Dr. Jason Boglioli, MD

Homocysteine is an amino acid by-product of the metabolism of protein and can build up in the blood. As you age, your homocysteine levels increase. No one is exactly sure how homocysteine ages your arteries, other than by causing inflammation of the arteries, but it is well established that people with high homocysteine levels have considerably higher levels of inflammatory arterial disease and much greater damage from plaque deposits on the arteries than those who don't have high levels of homocysteine.

Some theories are that high levels of homocysteine seem to disturb the endothelium, the inner lining of the artery. Some scientists believe that homocysteine causes small openings between the endothelial cells that make up the inner lining of your arteries, leading to deterioration of the arterial wall, buildup of plaque, and inflammation.

Other theories on how homocysteine ages your arteries may also be correct. Homocysteine may decrease the production of relaxing factors that allow the blood vessels to dilate. It may also stimulate blood clots by changing the shape or form of cells that make up the epithelium. In addition, homocysteine might oxidize low-density lipoproteins (LDL cholesterol; remember "L" for lousy), promoting plaque buildup along the walls of arteries. Although we don't know all the reasons, an established link exists between high homocysteine levels and arterial aging.

The purpose of the heart is to provide oxygen and nutrients to the rest of the body. Congestive Heart Failure (or CHF) is the failure of the heart to do this adequately. CHF occurs when cardiac output, or the flow of blood from the heart, decreases. Congestive Heart Failure is also when fluid backs-up behind the failing ventricle or fluid back up together with decreased cardiac output.

Time-dependent heart failure is either sudden or develops gradually.

Acute heart failure occurs suddenly. Acute heart failure happens if a large enough part of the heart muscle dies, which means the heart cannot pump out enough blood, resulting in heart failure and pulmonary edema. Breathing becomes very difficult and can lead to death. When a heart valve suddenly stops functioning, this is also acute heart failure, as when the chordae tendineae, which are the muscle and cord that help the mitral valve function properly, rupture all of a sudden.

It's called Chronic heart failure when the heart failure that develops gradually. The symptoms begin subtly but become more acute over time.