main|Coronary artery disease}}

Coronary artery disease, also known as "ischemic heart disease",<ref>{{cite book|last=Bhatia|first=Sujata K.|title=Biomaterials for clinical applications|year=2010|publisher=Springer|location=New York|isbn=9781441969200|page=23|url=https://books.google.com/books?id=bXtaX468LRYC&pg=PA23|edition=Online-Ausg.}}</ref> is a group of diseases that includes: [[stable angina]], [[unstable angina]], myocardial infarction, and is one of the causes of [[sudden cardiac death]].<ref name=Wong2014>{{cite journal|last1=Wong|first1=ND|title=Epidemiological studies of CHD and the evolution of preventive cardiology.|journal=Nature Reviews. Cardiology|date=May 2014|volume=11|issue=5|pages=276–89|pmid=24663092|doi=10.1038/nrcardio.2014.26|s2cid=9327889}}</ref> It is within the group of cardiovascular diseases of which it is the most common type.<ref name="pmid25530442"/> A common symptom is [[chest pain]] or discomfort which may travel into the shoulder, arm, back, neck, or jaw.<ref name=HLB2014/> Occasionally it may feel like [[heartburn]]. Usually symptoms occur with exercise or emotional [[Stress (psychological)|stress]], last less than a few minutes, and get better with rest.<ref name=HLB2014/> [[Shortness of breath]] may also occur and sometimes no symptoms are present.<ref name=HLB2014>{{cite web|title=What Are the Signs and Symptoms of Coronary Heart Disease?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|access-date=23 February 2015|date=29 September 2014|archive-url=https://web.archive.org/web/20150224034615/http://www.nhlbi.nih.gov/health/health-topics/topics/cad/signs|archive-date=24 February 2015|url-status=dead}}</ref> The first sign is occasionally a heart attack.<ref name=CDC2013/> Other complications include [[heart failure]] or an [[Heart arrhythmia|irregular heartbeat]].<ref name=CDC2013>{{cite web|title=Coronary Artery Disease (CAD)|url=https://www.cdc.gov/heartdisease/coronary_ad.htm|access-date=23 February 2015|date=12 March 2013|archive-url=https://web.archive.org/web/20150302152003/http://www.cdc.gov/heartdisease/coronary_ad.htm|archive-date=2 March 2015|url-status=dead}}</ref>

<!--Cause and diagnosis -->
Risk factors include: [[hypertension|high blood pressure]], [[tobacco smoking|smoking]], [[diabetes mellitus|diabetes]], lack of exercise, [[obesity]], [[hypercholesterolaemia|high blood cholesterol]], poor diet, and excessive [[ethanol|alcohol]], among others.<ref>{{cite journal|last1=Mehta|first1=PK|last2=Wei|first2=J|last3=Wenger|first3=NK|title=Ischemic heart disease in women: A focus on risk factors|journal=Trends in Cardiovascular Medicine|date=16 October 2014|pmid=25453985|doi=10.1016/j.tcm.2014.10.005|volume=25|issue=2|pages=140–151|pmc=4336825}}</ref><ref name=WHO2011b>{{cite book|last1=Mendis|first1=Shanthi|last2=Puska|first2=Pekka|last3=Norrving|first3=Bo|title=Global atlas on cardiovascular disease prevention and control|date=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|location=Geneva|isbn=9789241564373|pages=3–18|edition=1st|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1}}</ref> Other risks include [[major depressive disorder|depression]].<ref>{{cite journal|last1=Charlson|first1=FJ|last2=Moran|first2=AE|last3=Freedman|first3=G|last4=Norman|first4=RE|last5=Stapelberg|first5=NJ|last6=Baxter|first6=AJ|last7=Vos|first7=T|last8=Whiteford|first8=HA|title=The contribution of major depression to the global burden of ischemic heart disease: a comparative risk assessment|journal=BMC Medicine|date=26 November 2013|volume=11|page=250|pmid=24274053|doi=10.1186/1741-7015-11-250|pmc=4222499 |doi-access=free }}</ref> The underlying mechanism involves [[atherosclerosis]] of the [[Coronary circulation|arteries of the heart]]. A number of tests may help with diagnoses including: electrocardiogram, [[cardiac stress test]]ing, [[coronary computed tomographic angiography]], and [[Coronary catheterization|coronary angiogram]], among others.<ref>{{cite web|title=How Is Coronary Heart Disease Diagnosed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/diagnosis|access-date=25 February 2015|date=29 September 2014}}</ref>

<!-- Prevention and treatment -->
Prevention is by eating a healthy diet, regular exercise, maintaining a healthy weight and not smoking.<ref name=HLB2013P/> Sometimes medication for diabetes, high cholesterol, or high blood pressure are also used.<ref name=HLB2013P>{{cite web|title=How Can Coronary Heart Disease Be Prevented or Delayed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/prevention|access-date=25 February 2015}}</ref> There is limited evidence for screening people who are at low risk and do not have symptoms.<ref>{{cite journal|last1=Desai|first1=CS|last2=Blumenthal|first2=RS|last3=Greenland|first3=P|title=Screening low-risk individuals for coronary artery disease|journal=Current Atherosclerosis Reports|date=April 2014|volume=16|issue=4|page=402|pmid=24522859|doi=10.1007/s11883-014-0402-8|s2cid=39392260}}</ref> Treatment involves the same measures as prevention.<ref>{{cite journal|last1=Boden|first1=WE|last2=Franklin|first2=B|last3=Berra|first3=K|last4=Haskell|first4=WL|last5=Calfas|first5=KJ|last6=Zimmerman|first6=FH|last7=Wenger|first7=NK|title=Exercise as a therapeutic intervention in patients with stable ischemic heart disease: an underfilled prescription.|journal=The American Journal of Medicine|date=October 2014|volume=127|issue=10|pages=905–11|pmid=24844736|doi=10.1016/j.amjmed.2014.05.007}}</ref><ref name=HLB2013Tr/> Additional medications such as [[antiplatelet drug|antiplatelets]] including [[aspirin]], [[beta blocker]]s, or [[Medical use of nitroglycerin|nitroglycerin]] may be recommended.<ref name=HLB2013Tr/> Procedures such as [[percutaneous coronary intervention]] (PCI) or [[coronary artery bypass surgery]] (CABG) may be used in severe disease.<ref name=HLB2013Tr>{{cite web|title=How Is Coronary Heart Disease Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment|access-date=25 February 2015|date=29 September 2014}}</ref><ref>{{cite journal|last1=Deb|first1=S|last2=Wijeysundera|first2=HC|last3=Ko|first3=DT|last4=Tsubota|first4=H|last5=Hill|first5=S|last6=Fremes|first6=SE|title=Coronary artery bypass graft surgery vs percutaneous interventions in coronary revascularization: a systematic review.|journal=JAMA|date=20 November 2013|volume=310|issue=19|pages=2086–95|pmid=24240936|doi=10.1001/jama.2013.281718|doi-access=free}}</ref> In those with stable CAD it is unclear if PCI or CABG in addition to the other treatments improve [[life expectancy]] or decreases heart attack risk.<ref>{{cite journal|last1=Rezende|first1=PC|last2=Scudeler|first2=TL|last3=da Costa|first3=LM|last4=Hueb|first4=W|title=Conservative strategy for treatment of stable coronary artery disease|journal=World Journal of Clinical Cases|date=16 February 2015|volume=3|issue=2|pages=163–70|pmid=25685763|doi=10.12998/wjcc.v3.i2.163|pmc=4317610 |doi-access=free }}</ref>

<!--Epidemiology  -->
In 2013 CAD was the [[most common causes of death|most common cause of death]] globally, resulting in 8.14 million deaths (16.8%) up from 5.74 million deaths (12%) in 1990.<ref name="pmid25530442">{{cite journal | vauthors = ((GBD 2013 Mortality and Causes of Death Collaborators))| title = Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 | journal = Lancet | volume = 385 | issue = 9963 | pages = 117–71 | date = January 2015 | pmid = 25530442 | pmc = 4340604 | doi = 10.1016/S0140-6736(14)61682-2 }}</ref> The risk of death from CAD for a given age has decreased between 1980 and 2010 especially in [[developed country|developed countries]].<ref>{{cite journal|last1=Moran|first1=AE|last2=Forouzanfar|first2=MH|last3=Roth|first3=GA|last4=Mensah|first4=GA|last5=Ezzati|first5=M|last6=Murray|first6=CJ|last7=Naghavi|first7=M|title=Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study|journal=Circulation|date=8 April 2014|volume=129|issue=14|pages=1483–92|pmid=24573352|doi=10.1161/circulationaha.113.004042|pmc=4181359}}</ref> The number of cases of CAD for a given age has also decreased between 1990 and 2010.<ref>{{cite journal|last1=Moran|first1=AE|last2=Forouzanfar|first2=MH|last3=Roth|first3=GA|last4=Mensah|first4=GA|last5=Ezzati|first5=M|last6=Flaxman|first6=A|last7=Murray|first7=CJ|last8=Naghavi|first8=M|title=The global burden of ischemic heart disease in 1990 and 2010: the Global Burden of Disease 2010 study|journal=Circulation|date=8 April 2014|volume=129|issue=14|pages=1493–501|pmid=24573351|doi=10.1161/circulationaha.113.004046|pmc=4181601}}</ref> In the U.S. in 2010 about 20% of those over 65 had CAD, while it was present in 7% of those 45 to 64, and 1.3% of those 18 to 45.<ref name=US2011/> Rates are higher among men than women of a given age.<ref name=US2011>{{cite journal|last1=Centers for Disease Control and Prevention|first1=(CDC)|title=Prevalence of coronary heart disease—United States, 2006–2010.|journal=MMWR. Morbidity and Mortality Weekly Report|date=14 October 2011|volume=60|issue=40|pages=1377–81|pmid=21993341}}</ref>

===Cardiomyopathy===
{{main|Cardiomyopathy}}
{{expand section|date=November 2021}}

Heart failure, or formally cardiomyopathy, is the impaired function of the heart, and there are numerous causes and forms of heart failure.

The causes of cardiomyopathy can be [[Genetic disorder|genetic]], viral, or lifestyle-related. Key symptoms of cardiomyopathy include shortness of breath, fatigue, and irregular heartbeats. Understanding the specific function of cardiac muscle is crucial, as the heart muscle's main role is to pump blood throughout the body efficiently.<ref>"[https://atriuscardiac.care/blogs/comprehensive-guide-to-understanding-cardiomyopathy/ Comprehensive Guide to Understanding and Managing Cardiomyopathy]" by [https://atriuscardiac.care/ Atrius Cardiac Care]</ref>

===Cardiac arrhythmia===
{{Main|Arrhythmia}}

Cardiac arrhythmia, also known as "cardiac dysrhythmia" or "irregular heartbeat", is a group of conditions in which the [[Cardiac cycle|heartbeat]] is too fast, too slow, or irregular in its rhythm.<!-- <ref name=NIH2011Def/> --> A [[heart rate]] that is too fast – above 100 beats per minute in adults – is called [[tachycardia]]. A heart rate that is too slow – below 60 beats per minute – is called [[bradycardia]].<ref name="NIH2011Def">{{cite web|title=What Is Arrhythmia?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/arr|website=www.nhlbi.nih.gov|access-date=7 March 2015|date=July 1, 2011|archive-url=https://web.archive.org/web/20150302074103/http://www.nhlbi.nih.gov/health/health-topics/topics/arr/|archive-date=2 March 2015|url-status=dead}}</ref> Many types of arrhythmia present no symptoms.<!-- <ref name=NIH2011Sym-a/> --> When symptoms are present, they may include [[palpitations]], or feeling a pause between heartbeats.<!-- <ref name=NIH2011Sym-a/> --> More serious symptoms may include [[presyncope|lightheadedness]], [[Syncope (medicine)|passing out]], [[shortness of breath]], or [[chest pain]].<ref name="NIH2011Sym-a">{{cite web|title=What Are the Signs and Symptoms of an Arrhythmia?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/arr/signs|website=www.nhlbi.nih.gov|access-date=7 March 2015|date=July 1, 2011|archive-url=https://web.archive.org/web/20150219081446/http://www.nhlbi.nih.gov/health/health-topics/topics/arr/signs|archive-date=19 February 2015|url-status=dead}}</ref> While most types of arrhythmia are not serious, some predispose a person to complications such as [[stroke]] or [[heart failure]].<ref name="NIH2011Def" /><ref name="NIH2011Type" /> Others may result in [[cardiac arrest]].<ref name="NIH2011Type" />

<!-- Cause and diagnosis -->
There are four main types of arrhythmia: [[premature heart beat|extra beats]], [[supraventricular tachycardia]]s, [[ventricular arrhythmia]]s, and [[bradyarrhythmia]]s.<!-- <ref name=NIH2011Type/> --> Extra beats include [[premature atrial contraction]]s, [[premature ventricular contraction]]s, and [[premature junctional contractions]].<!-- <ref name=NIH2011Type/> --> Supraventricular tachycardias include [[atrial fibrillation]], [[atrial flutter]], and [[paroxysmal supraventricular tachycardia]].<!-- <ref name=NIH2011Type/> --> Ventricular arrhythmias include [[ventricular fibrillation]] and [[ventricular tachycardia]].<ref name="NIH2011Type">{{cite web|title=Types of Arrhythmia|url=http://www.nhlbi.nih.gov/health/health-topics/topics/arr/types|website=www.nhlbi.nih.gov|access-date=7 March 2015|date=July 1, 2011|archive-url=https://web.archive.org/web/20150607165144/http://www.nhlbi.nih.gov/health/health-topics/topics/arr/types|archive-date=7 June 2015|url-status=dead}}</ref><ref name="Martin2012">{{cite journal|last1=Martin|first1=C|last2=Matthews|first2=G|last3=Huang|first3=CL|title=Sudden cardiac death and Inherited channelopathy: the basic electrophysiology of the myocyte and myocardium in ion channel disease|journal=Heart|date=2012|volume=98|issue=7|pages=536–543|pmid=22422742|doi=10.1136/heartjnl-2011-300953|pmc=3308472}}</ref> Arrhythmias are due to problems with the [[electrical conduction system of the heart]].<ref name="NIH2011Def" /> Arrhythmias may occur in children; however, the normal range for the heart rate is different and depends on age.<ref name="NIH2011Type" /> A number of tests can help diagnose arrhythmia, including an electrocardiogram and [[Holter monitor]].<ref>{{cite web|title=How Are Arrhythmias Diagnosed?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/arr/diagnosis|website=www.nhlbi.nih.gov/|access-date=7 March 2015|date=July 1, 2011|archive-url=https://web.archive.org/web/20150218075708/http://www.nhlbi.nih.gov/health/health-topics/topics/arr/diagnosis|archive-date=18 February 2015|url-status=dead}}</ref>

<!-- Treatment -->
Most arrhythmias can be effectively treated.<ref name=NIH2011Def/> Treatments may include medications, medical procedures such as a [[pacemaker]], and surgery.<!-- <ref name=NIH2011Tx-Arrhythmias/> --> Medications for a fast heart rate may include [[beta blockers]] or [[antiarrhythmic agent|agents that attempt to restore a normal heart rhythm]] such as [[procainamide]].<!-- <ref name=NIH2011Tx-Arrhythmias/> --> This later group may have more significant side effects especially if taken for a long period of time.<!-- <ref name=NIH2011Tx-Arrhythmias/> --> Pacemakers are often used for slow heart rates.<!-- <ref name=NIH2011Tx-Arrhythmias/> --> Those with an irregular heartbeat are often treated with [[blood thinner]]s to reduce the risk of complications.<!-- <ref name=NIH2011Tx-Arrhythmias/> --> Those who have severe symptoms from an arrhythmia may receive urgent treatment with a jolt of electricity in the form of [[cardioversion]] or [[defibrillation]].<ref name=NIH2011Tx-Arrhythmias>{{cite web|title=How Are Arrhythmias Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/arr/treatment|website=www.nhlbi.nih.gov/|access-date=7 March 2015|date=July 1, 2011|archive-url=https://web.archive.org/web/20150217135319/http://www.nhlbi.nih.gov/health/health-topics/topics/arr/treatment|archive-date=17 February 2015|url-status=dead}}</ref>

<!-- Epidemiology -->
Arrhythmia affects millions of people.<ref name=NIH2011Risk>{{cite web|title=Who Is at Risk for an Arrhythmia?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/arr/atrisk|website=www.nhlbi.nih.gov/|access-date=7 March 2015|date=July 1, 2011|archive-url=https://web.archive.org/web/20150303190136/http://www.nhlbi.nih.gov/health/health-topics/topics/arr/atrisk|archive-date=3 March 2015|url-status=dead}}</ref> In Europe and North America, as of 2014, atrial fibrillation affects about 2% to 3% of the population.<ref name=Zoni2014>{{cite journal|last1=Zoni-Berisso|first1=M|last2=Lercari|first2=F|last3=Carazza|first3=T|last4=Domenicucci|first4=S|title=Epidemiology of atrial fibrillation: European perspective|journal=Clinical Epidemiology|date=2014|volume=6|pages=213–20|pmid=24966695|doi=10.2147/CLEP.S47385|pmc=4064952|doi-access=free}}</ref> Atrial fibrillation and atrial flutter resulted in 112,000 deaths in 2013, up from 29,000 in 1990.<ref name="pmid25530442"/> [[Sudden cardiac death]] is the cause of about half of deaths due to cardiovascular disease or about 15% of all deaths globally.<ref name=Meh2007>{{cite journal|last1=Mehra|first1=R|title=Global public health problem of sudden cardiac death|journal=[[Journal of Electrocardiology]]|date=2007|volume=40|issue=6 Suppl|pages=S118–22|pmid=17993308|doi=10.1016/j.jelectrocard.2007.06.023}}</ref> About 80% of sudden cardiac death is the result of ventricular arrhythmias.<ref name=Meh2007/> Arrhythmias may occur at any age but are more common among older people.<ref name=NIH2011Risk/>

=== Cardiac arrest ===
{{Main|Cardiac arrest}}

Cardiac arrest is a sudden stop in effective [[circulatory system|blood flow]] due to the failure of the heart to contract effectively.<ref name=NIH2016What/> Symptoms include [[unconsciousness|loss of consciousness]] and [[respiratory arrest|abnormal or absent breathing]].<ref name=Fie2009>{{cite book|last1=Field|first1=John M.|title=The Textbook of Emergency Cardiovascular Care and CPR|date=2009|publisher=Lippincott Williams & Wilkins|isbn=9780781788991|page=11|url=https://books.google.com/books?id=JaOoXdSlT9sC&pg=PA11|language=en}}</ref><ref name=NIH2016Sign/> Some people may have [[chest pain]], [[shortness of breath]], or [[nausea]] before this occurs.<ref name=NIH2016Sign>{{cite web|title=What Are the Signs and Symptoms of Sudden Cardiac Arrest?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/scda/signs|website=NHLBI|access-date=16 August 2016|date=June 22, 2016}}</ref> If not treated within minutes, [[death]] usually occurs.<ref name=NIH2016What>{{cite web|title=What Is Sudden Cardiac Arrest?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/scda|website=NHLBI|access-date=16 August 2016|date=June 22, 2016}}</ref>

<!-- Cause and diagnosis -->
The most common cause of cardiac arrest is [[coronary artery disease]].<!-- <ref name=NIH2016Ca/> --> Less common causes include [[bleeding|major blood loss]], lack of oxygen, [[hypokalemia|very low potassium]], [[heart failure]], and intense physical exercise.<!-- <ref name=NIH2016Ca/> --> A number of inherited disorders may also increase the risk including [[long QT syndrome]].<!-- <ref name=NIH2016Ca/> --> The initial heart rhythm is most often [[ventricular fibrillation]].<ref name=NIH2016Ca>{{cite web|title=What Causes Sudden Cardiac Arrest?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/scda/causes|website=NHLBI|access-date=16 August 2016|date=June 22, 2016}}</ref> The diagnosis is confirmed by finding no pulse.<ref name=Fie2009/> While a cardiac arrest may be caused by heart attack or heart failure these are not the same.<ref name=NIH2016What/>

<!-- Treatment and prognosis -->
Prevention includes not smoking, physical activity, and maintaining a healthy weight.<ref name=NIH2016Pre/> Treatment for cardiac arrest is immediate [[cardiopulmonary resuscitation]] (CPR) and, if a [[shockable rhythm]] is present, [[defibrillation]].<ref name=NIH2016Tx>{{cite web|title=How Is Sudden Cardiac Arrest Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/scda/treatment|website=NHLBI|access-date=16 August 2016|date=June 22, 2016}}</ref> Among those who survive [[targeted temperature management]] may improve outcomes.<ref name="pmid27521472">{{cite journal | vauthors = Schenone AL, Cohen A, Patarroyo G, Harper L, Wang X, Shishehbor MH, Menon V, Duggal A | title = Therapeutic hypothermia after cardiac arrest: A systematic review/meta-analysis exploring the impact of expanded criteria and targeted temperature | journal = Resuscitation | volume = 108 | issue = | pages = 102–110 | date = November 2016 | pmid = 27521472 | doi = 10.1016/j.resuscitation.2016.07.238 }}</ref> An [[implantable cardiac defibrillator]] may be placed to reduce the chance of death from recurrence.<ref name=NIH2016Pre>{{cite web|title=How Can Death Due to Sudden Cardiac Arrest Be Prevented?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/scda/prevention|website=NHLBI|access-date=16 August 2016|date=June 22, 2016}}</ref>

<!-- Epidemiology and history -->
In the [[United States]], cardiac arrest outside of [[hospital]] occurs in about 13 per 10,000 people per year (326,000 cases). In hospital cardiac arrest occurs in an additional 209,000<ref name="pmid26472992">{{cite journal | vauthors = Kronick SL, Kurz MC, Lin S, Edelson DP, Berg RA, Billi JE, Cabanas JG, Cone DC, Diercks DB, Foster JJ, Meeks RA, Travers AH, Welsford M | title = Part 4: Systems of Care and Continuous Quality Improvement: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care | journal = Circulation | volume = 132 | issue = 18 Suppl 2 | pages = S397–413 | date = November 2015 | pmid = 26472992 | doi = 10.1161/CIR.0000000000000258 |doi-access=free}}</ref> Cardiac arrest becomes more common with age.<!-- <ref name=NIH2016Risk/> --> It affects males more often than females.<ref name=NIH2016Risk>{{cite web|title=Who Is at Risk for Sudden Cardiac Arrest?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/scda/atrisk|website=NHLBI|access-date=16 August 2016|date=June 22, 2016}}</ref> The percentage of people who survive with treatment is about 8%.<!-- <ref name=Adam2012/> --> Many who survive have significant [[disability]].<!-- <ref name=Adam2012/> --> Many U.S. television shows, however, have portrayed unrealistically high survival rates of 67%.<ref name=Adam2012>{{cite book|last1=Adams|first1=James G.|title=Emergency Medicine: Clinical Essentials (Expert Consult – Online)|date=2012|publisher=Elsevier Health Sciences|isbn=978-1455733941|page=1771|url=https://books.google.com/books?id=rpoH-KYE93IC&pg=PA1771|language=en}}</ref>

=== Hypertension ===
{{Main|Hypertension}}

[[Hypertension]], also known as "high blood pressure", is a [[Chronic (medicine)|long term]] [[Disease|medical condition]] in which the [[blood pressure]] in the [[artery|arteries]] is persistently elevated.<ref name=Nai2014>{{cite book|last1=Naish|first1=Jeannette|last2=Court|first2=Denise Syndercombe|title=Medical sciences|date=2014|isbn=9780702052491|page=562|publisher=Elsevier Health Sciences |edition=2|url=https://books.google.com/books?id=K21_AwAAQBAJ&pg=PA562}}</ref> High blood pressure usually does not cause symptoms.<ref name=CDC2015>{{cite web|title=High Blood Pressure Fact Sheet|url=https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm|website=CDC|access-date=6 March 2016|date=February 19, 2015}}</ref> Long term high blood pressure, however, is a major risk factor for [[coronary artery disease]], [[stroke]], [[heart failure]], [[peripheral vascular disease]], [[vision loss]], and [[chronic kidney disease]].<ref>{{cite journal|last1=Lackland|first1=DT|last2=Weber|first2=MA|title=Global burden of cardiovascular disease and stroke: hypertension at the core|journal=The Canadian Journal of Cardiology|date=May 2015|volume=31|issue=5|pages=569–71|pmid=25795106|doi=10.1016/j.cjca.2015.01.009}}</ref><ref name=WHO2011a>{{cite book|last1=Mendis|first1=Shanthi|last2=Puska|first2=Pekka|last3=Norrving|first3=Bo|title=Global atlas on cardiovascular disease prevention and control|date=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|location=Geneva|isbn=9789241564373|page=38|edition=1st|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1}}</ref>

<!-- Causes -->
Lifestyle factors can increase the risk of hypertension. These include [[Salt and cardiovascular disease|excess salt]] in the diet, [[overweight|excess body weight]], [[smoking]], and alcohol consumption.<ref name=CDC2015/><ref name=Lancet2015/> Hypertension can also be caused by other diseases, or occur as a side-effect of drugs.<ref>{{cite web|url=https://www.nhlbi.nih.gov/health-topics/high-blood-pressure|title=High Blood Pressure|date=8 May 2020|website=[[National Heart, Lung, and Blood Institute]]|access-date=11 October 2021}}</ref>

<!-- Diagnosis -->
Blood pressure is expressed by two measurements, the [[Systole (medicine)|systolic]] and [[diastolic]] pressures, which are the maximum and minimum pressures, respectively.<ref name=CDC2015/> Normal blood pressure when at rest is within the range of 100–140 [[Millimeter of mercury|millimeters mercury]] (mmHg) systolic and 60–90 mmHg diastolic.<ref name="EU2013">{{cite journal|last1 = Giuseppe|first1 = Mancia|title = 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)|journal = European Heart Journal|date = July 2013|volume = 34|issue = 28|pages = 2159–219|pmid = 23771844|doi = 10.1093/eurheartj/eht151|first2 = R|last3 = Narkiewicz|first3 = K|last4 = Redon|first4 = J|last5 = Zanchetti|first5 = A|last6 = Bohm|first6 = M|last7 = Christiaens|first7 = T|last8 = Cifkova|first8 = R|last9 = De Backer|first9 = G|last10 = Dominiczak|first10 = A|last11 = Galderisi|first11 = M|last12 = Grobbee|first12 = DE|last13 = Jaarsma|first13 = T|last14 = Kirchhof|first14 = P|last15 = Kjeldsen|first15 = SE|last16 = Laurent|first16 = S|last17 = Manolis|first17 = AJ|last18 = Nilsson|first18 = PM|last19 = Ruilope|first19 = LM|last20 = Schmieder|first20 = RE|last21 = Sirnes|first21 = PA|last22 = Sleight|first22 = P|last23 = Viigimaa|first23 = M|last24 = Waeber|first24 = B|last25 = Zannad|first25 = F|last26 = Redon|first26 = J|last27 = Dominiczak|first27 = A|last28 = Narkiewicz|first28 = K|last29 = Nilsson|first29 = PM|last30 = Burnier|first30 = M|last2 = Fagard|display-authors = 29|hdl = 1854/LU-4127523|url = https://academic.oup.com/eurheartj/article-pdf/34/28/2159/17895598/eht151.pdf}}</ref> High blood pressure is present if the resting blood pressure is persistently at or above 140/90 mmHg for most adults.<ref name=Lancet2015/> Different numbers apply to children.<ref name=JNC8>{{Cite journal  |last1 = James|first1 = PA.|last2 = Oparil|first2 = S.|last3 = Carter|first3 = BL.|last4 = Cushman|first4 = WC.|last5 = Dennison-Himmelfarb|first5 = C.|last6 = Handler|first6 = J.|last7 = Lackland|first7 = DT.|last8 = Lefevre|first8 = ML.|last9 = Mackenzie|first9 = TD.|last10 = Ogedegbe|first10 = Olugbenga|last11 = Smith|first11 = Sidney C.|last12 = Svetkey|first12 = Laura P.|last13 = Taler|first13 = Sandra J.|last14 = Townsend|first14 = Raymond R.|last15 = Wright|first15 = Jackson T.|last16 = Narva|first16 = Andrew S.|last17 = Ortiz|first17 = Eduardo|title = 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)|journal = JAMA|volume = 311|issue = 5|pages = 507–20|date = Dec 2013|doi = 10.1001/jama.2013.284427|pmid = 24352797|display-authors = 8|doi-access = free}}</ref> When diagnosing high blood pressure, [[ambulatory blood pressure monitoring]] over a 24-hour period appears to be more accurate than "in-office" [[blood pressure measurement]] at a physician's office or other blood pressure screening location.<ref name=Nai2014/><ref name=Lancet2015/><ref name="Stergiou-Kollias">{{cite journal | last1=Stergiou | first1=George | last2=Kollias | first2=Anastasios | last3=Parati | first3=Gianfranco | last4=O’Brien | first4=Eoin | title=Office Blood Pressure Measurement | journal=Hypertension | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=71 | issue=5 | year=2018 | issn=0194-911X | pmid=29531176 | doi=10.1161/hypertensionaha.118.10850 | pages=813–815| s2cid=3853179 | doi-access=free }}</ref>

<!-- Treatment and epidemiology -->
Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications.<ref name=NIH2015Tx>{{cite web|title=How Is High Blood Pressure Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/treatment|website=National Heart, Lung, and Blood Institute|access-date=6 March 2016|date=September 10, 2015}}</ref> Lifestyle changes include weight loss, decreased salt intake, physical exercise, and a healthy diet.<ref name=Lancet2015/> If changes in lifestyle are insufficient, [[blood pressure medication]]s may be used.<ref name=NIH2015Tx/> A regimen of up to three medications effectively controls blood pressure in 90% of people.<ref name=Lancet2015>{{cite journal|last1=Poulter|first1=NR|last2=Prabhakaran|first2=D|last3=Caulfield|first3=M|title=Hypertension.|journal=Lancet|date=22 August 2015|volume=386|issue=9995|pages=801–12|pmid=25832858|doi=10.1016/s0140-6736(14)61468-9|s2cid=208792897}}</ref> The treatment of moderate to severe high arterial blood pressure (defined as >160/100 mmHg) with medication is associated with an improved [[life expectancy]] and reduced [[morbidity]].<ref>{{Cite journal|last1=Musini|first1=Vijaya M|last2=Tejani|first2=Aaron M|last3=Bassett|first3=Ken|last4=Puil|first4=Lorri|last5=Wright|first5=James M|date=2019-06-05|editor-last=Cochrane Hypertension Group|title=Pharmacotherapy for hypertension in adults 60 years or older|journal=Cochrane Database of Systematic Reviews|volume=6|issue=6 |pages=CD000028|language=en|doi=10.1002/14651858.CD000028.pub3|pmid=31167038|pmc=6550717}}</ref> The effect of treatment for blood pressure between 140/90&nbsp;mmHg and 160/100&nbsp;mmHg is less clear, with some studies finding benefits<ref>{{cite journal|last1=Sundström|first1=Johan|last2=Arima|first2=Hisatomi|last3=Jackson|first3=Rod|last4=Turnbull|first4=Fiona|last5=Rahimi|first5=Kazem|last6=Chalmers|first6=John|last7=Woodward|first7=Mark|last8=Neal|first8=Bruce|title=Effects of Blood Pressure Reduction in Mild Hypertension|journal=Annals of Internal Medicine|date=February 2015|pmid=25531552|doi=10.7326/M14-0773|volume=162|issue=3|pages=184–91}}</ref><ref>{{cite journal|last1=Xie|first1=X|last2=Atkins|first2=E|last3=Lv|first3=J|last4=Bennett|first4=A|last5=Neal|first5=B|last6=Ninomiya|first6=T|last7=Woodward|first7=M|last8=MacMahon|first8=S|last9=Turnbull|first9=F|last10=Hillis|first10=GS|last11=Chalmers|first11=J|last12=Mant|first12=J|last13=Salam|first13=A|last14=Rahimi|first14=K|last15=Perkovic|first15=V|last16=Rodgers|first16=A|title=Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis|journal=Lancet|date=30 January 2016|pmid=26559744|doi=10.1016/S0140-6736(15)00805-3|volume=387 |issue=10017|pages=435–43|s2cid=36805676|url=http://www.med-sovet.pro/jour/article/view/1765}}</ref> while others do not.<ref name=Diao2012>{{cite journal|last1=Diao|first1=D|last2=Wright|first2=JM|last3=Cundiff|first3=DK|last4=Gueyffier|first4=F|title=Pharmacotherapy for mild hypertension|journal=The Cochrane Database of Systematic Reviews|date=Aug 15, 2012|volume=8|issue=8|pages=CD006742|pmid=22895954|doi=10.1002/14651858.CD006742.pub2|pmc=8985074}}</ref> High blood pressure affects between 16% and 37% of the population globally.<ref name=Lancet2015/> In 2010, hypertension was believed to have been a factor in 18% (9.4 million) deaths.<ref>{{cite journal|last1=Campbell|first1=NR|last2=Lackland|first2=DT|last3=Lisheng|first3=L|last4=Niebylski|first4=ML|last5=Nilsson|first5=PM|last6=Zhang|first6=XH|title=Using the Global Burden of Disease study to assist development of nation-specific fact sheets to promote prevention and control of hypertension and reduction in dietary salt: a resource from the World Hypertension League|journal=Journal of Clinical Hypertension|date=March 2015|volume=17|issue=3|pages=165–67|pmid=25644474|doi=10.1111/jch.12479|pmc=8031937|s2cid=206028313}}</ref>

==== Essential vs Secondary hypertension ====
{{Main|Essential hypertension|Secondary hypertension}}

Essential hypertension is the form of [[hypertension]] that by definition has no identifiable cause. It is the most common type of hypertension, affecting 95% of hypertensive patients,<ref name="pmid10645931-a">{{cite journal |vauthors=Carretero OA, Oparil S |title=Essential hypertension. Part I: definition and etiology |journal=[[Circulation (journal)|Circulation]] |volume=101 |issue=3 |pages=329–35 |date=January 2000 |pmid=10645931 |doi=10.1161/01.CIR.101.3.329 |doi-access=free }}</ref><ref name="pmid14597461">{{cite journal |vauthors=Oparil S, Zaman MA, Calhoun DA |title=Pathogenesis of hypertension |journal=[[Ann. Intern. Med.]] |volume=139 |issue=9 |pages=761–76 |date=November 2003 |pmid=14597461 |doi= 10.7326/0003-4819-139-9-200311040-00011|s2cid=32785528 }}</ref><ref name="isbn0-7216-0240-1">{{cite book |author1=Hall, John E. |author2=Guyton, Arthur C. |title=Textbook of medical physiology |publisher=Elsevier Saunders |location=St. Louis, Mo |year=2006 |pages=228 |isbn=978-0-7216-0240-0 }}</ref><ref name="urlHypertension: eMedicine Nephrology">{{cite web |url=http://emedicine.medscape.com/article/241381-overview |title=Hypertension: eMedicine Nephrology |access-date=2009-06-05}}</ref> it tends to be familial and is likely to be the consequence of an interaction between [[Environment (biophysical)|environmental]] and [[genetics|genetic]] factors. [[Prevalence]] of essential hypertension increases with [[Ageing|age]], and individuals with relatively high blood pressure at younger ages are at increased risk for the subsequent development of hypertension.
Hypertension can increase the risk of [[cerebrum|cerebral]], [[cardiac]], and [[renal]] events.<ref name="pmid17707755">{{cite journal | vauthors = Messerli FH, Williams B, Ritz E | title = Essential hypertension | journal = Lancet | volume = 370 | issue = 9587 | pages = 591–603 | date = August 2007 | pmid = 17707755 | doi = 10.1016/S0140-6736(07)61299-9 | s2cid = 26414121 }}</ref>

[[Secondary hypertension]] is a type of [[hypertension]] which is caused by an identifiable underlying secondary cause. It is much less common than essential hypertension, affecting only 5% of hypertensive patients. It has many different causes including [[endocrine diseases]], [[kidney diseases]], and [[tumors]]. It also can be a [[Adverse effect|side effect]] of many [[medications]].<ref>{{Cite web |title=Secondary hypertension |url=https://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679 |access-date=2024-07-21 |website=Mayo Clinic |language=en}}</ref>

==== Complications of hypertension ====
[[Image:Main complications of persistent high blood pressure.svg|thumb|right|250px|Main complications of persistent [[high blood pressure]]]]
{{Main|Complications of hypertension}}

[[Complications of hypertension]] are clinical outcomes that result from [[hypertension|persistent elevation]] of blood pressure.<ref name="pmid19393824">{{cite journal |author=White WB |title=Defining the problem of treating the patient with hypertension and arthritis pain |journal=[[The American Journal of Medicine]] |volume=122 |issue=5 Suppl |pages=S3–9 |date=May 2009 |pmid=19393824 |doi=10.1016/j.amjmed.2009.03.002 }}</ref> Hypertension is a risk factor for all clinical manifestations of [[atherosclerosis]] since it is a risk factor for atherosclerosis itself.<ref name="pmid19110086">{{cite journal |author=Insull W |title=The pathology of atherosclerosis: plaque development and plaque responses to medical treatment |journal=[[The American Journal of Medicine]] |volume=122 |issue=1 Suppl |pages=S3–S14 |date=January 2009 |pmid=19110086 |doi=10.1016/j.amjmed.2008.10.013 }}</ref><ref name="pmid19394559">{{cite journal |vauthors=Liapis CD, Avgerinos ED, Kadoglou NP, Kakisis JD |title=What a vascular surgeon should know and do about atherosclerotic risk factors |journal=[[Journal of Vascular Surgery]] |volume=49 |issue=5 |pages=1348–54 |date=May 2009 |pmid=19394559 |doi=10.1016/j.jvs.2008.12.046 |doi-access=free }}</ref><ref name="pmid19275607">{{cite journal |author=Riccioni G |title=The effect of antihypertensive drugs on carotid intima media thickness: an up-to-date review |journal=[[Current Medicinal Chemistry]] |volume=16 |issue=8 |pages=988–96 |year=2009 |pmid=19275607 |doi=10.2174/092986709787581923 |url=http://www.bentham-direct.org/pages/content.php?CMC/2009/00000016/00000008/0006C.SGM |access-date=2009-06-20 |archive-url=https://archive.today/20130112181214/http://www.bentham-direct.org/pages/content.php?CMC/2009/00000016/00000008/0006C.SGM |archive-date=2013-01-12 |url-status=usurped }}</ref><ref name="pmid19138169">{{cite journal |vauthors=Safar ME, Jankowski P |title=Central blood pressure and hypertension: role in cardiovascular risk assessment |journal=[[Clinical Science (journal)|Clinical Science]] |volume=116 |issue=4 |pages=273–82 |date=February 2009 |pmid=19138169 |doi=10.1042/CS20080072 }}</ref><ref name="pmid19124420">{{cite journal | vauthors = Werner CM, Böhm M | title = The therapeutic role of RAS blockade in chronic heart failure | journal = Therapeutic Advances in Cardiovascular Disease | volume = 2 | issue = 3 | pages = 167–77 | date = June 2008 | pmid = 19124420 | doi = 10.1177/1753944708091777 |s2cid = 12972801 |doi-access = free}}</ref> It is an independent predisposing factor for [[heart failure]],<ref name="pmid19427498">{{cite journal |vauthors=Gaddam KK, Verma A, Thompson M, Amin R, Ventura H |title=Hypertension and cardiac failure in its various forms |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=665–80 |date=May 2009 |pmid=19427498 |doi=10.1016/j.mcna.2009.02.005 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00020-0|access-date=2009-06-20}}</ref><ref name="pmid19427502">{{cite journal |vauthors=Reisin E, Jack AV |title=Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=733–51 |date=May 2009 |pmid=19427502 |doi=10.1016/j.mcna.2009.02.010 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00025-X|access-date=2009-06-20}}</ref> [[coronary artery disease]],<ref name="pmid19363848">{{cite journal | vauthors = Agabiti-Rosei E | title = From macro- to microcirculation: benefits in hypertension and diabetes | journal = J Hypertens Suppl | volume = 26 | issue = 3 | pages = S15–9 | date = September 2008 | pmid = 19363848 | doi = 10.1097/01.hjh.0000334602.71005.52}}</ref><ref name="pmid19427499">{{cite journal |vauthors=Murphy BP, Stanton T, Dunn FG |title=Hypertension and myocardial ischemia |journal=[[The Medical Clinics of North America]] |volume=93 |issue=3 |pages=681–95 |date=May 2009 |pmid=19427499 |doi=10.1016/j.mcna.2009.02.003 |url=http://journals.elsevierhealth.com/retrieve/pii/S0025-7125(09)00018-2|access-date=2009-06-20}}</ref> [[stroke]],<ref name="pmid19393824"/> [[renal disease]],<ref name="pmid12728683">{{cite journal |vauthors=Tylicki L, Rutkowski B |title=[Hypertensive nephropathy: pathogenesis, diagnosis and treatment] |language=pl |journal=[[Polski Merkuriusz Lekarski]] |volume=14 |issue=80 |pages=168–73 |date=February 2003 |pmid=12728683 }}</ref><ref name="pmid19195963">{{cite journal |vauthors=Truong LD, Shen SS, Park MH, Krishnan B |title=Diagnosing nonneoplastic lesions in nephrectomy specimens |journal=[[Archives of Pathology & Laboratory Medicine]] |volume=133 |issue=2 |pages=189–200 |date=February 2009 |pmid=19195963 |doi= 10.5858/133.2.189|url=https://www.archivesofpathology.org/doi/full/10.1043/1543-2165-133.2.189|access-date=2009-06-20}}</ref><ref name="pmid11842376">{{cite journal |vauthors=Tracy RE, White S |title=A method for quantifying adrenocortical nodular hyperplasia at autopsy: some use of the method in illuminating hypertension and atherosclerosis |journal=[[Annals of Diagnostic Pathology]] |volume=6 |issue=1 |pages=20–9 |date=February 2002 |pmid=11842376 |doi= 10.1053/adpa.2002.30606}}</ref> and [[peripheral arterial disease]].<ref name="pmid18672184">{{cite journal |author=Aronow WS |title=Hypertension and the older diabetic |journal=[[Clinics in Geriatric Medicine]] |volume=24 |issue=3 |pages=489–501, vi–vii |date=August 2008 |pmid=18672184 |doi=10.1016/j.cger.2008.03.001 |url=http://journals.elsevierhealth.com/retrieve/pii/S0749-0690(08)00012-8|access-date=2009-06-20}}</ref><ref name="pmid19008688">{{cite journal |vauthors=Gardner AW, Afaq A |journal=[[Journal of Cardiopulmonary Rehabilitation and Prevention]] |volume=28 |issue=6 |pages=349–57 |year=2008 |pmid=19008688 |doi=10.1097/HCR.0b013e31818c3b96 |pmc=2743684|title=Management of Lower Extremity Peripheral Arterial Disease }}</ref> It is the most important [[Risk factor (epidemiology)|risk factor]] for [[cardiovascular]] [[morbidity]] and [[mortality rate|mortality]], in [[industrialized countries]].<ref name="pmid19149532">{{cite journal |vauthors=Novo S, Lunetta M, Evola S, Novo G |title=Role of ARBs in the blood hypertension therapy and prevention of cardiovascular events |journal=[[Current Drug Targets]] |volume=10 |issue=1 |pages=20–5 |date=January 2009 |pmid=19149532 |doi=10.2174/138945009787122897 |url=http://www.bentham-direct.org/pages/content.php?CDT/2009/00000010/00000001/0003J.SGM |access-date=2009-06-20 |archive-url=https://archive.today/20130112095900/http://www.bentham-direct.org/pages/content.php?CDT/2009/00000010/00000001/0003J.SGM |archive-date=2013-01-12 |url-status=usurped }}</ref>

=== Congenital heart defects ===
{{Main|Congenital heart defect}}

A congenital heart defect, also known as a "congenital heart anomaly" or "congenital heart disease", is a problem in the structure of the heart that is present at [[childbirth|birth]].<ref name=NIH2011>{{cite web|title=What Are Congenital Heart Defects?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Signs and symptoms depend on the specific type of problem.<ref name=WHO2011/> Symptoms can vary from none to life-threatening.<ref name=NIH2011/> When present they may include rapid breathing, [[cyanosis|bluish skin]], poor weight gain, and feeling tired.<ref name=NIH2011Sym-b/> It does not cause chest pain.<ref name=NIH2011Sym-b>{{cite web|title=What Are the Signs and Symptoms of Congenital Heart Defects?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd/signs|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Most congenital heart problems do not occur with other diseases.<ref name=WHO2011>{{cite book|author1=Shanthi Mendis|author2=Pekka Puska|author3=Bo Norrving|author4=World Health Organization|title=Global Atlas on Cardiovascular Disease Prevention and Control|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1|year=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|pages=3, 60|isbn=978-92-4-156437-3}}</ref> Complications that can result from heart defects include [[heart failure]].<ref name=NIH2011Sym-b/>

<!-- Cause and diagnosis-->
The cause of a congenital heart defect is often unknown.<ref>{{cite web|title=What Causes Congenital Heart Defects?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd/causes|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Certain cases may be due to infections during [[pregnancy]] such as [[rubella]], use of certain medications or drugs such as [[ethanol|alcohol]] or [[tobacco]], parents being closely related, or poor nutritional status or [[obesity]] in the mother.<ref name=WHO2011/><ref name=Dean2014>{{cite journal|last1=Dean|first1=SV|last2=Lassi|first2=ZS|last3=Imam|first3=AM|last4=Bhutta|first4=ZA|title=Preconception care: nutritional risks and interventions|journal=Reproductive Health|date=26 September 2014|volume=11|issue=Suppl 3 |pages=S3|pmid=25415364|doi=10.1186/1742-4755-11-s3-s3|pmc=4196560 |doi-access=free }}</ref> Having a parent with a congenital heart defect is also a risk factor.<ref name=Mil2011/> A number of genetic conditions are associated with heart defects including [[Down syndrome]], [[Turner syndrome]], and [[Marfan syndrome]].<ref name=WHO2011/> Congenital heart defects are divided into two main groups: [[cyanotic heart defect]]s and [[non-cyanotic heart defect]]s, depending on whether the child has the potential to turn bluish in color.<ref name=WHO2011/> The problems may involve the interior walls of the heart, the [[heart valves]], or the large blood vessels that lead to and from the heart.<ref name=NIH2011/>

<!-- Prevention and treatment -->
Congenital heart defects are partly preventable through [[rubella vaccination]], the adding of [[iodine]] to salt, and the adding of [[folic acid]] to certain food products.<ref name=WHO2011/> Some defects do not need treatment.<ref name=NIH2011/> Other may be effectively treated with [[catheter procedure|catheter based procedures]] or [[cardiac surgery|heart surgery]].<ref name=NIH2011Tx/> Occasionally a number of operations may be needed.<ref name=NIH2011Tx>{{cite web|title=How Are Congenital Heart Defects Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd/treatment|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Occasionally [[heart transplantation]] is required.<ref name=NIH2011Tx/> With appropriate treatment outcomes, even with complex problems, are generally good.<ref name=NIH2011/>

<!-- Epidemiology and prognosis -->
Heart defects are the most common [[birth defect]].<ref name=WHO2011/><ref name=GBD2015/> In 2013 they were present in 34.3 million people globally.<ref name="GBD2015">{{cite journal |last1= Vos|first1= Theo|last2= Barber|first2= Ryan M.|last3= Bell|first3= Brad|last4= Bertozzi-Villa|first4= Amelia|last5= Biryukov|first5= Stan|last6= Bolliger|first6= Ian|last7= Charlson|first7= Fiona|last8= Davis|first8= Adrian|last9= Degenhardt|first9= Louisa|last10= Dicker|first10= Daniel|last11= Duan|first11= Leilei|last12= Erskine|first12= Holly|last13= Feigin|first13= Valery L.|last14= Ferrari|first14= Alize J.|last15= Fitzmaurice|first15= Christina|last16= Fleming|first16= Thomas|last17= Graetz|first17= Nicholas|last18= Guinovart|first18= Caterina|last19= Haagsma|first19= Juanita|last20= Hansen|first20= Gillian M.|last21= Hanson|first21= Sarah Wulf|last22= Heuton|first22= Kyle R.|last23= Higashi|first23= Hideki|last24= Kassebaum|first24= Nicholas|last25= Kyu|first25= Hmwe|last26= Laurie|first26= Evan|last27= Liang|first27= Xiofeng|last28= Lofgren|first28= Katherine|last29= Lozano|first29= Rafael|last30= MacIntyre|first30= Michael F.|display-authors= 1|date=7 June 2015 |title=Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |journal=Lancet |volume=386 |issue=9995 |pages=743–800 |doi=10.1016/S0140-6736(15)60692-4 |pmc=4561509 |pmid=26063472}}</ref> They affect between 4 and 75 per 1,000 live births depending upon how they are diagnosed.<ref name=WHO2011/><ref name=Mil2011>{{cite book|last1=Milunsky|first1=Aubrey|title=Genetic Disorders and the Fetus: Diagnosis, Prevention and Treatment|date=2011|publisher=John Wiley & Sons|isbn=9781444358216|chapter-url=https://books.google.com/books?id=yY-gIvbnRDUC&pg=PT28|chapter=1}}</ref> About 6 to 19 per 1,000 cause a moderate to severe degree of problems.<ref name=Mil2011/> Congenital heart defects are the leading cause of birth defect-related deaths.<ref name=WHO2011/> In 2013 they resulted in 323,000 deaths down from 366,000 deaths in 1990.<ref name="pmid25530442"/>

==== Tetralogy of Fallot ====
[[Tetralogy of Fallot]] is the most common congenital heart disease arising in 1–3 cases per 1,000 births. The cause of this defect is a [[ventricular septal defect]] (VSD) and an [[overriding aorta]]. These two defects combined causes deoxygenated blood to bypass the lungs and going right back into the circulatory system. The [[modified Blalock-Taussig shunt]] is usually used to fix the circulation. This procedure is done by placing a graft between the subclavian artery and the ipsilateral pulmonary artery to restore the correct blood flow.

==== Pulmonary atresia ====
[[Pulmonary atresia]] happens in 7–8 per 100,000 births and is characterized by the aorta branching out of the right ventricle. This causes the deoxygenated blood to bypass the lungs and enter the circulatory system. Surgeries can fix this by redirecting the aorta and fixing the right ventricle and pulmonary artery connection.

There are two types of pulmonary atresia, classified by whether or not the baby also has a [[ventricular septal defect]].<ref name="Medscape2015">{{cite web |url=https://emedicine.medscape.com/article/892980-overview |title=Ventricular Septal Defects: Background, Anatomy, Pathophysiology |vauthors = Ramaswamy P, Webber HS|website=Medscape |publisher=WebMD LLC |access-date=August 22, 2017 }}</ref><ref name=":0">{{cite web |url=https://www.cdc.gov/ncbddd/heartdefects/pulmonaryatresia.html |title=Facts about Pulmonary Atresia: Types of Pulmonary Atresia|author=<!--Not stated--> |website=CDC |publisher=USA.gov |access-date=August 22, 2017 }}</ref>
* Pulmonary atresia with an intact ventricular septum: This type of pulmonary atresia is associated with complete and intact [[septum]] between the ventricles.<ref name=":0" />
* Pulmonary atresia with a ventricular septal defect: This type of pulmonary atresia happens when a ventricular septal defect allows blood to flow into and out of the right ventricle.<ref name=":0" />

==== Double outlet right ventricle ====
[[Double outlet right ventricle]] (DORV) is when both great arteries, the pulmonary artery and the aorta, are connected to the right ventricle. There is usually a VSD in different particular places depending on the variations of DORV, typically 50% are subaortic and 30%. The surgeries that can be done to fix this defect can vary due to the different physiology and blood flow in the defected heart. One way it can be cured is by a VSD closure and placing conduits to restart the blood flow between the left ventricle and the aorta and between the right ventricle and the pulmonary artery. Another way is systemic-to-pulmonary artery shunt in cases associated with [[Pulmonic stenosis|pulmonary stenosis]]. Also, a [[Atrial septostomy|balloon atrial septostomy]] can be done to relieve hypoxemia caused by DORV with the Taussig-Bing anomaly while surgical correction is awaited.<ref>{{Cite journal |last=Rao |first=P. Syamasundar |date=2019-04-04 |title=Management of Congenital Heart Disease: State of the Art—Part II—Cyanotic Heart Defects |journal=Children |volume=6 |issue=4 |pages=54 |doi=10.3390/children6040054 |issn=2227-9067 |pmc=6518252 |pmid=30987364|doi-access=free }}</ref>

==== Transposition of great arteries ====
[[File:D-tga-575px.jpg|thumb|Dextro-transposition of the Great Arteries]]
There are two different types of [[Transposition of the great vessels|transposition of the great arteries]], [[Dextro-Transposition of the great arteries|Dextro-transposition of the great arteries]] and [[Levo-Transposition of the great arteries|Levo-transposition of the great arteries]], depending on where the chambers and vessels connect. Dextro-transposition happens in about 1 in 4,000 newborns and is when the right ventricle pumps blood into the aorta and deoxygenated blood enters the bloodstream. The temporary procedure is to create an [[atrial septal defect]]. A permanent fix is more complicated and involves redirecting the pulmonary return to the right atrium and the systemic return to the left atrium, which is known as the [[Senning procedure]]. The [[Rastelli procedure]] can also be done by rerouting the left ventricular outflow, dividing the pulmonary trunk, and placing a conduit in between the right ventricle and pulmonary trunk. Levo-transposition happens in about 1 in 13,000 newborns and is characterized by the left ventricle pumping blood into the lungs and the right ventricle pumping the blood into the aorta. This may not produce problems at the beginning, but will eventually due to the different pressures each ventricle uses to pump blood. Switching the left ventricle to be the systemic ventricle and the right ventricle to pump blood into the pulmonary artery can repair levo-transposition.{{citation needed|date=April 2021}}

==== Persistent truncus arteriosus ====
[[Persistent truncus arteriosus]] is when the [[truncus arteriosus]] fails to split into the aorta and pulmonary trunk. This occurs in about 1 in 11,000 live births and allows both oxygenated and deoxygenated blood into the body. The repair consists of a VSD closure and the Rastelli procedure.<ref>{{Cite web |title=Persistent Truncus Arteriosus – Pediatrics |url=https://www.msdmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/persistent-truncus-arteriosus |access-date=2022-06-19 |website=MSD Manual Professional Edition |language=en}}</ref><ref>{{Cite web |last=Cleveland Clinic |date=September 17, 2021 |title=Truncus Arteriosus |url=https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus |url-status=live |website=[[Cleveland Clinic]]|archive-url=https://web.archive.org/web/20200804222430/https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus |archive-date=2020-08-04 }}</ref>

==== Ebstein anomaly ====
[[Ebstein's anomaly]] is characterized by a right atrium that is significantly enlarged and a heart that is shaped like a box. This is very rare and happens in less than 1% of congenital heart disease cases. The surgical repair varies depending on the severity of the disease.<ref>{{Cite journal|last=Bhat|first=Venkatraman|title=Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part III: Cyanotic Heart Diseases and Complex Congenital Anomalies|journal=Journal of Clinical and Diagnostic Research|doi=10.7860/jcdr/2016/21443.8210|pmc=5020285|pmid=27630924|volume=10|issue=7|year=2016|pages=TE01–10}}</ref>

Pediatric cardiology is a sub-specialty of [[pediatrics]]. To become a pediatric cardiologist in the U.S., one must complete a three-year residency in pediatrics, followed by a three-year fellowship in pediatric cardiology. Per [[doximity]], pediatric cardiologists make an average of $303,917 in the U.S.<ref name="r1" />