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Jordan Wolke
English 102
10/15/15
Research Paper
Killing America: The Epidemic of Heart Disease and its Implications Worldwide
Heart disease is the number one cause of death in the world. In the United States alone,
according to Julianna Schaeffer, Heart disease is the leading cause of death in Americans. In
fact, it's responsible for roughly 25% of deaths in the United States, according to the Centers for
Disease Control and Prevention. (Prevent Heart Disease 21). Unfortunately, many individuals
are unaware of how severe the problem is, let alone, believe it. Although people are more
familiar with diseases such as cancer, and believe these horrible diseases require the most
concern and attention; in reality, heart disease is the leading cause of death. This is precisely why
the United States specifically needs to educate and inform the public on preventative measures,
symptoms and prognosis, and the personal experience of others. Society as a whole needs to
understand the effects that heart disease has on those around us to fully grasp the importance to
press the issue of heart disease awareness and express the importance of diagnosis.
It is astounding that a quarter of the deaths that occur in the United States are a direct result
of heart disease and the lack of awareness that can lead to the condition worsening without
diagnosis and intervention. According to the Centers of Disease Control; For a condition that
(RD) [Registered Dietitians] know can be largely prevented, treated, and reversed through
lifestyle modifications, this number is far too high. (Prevent Heart Disease pg. 21). If 25% of
the US deaths are in direct correlation to heart disease, why is more time and money not being
spent on informing the public of the severity? Understandably, diseases such as cancer are

horrible and in order to progress in healing the disease, scientists and doctors need to invest time
and money into the research. On the other hand, the world is still unaware of the dangers of
having certain heart conditions unknowingly. The United States needs to educate the population
to save their lives. This entails money being spent on educating children in schools in addition to
advertisements on television and the internet to press the issue. There is so much being done in
relation to cancer awareness and so little progress on informing individuals on heart disease.
Heart disease, believe it or not, is actually a more pressing issue for women than it is for
men. Despite the fact that we are unaware of why women have a higher chance at having a heart
condition than men do, it is fact that women not only develop heart conditions more often but
carry genes containing heart disease as well. According to Teresa G. Odle who is a freelance
writer and editor and a frequent contributor to Radiologic Technology for more than 14 years,
even though heart disease cases have been decreasing for men and women over the years, it
continues to be the number one killer of women throughout the world in developed and
developing countries. (Women and Heart Disease pg. 384). This may be because of the
populations lack of being prepared and more importantly informed of different heart conditions
worldwide. The majority of women believe that their greatest threat is breast cancer. In reality,
cardiovascular disease since 1900 has killed more women yearly, specifically in the US, than
diseases like cancer or lung disease, for example. (389). These statistics and facts blatantly prove
that heart disease has become, and will continue to be, the leading killer in America until we
learn as a society to change the way heart disease is being taught and our own personal habits or
behaviors. Over the last ten years there has been increasing awareness in heart disease as the
leading cause of death in America, however, the knowledge in college students is minuscule.
Which leads the question: if the facts are true, why are college student uninformed and unaware?

Typically, cardiovascular disease begins at a younger age than previously thought including high
school and college age. Yet nothing is being done to prevent this from happening. There are
specific heart conditions that are more pressing than others but all of them need to have some
sort of attention drawn to it.
A subcategory of heart disease is cardiomyopathies which often go undetected.
Cardiomyopathies can cause sudden death in individuals who do not have the faintest idea there
is even a problem to begin with. Many athletes, runners, or average everyday people can drop
over dead without warning. Since January 1st of 2015 according to the National news there has
been 138 reported deaths from one specific cardiomyopathy. In fact there was a 9 year old
football player from Florida who died of sudden death. The parents and doctors later discovered
that he had a heart condition that unfortunately led to his demise. There are many types of
cardiomyopathies that can occur, basically caused by abnormal heart tissue/muscle that result
from several different causes. One specific cardiomyopathy that I am extremely familiar with is;
Hypertrophic cardiomyopathy [which] is a heterogeneous monogenic heart disease studied for
more than 50 years and recognized to be an important cause of arrhythmic sudden death, heart
failure, and atrial brillation (with embolic stroke). (Hypertrophic cardiomyopathy pg. 242).
From personal loss to costly medical treatment, the devastation of this disease can effect entire
families for generations. To elaborate, this disease is genetic and can live through generations
and generations. If an individual is a carrier of this disease then there is no possible way to
ensure the safety of their children if they were to have any.
Depending on the type of cardiomyopathy, there are two courses of treatment, first being
medical, which includes diet, exercise if allowed, and medication. When the disease becomes
very severe, causing other complications, there is a surgical procedure called a Myectomy that

can be done to remove tissue if there is an obstruction to blood flow out of the heart. When endstage heart failure occurs, the person may need a heart transplant and this is only possible if all
other organs in the body are healthy enough to complete the procedure successfully. The
American Journal of Cardiology states, Heart transplantation is a treatment option for patients
with hypertrophic cardiomyopathy (HC) who have developed refractory heart failure and/or lifethreatening arrhythmia unresponsive to medical therapy. (Cardiac Transplantation pg. 568)
The experience of diagnosis is extremely stressful. Imagine being told by a doctor that
ones entire life must be altered for ones own survival. Imagine hearing someone tell you that
you will no longer be able to play sports, exercise, immensely, or even participate in gym class.
This can be a heavy burden on not only the one being diagnosed but also their loved ones;
Mothers, fathers, sisters, or brothers learning that one they love has a condition that could
possibly end their life at any given moment without specific cause. Bratt, Lundin, Smith, and
Axelsson (2012) conducted a study of children being diagnosed: One case that touched me while
I was researching was the case of a 15 year old boy who was diagnosed months prior to the
interview. The boy kindly states; Yes, it was as if the world had collapsed (boy 15 years).
(Experience of being diagnosed pg. 530). Unfortunately, I found after further research, the boy
had to stop playing all sports and change his entire lifestyle in order to escape death and
transplant. Depending on the age of the person, especially women, a change in lifestyle can be
very traumatic; eliminating the ability to work, decrease in physical activity, and shortness of
breath in daily activity to name a few unfortunate symptoms of heart disease. Because heart
disease, including cardiomyopathies can be such a devastating illness, it is very important to
understand what as individuals we can do to either prevent or treat the disease.

With behavior modifications, heart disease can be prevented or slowed down: Lifestyle
modifications have been shown to result in decreased mortality rates. (Experience of Being
Diagnosed pg. 528). Lifestyle changes that can be made on an individual basis to improve your
likelihood of maintaining a healthy heart include no smoking, proper nutrition (low sodium and
low fat diet); healthy exercise including cardio for at least 30 minutes daily; and limiting stress
induced factors in life. Although this may be difficult, in order to remain healthy, this must
happen.
One factor contributing to the number of heart disease deaths and chronic illnesses
caused by heart disease can be genes. Unfortunately, one cannot change their genetic makeup, so
if there are genetic risk factors evident in their family it is extremely important to make any
behavioral changes possible. Some of the inheritable factors include high cholesterol, clogged
arteries or atherosclerosis, obesity, lung disease, and diabetes. Another inheritable problem is
high blood pressure, commonly caused by the previous factors; but it may also be seen without
them. Some risk factors in heart disease is usually more prevent in Hispanics and African
Americans such as diabetes for the Hispanic culture and high blood pressure for African
Americans. Treatments are available that can successful to stop life threatening irregular
heartbeats as HCM causing the patient to be at a high risk for sudden cardiac death. Including
implantation of the ICD (Implantable Cardioverter-Defibrillator). (Implantable CardioverterDefibrillators in Hypertrophic Cardiomyopathy pg. 502). In 2013, 6.8 percent of the patients
received an ICD.
Awareness of heart disease is growing, but yet we have so far to go. Life is so precious
and with this being said, we take for granted our everyday gifts in life. According to three
Californian Journal of Health Promotion article writers at California State University of the

Department of Nutrition and Food Sciences, On average, one American dies every 39 seconds
from cardiovascular disease (Roger et al., 2012). (Awareness of the Red Dress Symbol pg. 36).
With the help of knowledge and education we can significantly reduce this number. Although
heart disease is discussed more readily in the public sector we still have a long way to go. There
is a limited number of educational offerings on heart disease causing the lack of understanding
by both the medical community and the general population.
Cancer and diseases with similar severities are constantly being advertised everywhere
we turn. On the other hand, heart disease is rarely expressed through the media. Research shows
that More women die each year of cardiovascular disease than men (Women Heart, 2012). In
2008, 419,730 women died from cardiovascular disease, representing more deaths than from
cancer, chronic lower respiratory disease and Alzheimers disease combined. (Awareness of the
Red Dress Symbol pg. 36). The heart disease epidemic, in my opinion has been around for far to
long considering there are so many things that we can do to prevent it. As a society, we need to
stop being so oblivious and step up our knowledge and understanding in order to change these
statistics and save ourselves or those we hold dear. If this generation is educated, then future
generations will no longer suffer. Most people dont even know of the most important tool to
help control heart disease which happens to be the defibrillator. The defibrillator is put in place
attached to the heart through a surgical procedure in order to control the heart beating. The
defibrillator is extremely important for the main reason of keeping track of sudden death and
preventing it. Once the individual has the defibrillator in it can be life changing, as much as it is
able to save someones life, it is also a very scary piece of equipment which may feel like being
hit in the chest by an uncontrollable baseball bat.

In the discussion of IHSS (Idiopathic Hypertrophic Subaortic Stenosis), it is important to

know that it can be caused by the genetic mutation of DNA. It is considered a dominant
characteristic so each person born of an individual who has hypertrophic cardiomyopathy has a
50% chance of inheriting the mutation. Owing to the autosomal dominant nature of this disease,
persons who have a parent with hypertrophic cardiomyopathy have a 50% risk of inheriting the
mutation. (Experience of Being Diagnosed pg. 529). Because of this, once diagnosed in a
family, it would be important for other immediate relatives to be screened for the same
mutations. However, if you do not have a parent who has it then you will not develop this form
of cardiomyopathy. Some cardiomyopathies arent genetic and can be caused by things such as
infections, viruses, pregnancy, which also increases womens chance in developing these
diseases. Part of the education process of these devastating diagnosis of heart disease is for
people to understand and be able to identify the symptoms and terms. (532).
Women with heart disease often present different symptoms than men. This is part of the
problem for improper diagnosis of the disease. Heart disease in general causes symptoms such
as; extreme fatigue or increased fatigue with activity, chest pain often radiating to the left arm,
either with or without activity, shortness of breath with or without activity, and perspiration with
activity. Varying symptoms related to female heart disease include throat pain, back pain and
shoulder pain, chest pain radiating to both arms, jaw pain, tooth aches, and/or nausea or
epigastric pain. One of my close family friends had a heart attack, and when she was in the
hospital the doctor asked her if she had recently been to the dentist on an account of tooth pain.
She responded with yes, but why is this relevant. The doctor then explained that common
symptoms of heart disease is tooth pain among women which astonishingly enough happen
nearly every time a women is nearing a heart attack.

There are tests that can be done for diagnosis that include blood test, chest x-ray, heart
catheterization which shows through radio logic, pictures of the blood flow supplying oxygen to
the heart muscle. Now doctors are also doing magnetic MRIs and echocardiograms. Physical
symptoms that can be detected in the tests are function of the heart muscle, size of the chambers
of the heart, problems with heart valves, and size of heart muscle. Signs and symptoms of
cardiomyopathy specifically HCM, can include in addition to the above, dizziness and fainting
with or without activity, palpitation (irregular heartbeat), and inability to sleep flat, shortness of
breath when sleeping which are both symptoms of congestive heart failure. Congestive heart
failure can be common in the end stages of cardiomyopathy.
I think that it is a hard thing to understand a heart condition without living it. As you see
people parking in a handicapped parking space or stopping halfway through every time they
walk up the stairs and the only thing running through your mind is, whats the big deal?, you
need to stop and think about the things you cannot see. Having to live with a heart condition is
hard and living with people constantly questioning why you cant do things make life even more
difficult. Heart conditions run in my family. My great grandmother, grandmother, Aunt, Cousin,
and Mom have been diagnosed with the hereditary heart condition known as Idiopathic
Hypertrophic Subaortic Stenosis. My brother, sister, and I are yet to find out if the disease has
been passed down to us. My great grandmother was diagnosed with this disease and because of
the lack of knowledge and control over the situation she passed away at only forty years of age.
It was a shock when my family then realized that this horrible disease was hereditary. My
grandmother was the only one of all of her siblings who showed symptoms of the condition.
Therefore, her children were exposed to this as well. This gene has since then been passed down

to my mother, Aunt Julie, and Aunt Dawn. Within my generation, my Aunt Julies son, Austin,
has been also diagnosed.
My mother passed away less than a year ago. I cannot say that this was a complete lack
of knowledge that ended her battle but rather being unprepared and unaware of the severity from
both our perspectives as well as her doctors. Unfortunately, we were too late to do anything and
when she went in for surgery which was supposed to change her life, she was robbed. For this
reason, I felt the need to write this paper on heart disease, not only to bring awareness to others
but also educate myself to better prepare my family and I for what is yet to come. I strongly
believe that if we are willing to change our ways, exercise and eating well, we can prevent early
death to people we care about. The world needs to understand the how important it is to be
prepared, to be knowledgeable, and to be aware. Symptoms can be spotted, severe circumstances
can be prevented, and lives can be saved. In the following paragraphs are excerpts from
interviews with some of my family members who have been touched by heart disease.
Grandma: What is life like when living with a heart condition?: very difficult
because you dont look sick, and people tend to judge appearance without understanding the
underlying issues that they are unaware of. This includes friends, employers, and even family.
We have the inability to even accept it yourself. Especially the physical restrictions of not being
able to walk with being short of breath or limiting exercise to escape death. Not being able to
enjoy your life to the fullest but rather accepting the way things are. Once you are diagnosed you
do not receive any life insurance and health insurance does not cover very well. Even your own
children dont understand the struggles youre having because you look like anyone else in their
lives on the outside.

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Aunt Julie: I can definitely say challenging and very frustrating. It is what it is. People try to
understand it but nobody can truly understand. I couldnt understand it until I myself got
diagnosed. Eventually its hard to tell how sick you really are because essentially, you change to
fit the disease. I knew I was short of breath all the time but because I got so used to it, I didnt
know how bad it really was. I never pictured myself in this position despite seeing my son, sister,
and mother go through it. You miss the signs because you slow down and adapt. Things take an
hour instead of a half hour. Now at the stage that I am at, I am awaiting transplant. People began
to treat me with kid gloves and like I am a glass jar waiting to be broken. It makes you realize
everything thats happening has restricted your life. Also, medications Im on all have side
effects which includes forgetfulness. I can be working on something and completely forget what
I was working on in the first place.
Austin: My cousin, Austin, was diagnosed with the hereditary heart condition at birth. He is the
first known case to have been diagnosed at such a young age. Unfortunately this means the
doctors dont know what to expect. Often the individual can live many years with little to no
symptoms. The earlier the individual is, there is an increased potential for problems or sudden
death as they grow older. How do you live your life knowing or rather not knowing what could
happen? Constantly wondering how long you have left?:
Understandably; cancer, respiratory disease, and Alzheimers are extremely dangerous
and very important to learn about, but, heart disease is underrated. Therefore, we need to educate
others on the severity of heart disease. We as a society have lost too much, too many, to sit back
and not react. The United States needs to better educate the public on heart disease symptoms as
well as the ways to prevent the severity of being diagnosed with a heart condition. According to
Ann Marie C. Depalma, One in two women will die of heart disease, more than from all cancers

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combined." (Women and Heart Disease 80). We can make a difference by simply being aware of
the statistics and symptoms to recognize the signs and be proactive on diagnosing the specific
disease. To do so, we can change our lifestyle, eating habits, and reduce stress inducing factors in
our lives. After everything my family and I have gone through in life, I would never wish this
upon anyone and I would like to dedicate my time to helping those who have gone through
similar circumstances.

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