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Home >> Cardiology Explained  

 Cardiology Explained

To deal effectively with heart disease, you need to know the language. Dealing with heart disease, or any serious illness for that matter, is like being suddenly deposited into a foreign country. In a foreign land, most of us feel most comfortable if we can at least ask the basics or understand the language.

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Cardiology, 'the land of the heart' is not much different. You would like to communicate with the doctors, nurses and lab technicians effectively. By speaking the same language, you will be empowered. You will be less likely to be intimidated, and you can absorb information from the media.

Cardia means pertaining to the heart; hence, cardiology is the study of the heart, and a cardiologist is a doctor who specializes in the study and treatment of the heart. Doctors tend to refer to almost all heart problems by using the umbrella term 'heart disease'. They use the term when speaking of congenital heart defects, which are heart problems which people are born with, valve problems or irregular heartbeats. But when most people use the term 'heart disease' what they are really talking about is coronary heart disease.

Coronary heart disease is a particular type of heart disease, the one most people talk about when they refer to atherosclerosis, a build-up of fatty material in the artery wall which causes it to become thickened and irregular. This build-up, sometimes called plaque, results in a narrowing of the coronary arteries.
Studies have also shown that, by making lifestyle changes, regarding eating, exercise and quitting smoking, you may be able to accomplish a regression in the process of atherosclerosis. In fact, studies have shown that making heart-healthy lifestyle changes can result in a 5 to 10% regression in the process of atherosclerosis. That may not sound like much, but it could mean the difference between having a heart attack or requiring coronary bypass surgery and avoiding it.

Blood carries oxygen to all the tissues of the body including your heart, which needs oxygen to survive. If this oxygen is cut off, it can result in a heart attack, which results in permanent damage to the heart muscle caused by a lack of blood supply to the heart for an extended period.

There are different ways of diagnosing heart disease. You may have already undergone some of these tests. An electrocardiogram, known as an ECG, is the familiar test in which electrodes are placed on your chest and a picture of your heartbeat is conveyed on graph paper. This picture shows the electrical impulses traveling through the heart muscle. An exercise (EKG) stress test is a diagnostic procedure in which an activity, such as walking on a treadmill or riding a stationary bicycle, is used to evaluate the effect of physical exertion on the heart.

Another diagnostic test, an echo cardiogram, uses ultrasound to detect and electronically record structural and some functional abnormalities of the heart, like a malfunctioning heart valve. Although traditionally an echo cardiogram is not used to diagnose coronary artery disease, it can be a useful tool if combined with an exercise stress test. This is sometimes called an exercise echo.

All these tests are non-invasive, which means that they do not require any instruments to penetrate the body, and are generally painless and nearly risk-free. Such tests can indicate you have heart disease, but do not completely evaluate its extent. Your doctor may then turn to what has been termed the 'gold standard' of cardiac testing, cardiac catheterization, known as coronary angiography. In this procedure, a tube is inserted into an artery in the arm or leg and guided to the heart. Contrast dye is injected and X-ray movies are taken of the dye flowing through the coronary arteries. The progression of the dye gauges the extent of the narrowing of the arteries. Thus, your doctor is provided with a 'road map' of your coronary arteries that pinpoints exactly where the narrowing or blockages are. This test is required before such procedures as coronary bypass surgery and balloon angioplasty.

There is another class of drugs which are administered during a heart attack to abort the attack itself. These are called thrombolytic drugs or clot busters. If used in time, they can dissolve the blood clot that caused the heart attack and minimize the damage to the heart muscle that the attack could cause.
The main surgical treatment for coronary artery disease is coronary bypass surgery. Pioneered in the 1960s, this common procedure involves taking a vein from the leg or artery from the chest and using it as a conduit (pipe) to bypass the blockage and create an alternate flow of blood to the heart.

More recently, however, an alternative treatment that does not require opening the chest has gained greater popularity. This is balloon angioplasty, a procedure used to widen narrowed arteries. Unlike coronary bypass surgery, no new conduit is created. Instead, a balloon tipped catheter is passed into the narrowed segment of the artery from an entry point in the groin. The balloon is inflated and the artery opened (or dilated). There are two related procedures, such as atherectomy, in which tiny drill-like or blade like instruments drill through or shave the atherosclerotic plaque causing the narrowing.

If you have experienced a heart attack, or undergone coronary bypass surgery or balloon angioplasty, you may have been referred for cardiac rehabilitation. This programme of exercise, psychological and social support is designed to return people to normalcy or better after a heart attack or other cardiac crisis. It can be used as a treatment for heart disease alone, or following coronary bypass surgery, angioplasty, or atherectomy. It is always easier to talk with professionals if you 'know the language.'

Learn and practice the terminology of cardiology by clipping an article about heart disease from a newspaper or magazine or read a book on the subject. If some of the terms are not clear, look them up in a medical dictionary or discuss them with your doctor or other health professional. Never hesitate to ask questions.

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