Category Archives: Cardiology Topics

What is TAVR

TAVR, known as Transcatheter Aortic Valve Replacement, is a heart procedure in which an aortic valve is narrowed down due to the formation of plaque and stops opening properly thereby hindering the blood flow is replaced with a healthy valve inside the old valve itself.

This is a minimally intrusive procedure that takes only about 1-2 hours of time. In TAVR heart procedure, the interventional cardiologist makes an incision either on the patient’s groin, neck, or the space between the patient’s ribs. A thin, flexible tube with the heart valve is guided through that incision into the patient’s artery to the faulty valve. Finally, the valve is replaced with a healthy valve thereby restoring the full blood flow. The tube is removed and then the incision is closed.

TAVR Procedure Risks

Although this is a less evasive surgery and usually very safe, there are risks involved in every procedure. The risks include:-

Valve Leak:- In this procedure, since the new valve is inserted inside the faulty one, sometimes due to difference in size or due to intrusion from the calcium buildup sometimes blood can leak around the new valve. This has to be taken care of so that it does not lead to major blood leaks.

Artery Damage:- Since the tube is passed through the arteries, if not done properly or if they are too narrow, there can be some damage to the arteries. Usually, this damage can be repaired but it has to be taken care of immediately.

Stroke:- There is a very small percentage chance of this happening but it has come to notice that stroke does sometimes occur during the procedure or immediately in the days after surgery.

Pacemaker:- When this procedure is completed, it affects the electrical system of the heart and thereby the patient ends up needing a permanent pacemaker, which is a major drawback of this procedure.

Death:- Although this is a minimal evasive surgery and is very effective, but due to the huge build-up of calcium in the arteries and valve, the replacement becomes complicated and can lead to serious consequences for the patient.

TAVR Procedure Benefits

Some of the TAVR benefits are:-

Faster Recovery:- This is a minimally invasive surgery, therefore the recovery time is much faster as compared with the other procedures.

Active Life:- Once this procedure is done successfully, the patient has more energy and can lead a normal life doing all their everyday activities.

Less Pain:- This procedure is fast and therefore, recovery is much faster resulting in less pain for the patient.

Medical procedures over the years have improved massively. Interventional cardiologists decide which procedure is the most effective and less harmful for patients to ensure a healthy active lifestyle.

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What is Atherectomy

Atherectomy devices are used in the diagnosis process of atherosclerosis. Atherosclerosis is a peripheral artery disease in which plaque gets deposited in the arteries and restricts the blood flow of the body. If this unwanted fat deposit, known as plaque, is not removed in time, it can cause a blockage that can turn life-threatening.

Atherectomy is the process by which the plaque is cut from the walls of the arteries and the arteries are widened. A catheter is inserted through the groin which has a blade attached to it which cuts the plaque and the residue is collected in a bag that is later removed from the catheter. There are different types of devices that can be used in this process depending on the extent of the patient problem as well as the preference of the doctor.

Types of Atherectomy Devices

The different types of devices used in the process of Atherectomy are: –

1. Rotational Atherectomy:- In this procedure, a rotablator catheter is used which consists of a spring coil shaft with a burr at the tip. The burr is oval-shaped and covered with diamond crystals. This burr along with a shaft that is encased in a plastic sheath is connected to an advancer that is hand controlled so that the burr can be moved too and from to cut through the plaque. The burr comes in different sizes and as per the doctor judgment it is used. The whole device is controlled by a rotablator console by which the speed of burr rotation can be controlled. This console can be powered by either nitrogen or compressed air. Rotational atherectomy technique is particularly advocated for heavily calcified, inelastic, and eccentric coronary lesions.
2. Directional Atherectomy:- In this procedure, a catheter is attached with a metal cylinder which has a coaxial rotating cub shaped blade at its distal end. This blade rotates in one direction and shaves the plaque. The shavings are collected in the nose cone of the catheter and removed out of the body. This needs to be done multiple times as then only the plaque can be shaved. This procedure is best suited for bifurcation lesions, ostial stenoses, or in-stent restenosis.  
3. Orbital Atherectomy:- In this procedure, a device is used which utilizes an orbiting eccentric diamond-coated crown on the end of a drive shaft in an off-center wire channel powered by a pneumatic drive console. This results in rotation which causes a wider orbital path which leads to continuous blood flow. This procedure requires a single insertion, with plaque getting collected at the nose cone of the catheter as the crown is advanced back and forth through the lesion. The atherectomy catheter is more advanced than the catheter used in directional atherectomy.
4. Laser Atherectomy:- Now a days, the most common procedure for treating peripheral artery disease, also known as PAD, is laser atherectomy. In this procedure, a catheter is used which emits high energy light also known as laser to vaporize the blockage of fat. In this procedure, continuous saline infusion is used to provide a shield against damaging red blood cells. This procedure is more faster, efficient, and precise. This procedure is being used a lot since it is a minimally evasive than mechanical methods.

These are the procedures that are being used to treat atherosclerosis and peripheral artery disease. The procedure that will be used depends on the patients’ condition and the cardiologist.

What is Atherectomy

Atherectomy is a procedure used to clear out clogged heart arteries. An atherectomy catheter has a hollow cylinder on the tip with an open window on one side and a balloon on the other. When the catheter is inserted into the narrowed artery, the balloon is inflated, pushing the window against the fatty matter clogging the vessel.

A blade (cutter) within the cylinder rotates and shaves off any fat that protrudes into the window. The shavings are caught in a chamber within the catheter and removed. This process is repeated as needed to allow better blood flow. In some cases, after the plaque is removed, a stent may be placed to keep the artery open.

Atherectomy is a minimally invasive procedure that is performed to treat people who have peripheral artery disease or coronary artery disease. Sometimes this procedure is also done on patients who already had an angioplasty done but they still have hard plaque blocking the free flow of blood. This procedure is for clearing away of plaque which builds up in the arteries. This build-up is known as atherosclerosis. Therefore, we can easily say that atherectomy is the treatment for atherosclerosis.

Risks of Atherectomy Procedures

Although it is a minimum evasive surgery but like all procedures, there are some risks. For example, the risk of bleeding during the process or the plaque which is cut off during the process gets lodged in smaller arteries and damage the heart tissue. This can lead to closing off the artery and require emergency bypass surgery. However, these complications rarely occur so the risks are very low.

The major reason why atherectomy is done is for the removal of the plaque from the arteries. This plaque formation happens because of unhealthy eating habits and poor lifestyle, which leads to increased cholesterol. The excessive cholesterol build up inside the arteries can cause blockage. Other habits, such as smoking and excessive drinking can also lead to this condition.

Treatment of Atherectomy

Although the atherectomy procedure and recovery is very fast but care needs to be taken after the surgery. One has to lie flat for a while since groin is used as an entry site for the procedure. The check has to be kept on the entry side to make sure no bleeding happens. In other cases, people may develop swelling or pain at this entry point. One has to drink a lot of fluids in order to flush out the bad material from the body. Moreover, blood thinners can be prescribed to manage the blooding clotting.

In conclusion, the advancement of medicine, procedures are relatively safe and have fast recovery. However, it is always important to take preventive measures and lead a healthy lifestyle in order to avoid serious heart-related issues.

What is a Heart Attack

Due to increasing stress and changing lifestyle, nowadays we hear a lot about heart attacks (Known as Myocardial Infarction). This occurs when the blood flow to the heart is reduced, insufficient, or blocked.

The major cause of a heart attack is the blockage of the coronary arteries caused due to fat and cholesterol build up. Heart attack is also caused due to spasm of the coronary artery that results in shutting down of blood flow to part of the heart. It can be a life-threatening condition if heart attack treatment is not done in time.

How to treat a Heart Attack

Usually, there are two ways of treating a heart attack. One and the most immediate way is through medications. Here are the types of medications which are given immediately when a patient shows symptoms of heart attack:-

• Anticoagulant Medicines:- Anticoagulant medicines are the ones that stop blood clotting to happen and ensure the flow of the blood resumes to the heart.
• Antiplatelet Medicines:- Medicines having Antiplatelet agents are given to the patient so that they prevent the blood clots from forming by not letting the blood platelets from sticking together.
• Beta-Blockers:- These medicines reduce the heart rate and which in turn lowers the blood pressure. This results in making the heartbeat slowly and with less force giving it time to recover.
• Thrombolytic therapy:- These are also known as clot busters. These help to dissolve blood clots in patients heart’s arteries and resumes free flow of blood.

But the treatment of heart attacks patients are not possible via medication only. At times, the attack is so severe that the use of medical procedure becomes necessary. A few medical procedures which are used to treat a heart attack:-

• Angioplasty:- If a patient is diagnosed with blocked arteries, this preventive medical procedure is undertaken by cardiologists to widen the blocked arteries by use of a tiny balloon catheter which helps restore blood flow to the heart.
• Bypass surgery:- In this surgery, doctors use blood vessels from other parts of the body to create a new route for the blood to reach the heart. This way a bypass is created around the blocked arteries to supply oxygen-rich blood to the heart freely.
• Stent procedure:- In this procedure, a tiny tube is inserted inside the blood arteries to open them up so that free blood flow can happen. These tubes are coated with medicines that release into the bloodstream and prevent the arteries from getting blocked again in the future. 
• Heart Transplant:- This is the last resort available when all procedures have been done. The patients’ heart is replaced by another healthy heart.

Click here to learn more about Coronary Artery Disease

As you can see, the first necessary steps are through medications to treat the condition of a heart attack. However, in other cases, medical procedures need to be taken into consideration. Once again, to minimize the risk of heart-related conditions, it is vital to ensure a healthy and active lifestyle.

What is Peripheral Artery Disease?

Peripheral Artery Disease is a condition where the peripheral arteries which carry blood to the legs, stomach, arms, and head are narrowed down. Peripheral artery disease is also known as PAD and is often caused by atherosclerosis. 

Atherosclerosis is a condition where fat deposits buildup in your artery walls and reduce blood flow. This is usually associated with the heart, but this condition affects arteries throughout the body and leads to PAD.

How to treat PAD

Peripheral Artery Disease treatment is a mix of lifestyle changes, medications and in extreme cases, medical procedures for control. Let us see what changes we need to make in order to manage this disease:-

Exercise: – Exercise is very important to manage this condition. It does not only help control the growth of this condition, but it also helps in peripheral artery disease treatment. Exercise does not mean heavy-duty or gym-related exercises, but even a simple regular walk will make a huge impact. Initially walking will be painful but as the condition improves, the pain will decrease as the blood flow to the legs will increase.

Balanced Diet: – One should always have a balanced diet, but in case a person is diagnosed with PAD, then it is very important that the person has a high fiber and low cholesterol diet. The person should also control the intake of saturated and trans fat as well as sodium. If a person is overweight, then it is very important to lose the extra weight and control cholesterol levels.

No Smoking: – People who smoke have increased chances of suffering from PAD. The use of tobacco must be immediately stopped. Smoking is bad for the body in many ways and quitting will lead to overall good health.

Managing other health conditions: – If the person has underlying conditions, such as diabetes or other heart conditions, taking medications for proper care may be needed. Managing these underlying conditions is very important as these can lead to PAD and may in fact, be life-threatening.

The other way of peripheral artery disease treatment is the use of medications and procedures:-

Medications: – There is no direct medication for PAD, but the use of medication is done to control the conditions which cause PAD. Doctors may prescribe medication for cholesterol control, high blood pressure regulation, and for blood clot formations. 

Medical Procedures: – In extreme conditions, peripheral artery disease medical procedures, such as Angioplasty, may be considered. Angioplasty is a procedure done to widen the blocked artery to increase blood flow. Another procedure a cardiologist may recommend is Atherectomy. A procedure used to remove plaque buildup. Lastly, Thrombolytic therapy may be considered, in which a drug is injected into the artery to get rid of a clot.

As you can see, proper lifestyle and the use of necessary medications may control PAD and ensure a healthy active lifestyle.

*Content is made for educational purposes. Please consult your cardiologist should you experience heart-related conditions*

What is Congestive Heart Failure

Congestive Heart Failure is also known as CHF. This is a chronic progressive condition in which the heart gets affected and the heart muscles do not pump the blood properly. In this condition, fluid builds up around the heart and causes it to pump inefficiently. Congestive heart failure can be life-threatening as when your ventricles can’t pump enough blood volume to the body. Eventually, blood and other fluids start to back up inside your lungs, abdomen, liver, and lower body.

Causes of CHF

Let us dive into the main causes that can result in Congestive Heart Failure.

Hypertension: – If you have a condition of high blood pressure over a while, it makes one susceptible to heart conditions, such as congestive heart failure as high blood pressure leads to narrowing of the arteries which affects the blood flow.

Coronary Artery Disease: – In coronary artery disease, the arteries are narrowed down due to cholesterol built up and this affects the blood flow which can lead to developing of congestive heart condition.

Valve conditions: – The heart valves are the ones that keep the blood flowing properly in the right direction through the heart. A fault valve can make the heart work harder and irregular, which can in turn weaken the heart. This can lead to serious heart conditions.

Underlying heart conditions: – Heart conditions, such as Cardiomyopathy (Where the heart muscles are damaged), or Myocarditis (A condition in which there is inflammation of the heart muscle) can lead to congestive heart failure.

Other Chronic Diseases: – Medical conditions, such as diabetes, HIV, hyperthyroidism, severe allergic reactions, and obesity can also lead to congestive heart failure.

Symptoms of CHF

It is critical to understand the symptoms of Congestive Heart Failure to avoid further complications. These can include:

Congested lungs: – Due to fluid accumulation in the lungs, it can cause shortness of breath, wheezing, bad cough, chest pains, and the inability to exercise or do any heavy duty work.

Irregular heartbeats: – Due to lack of proper pumping of blood, the heart has to work harder which can in turn lead to rapid and irregular heartbeats.

Fatigue and weakness: – As there is reduced blood supply to the body, there can be feelings of dizziness, fatigue, and weakness.

Water and fluid retention: – Less blood to different body organs, such as the kidney, can potentially lead to water retention. This can encourage other conditions to develop, for example, swelling of the abdomen, weight gain, swelling in legs, ankles, and feet. Symptoms also include an increased need to urinate and loss of appetite.

What are the symptoms of a heart attack? Click here to find out

Treatments of CHF

The treatment for congestive heart failure has to be done in consultation with your cardiologist. It is a mix of lifestyle changes along with the use of some medication so that various conditions arising can be controlled. If the condition is beyond the control of medications, surgery will then be required. Each case depends on each person’s condition, but a cardiologist will make the necessary suggestions. However, maintaining a proper and healthy lifestyle is the prominent solution for a strong heart.

What is a Pacemaker?

A pacemaker is a small electrically charged medical device that is implanted under the skin to help manage irregular heartbeats. Pacemakers are used to treat heart conditions, such as arrhythmia, in which the heart beats either too fast, too slow, or has an irregular rhythm. This device generates small electric stimulation which helps the heartbeat at regular rhythms to ensure a normal lifestyle.

Pacemakers are used to record the heart’s electrical activity and heart rhythms. These days, the advancement of new pacemakers have been developed that can also monitor blood temperature, breathing rates, and other activities. According to that, they can adjust the heart rate to change as per the activity of your body.

Types of Pacemakers

There are different types of pacemakers. Some are distinguished as per the placement in the heart and then there are ones as per the life of the pacemaker.

Temporary Pacemakers: – These pacemakers are used to treat short-term heart problems in patients, for example, variation in heartbeats due to a heart attack or a patient might have had heart surgery. These temporary pacemakers are usually used during medical emergencies. For example, when the patient is in the hospital for temporary relief until a proper solution is done for the medical problem.

Permanent Pacemakers: – This is the pacemaker that is placed in a patient in place of temporary ones before they can be discharged from the hospital. Permanent pacemakers helps lead a person a normal life without any complications as they can control any heart rhythm problems.

Here are the different pacemakers types as per the heart placements:-

Single Chamber Pacemaker: – This type of pacemaker is used when one side of the heart chamber has a problem. This pacemaker usually carries electrical stimulation to the right ventricle of the heart.

Dual Chamber Pacemaker: – This pacemaker is connected to both of the chambers on the right side of the heart, the right atrium, and the right ventricle. It regulates the pace of contractions of both the chambers allowing the blood to flow properly. 

Biventricular Pacemaker: – Biventricular pacemaker, also known as Cardiac Resynchronization Therapy. This type of pacemaker has three leads. One of the lead is placed in the right atrium, one is placed in the right ventricle, and the third one is placed in the left ventricle. This leads to total stimulation of the lower chambers of the heart and makes it beat more efficiently.

Here are the reasons to see a cardiologist

Which pacemaker is used for which patient depends on the diagnosis made by the doctor. As per the needs of the patient, the decision is made by their cardiologist. With the use of proper pacemaker type, a person can lead a good normal and healthy life.

What is Mitral Valve Disease

First off, we need to understand what is the mitral valve? The mitral valve is located on the left side of the heart between the left atrium and the left ventricle. This is the valve that keeps the blood flowing properly in one direction and prevents the blood from flowing backward.

Mitral Valve Disease occurs when the valve doesn’t work properly and correctly. With mitral valvular disease, the blood starts to flow backward into the left atrium. As a result, the heart does not pump enough blood out of the left ventricular chamber to supply the body with oxygen-filled blood. There are different types of mitral valvular diseases, such as:

• Mitral Valve Stenosis,
• Mitral Valve Prolapsed

Mitral Valve Disease Symptoms

It is important not to only understand what mitral valve disease is, but also its’ symptoms. Symptoms include:

• Cough
• Light-headedness
• Irregular heartbeat (heart murmur) 
• Fatigue
• Shortness of breath, particularly when you have been very active or when you lie down
• Pain or tightness in chest
• Irregular heart beating or very quick heartbeats

The problem with mitral valve disease is that it can go unnoticed for a long period of time since many times the person does not show any symptoms of any sort. This leads to an even bigger problem that is if left untreated, mitral valve disease can lead to serious, life-threatening complications, such as heart failure.

If a doctor suspects a person who might have mitral valvular disease, then various cardiology tests will be required such as, Echocardiogram, X-ray, and Transesophageal Echocardiogram.

Mitral Valve Disease Treatment

Once diagnosed in time, there are different options for mitral valve disease treatments depending upon the severity of the disease. A brief overlook at the different treatment options availabl :-

*Please consult a cardiologist for detailed information – This article is made for educational purposes*

Drugs and medication

If a person is diagnosed at an early stage of mitral valve disease, a doctor might prescribe different medications for controlling the advancement of the disease. The problem is that there is no direct medication available for this disease. Usually doctors prescribe drugs to control the symptoms, such as beta blockers to control the heart rate or anticoagulants to keep your blood thin. 

Valvuloplasty

Valvuloplasty is a medical process in which the doctor uses a balloon to open the valve which has become narrow and is causing hindrance in the blood flow. With this procedure, the valve is opened up so that the blood can flow freely in the right direction.

Surgery

In the most severe cases, a surgery might need to be performed to repair the mitral valve.

Just like all diseases, the best cure is to lead a healthy lifestyle and to go for regular checkups to avoid future and further complications.

Click here to learn more about the different types of Valvular Heart Diseases

We are usually told to go for our regular doctor’s checkups and at times, our family doctor might refer us to go a see a cardiologist. The moment we are told to consult a cardiologist, the first thought which comes to our mind is what is wrong with our heart. The truth is that it is not always “what is wrong with our heart” but at times, our general physician just wants us to have a regular heart checkup. Let us see what the reasons are when we are told to consult a cardiologist:-

Age of the Person

One of the common cases, when people are asked or referred to consult a cardiologist, is when they reach a certain age as old people are more prone to heart-related diseases. Therefore, it becomes necessary to have heart checkups done at regular intervals so that if there is any underlining disease, it can be caught in time and prevented from turning into a serious condition. 

Family History

You might not be showing any symptoms of heart-related problems, but if you have family history of any cardiovascular diseases, it clearly implies that your parents, grandparents or siblings have been diagnosed with heart problems. For this reason, your family doctor will refer you to a cardiologist for regular consultations to avoid complications should they arise. It has been noticed that in most of such referred cases, thorough check up is usually needed and specific cardiology tests are done for early detection.

Risk Indicators

If a person suffers from high blood pressure, high cholesterol, diabetes or even overweight, then in all these cases a family doctor will ask you to consult a cardiologist as these factors usually lead to some kind of heart condition.

Pregnancy Conditions 

It is very hard to detect heart conditions in women as they are usually mixed with other conditions that have similar symptoms. In pregnant women, a consult with a cardiologist is recommended for conditions like Pre-eclampsia. Preeclampsia is a pregnancy complication that is indicated by high blood pressure.

In cardiology, there are a number of tests that are conducted to review the health of your heart. Some of these cardiology tests are commonly known, such as:

• ECG or EKG (Electrocardiogram)
• Chest X-rays or MRI (Magnetic Resonance Imaging) 

There are many tests not known to the general public, but with proper consultation with a cardiologist, they can best suggest tests as per each person’s conditions.

Click here to learn more about heart disease and its causes

Some of these tests can be non-invasive or invasive depending on the scale of the problem. For example, a Holter Monitor is described as a non-invasive test in which the person is required to wear a device to check activity or Echocardiogram or CT (Computerized Tomography) of the heart

On the other hand, Cardiac Catheterization and Angiogram are known as minimally invasive cardiology tests. Test like Transesophageal Echocardiogram (TEE) are invasive cardiology tests which requires the use of anesthesia. 

Although medical science has advanced massively in the field of cardiology, the best way to maintain good health is leading a healthy lifestyle alongside a proper diet and exercise.

What is Atherosclerosis?

In our bodies, arteries are the connecting roads for the whole body. They are the blood vessels that carry oxygen-rich blood to the heart and to all other parts of the body. These arteries need to be in good condition so that the blood can easily flow through the body. However, sometimes plaque formation happens. The question which comes to mind; What is plaque; Plaque is the substance that is made up of bad fat, cholesterol, and calcium. This plaque starts to accumulate inside the arteries and with the passage of time, it hardens and narrows the blood arteries, which start hindering the blood flow in the body. This condition where plaque forms inside the arteries and starts to clog them is known as Atherosclerosis.

Causes of Atherosclerosis

So the next question which comes to mind is, what are the root causes of Atherosclerosis? What is known that it develops over a period of time and the speed of its progress increases gradually. It is usually said that it starts with the damage of the artery’s inner lining. However, here are some of the main causes:

• Uncontrolled High Blood Pressure

• High levels of Cholesterol and Triglycerides in the blood

• Smoking Cigarette as it leads to fat accumulation

All these factors either form the fat deposit inside the arteries or they help in the progression of the fat deposits. These can be detrimental to one’s health and heart.

Atherosclerosis and Relation with the Heart

The big question, is there a relationship between Atherosclerosis and the heart? Well, the answer is Yes. Anything which accumulates inside the body leads to harmful side effects. In the case of Atherosclerosis, the accumulation is inside the arteries which provide the blood supply. If the heart does not receive blood supply in the right quantity then the chances of Coronary Artery Disease (CAD) is always on a higher side. A person suffering from Atherosclerosis has increased chances of heart attack, strokes, and other cardiovascular diseases as there is a reduced supply of oxygenated blood to the heart.

Atherosclerosis combined with any other underlying health condition that can put stress on the heart can be very dangerous and can even have fatal results. It can be controlled if diagnosed immediately in time with proper medications and lifestyle changes. Overall, one should have a good diet and an active lifestyle to avoid the accumulation of fats in the body. Arteries are the body’s railroad and they need to be in good condition to provide oxygenated blood around the body.