What conditions are classified as heart disease?

Classifications of Heart Disease

Heart disease encompasses a wide range of cardiovascular conditions affecting the heart and blood vessels, including congenital heart defects, coronary artery disease, valvular disorders, arrhythmias, and heart failure. 1

Congenital Heart Disease (CHD)

The American College of Cardiology/American Heart Association classifies congenital heart disease based on anatomical complexity and physiological stage:

Anatomical Classification

1. Simple Complexity

   • Isolated small atrial septal defect (ASD) 1
   • Isolated small ventricular septal defect (VSD) 1
   • Mild isolated pulmonic stenosis 1
   • Previously repaired conditions without significant residual issues 1

2. Moderate Complexity

   • Anomalous pulmonary venous connection 1
   • Anomalous coronary artery conditions 1
   • Atrioventricular septal defect (AVSD) 1
   • Congenital aortic and mitral valve disease 1
   • Coarctation of the aorta 1
   • Ebstein anomaly 1
   • Moderate/large unrepaired secundum ASD 1
   • Patent ductus arteriosus 1
   • Repaired tetralogy of Fallot 1

3. Great Complexity

   • Cyanotic congenital heart defects 1
   • Double-outlet ventricle 1
   • Fontan procedure 1
   • Single ventricle conditions 1
   • Pulmonary atresia 1
   • Transposition of the great arteries 1
   • Truncus arteriosus 1

Physiological Classification

• Stage A: No symptoms, normal function 1
• Stage B: Mild symptoms, mild hemodynamic sequelae 1
• Stage C: Moderate symptoms, significant valvular disease 1
• Stage D: Severe symptoms, severe complications 1

Acquired Heart Disease

Coronary Artery Disease/Ischemic Heart Disease

• Leading cause of death worldwide 2
• Includes:
  • Myocardial infarction (heart attack) 2
  • Ischemic cardiomyopathy 2
  • Angina pectoris 3

Valvular Heart Disease

• Affects heart valve function through stenosis or regurgitation 3
• Includes:
  • Aortic stenosis/regurgitation 1
  • Mitral stenosis/regurgitation 1
  • Tricuspid valve disease 1
  • Pulmonary valve disease 1

Heart Failure

• Systolic heart failure (reduced ejection fraction) 4
• Diastolic heart failure (preserved ejection fraction) 4
• Right-sided heart failure 1
• Left-sided heart failure 1

Arrhythmias

• Supraventricular arrhythmias (including atrial fibrillation) 5
• Ventricular arrhythmias 5
• Bradyarrhythmias 5
• Conduction disorders 1

Hypertensive Heart Disease

• Characterized by left ventricular hypertrophy 5
• Can lead to heart failure and arrhythmias 5
• Associated with accelerated atherosclerosis 6

Cardiomyopathies

• Dilated cardiomyopathy 4
• Hypertrophic cardiomyopathy 1
• Restrictive cardiomyopathy 1
• Stress-induced cardiomyopathy 4

Pericardial Disease

• Pericarditis 1
• Pericardial effusion 1
• Cardiac tamponade 1
• Constrictive pericarditis 1

Vascular Disease

• Aortic aneurysm and dissection 1
• Peripheral arterial disease 3
• Venous thromboembolism 1
• Pulmonary hypertension 1

Clinical Implications

• Heart disease classification guides appropriate specialist referral and management 1
• Complex congenital heart disease patients have better outcomes when managed in specialized centers 1
• Physiological staging helps determine prognosis and treatment intensity 1
• Cardiovascular symptoms significantly impact quality of life and healthcare utilization 3

Common Pitfalls in Classification

• Failing to recognize that patients may have multiple types of heart disease simultaneously 1
• Not accounting for physiological status when assessing anatomical defects 1
• Overlooking acquired comorbidities in congenital heart disease patients 1
• Underestimating the impact of hypertension as a risk factor for multiple cardiovascular conditions 6