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Coronary Bypass Surgery Health Feed

Acute Coronary Syndrome - How To Administer It?

Acute Coronary Syndrome - How To Administer It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms:

 The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis:

Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure the electrical activity of the heart and identify irregular electrical activity which is indicative of myocardial infarction.

- Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.

- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.

Management:  

Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

- Dissolve the clot - Using thrombolytics like clopidogrel 

- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles

- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.

- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used

- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

961 people found this helpful

Coronary Artery Disease - How To Administer It?

Coronary Artery Disease -  How To Administer It?

Coronary artery disease is one of the major killer diseases of modern society. It is not a solitary problem but brings with it a multitude of issues including obesity, diabetes, stroke, and other metabolic disorders. A thorough understanding of what causes it and how to manage it can help save thousands of lives.

Causes: The circulatory system is mainly made up of the heart and a complex network of arteries and veins. The inner walls of these are lined with smooth muscles, allowing for free flow of blood. Gradually, over a period of time, given the density, the fat from the blood flowing through these vessels settles along the walls of these vessels. This attracts more fat, lipoproteins, and other inflammatory cells and so the process continues. This reduces the diameter of the blood vessels, therefore reducing the amount of blood supply to the target organs. If the target organ is a vital one like the brain or the heart, then it could lead to stroke or heart attacks.

Main causes of coronary artery disease include high blood pressure, high cholesterol, sedentary lifestyle, obesity, smoking, diabetes, and stress. Men are more prone than women, and family history and age puts them at higher risk.

Symptoms: Reduced blood supply to the target organ causes the following symptoms:

  1. Shortness of Breath: A person with coronary artery disease will feel short of breath and tired with most activities, even like walking a few meters.

  2. Chest Pain: A strong pressure sensation on the left side of the chest is an indication of coronary artery disease. Known as angina, it comes with stress and goes away once the stress is removed. It could sometimes radiate to the shoulder, down the arm, or up into the jaw also. These are classical symptoms of angina or heart attack and is considered an emergency. Of note, this is often mistaken for indigestion.

  3. Palpitations: A sensation where you are able to hear your heartbeat.

  4. Nausea and Excessive Sweating: Nausea and excessive sweating are also seen during angina.

Treatment: There are 3 modes to manage this.

  • Medications:

  • Surgical Procedures:  Surgical procedures including balloon angioplasty followed by placement of drug-eluting stents and coronary artery bypass surgery are done to manage more severe cases.

  • Lifestyle Change: Lifestyle changes including reduced fat consumption, decrease body weight, stop smoking, increased physical exercise, and reducing stress are highly important in preventing further damage.

Once suspected, coronary artery disease can be effectively managed and the extent of damage controlled using the above techniques.

3 people found this helpful

Acute Coronary Syndrome - How To Diagnose It?

Acute Coronary Syndrome - How To Diagnose It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms:

 The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.


Diagnosis: Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.


- Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.


- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.


Management:  Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 


- Dissolve the clot - Using thrombolytics like clopedigrol 


- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles


- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.


- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used


- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.


Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

2946 people found this helpful

Multivessel Stenting Or Bypass Surgery - Which One To Opt For?

Multivessel Stenting Or Bypass Surgery - Which One To Opt For?

The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.

How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass has recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which show that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.

Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.

Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much-preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus-Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.

This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.

All the patients were tracked for about five years and during this prolonged follow-up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.

If you are one of these patients and this concern plagues you, it is recommended to talk to your cardiologist without much delay.

2141 people found this helpful

Acute Coronary Syndrome - How To Diagnose It?

Acute Coronary Syndrome - How To Diagnose It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms:  The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis:

Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.

- Blood tests:  

Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.


- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.

Management:  

Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

- Dissolve the clot - Using thrombolytics like clopedigrol 

- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles

- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.

- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used

- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

3412 people found this helpful

Coronary Artery Disease - Knowing The Key Signs Of It!

Coronary Artery Disease -  Knowing The Key Signs Of It!

Your heart is the most important and vital organ of all and regulates the flow of heart to all parts of the body. Thus, the valves and the arteries which take the blood to your heart are also an important component in ensuring that the circulation is constant. Thus, any hindrance to this process will put a lot of pressure on your heart and lead to more serious problems in the long run. Coronary artery disease is one such problem and can seriously put the health of your heart at risk.

What is coronary heart disease?
Coronary arteries are very important blood vessels, which carry nutrients, blood and oxygen to your heart. If the level of bad cholesterol is high in your blood, it will start leaving deposits on the walls of the arteries which are commonly known as plaque. This plaque will start building up over time causing blockage of the arteries and disrupting proper blood flow. Excessive build up of the plaque may then rupture the lining of the plaque. This will then induce blood clotting and further prevent the normal flow of blood.

Symptoms
Primary symptoms may include

  1. Shortness of breathThis may occur while you are exercising or performing activities which are mildly exerting.
  2. Heart beats very hard and fast: Your heart may beat very hard and fast, especially when doing everyday activities such as climbing stairs or walking for a prolonged distance.
  3. Angina or chest painYou may experience pain in your chest as if someone was pressing against it with a lot of force. Angina is also triggered due to stressful activities or even emotional stress. It usually occurs on the left or the middle of the chest and may even be felt in the back, arms, and neck.
  4. Heart attackHeart attacks are the most common and the most serious complications of coronary heart disease. You would feel extreme pain, akin to crushing on your chest, shoulder, or arm. It may even be accompanied by jaw pain, and sweatiness.

Treatment
Non invasive forms of treatment are always preferable rather than invasive surgeries or procedures to treat coronary heart disease, especially where the risk of serious complications such as heart attack are still on the lower side. Some of the treatments used for coronary heart disease are as follows:

  1. Making lifestyle changes: Quit smoking, reduce alcohol consumption along with consumption of regulated diet will automatically start cleaning plaque that has built up within the arteries. Losing weight also tends to help.
  2. Medications: Special medications can take care of cases wherein the deposits are still lesser and the plaque buildup can be removed without the requirement of extensive surgery. Anti-cholesterol medications are one example of this.
  3. Surgical procedures: These are usually employed when the blockage is severe and cannot be corrected by the conventional methods mentioned above. Some of the procedures are angioplasty, stent replacement, as well as coronary artery bypass surgery.
5622 people found this helpful

Open Heart Surgery - What All Should You Know

Open Heart Surgery - What All Should You Know

Open heart surgery is a complicated heart procedure. Howeevr, it is still an important surgical procedure to fix critical heart ailments.

Here is a quick fact-checker about this procedure:

  • The Coronary Artery Bypass Graft or CABG is one of the frequently performed procedures in the open-heart surgery space. This is a procedure that is related to fixing the blocked arteries of the heart. A study conducted by the National Institutes of Health revealed that most patients who had undergone CABG become angina-free within a span of five years.
  • Many hospitals refuse to share any data related to the surgery. It makes sense to run a background check on the surgeon who is scheduled to perform the procedure. Society of Thoracic Surgery lists all doctors and the number of procedures they have performed in this space.
  • This is one of the few surgeries where a doctor needs to make a deep incision close to 2-2.5 inch through the breastbone to separate muscle and get access to the heart.
  • The recent trend is that the doctor can achieve the same result with beating heart CABG where heart does not need to be stopped just to avoid the complications of heart lung machine Once the procedure is over, the doctor closes the incision made through the breastbone with sternal wires. Subsequently, the patient is taken off from the heart-lung machine.
  • The patient might find himself tangled with many tubes as he wakes for the first time after the surgery. These wires take the fluid out of the body. They serve as a temporary pacemaker for the patient.
  • It is important to get a clarification from the surgeon as to from which location of the body would the veins be taken from to perform CABG. Most doctors prefer the vein from the leg.
  • The patient is kept in an ICU for a couple of days before he is shifted to the general ward where he spends close to a couple of weeks before he is released. After the patient gets home, the typical recovery time for the patient is approximately 6-8 weeks.
  • One has to usually deal with heightened emotions after an open-heart surgery. 
5628 people found this helpful

Acute Coronary Syndrome - How To Manage It?

Acute Coronary Syndrome - How To Manage It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms:  The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis: Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.

- Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.

- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.


Management:  Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

- Dissolve the clot - Using thrombolytics like clopedigrol 

- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles

- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.

- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used

- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

2573 people found this helpful

Acute Coronary Syndrome - How To Diagnose It?

Acute Coronary Syndrome - How To Diagnose It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms

The tell-tale signs of a heart attack are as follows:

  1. Chest pain and discomfort usually described as a tightness or burning in the chest region
  2. Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
  3. Nausea and vomiting 
  4. Profuse sweating 
  5. Difficulty breathing 
  6. Dizzy or fuzzy feeling 
  7. Tired, extreme fatigue
  8. Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis

Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following tests will be performed.

  1. Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.
  2. Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.
  3. In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.

Management

Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

  1. Dissolve the clot - Using thrombolytics like clopedigrol 
  2. Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles
  3. Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.
  4. Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used
  5. Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.

In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

2786 people found this helpful

Heart Bypass Surgery Brings Long-Term Benefits!

Heart Bypass Surgery Brings Long-Term Benefits!

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

3384 people found this helpful
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