Critical Medicine and Treatment

Posts Tagged ‘Coronary Artery Disease’

Risk 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

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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

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.

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.

What is coronary artery disease (CAD)?
Coronary artery disease is the commonest form of heart disease in Europe and America. If you have coronary artery disease, it is a narrowing or blockage of the coronary arteries, the tanks which supply the heart with blood. It is not certain that the blood supply to the heart is good enough.

A narrowing of the arteries due to wax-like deposits, called plaque, on the inside of blood vessels. Plaque is a collection of fat and cholesterol that circulates in the blood. Fat and cholesterol are usually from the food you eat and accumulate time.

A fresh artery is elastic, smooth on the inside and able to carry enough blood to the heart.
A diseased artery is stiffer and narrowed due. Deposition of plaque is a problem because it can cause a blockage of the artery. Narrowing or blockage of an artery is called stenosis.

An artery with stenosis is like a clogged pipe. A blocked coronary artery is serious because the artery is the only passage that provides the heart with oxygen. A narrowed or blocked coronary artery means less blood and less oxygen to the heart muscles. The heart relies on the supply of sufficient oxygen and nutrients to function properly.

Plaque may be deposited in the arteries over many years. Coronary artery disease is generally a disease that develops gradually. The progressive deposition of plaque inside arteries is called atherosclerosis. If this process continues, you eventually have symptoms of chest pain, shortness of breath and numbness in arms and shoulders. Coronary artery disease can even cause heart attack or myocardial infarction (MI).

Fortunately it is possible to treat coronary artery disease. If you have been given this diagnosis, you can talk to your doctor about treatment options.