Lisa Marie Presley passed away on January 12, 2023 following a cardiac arrest. While the cause of death has not yet been released, Presley's family has a history of heart disease going back generations. "Many different types of heart disease can be passed down through families," says Harvard Health. "Some are caused by just one or a few genetic changes that have a very strong effect in causing disease. Known as monogenic conditions, they include uncommon disorders that mostly affect the heart's muscle (such as hypertrophic cardiomyopathy) or electrical system (such as long QT syndrome). Another example is familial hypercholesterolemia, which causes very high cholesterol levels and may lead to premature coronary artery disease (occurring before age 50)." Lisa Marie's father Elvis Presley died on Aug. 16, 1977 at age 42. His cause of death was reported as cardiac arrhythmia with ventricular fibrillation, which can be triggered by a heart attack. Factors cited in his death included high blood pressure, clogged coronary arteries, and an enlarged heart, plus an addiction to opiates. Gladys Love Presley, Elvis' mother, passed away at 46 from heart failure, and his father Vernon died at 63 after a cardiac arrest. Gladys' three brothers allegedly passed away in their 40s from heart and lung conditions. Heart disease is the leading cause of death in the US. While lifestyle factors make a significant difference, genetics play a role. "Heart disease is 90 percent treatable – everyone can prevent heart disease anywhere in the world, especially by eating foods that are low in salt and cholesterol, exercising regularly, and not smoking," says Leslie Cho, MD, Section Head for Preventive Cardiology and Cardiac Rehabilitation at Cleveland Clinic. "Even if a person has a family history of heart disease, we can still prevent and treat heart disease thanks to incredible advances in medicine." Here's what to be aware of when it comes to inherited heart conditions. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
Familial Hypertrophic Cardiomyopathy
Familial hypertrophic cardiomyopathy is an inherited heart condition which may cause sudden death. "Familial hypertrophic cardiomyopathy is a fairly common inherited heart condition that can affect people of any age," says Penn Medicine. "This disease can thicken part or all of the heart muscle. In extreme cases, it can even cause sudden death. The thickening often happens in the interventricular septum –– the wall that separates the left and right ventricles (the two lower chambers of the heart). This can prevent proper blood flow from the heart and force the heart to pump harder than it should. This thickening can also give the left ventricle less room to hold blood, which can raise pressure inside that chamber. When this happens, you may feel short of breath. You may also be at risk for abnormal heart rhythms." Symptoms of familial hypertrophic cardiomyopathy may differ among family members. While one person may have chest pain, another may have palpitations, or even no symptoms at all. "This difference in symptoms can be dangerous because you might not attribute your symptoms to your family history of this disease, which can cause you to delay seeking medical help. Fortunately, getting medical help early on can help prevent the disease from progressing or causing complications, and manage symptoms."
Familial Dilated Cardiomyopathy
Familial dilated cardiomyopathy is another inherited heart condition. "All first-degree family members (sons, daughters, brothers, sisters, parents) of a patient with familial dilated cardiomyopathy should undergo screening for dilated cardiomyopathy with echocardiography and electrocardiogram," says Stanford Health. "Other family members may undergo screening if their first-degree relatives are found to have disease or have high risk occupations or activities such as competitive sports. If genetic testing is performed and a mutation is found, all family members who have the mutation are recommended to undergo a comprehensive clinical assessment. All Individuals with symptoms of dilated cardiomyopathy should undergo clinical evaluation." "An inherited cardiac condition is a disease affecting the heart that is caused by genetic problems. These are misspellings of the genetic code, known as DNA, and are often called mutations," says Elijah Behr, M.D., a cardiologist at Mayo Clinic Healthcare. "Mutations can be inherited from parents or, if it is a sporadic mutation, occur for the first time in a specific family member. If a family member has died suddenly and unexpectedly at a young age, it is possible that genetic heart disease is the cause. This means that other family members may be at risk. Expert evaluation of cases of sudden death and family members is an important way to try to prevent further deaths."
"Familial Hypercholesterolemia (FH) is one of the most common inherited lipid disorders in the United States," says cardiologist Ashish Sarraju, MD. "It's a condition that through genetic mutation or mutations, leads to lifelong elevations in cholesterol, particularly low density lipoprotein cholesterol or LDL cholesterol, which is the one that often gets tagged as the bad cholesterol. It is surprisingly common. So there are two forms of the disease. There's a form called heterozygous FH, in which folks carry a single copy of the mutation, and then there's homozygous FH in which folks carry two copies of the mutation. Heterozygous FH is as common as one in 200 to one in 300 people in the US and it's estimated that maybe only 10% of those are diagnosed with the condition. Homozygous FH is much more rare. It's really more on the order of one in several hundred thousand to one in a million." Dr. Sarraju says those with certain health factors should consider additional screening. "So I would say adults with an LDL cholesterol that's greater than 190, 190 mg/dl should certainly consider it, as well as those who have a strong family history of heart disease, even if their LDL cholesterol doesn't quite reach the 190 level. If it's elevated, I think it's reasonable to think about it.. at that degree of LDL cholesterol it makes sense to think about FH proactively, and then go through the diagnostic testing and screening for FH, which includes everything from taking a very detailed personal and family history, doing a focused physical exam, for findings consistent with FH and potentially even thinking about genetic testing to establish the diagnosis."
Blood Type A, B, Or AB
Blood types A, B, or AB are the most dangerous when it comes to heart disease. "While people cannot change their blood type, our findings may help physicians better understand who is at risk for developing heart disease," says Lu Qi, Ph.D. "It's good to know your blood type in the same way you should know your cholesterol or blood pressure numbers. If you know you're at higher risk, you can reduce the risk by adopting a healthier lifestyle, such as eating right, exercising, and not smoking." Dr. Cho believes screening for heart disease should start when children are around seven years old. "We do not want to start children on cholesterol medication at that age, but rather to get them thinking about the importance of a healthy diet and regular exercise," says Dr. Cho. "We think of heart disease as an old person's problem but, really, prevention should start in childhood."
Lifestyle factors such as diet and exercise can have a significant impact on heart health, even with genetic factors. "We focus on a Mediterranean-style diet of eating for optimum heart health," says Julia Zumpano, a registered dietitian with the Cleveland Clinic who works in preventative cardiology. "The Mediterranean diet is abundant in fruits and vegetables, grains, fish, extra virgin olive oil, nuts, and seeds. Starting off with eating more meatless meals will definitely get you closer to heart health. Incorporating beans, legumes, any kind of nuts and seeds, and meatless products like tofu, tempeh, if you want to get adventurous into your diet a little more regularly. I generally say start with one meatless meal a week, replacing a meal of meat, ideally red meat, with a meatless meal." Not smoking, prioritizing sleep, managing stress, staying at a healthy weight, and monitoring cholesterol are other important ways to support heart health. "We know that smoking is a risk factor for cardiovascular disease and that cessation leads to decreases in cardiovascular disease and the risk of death," says Dr. Mayank Sardana, a cardiac electrophysiology fellow at the University of California San Francisco School of Medicine. "But only a minority of smokers are receiving counseling in cardiology clinics and assistance in trying to quit."