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Cardiology is a medical specialty dealing with disorders of the heart (specifically the human heart). The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians specializing in this field of medicine are called cardiologists.
As the center focus of cardiology, the heart has numerous anatomical features (e.g., atria, ventricles, heart valves) and numerous physiological features (e.g., systole, heart sounds, afterload) that are of concern.
Disorders of the heart leads to heart disease and cardiovascular disease and they lead to a significant number of deaths: cardiovascular disease is the leading cause of death and caused 29.34% of all deaths in 2002.
The primary responsibility of the heart is to pump blood around the body.This means that the heart is connected and affects the entirety of the body. While plenty is known about the healthy heart, the bulk of the study in cardiology is in the disorders of the heart and restoration, where possible, of function.
The symptoms of heart diseases depend on the types of heart diseases. Chest pain and heart attack are the symptoms of Coronary heart diseases. Shoulder or back ache, indigestion or nausea, upper abdominal pain is also the symptoms of heart diseases.Heart diseases are diagnosed by recognition of diseases. Its diagnosis begins with obtaining the history of the patient following that tests are done. ECG and EKG are used to know heart diseases and conditions.
We should not ignore or delay in diagnosing these diseases.
Coronary angioplasty (AN-jee-oh-plas-tee) is a procedure used to open blocked or narrowed coronary (heart) arteries. The procedure improves blood flow to the heart muscle.
Over time, a fatty substance called plaque (plak) can build up in your arteries, causing them to harden and narrow. Atherosclerosis can affect any artery in the body. When atherosclerosis affects the coronary arteries, the condition is called coronary heart disease (CHD) or coronary artery disease.
Angioplasty can restore blood flow to the heart if the coronary arteries have become narrowed or blocked because of CHD.
Angioplasty is a common medical procedure. It may be used to:
• Improve symptoms of CHD, such as angina (an-JI-nuh or AN-juh-nuh) and shortness of breath. (Angina is chest pain or discomfort.)
• Reduce damage to the heart muscle caused by a heart attack. A heart attack occurs if blood flow through a coronary artery is completely blocked. The blockage usually is due to a blood clot that forms on the surface of plaque. During angioplasty, a small balloon is expanded inside the coronary artery to relieve the blockage.
• Reduce the risk of death in some patients.
Angioplasty is done on more than 1 million people a year in the United States. Serious complications don't occur often. However, they can happen no matter how careful your doctor is or how well he or she does the procedure.
Research on angioplasty is ongoing to make it safer and more effective, to prevent treated arteries from narrowing again, and to make the procedure an option for more people.
Before coronary angioplasty is done, your doctor will need to know the location and extent of the blockages in your coronary (heart) arteries. To find this information, your surgeon will use coronary angiography (an-jee-OG-ra-fee). This test uses dye and special x rays to show the insides of your arteries.
During angiography, a small tube (or tubes) called a catheter is inserted in an artery, usually in the groin (upper thigh). The catheter is threaded to the coronary arteries.
Special dye, which can be seen on an x ray, is injected through the catheter. X-ray pictures are taken as the dye flows through your coronary arteries. This outlines blockages, if any are present, and tells your doctor the location and extent of the blockages.
For the angioplasty procedure, another catheter with a balloon on its tip (a balloon catheter) is inserted in the coronary artery and positioned in the blockage. The balloon is then expanded. This pushes the plaque against the artery wall, relieving the blockage and improving blood flow.
Coronary Anigioplasty usually takes about 2 hours. During the procedure, the patient is kept awake but feels drowsy as an effect of medication given to him.
Coronary angioplasty is a common medical procedure. Serious complications don't occur often. However, they can happen no matter how careful your doctor is or how well he or she does the procedure. Serious complications include:
• Bleeding from the blood vessel where the catheters were inserted.
• Blood vessel damage from the catheters.
• An allergic reaction to the dye given during the angioplasty.
• An arrhythmia (irregular heartbeat).
• The need for emergency coronary artery bypass grafting during the procedure (2–4 percent of people). This may occur if an artery closes down instead of opening up.
• Damage to the kidneys caused by the dye used.
• Heart attack (3–5 percent of people).
• Stroke (less than 1 percent of people).
• Stent Restenosis.
• Aggravation of a heart attack.
• Angioplasty done soon after a myocardial infarction may cause stroke.
Allergic reaction to the contrast dye is possible in rare cases.
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. It's used for people who have severe coronary heart disease (CHD), also called coronary artery disease.
CHD is a condition in which a substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.
Plaque can narrow or block the coronary arteries and reduce blood flow to the heart muscle. If the blockage is severe, angina (an-JI-nuh or AN-juh-nuh), shortness of breath, and, in some cases, heart attack can occur. (Angina is chest pain or discomfort.).
CABG is one treatment for CHD. During CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery.
This creates a new passage, and oxygen-rich blood is routed around the blockage to the heart muscle. CABG also may be a treatment option if you have blockages in the heart that can't be treated with angioplasty.
Your doctor will decide whether you're a candidate for CABG based on a number of factors, including:
• The presence and severity of CHD symptoms.
• The severity and location of blockages in your coronary arteries.
• Your response to other treatments.
• Your quality of life.
• Any other medical problems you have.
CABG may be done on an emergency basis, such as during a heart attack.
To decide whether you're a candidate for CABG, your doctor will do a physical exam. He or she will check your cardiovascular system, focusing on your heart, lungs, and pulse.
An EKG is a simple test that detects and records your heart's electrical activity. This test is used to help detect and locate the source of heart problems.
The duration of a coronary artery bypass surgery ranges between 6 to 8 hours. However it depends on the complications and condition of the patient.
- Infections at the site of the graft.
- Deep Vein Thrombosis.
- Non union/ Malunion of sternum.
- Anesthetic complications.
- Myocardial infarction.
- Graft failure.
- Death due to myocardial infarction.
- Acute renal failure.
- Keloid scarring.
- Chronic pain at the sites of incisions.
Coronary angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your coronary arteries. The coronary arteries supply oxygen-rich blood to your heart.
A material called plaque (plak) can build up on the inside walls of the coronary arteries, causing them to narrow. When this happens, it's called coronary heart disease (CHD) or coronary artery disease.Most of the time, the coronary arteries can't be seen on an x ray. During coronary angiography, special dye is injected into the bloodstream to make the coronary arteries show up on an x ray.
A procedure called cardiac catheterization (KATH-e-ter-i-ZA-shun) is used to get the dye to your coronary arteries. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck.
The tube is then threaded into your coronary arteries, and the dye is injected into your bloodstream. Special x rays are taken while the dye is flowing through the coronary arteries.Your doctor may recommend coronary angiography if you have signs or symptoms of coronary heart disease (CHD). Signs and symptoms include:
• Angina: This is unexplained pain or pressure in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. Angina may only happen when you're active. Emotional stress also can trigger the pain.
• Sudden cardiac arrest: This is a condition in which your heart suddenly and unexpectedly stops beating.
• Results from an EKG (electrocardiogram): exercise stress test, or other test that suggest you have heart disease.
You also may need coronary angiography on an emergency basis if you're having a heart attack.
Cardiologists (heart specialists) usually do cardiac catheterization in a hospital. You're awake during the procedure.
It usually causes little to no pain, although you may feel some soreness in the blood vessel where your doctor put the catheter.
During coronary angiography, you're kept on your back and awake. That way, you can follow your doctor's instructions during the test. You'll be given medicine to help you relax. The medicine may make you sleepy.
Hospitals use CT Angiography or Coronary Computed Tomography Angiography, as a non invasive method to detect blockages in the coronary arteries. 64 slice CT Angio system is used to detect dysfunctions like narrowing of the coronary arteries, soft plaque and fat.
Simple Coronary Angiography usually takes about half an hour to complete.
The general risks of Coronary Angiography are
• Pain at the IV site.
• Blood clots.
• Damage to blood vessels. This is a very rare complication.
• An allergic reaction to the dye used.
Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system except that of the heart and brain.
Prevention & Management of Vascular Disease.
• Aortic dissections
• Carotid body tumours.
• Critical Limb Ischemia.
• Diabetic feet.
• Intermittent Claudication.
• Leg Ulcers.
• Lower limb ischemia.
• Popliteal Aneurysm.
• Strokes, carotid artery diease.
• Thoracic aneurysm.
• Thread Veins.
• Varicose Vein.
Heart surgery for children/new born/ unborn is done to repair heart defects a child is born with (congenital heart defects) and heart diseases a child gets after birth that need surgery. The surgery is needed for the child’s well-being.
There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels outside the heart. Some heart defects may need surgery right after the baby is born. For others, your child may be able to safely wait for months or years to have surgery.
One surgery may be enough to repair the heart defect, but sometimes a series of procedures is needed. Three different techniques for fixing congenital defects of the heart in children are described below.
Open-heart surgery is when the surgeon uses a heart-lung bypass machine.
• An incision is made through the breastbone (sternum) while the child is under general anesthesia (the child is unconscious and does not feel pain).
• Tubes are used to re-route the blood through a special pump called a heart-lung bypass machine. This machine adds oxygen to the blood and keeps the blood warm and moving through the rest of the body while the surgeon is repairing the heart.
• Using the machine allows the heart to be stopped. Stopping the heart makes it possible to repair the heart muscle itself, the heart valves, or the blood vessels outside the heart. After the repair is done, the machine is removed, and the heart is started again. The breastbone and the skin incision are closed up.
For some heart defect repairs, the incision is made on the side of the chest, between the ribs. This is called a thoracotomy. It is sometimes called closed-heart surgery. This surgery is done using special instruments and a camera. Another way to fix defects in the heart is to insert a few small tubes into an artery in the leg and pass them up to the heart. Only some heart defects can be repaired this way.
Hospitals and medical centers that perform heart surgery on children have surgeons, nurses, and technicians who are specially trained to perform these surgeries. They also have staff who will take care of your child after surgery. Risks for any surgery are:
• Bleeding during surgery or in the days after surgery.
• Bad reactions to medicines.
• Problems breathing.
Additional risks of heart surgery are:
Blood clots (thrombi), Air bubbles (air emboli), Pneumonia, Heartbeat problems (arrhythmias), Heart attack, Stroke