Archive for the ‘Coronary Artery Disease’ Category

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Risk Factors and Stroke Prevention (Part 2)

Thursday, March 25th, 2010

strokeRisk factors that may cause blood more likely to clot, which can lead to stroke include:

* Birth control pills may increase the likelihood of blood clots, especially in women who smoke and are over 35 years
* Disorders of blood clotting
* Cancer
* Rheumatoid arthritis, lupus erythematosus, vasculitis and ulcerative colitis
* Pregnancy: Women have a higher risk of stroke during pregnancy and the weeks immediately after it

Risk factors for strokes caused by blood clots (emboli) that develop in the heart include:

* Infected or artificial heart valves
* Inflammation of the lining of the heart chambers and valves (endocarditis)
* An attack that is not beating strongly or regularly, which can cause blood to remain in the area of the heart, leading to the formation of a clot. The clot can break off and travel to the brain

(more…)

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Risk Factors and Stroke Prevention (Part 1)

Tuesday, March 23rd, 2010

strokeA stroke is an interruption of blood supply to any part of the brain, sometimes called “brain attack.”

There are two main types of stroke: ischemic stroke and hemorrhagic stroke.

When a blood vessel supplying the brain becomes blocked by a blood clot, it is called ischemic stroke. The blockage of the artery can happen in two ways.

* You can form a clot in an artery that is already very close and is called a thrombus. If you block the artery completely, is called thrombotic stroke.
* A blood clot may become dislodged from part of the body and travel to the brain to block a smaller artery. This is called an embolism, causing an embolic stroke.

A second major cause of stroke is bleeding in the brain. This is called a hemorrhagic stroke can occur when small blood vessels in the brain become weak and burst.

Some people have defects in blood vessels of the brain that make this more likely. The flow of blood that occurs after the rupture of blood vessels causes damage to neurons.
Men have more strokes than women.

(more…)

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Improve the Narrowed Artery

Saturday, January 30th, 2010

Which opens narrowed arteries, is a procedure performed by interventional cardiologists using a long, thin tube called a catheter carrying a balloon (or balloon) at the end, they inflate in place obstruction of the artery to compress the plaque against the artery wall. Angioplasty is also called percutaneous transluminal coronary angioplasty (PTCA). The procedure involves threading a thin wire (guide catheter) into an artery in the leg and is guided to the narrowed area of the coronary artery. The catheter with the balloon passed over the guide catheter and is located at the site of the blockage, where the balloon is inflated. After treatment, the guide catheter is withdrawn and the catheter with a balloon. The hospital stay and recovery time for this procedure are less than a bypass. But about 35% of patients run the risk of blockages in the treated area (which is called restenosis). Restenosis usually occurs within six months following the completion of the procedure.

Balloon angioplasty is complemented by the placement of a stent. A stent is a device made of metal mesh that is implanted in the area of the artery narrowed by plaque. The stent is mounted on a catheter with a balloon at the tip, is inserted through the artery and is located at the site of obstruction. Then the balloon is inflated, which causes the stent. Then removed the catheter and deflated balloon, leaving the stent in place. Restenosis rates with this procedure is typically between 15 to 20 percent.

Balloon angioplasty is complemented by placing a stent. Restenosis is a problem with the stenting procedure, doctors have been trying to find ways to prop open arteries in which stents were placed. Some newer stents are coated with medicines that reduce the likelihood that the artery from closing again. These are called coated stents or “drug-eluting stents”

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Coronary Heart Disease is the Leading Cause of Death for Men & Women in the United States.

Friday, January 29th, 2010

Many things increase your risk of heart disease:

  • Men in their 40s have a higher risk of CHD than women, but as women get older (especially if it comes to menopause), the risk increases almost to equal that of men. (See: Heart disease and women)
  • Bad genes (heredity) can increase the risk. In fact, one is more likely to develop the condition if someone in your family has suffered, especially if it was before 50 years, and the risk increases as you get older.
  • Diabetes is a potent risk factor for heart disease.
  • High blood pressure increases the risk of coronary artery disease and heart failure.
  • Abnormal levels of cholesterol: LDL ( “bad”) should be as low as possible and HDL ( “good”) should be as high as possible.
  • The metabolic syndrome refers to high triglyceride levels, hypertension, excess body fat around the waist and increased insulin levels. People with this group of problems are more likely to develop heart disease.
  • Smokers have a much higher risk of heart disease than nonsmokers.
  • Chronic kidney disease may increase the risk.
  • The fact already have atherosclerosis or atherosclerosis elsewhere in the body (examples are stroke and abdominal aortic aneurysm) increases the risk of CHD.
  • Other risk factors include excessive alcohol consumption, not enough exercise and excessive amounts of stress.

Levels above normal inflammation-related substances such as C-reactive protein and fibrinogen, are being studied as possible indicators of increased risk of heart disease. Elevated levels of a chemical called homocysteine, an amino acid, are also associated with an increased risk of heart attack.

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The Highest Troponin T is Associated With Heart Failure

Thursday, January 28th, 2010

In patients with stable coronary artery disease, measuring levels of troponin T with methods of high sensitivity analysis may give clues about the chances of developing heart failure or death from cardiovascular causes. The study, published today in The New England Journal of Medicine, suggests that levels of this protein does not affect the chances of these patients developing acute myocardial infarction. After adjusting for independent prognostic indicators with appropriate methods, concentrations of cardiac Troponin T are related Cadiovascular incidence of death and heart failure, but not with acute myocardial infarction in patients with coronary artery disease, according to data from the Peace , whose first

In most patients with stable coronary artery disease, troponin T levels are below the detection limit with conventional analysis. So Omland group has used a highly sensitive study to determine the concentration of troponin T in plasma samples in 3679 patients with stable coronary artery disease and preserved ventricular function. The results of the analysis used show a relationship between the incidence of cardiovascular disease during follow-up period of 5.2 years.

More sensitivity

With the sensitive method used, troponin T concentrations were above the detection limit of 0,001 nanograms per liter in 3593 patients, 97.7 percent, and below the 99th percentile of healthy subjects in 407 patients, 11.1 percent. After adjusting for prognostic indicators, there was an increase in the cumulative incidence of cardiovascular mortality and heart failure in this group.

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Heart Surgery (Heart Transplant)

Wednesday, January 27th, 2010

Description of Procedure – The surgeon cuts through skin and breastbone, opens the chest and connected to a heart-lung machine. This machine takes over the functions of the heart and lungs during the operation. Doctors remove all but the back wall of the upper chamber of the heart. The upper chambers of the donor heart are opened, and the donor heart is sewn into place. Then, connect the blood vessels and the blood starts to flow and warms the heart. The new heart starts beating on its own or doctors administered an electrical shock to get it started. For safety, you will also have a temporary pacing wire connected to the heart. Once doctors are sure that the heart is beating fine and no further problems are anticipated, the blood is rewarmed and disconnect the heart-lung machine, catheters are placed in the chest cavity to drain any residual blood that may collect. The surgeon closes the chest with stainless steel wires and the skin is closed with absorbable sutures.

After Procedure – be closely monitored in an intensive care unit, with the help of the following devices:

  • Heart Rate Monitor
  • Cables used to help control heart rate
  • Tubes connected to a machine that helps drain excess blood and air
  • Breathing through hoses until you can do independently

How Long Will It Take ? 4-6 hours

Hurt? Anesthesia prevents pain during surgery. You may experience pain while recovering but will receive drugs to relieve the discomfort.

Possible Complications

  • Infection
  • Rejection of the new heart
  • Coronary Artery Disease (half of all transplant patients develop coronary artery disease)
  • Pneumonia
  • Phlebitis (blood clots in a vein)
  • Excessive bleeding
  • Neurological deficits, stupor, coma, decreased intellectual function
  • Renal dysfunction
  • Heart palpitations
  • Problems related to anesthesia
  • infection or cancer related to taking immunosuppressive medications

Approximate time of stay in the hospital – two weeks if no signs of rejecting the new heart

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How is CAD (Coronary Artery Disease) Diagnosed ?

Tuesday, January 26th, 2010

The doctor checks the patient’s medical history, asks you to describe your symptoms, he listens to the heart with a stethoscope and perform studies that often include a chest Radiograph. The following is a list of other tests that your doctor may prescribe:

  • An electrocardiogram (ECG) reference that records the electrical activity of the heart at rest and while performing an ECG exercise, also called “stress test”, which indicates how the heart responds to exercise more and more intense. The purpose of both studies is to detect if the heart is not working properly, possibly due to a lack of oxygen.
  • A thallium stress test, a nuclear cardiology study that involves injecting a radioactive substance into the bloodstream to show how blood flows through the arteries. Doctors can determine if your heart muscle is damaged or dead, or if an artery has a significant narrowing. People who can not undergo a stress test may receive medications that make the heart beat as if you were exercising.
  • An Echocardiogram, a test that uses sound waves to produce an image of the heart to see how it works.
  • Coronary angiography, a study performed in a cardiac Catheterization laboratory. First is given a sedative to relax the patient. A dye is then injected into the bloodstream to produce an X-ray “movie” of the heart’s activity and the flow of blood through the valves and arteries (what is called an angiogram). The angiogram shows how many obstructions there are and how serious they are. Doctors often use this test to determine what would be the most effective treatment.
  • A positron emission tomography (PET), a technique that uses information about the power of certain elements of the organism to determine whether certain parts of the heart muscle are alive and active. The PET scan can also determine if the heart gets enough blood to keep the muscle healthy.
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Treatment of CAD (Coronary Artery Disease)

Monday, January 25th, 2010

Several medicines can help relieve the pain of angina pectoris caused by CAD. People who suffer from severe angina often receive several different medications. Can also be given antiplatelets such as aspirin to patients suffering from angina, as these medicines reduce the likelihood of blood clots forming in places blockages.


  • A medicine called nitroglycerin can widen or dilate the arteries and improve blood flow to the heart. Nitroglycerin can be administered through a transdermal patch or pill form, ointment or spray.
  • Beta-blockers “block” the chemical or hormonal messages sent to your heart. In situations of physical or emotional stress, the body sends signals to the heart to work harder. Beta-blockers block the effect of these signals have on the heart, thereby reducing oxygen demand by the heart.
  • Calcium channel blockers help keep arteries open and reduce blood pressure by relaxing the smooth muscle surrounding the arteries of the body. These drugs also reduce oxygen demand by the heart.
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What is the Cause of Atherosclerosis?

Sunday, January 24th, 2010

Scientists believe the disease occurs when the layer is damaged lining the inside of the artery (the Endothelium). It is believed that high blood pressure, elevated cholesterol and triglycerides, and smoking are the factors that contribute to plaque formation.

What are the symptoms?

A person can suffer from atherosclerosis for many years without symptoms. This slow process of the disease may begin in childhood. In some people the disease can cause symptoms between 30 and 40 years of age, while others have no symptoms until after 50 or 60 years. But with increasing the degree of obstruction, reduced blood flow to the heart can start to cause what is called angina pectoris, a term that comes from Latin and means “strangling in the chest.” Patients with angina often report feeling a choking sensation, or burning feeling in the chest. The pain usually occurs when the heart needs more blood supply, such as during exercise or times of emotional stress.

Angina usually begins in the center of the chest but may extend to the arm, neck or jaw. Some people say they feel a numbness or loss of sensation in the arms, shoulders or wrists. An episode usually lasts only a few minutes and goes away with rest. Some patients with CAD may not suffer from angina. Sometimes the poor oxygen supply to the heart (called ischemia) does not cause any pain. This is called silent ischemia.

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Coronary Artery Disease

Saturday, January 23rd, 2010

Coronari arteries coronary artery disease (CAD) affects almost 13 million Americans, making it the most common type of cardiovascular disease. The CAD and its complications such as arrhythmia, angina and heart attack are the main causes of death in the United States. The most common cause of CAD is a condition called atherosclerosis, which occurs when a waxy substance forms inside the arteries that supply the heart. This substance, called plaque, is made of cholesterol, fatty compounds, calcium and a clotting material called fibrin. Have identified two types of plaque: hard plaque and soft plaque.

Most people have heard of the hard plaque and knows it can cause a heart attack. If hard plaque builds up in arteries supplying the heart, blood flow slows or stops. This decreases the amount of oxygen reaching the heart, which can cause a heart attack.

But it has been determined that although some heart attacks are caused by hard plaque, most of them are caused by the soft plaque or vulnerable plaque. The vulnerable plaque is an inflamed section of an artery that can rupture. This may lead to the formation of a blood clot that can cause a heart attack.

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