Common procedures for heart disease
Find out more about the three procedures for detecting and treating coronary heart disease, and what you can expect during a hospital visit.
Every day, 15 people die from cardiovascular disease (heart disease and stroke) in Singapore, according to the Singapore Heart Foundation (SHF). In 2013, cardiovascular disease accounted for 29.5 percent of all deaths, which means that nearly one out of three deaths in Singapore is due to heart disease or stroke.
When it comes to heart disease, there are a number of procedures that are common. Here are three such procedures and what you can expect:
If your doctor suspects that you may have coronary heart disease, he may suggest an angiogram, which is the gold standard of coronary heart tests. It will be able to pinpoint accurately both the location and extent of damage to the coronary arteries.
The arteries can get clogged with fat cells or a hard material called plaque. During an angiogram, a dye is injected into the coronary arteries through your groin or arm, a catheter is then deployed to detect blockages in your heart. The invasive screening will indicate whether you could benefit from further medical procedures. It may also be used if you have had a heart attack, or have been treated for a heart clot, and are experiencing further problems.
If the arteries are blocked, it affects the flow of blood to your heart and this may lead to a heart attack. If the angiogram reveals these problems, there are further procedures that can be carried out to ease the condition, such as heart stenting or bypass surgery.
An angiogram takes about half an hour and you remain fully awake while it’s being carried out. You’ll need to rest for a few hours in the hospital post-procedure; an angioplasty is a day procedure.
Heart stenting can reduce the effects of blocked arteries if prescribed medications
and lifestyle changes have not been sufficiently effective. Stenting can be done as one combined procedure, post-angiogram, if your cardiologist suggests. A minimally-invasive procedure, heart stenting (angioplasty) has a high success rate of around 90 percent with few complications.
If blockages are detected and an angioplasty is to be performed right after your angiogram,a catheter is then reintroduced into an artery in the leg with a little balloon-like device at the tip, which is inflated and deflated several times to prise open the blocked artery. It is now common for stents (little pieces of expandable metal made from stainless steel mesh) to be inserted and flattened against the wall of the artery to keep it open and allow the blood to flow smoothly. Drugs that help prevent blood clogs may be administered into the artery at the same time as the stent.
Today, most angioplasty procedures involves the use of stents. When a heart stenting procedure or what is formally called percutaneous transluminal coronary angioplasty (PTCA) is performed without stenting, there are often high recurrence rates where the coronary artery becomes blocked again within six months of the procedure.
A stenting procedure may take as fast as 30 minutes or may take up to two hours.
After the day procedure, you will need to rest in the hospital for between two to six hours, after which you should be able to walk around. You may experience some soreness over the next few days. Mount Elizabeth Hospitals’ cardiologists advises that one should refrain from lifting heavy items and driving, but there should be no major disruption in your normal way of life. If you feel any pain during or after a heart stentingprocedure, please consult your cardiologist for further advice.
A heart bypass (called a coronary artery bypass grafting or CABG) is a surgical procedure performed in cases of severe coronary heart disease to bypass blocked arteries and restore normal blood flow to the heart.
During this procedure, healthy blood vessels are grafted from another part of the body, for example — leg veins or the internal mammary artery (which supplies the chest wall and breasts). The vessels are then grafted around the blocked part of the affected artery to create a new route for the blood to flow to the heart. This alleviates symptoms such as angina (chest pain) and can lower the risk of heart attack, especially for diabetics.
Today, with newer techniques minimally-invasive CABG procedures, the average operating time for a heart bypass is around two to three hours, and the post-operative hospital stay is shortened to three to five days. This also means you can return to work sooner.
This article has been contributed by Mount Elizabeth Hospitals. To increase public awareness in the prevention and management of heart disease, the hospitals launched the ‘Be Heart Strong’ website where readers can find articles on practical heart-healthy lifestyle tips, how to recognise symptoms, and manage common risk factors such as high blood pressure and diabetes. Beyond prevention strategies, articles on the latest treatment options and guide to help individuals better comprehend their medical insurance are also available.
(** PHOTO CREDIT: Heart, freeimages, wgroesel)