A wide variety of medications work to treat heart problems and provide a greater quality of life to patients. Cardiologists will discuss with you the prescription options available, how they work, potential side effects and which ones are most ideal for your individual condition. Although cardiac medications don't eliminate heart disease, they are very conducive to minimizing symptoms as much as possible.
For additional information, please refer to the following. Remember, however, that only your physician who knows your medical history and current requirements can accurately determine what will be the most effective for your treatment plan.
Cardiac catheterization (a catheter is a long, thin tube) includes a variety of interventional procedures, permitting cardiologists to directly correct heart problems.
The most common interventional heart catheterization procedures are Coronary Angioplasty, often referred to as a "balloon" procedure, and Stent Placement.
For both procedures, patients initially receive preparatory tests, such as x-rays, blood work and ECAs. After these are processed, as with any diagnostic procedure, patients must not eat or drink for a specified period before the procedure. The arm or leg region of actual catheter insertion is shaved while an IV set-up is prepared to begin administering the fluids and medications.
Coronary Angioplasty
Coronary angioplasty works by compressing the fatty build-up against the artery wall, widening the artery with the balloon and permitting increased blood flow to the heart regions served by that vessel.
Utilizing the guiding catheter and monitoring its progress on an x-ray screen, the cardiologist places a very small balloon into a constricted area. Expanding and deflating the balloon at the blockage several times compress the build-up against the walls, which enlarges the opening. Upon completion, the balloon and catheter are removed and blood can flow more freely.
Stent Placement
Some patients require the additional placement of a stent in the area opened by the angioplasty (balloon procedure). This small, metal coil or mesh-like device, placed where plaque build-up was compressed, ensures the blood vessel retains the new shape and remains open (patent) for blood to reach critical cardiac muscle tissue.
Due to its size, stent placement must follow dilated arteries that received angioplasty. The stent is larger than the balloon used in angioplasty, which limits its use to larger arteries only.
Placed in the artery with the end of a balloon catheter, the stent inflates as the balloon inflates (see angioplasty above). The expanded stent helps to further compress blockages. However, unlike the balloon, which is removed upon procedure completion, the stent remains in place to ensure sufficient blood flow.
Heart Surgery
The most common heart operations generally fall into three primary categories:
Valve Replacement Procedures
Coronary Artery Bypass Graft (CABG)
Heart Reduction Surgery
1. Valve Replacement Procedures
Four valves comprise the heart: Two control blood inflow to ventricles from the atria. The second set controls the outflow of blood from the heart to the body. Each valve has two or three leaflets, or tissue flaps, that act as one-way doors opening to allow the flow of blood in one direction and closing to prevent the blood from backing up into chambers of the heart that it has just left.
Healthy Hearts: The valves open freely, close completely and blood flows properly.
The valves between the atria and ventricles (tricuspid on the right side and mitral on the left) have fibrous cords that help the valve's overlapping leaflets to function by connecting them to the muscle wall of the ventricles. The valves that control the flow of blood from the ventricles to the arteries (pulmonary on the right side and aortic on the left) are cup-shaped structures that do not overlap.
Heart Problems: Adverse conditions are created when the valves leak or develop torn fiber cords connecting the valve leaflets to the papillary muscles on the wall of the ventricles. Injury, infection, or diseases such as rheumatic or scarlet fever can trigger this. In some cases, congenital birth defects can cause malformations.
If heart valves thicken or stiffen, which inhibits their functioning, it's called valvular stenosis. The most common heart valve problem is stenosis of the aortic and mitral valves.
Surgical Correction: In an effort to replace or adjust defective heart valves, open-heart surgery (cutting through the chest cavity) is required. The high success rate for this procedure continues to grow because of the ongoing technological advances and improved techniques.
To allow the surgeon to make an incision in the heart, granting access to the defective valve, the pumping action of the heart is stopped. While it is stopped, a heart-lung bypass machine ensures the flow of blood throughout the body. As the blood flow continues with the machine, the surgeon makes appropriate repairs or replaces it with an artificial valve, securing it and verifying its effectiveness before closing. Most patients return home in a few days.
This surgical correction of faulty valves not only helps a patient fully live his/her life, it often extends the lifespan. However, patients receiving artificial devices will need to be on anticoagulant drug therapy (blood thinners) to ensure the continued effectiveness of the procedure.
2. Coronary Artery Bypass Graft (CABG) Procedures
Coronary artery bypass graft surgery or CABG (often referred to as "cabbage") is the most common open-heart procedure. More than 200,000 are performed nationwide every year, with the vast majority experiencing a full and complete recovery. This surgery is usually the best option for patients experiencing dizziness, shortness of breath, or nausea and sweats resulting from blocked or narrowed arteries (atherosclerosis).
As the coronary arteries continue to narrow, the blood supply to the heart muscle is reduced or blocked, which can trigger a heart attack (myocardial infarction). Bypass surgery detours the blockage by providing alternative routes of blood flow around the narrowed artery regions. A blood vessel from another part of the body, often one of the long leg veins, is attached to route blood around the blockage or narrowing, ensuring normal blood flow for the heart muscle. Sometimes, the surgeon opts to use the Left Internal Mammary Artery (LIMA), which is on the undersurface of the sternum (breastbone), making it easily accessed during surgery.
As in valve replacement procedures, the pumping is stopped and a heart-lung bypass machine assumes the flow of blood throughout the body during CABG. Following the graft replacements, patients are carefully monitored, generally returning home within a week. Although it varies patient to patient, most resume their normal lifestyle within two months.
3. Heart Reduction Surgery
Also known as left ventricular reduction, heart reduction surgery has proven itself as an effective treatment for congestive heart failure and for many patients, a valid alternative to potentially risky heart transplants.
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