Cardiology is a branch of medicine dealing with disorders of the heart as well as parts of the circulatory system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology.
Coronary Artery Disease & Symptoms:
Coronary artery disease (CAD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. The most common symptom of coronary artery disease is angina, or chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina may also be felt in the shoulders, arms, neck, throat, jaw, or back. Some other symptoms of coronary artery disease include:
Investigations like EEG, Chest X- Ray, Stress test, Tilt Table test, Echocardiogram, Electrophysiology, Angiography, CT Heart Scan, Myocardial Biopsy, Heart MRI may be suggested by the doctor.
An angiography helps diagnose conditions that affect blood vessels and flow of blood through them. The image on an angiogram is used to plan surgeries involving the blood vessels, such as Coronary Artery Bypass Grafting (CABG) or Open Heart Surgery & coronary angioplasty (PTCA), which are performed to treat coronary heart disease.
PTCA is a treatment of coronary artery disease. In angioplasty a balloon-tipped catheter is inserted through the skin into a blood vessel and to the clogged portion of the artery. There it is threaded into the blockage and inflated, compressing the plaque (build up of fat and cholesterol) against the arterial walls. Frequent postoperative reclogging (narrowing of blood vessel) of the treated area has led to the use of stent (sometimes coated with a drug that inhibits narrowing of a blood vessel) designed to hold the plaque back.
(RFA) is a medical procedure where part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from the high frequency alternating current to treat a medical disorder. Radio frequency ablation is a minimally invasive procedure used in the treatment of varicose veins and certain types of Artery Blockages. It is an alternative to the traditional stripping operation. If radio frequency ablation is recommended, a doctor will explain the procedure in detail, including possible complications and side effects.An intravenous (IV) line may be placed in a vein in your arm before the procedure and a local anesthetic and mild sedative may be used to reduce any discomfort during RFA. You may be awake during the process to aid in properly assessing the procedure.
Electrophysiology Study (EP test or EP study) is a minimally invasive procedure which tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. The study is indicated to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms. This type of study is performed by an electro physiologist and using a single or multiple catheters situated within the heart through a vein or artery. The study involves placing wire electrodes in the heart. These electrodes measure electrical activity in the heart and its muscle cells. The procedure is done in a hospital laboratory by trained staff that includes a cardiologist, technicians, and nurses. The electrodes detect the heart electrical activity and are used to check the hearts electrical system.
Electrical signals may be used to make the heart skip beats or produce an abnormal heart rhythm. This can help the doctor understand more about what is causing the abnormal heart rhythm or where in the heart it is starting.
An EPS may be done to:
Coronary Artery Bypass Grafting (CABG) surgery is a procedure used to treat coronary artery disease in certain circumstances. Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become narrowed, limiting the supply of oxygen-rich blood to the heart muscle.
Heart Valve Replacement (VR) surgery be done when valves are damaged or diseased and do not work the way they should. Conditions that may cause heart valve dysfunction are valve stenosis (stiffness) and valve regurgitation (leaky valve).
When one (or more) valve(s) becomes stenotic (stiff), the heart must work harder to pump the blood through the valve. Some reasons why heart valves become narrow and stiff include infection (such as rheumatic fever or staphylococcus infections) and aging. If one or more valves become leaky, blood leaks backwards, which means less blood is pumped in the right direction. Based on your symptoms and the overall condition of your heart, your health care provider may decide that the diseased valve(s) needs to be surgically repaired or replaced.
Valve Stenosis: valve does not open fully, it will obstruct the flow of blood Valve Incompetence: valve does not close properly, it will allow blood to leak backwards.
Treatment for Valve Replacement (VR) Surgery
Aortic Valve Replacement Surgery / Mitral Valve Replacement Surgery / Tricuspid Valve Replacement Surgery / Pulmonary Valve Replacement Surgery .
Traditional Heart Valve Surgery
During traditional heart Valve Replacement (VR) surgery, a surgeon will make an incision down the center of your sternum (breastbone) to get direct access to your heart. The surgeon then repairs or replaces your abnormal heart valve or valves. While this approach remains in use, today most patients with isolated valve disease can be treated with minimally invasive techniques.
Minimally invasive heart valve surgery (The modern procedure)
Minimally invasive surgery is a type of surgery performed through smaller incisions. This type of surgery reduces blood loss, trauma, and length of hospital stay. Heart Valve Replacement (VR) surgery is the most common minimally invasive procedure. Your surgeon will review your diagnostic tests prior to your surgery to see if your are a candidate for minimally invasive Valve Replacement (VR) surgery.
The Ross Procedure for Valve Replacement
This specialized aortic Valve Replacement (VR) surgery is used most often with children and adults under age 35. The procedure involves replacing the patients diseased aortic valve with the patients own pulmonary valve, called an autograft. Then the surgeon replaces the pulmonary valve with a homograft pulmonary valve. That is, a pulmonary valve from a human donor. Compared to traditional valve replacement using manufactured prosthetic valves, the Ross Procedure is most beneficial for young people and active older patients: The pulmonary valve lasts longer than prosthetic valves, which tend to fail after a few years in younger patients.