Diagnosis and Treatment of Heart Disease

30 Dec Diagnosis and Treatment of Heart Disease

1. How is heart disease diagnosed?
2. What Medical Therapy is available for heart disease?
3. What Surgical options are available?

Diagnosis of heart disease is made by your physician usually in conjunction with certain tests. “Stress Tests” are the most common; they are inexpensive, quick, easy to access, and easy to perform. Stress tests involve either an exercise treadmill test, or occur chemically with the injection of medication that dilates the arteries. Nuclear imaging may also occur, following the stress test, to record images of the heart walls, examining for regions that may be receiving less blood flow.

Echocardiography is another test that can look at the heart. Using an ultrasound probe placed on the chest, this test can estimate heart-pumping function in real-time and also check for valvular disease, and poorly contracting wall segments- indicating areas that are starving for oxygen.

Coronary Angiography, commonly known as a “heart cath”, is the gold standard and most sure way of evaluating for possible blockages due to heart disease. In this procedure your Cardiologist accesses the heart directly by thin catheters from inside the arteries, usually by way of a small incision in the groin (femoral artery) or wrist (radial artery). This allows a doctor to inject medication that shows up on a video X-ray, known as fluoroscopy. By watching dye flow through each heart artery in real-time, a doctor is able to directly see if there is an area of decreased flow. If there is a blockage seen during Angiography, the Cardiologist may then be able to reopen the blockage using a stent.

Medical therapy is aimed at treating existing disease, preventing a recurrence of heart attack, and preventing damaging remodeling of the heart. The most commonly prescribed medications include Aspirin, Plavix, Beta-blockers, Statins, and ACE-inhibitors- all of these medications have an evidence-based reduction in mortality from heart disease and heart attacks.

Aspirin, and other anti-platelet medications (Plavix, etc.) are an important part of keeping platelets from clumping together on a coronary plaque and occluding the artery. Beta-blockers decrease the rate and intensity of heart muscle contraction, which decreases the requirement of oxygen. Statins lower cholesterol, which slows the development of cholesterol-rich blockages inside the arteries. ACE-inhibitors help lower blood pressure and prevent remodeling of the heart wall after it has been damaged. If a stent has been placed during a heart catheterization, a patient will need to take Aspirin and Plavix to prevent blockages from occurring inside the metal of the stent.

Surgical interventions primarily include Percutaneous Coronary Intervention (PCI) with balloon angioplasty and coronary stenting, and Coronary-Artery Bypass Grafting (CABG).

Speak with your Primary Physician or Cardiologist if you have experienced any of these symptoms, medical risk factors, if you have a positive family history, or have a known diagnosis of heart disease. Ask your doctor if you should consider testing for heart disease, preventative medications and lifestyle changes, or possible procedures. Please always consult with your Cardiologist when considering these procedures and medications.