Interventional Cardiology

Last updated date: 28-Aug-2023

Originally Written in English

Interventional Cardiology 

Interventional cardiology is a cardiology subspecialty that diagnoses and treats various heart conditions with specialized catheter-based methods. Examples are coronary artery disease, structural heart disease, vascular disease, and congenital heart defects. 

Interventional cardiologists often use a variety of diagnostic devices and imaging approaches to assess cardiovascular functions. For instance, check blood pressure and blood circulation within major arteries around the body and in the heart's various chambers. However, interventional cardiology does not involve traditional or open cardiac surgeries. 

 

Advantages of Interventional Cardiology 

Aside from high success rates, interventional cardiology provides numerous benefits to heart patients. They include;

  • Less pain and scarring: When compared to traditional surgery, interventional cardiology is generally less invasive. It involves inserting the catheter through a single and tiny incision. In addition, the procedure is completed in almost 30 minutes, resulting in less pain. 
  • Short recovery period: Recovery time is shorter compared to other surgical interventions. Patients are not normally required to remain in the hospital following the treatment procedure. 
  • Reduces heart attack risks: Apart from alleviating symptoms such as shortness of breath and chest pain, interventional cardiology also opens up the arteries, restoring blood circulation. This lowers the heart attack risks. 
  • Suitable for infants and children: Interventional cardiology, especially a balloon valvuloplasty, is ideal for infants and minors who have heart diseases. This is because it is minimally invasive, successful, and less painful.
  • Cost-effective: Unlike traditional heart surgery procedures, interventional cardiology is less expensive.

 

Reason for Interventional Cardiology 

Interventional cardiology typically aims at diagnosing and treating the heart and major blood vessel conditions such as:

  • Arrhythmia: This is a heart rhythm disorder in which the heart tends to beats too quickly, too slowly, or irregularly.
  • Angina is a form of chest pain that normally occurs due to artery narrowing (coronary heart disease).
  • Cardiomyopathy: This is a condition in which your heart muscle weakens or enlarges.
  • Congenital heart defects: These are medical conditions that are present at birth. They include atrial septal defect and patent foramen ovale. 
  • Heart failure: Develops when your heart is unable to supply sufficient blood to the rest of the body.
  • Myocardial infarction (heart attack): This occurs if a section of the heart muscle is limited to blood rich in oxygen and eventually dies.
  • Heart valve disorders: These are abnormalities within the valves that allow blood to flow in only one direction via the heart.
  • Myocarditis, also known as heart inflammation, is a condition in which the heart wall becomes inflamed. 

 

When to Consider an Interventional Cardiology 

professional interventional cardiologist

Your primary care doctor often manages most medical conditions and heart disease risk factors like high blood pressure and high cholesterol. However, if he or she discovers or suspects any major heart or blood vessel issue, including a coronary artery blockage, you could be referred to a professional interventional cardiologist. 

Finding an experienced and certified interventional cardiologist for treatment or preventive care is essential. It’s also an effective way of lowering the risk of long-term heart damage, disability, and even death.

If you have any of the following, then you should consider interventional cardiology nearby:

  • You have EKG (electrocardiogram) changes that indicate a coronary artery blockage.
  • You have a heart condition requiring specialized care, including unstable angina, heart valve disease, and a heart attack.
  • You require specialized heart procedures, such as cardiac catheterization, angioplasty, or heart valve repair. 

Interventional cardiology is suitable for patients who have any of these symptoms or medical conditions:

  • Chest pain that can extend to the arms, shoulders, jaw, or neck
  • Dizziness
  • Palpitations, or the sensation that your heart is racing
  • Passing out
  • Breathing difficulty

 

Interventional Cardiology Tests and Procedures

Interventional cardiology involves conducting a wide range of tests and procedures on patients of all ages. While the cardiologists carry out a variety of life-saving procedures, they don’t perform traditional (open) surgery, which cardiac surgeons often do. The tests and procedures performed or ordered by an interventional cardiologist are determined by the patient's specific problem, overall health, as well as wellness goals.

Interventional cardiology involves a range of screening tests, diagnostic tests, and treatment procedures such as;

  • Echocardiogram

This form of imaging test creates pictures of the valves, chambers, blood vessels, and walls using high-frequency sound waves (ultrasound). As the heart beats, the specialized technique shows the shape and size of the patient's heart. It also reveals the thickness and motion of the heart walls.

  • Cardiac catheterization

This procedure is used to assess how well the heart is functioning. It involves inserting a catheter (a tiny and hollow tube) into the major blood vessel that runs towards the heart. This procedure helps determine whether one has a heart muscle, coronary artery, or heart valve disease. 

  • Coronary angiography

This imaging procedure employs the use of contrast dye injected into the bloodstream via a catheter. The dye will be visible in an x-ray technique as the blood moves through the arteries. This reveals the blockages in the heart and any other serious cardiovascular issues. 

  • Angioplasty

This minimally invasive technique uses a balloon or stent device to open the obstructed artery and restore blood supply. Angioplasty involves balloon angioplasty as well as cutting balloon angioplasty. The procedure is normally performed as an outpatient procedure on the same day.

  • Atrial septal defect closure

The interventional cardiologist can recommend this procedure to treat atrial septal defects (holes in the heart that are present from birth) that fail to close on their own. Specialized patches or plugs are typically used to cover the holes. The procedure may be conducted using minimally invasive cardiac catheterization or conventional “open” surgery. This depends on the overall health of the patient, the location and size of the defect, among other factors.

  • Alcohol septal ablation

This is a catheter-based method that is typically recommended for treating hypertrophic cardiomyopathy (HCM) without surgery. HCM is a condition in which the heart muscle thickens. The procedure involves injecting ethanol alcohol into a minor artery that transports blood towards the thickened portion of the heart muscle. This kills the cells and shrinks the diseased tissue. 

  • Exercise stress test

During an exercise stress test, the cardiologist attaches the electrodes of the cardiac monitor to the skin over and about the chest. Heart function data is obtained while one walks around or on the treadmill. This test can aid in diagnosing coronary artery disease and the identification of the reasons for symptoms like chest pain. This also includes the prediction of a variety of serious heart-related problems. 

  • Transcatheter aortic valve replacement
    Transcatheter aortic valve replacement

This is an endoscopic heart procedure that cardiologists use to replace the obstructed or narrowed aortic valve. This is whereby the aortic valve does not open and close properly, hence causing aortic valve stenosis. 

  • Cardiac computed tomography (cardiac CT)

This generates cross-sectional views of the anatomy, circulation, and the major blood vessels of the cardiovascular system using x-ray techniques, computers, and imaging. Cardiac CT imaging enables the cardiologist to evaluate and addresses various cardiovascular problems. These include aortic disease, pericardial disease, cardiac masses, and issues with the myocardium, pulmonary veins, and coronary arteries.

  • Cardiac magnetic resonance imaging (MRI)

This creates comprehensive pictures of the structures within and about the heart. These images are created using a magnetic field, radio waves, and a computer rather than radiation. They help in the evaluation, diagnosis, and monitoring of heart disease and assessing the structure and function of the heart in congenital and acquired heart disease. 

  • Intravascular ultrasound

This is a catheter-based procedure that employs sound waves to create images of the inner parts of blood vessels. This makes it easy for the doctors to evaluate the coronary arteries supplying blood towards the heart. 

  • Chronic total occlusion intervention

In some patients, a minimally invasive stenting procedure can be used to address a complete blockage of one or several coronary arteries (chronic total occlusion). Other chronic total occlusion patients may require conventional coronary bypass surgery to correct this severe cardiac condition.

  • Myocardial perfusion imaging

A radioactive material known as thallium is injected into the bloodstream when a patient is at utmost exertion. It is used to capture images of the muscle cells within the heart. This allows the cardiologist to measure heart blood flow while at rest and during stressful moments. This also makes it easy to determine things such as; 

  • The extent of a coronary artery blockage
  • The degree of damage due to a heart attack
  • The cause of chest pain, and 
  • Safe exercise levels for patients

 

Interventional Cardiology Training 

In general, interventional cardiologists must complete six years of post-medical school training in general interventional cardiology fellowship and internal medicine. This will be followed by at least two or three years of interventional cardiology training, which adds to a total of eight or nine years of postgraduate training. This is comparable to the majority of advanced surgery subspecialties in the medical field. 

 

Conclusion 

Interventional cardiology specializes in the diagnosis and treatment of heart and blood vessel conditions and diseases. It involves the use of nonsurgical, catheter-based techniques and specialized imaging tests. 

Interventional cardiologists specialize in treating coronary artery disease, congenital heart disease, and heart valve disorders, among other conditions. They are also experts in preventing heart disease and the associated complications, including heart failure.