Heart Disease Risk Assessment for Men
Heart Disease Risk Assessment for Women
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Cardiac Catheterization
This minimally invasive test offers clear, accurate information about the heart and coronary arteries. The procedure allows the physician to find narrowed or clogged arteries, evaluate the heart's valves and assess for any congenital heart defects. The procedure can be performed in an inpatient or outpatient setting.
An IV is inserted into the patient's wrist or arm so that the patient can be given a sedative and medications during the procedure. Small devices are taped to the patient's body allowing the physician to monitor heart rate and rhythm. A catheter is inserted into the femoral artery to the heart. The entire procedure takes approximately one hour.
During cardiac catheterization, measurements of blood pressure within the heart's major arteries are taken, and blood samples are taken for blood tests. A special dye is injected through the catheter into the coronary arteries so that clear X-rays of the arteries can be taken. The dye can be injected into the left ventricle so the doctor can assess the function of the heart muscle.
Interventional Balloon Angioplasty
Balloon angioplasty is a standard treatment for coronary artery disease, which occurs when blood flow to the heart is restricted due to hardened arteries. The physician uses local anesthetic to numb a specific area of the patient's body, usually the upper thigh area where the femoral artery is located. A small tube called a sheath is placed in the femoral artery. A balloon-tipped catheter passes through the sheath to an area of coronary narrowing. When the balloon inflates, it presses the plaque against the vessel wall. With the blood flow restored through the vessel, the balloon catheter is deflated and removed.
Stents
Coronary artery stenting is a catheter-based procedure in which a stent (a small, expandable wire mesh tube) is inserted into a diseased artery to hold it open. Its most common use is in conjunction with balloon angioplasty to treat coronary artery disease. After the angioplasty reduces the narrowing of the coronary artery, the stent is immediately inserted leaving less than 10 percent of the original blockage in the artery. Stents are always left in place.
Drug-Eluting Stents
The stent (a small, expandable wire mesh tube) is coated in a drug that releases uniformly onto the vessel wall; this procedure keeps the vessel open by impeding the re-growth of cells. The stents decrease the need for patients to return for additional interventional procedures. Several types of drug-eluting stents are available including Boston Scientific Corporation's FDA-approved TAXUS Express Paclitaxel-Eluting Coronary Stent System. The TAXUS Stent System has been in wide use in Europe and other international markets since February 2003. In clinical trials, the TAXUS Stent System consistently demonstrated safety and uniform healing across lesion types and vessel sizes. As a result, the technology can be used with more patient types and more lesions.
Direction Atherectomy
Directional coronary atherectomy devices allow the cutting of plaque from a blocked artery to restore blood flow. Often this method is used when plaque is too hard to use a balloon angioplasty. The upper thigh region is numbed with anesthetic and a thin tube called a sheath is inserted into the femoral artery. In a directional coronary atherectomy, the catheter tip is equipped with a bladed device that cuts away the plaque and stores the little pieces in a tiny container. The plaque is removed when the catheter is withdrawn from the artery. The technique also is useful in larger arteries with softer plaque.
Intracoronary Flow Measurements
The procedure begins as a left-heart catheterization. A new device allows the cardiologist to interpret the degree of blockage. Small wires are advanced beyond the blockage, and blood flow is assessed after a medication is injected into the artery. If blood flow is changed after the injection of the medication, then the vessel should be fixed with angioplasty or a stent. If blood flow is unchanged, the cardiologist may decide to adjust a heart medication rather than repair the vessel. The procedure allows the cardiologist to make the best decision using one of the latest technologies.
Pacemaker Placement
It is important for the heart to beat regularly. If the heart beats too slowly, a person can experience dizziness or fatigue. Pacemakers are for people whose hearts are beating too slowly or irregularly. The pacemaker is a small, lightweight, electronic device inserted into the body to keep track of the heart's electrical activity. If the pacemaker senses that the heart is beating too slowly or irregularly, it sends an electrical impulse to stimulate the heart.
A local anesthetic is injected into the area where the pacemaker will be inserted, usually the upper chest. An incision is made below the collarbone where a pocket is created under the skin where the pulse generator is placed. The physician inserts the lead through the chest incision and into the vein. The pacemaker leads are then advanced to the chambers of the heart. The pacemaker can work for one or both of the heart's chambers. Pacemakers are monitored with regular follow-up appointments with the cardiologist.
