Invasive Cardiology

Overview

Few things in life are as important as heart health when it comes to living a healthy lifestyle and having the best quality of life achievable. In addition to a healthy diet and regular exercise, visiting a cardiology clinic is essential.

However, genetics and family history are important predictors of whether or not you may develop heart disease. As a result, despite your best efforts, you may still have cardiac problems. It is critical to understand the differences between various forms of cardiac care.

The phrase "invasive cardiology" refers to open heart or minimally invasive surgical techniques used to treat heart diseases and disorders. Angioplasty and coronary stenting are two examples of invasive cardiology techniques.

 

What are Invasive, Non-Invasive & Interventional Cardiology?

Cardiology is a medical specialty dealing with the study, diagnosis, and treatment of the cardiovascular system. Because your heart functions in so many ways, your cardiologist must evaluate many variables when determining what is wrong with your heart. Among these variables are your heart, arteries, or blood vessels.

While assessing your overall heart health, a cardiologist may:

• Check your medical records.
• Examine your blood pressure and blood vessels.
• Examine and test your lung function.
• To diagnose the condition, utilize x-rays, blood tests, an electrocardiogram (ECG), or other specialist procedures.

A cardiologist does not do surgery. A cardiac surgeon is a different form of specialist that does physical heart surgery. Testing and other procedures are performed by a cardiologist.

Some cardiologists specialize in pediatric cardiology, sometimes known as children's cardiology. Others focus on adult cardiology.

Cardiology is classified into three types: invasive, non-invasive, and interventional. To diagnose and treat your cardiac diseases, your cardiologist may employ one or a combination of following procedures:

 

Invasive Cardiology

Open or minimally invasive procedures are used in invasive cardiology to discover and treat electrical or structural problems in the heart system. These processes include the following:

• Angioplasty: Arterial plaque is a soft, sticky film made up of cholesterol, calcium, fat, and other blood-derived compounds. If your arteries get clogged with too much plaque, your blood flow may decrease. This is where an angioplasty comes in. This procedure includes inserting a tiny balloon into your blocked vein, which pushes plaque against the walls, increasing blood flow and assisting your heart in getting back to normal capacity.
• Stenting: A cardiac stent is a small metal or plastic coil/tube that can permanently hold open a blocked artery and is frequently used in conjunction with angioplasty. Your cardiologist may prescribe these two treatments if you have obstructed arteries.

 

Non-invasive Cardiology

Non-invasive cardiology, as the name implies, is the diagnosis of cardiac problems without the insertion of needles, fluids, or other tools into your body. Among the most prominent non-invasive procedures are:

• Cardiac electrophysiology: This field of study and testing focuses on the electrical currents that drive heartbeats. Your cardiologist can tell you if this testing is appropriate for your situation.
• CT scans: CT scans provide pictures that can be used to determine if you have heart disease or atherosclerosis, also known as plaque accumulation on your arteries.
• Echocardiography: This procedure uses ultrasound waves to create pictures of the heart and surrounding tissues, allowing cardiologists to assess your heart's ability to pump blood, fight infections, and more. Furthermore, echocardiography can detect structural abnormalities that may have a significant influence on your heart health.
• Heart monitors: Wearing a heart monitor allows your cardiologist to measure the activity and capacity of your heart. These monitors, also known as Holter monitors or cardiac event records, act as a tape recorder for your heart's electrical activity over a set period of time.
• Nuclear cardiology: It is a non-invasive examination of cardiovascular problems that use radioactive materials in imaging. Cardiologists may inspect many elements of the heart and identify potential issues using advanced imaging tools.
• Stress tests: It often entail exercise and physical activity that is thoroughly monitored by your cardiologist. Your heart will be functioning under physical stress as a result of getting your blood pumping and your body moving, and this activity can provide your cardiologist with significant information about how your heart performs in these conditions.

Your cardiac specialist may use these noninvasive techniques to identify potential risks or current issues and recommend medications or lifestyle adjustments to help improve your heart health.

 

Interventional Cardiology

Interventional cardiology is a non-surgical procedure that uses a catheter - a short, flexible tube - to repair damaged or weakened vessels, narrowed arteries, or other impacted heart structural parts.

Interventional cardiology commonly treats the following conditions:

• Coronary artery disease: A constriction of the arteries that deliver blood and oxygen to the heart muscle.
• Heart valve disease: It occurs when the valves that control blood flow into the chambers of the heart do not function properly.
• Peripheral vascular disease: Clogged or hardened veins and arteries in other regions of your body can also damage your heart.

 

Reasons to See An Invasive Cardiologist

If a patient is experiencing a heart attack, they may need to visit an invasive cardiologist right away. They will also see patients to detect and treat issues such as coronary artery disease, heart valve disease, and peripheral vascular disease before they become an emergency.

Because invasive cardiologists are cardiology experts, your doctor or cardiologist will almost likely refer you if you have concerns about:

1. Too much arterial plaque that cannot be treated with medication alone

If you have atherosclerosis, or a build-up of fatty plaques in your blood vessels, you are most likely taking drugs to lower your chance of having your arteries blocked. You are more likely to have a heart attack if your arteries get obstructed. Medication, however, may not be sufficient. To unclog blocked arteries, you may require a minimally invasive therapy.

2. New or worsening coronary artery disease symptoms

When you have coronary artery disease, your arteries constrict as a result of plaque formation. This narrowing of the arteries might limit the supply of blood and oxygen to your heart muscles. If you have new or worsening symptoms, your doctor or cardiologist may refer you to an invasive cardiologist to determine whether additional minimally invasive therapies are required.

 

3. Peripheral vascular disease signs and symptoms

You may also notice new or worsening signs of artery congestion, narrowing, or hardness in other places of your body. As a result, you may be sent to an invasive cardiologist for additional evaluation and treatment options. Peripheral vascular disease can potentially impair your heart's function.

 

4. Heart valve disease concerns

The valves of your heart assist regulate blood flow to the chambers of your heart. Problems with your valves' performance might lead to serious health and cardiac problems. If your doctor or cardiologist suspects valve abnormalities, they may refer you to an invasive cardiologist for additional evaluation.

 

Benefits of Invasive Cardiology

Aside from high success rates, invasive cardiology provides other advantages to heart patients, including:

• Less pain and scarring: When compared to regular surgery, invasive cardiology is less intrusive. Normally, the catheter is inserted by a single, small incision. The treatment is completed in about 30 minutes, resulting in reduced discomfort.
• Faster recovery: Recovery time is shorter than for other surgical procedures. Patients are not required to stay in the hospital following the procedure.
• Reduces the risk of a heart attack: Invasive cardiology not only treats symptoms such as chest discomfort and shortness of breath, but it also opens the arteries and restores blood flow, lowering the chance of a heart attack.
• Ideal for infants and children: Invasive cardiology, particularly balloon valvuloplasty, is recommended by cardiologists for infants and children with heart issues since it is minimally invasive, less unpleasant, and extremely successful.
• More inexpensive: In terms of cost, invasive cardiology is less expensive than typical cardiac surgery operations.

 

What Types of Procedures Are Used in Angioplasty?

A coronary angioplasty is a technique that is done to open up restricted or obstructed coronary arteries (the main blood vessels supplying the heart).

The word "angioplasty" refers to the use of a balloon to open a restricted or obstructed artery. During most current angioplasty operations, however, a small wire-mesh tube called a stent is inserted into the artery. The stent is permanently implanted to allow blood to flow more freely.

Percutaneous transluminal coronary angioplasty is another name for coronary angioplasty (PTCA). Percutaneous coronary intervention is the term used to describe the combination of coronary angioplasty and stenting (PCI).

There are several your doctor will choose from. They include:

1. Balloon: A catheter with a tiny balloon tip is directed to the constriction in your artery. Once in position, the balloon is inflated to push the plaque and stretch the artery open, increasing blood flow to the heart.
   
2. Stent: A stent is a tiny tube that functions as a scaffold to support the interior of your coronary artery. The stent is inserted into your constricted coronary artery using a balloon catheter attached to a guide wire. Once in position, the balloon is inflated, and the stent extends to the size of the artery and holds it open. 
   The balloon is then deflated and removed, while the stent remains in place. Your artery recovers around the stent over several weeks. These are frequently used during angioplasty to assist in keeping the coronary artery open. The stent is generally constructed of metal and is intended to be permanent. It might alternatively be constructed of a substance that the body gradually absorbs.
   Some stents contain medication and are intended to lessen the likelihood of the artery becoming clogged again (your doctor may call that restenosis). The doctor will determine if this is the best stent for your obstruction.
   
   
3. Rotablation: It involves guiding a special catheter with an acorn-shaped, diamond-coated tip to the location of the constriction in your coronary artery. The tip rotates quickly and grinds away at the plaque on your artery walls. In your bloodstream, the small particles are flushed away. To enhance blood flow, this practice is repeated as needed. This is rarely used because balloon angioplasty and stenting have much better results. They’re also easier for the cardiologist to perform.
   
4. Atherectomy: On the tip of the catheter is a hollow cylinder with an open window on one side and a balloon on the other. The balloon is inflated when the catheter is inserted into the constricted artery, forcing the window against the plaque. A rotating blade in the cylinder shaves off any plaque that protrudes into the pane. The shavings are captured and removed in the catheter chamber. This practice is repeated as needed to improve blood flow.
   
5. Cutting balloon: This catheter features a unique balloon tip with tiny blades. When the balloon is inflated, the blades turn on. The tiny blades slice the plaque, and the balloon forces it against the arterial wall.

 

What Happens Before Angioplasty?

Before your angioplasty operation, your physician will normally ask you to avoid drinking or eating for a few hours. Tell your doctor about your other chronic disease (e.g. Asthma, diabetes, hypertension) Depending on your circumstances, the angioplasty operation might last from a half-hour to several hours.

When you arrive at the hospital, you will put on a hospital gown. You'll need to tell your provider about any medications you're taking and any sensitivities you have. Your doctor will insert an IV into your arm to provide sedative medication. You can still respond to your provider's queries. You'll also be given medication through your IV to prevent your body from forming blood clots.

 

What Happens During Angioplasty?

This article will focus on coronary angioplasty; however, angioplasty can also be performed on other regions of your body. They may, however, insert the catheter into a different artery than the one used for the heart.

A catheter or tube is passed through your skin and into a blood vessel in your wrist or groin by your physician. They give you drugs to prevent you from feeling the tube enter your body.

A cardiologist, or heart expert, guides the catheter (tube) through your blood arteries to reach your blocked or restricted coronary artery, using X-rays to guide the route. When doctors discharge a dye via the catheter to make it easier to visualize your blood vessels, you may feel warm for a brief period of time.

When they reach the issue location, your physician will insert a wire and another catheter (a balloon catheter) with a little balloon at the end.

When they inflate the balloon, the plaque is moved out of the path and to the side of the artery wall. This opens the route for blood to flow. Your clogged coronary artery is like a crowded subway car with passengers in the aisle. Others must shift closer to the walls in order for people to pass through the aisle. The catheter balloon is analogous to a football team forcing everyone to the side of the subway car so they could pass through the aisle.

Your doctor will next insert a stent, which is a tiny hollow scaffold made of metal. The stent, which is more powerful than a balloon, maintains the artery open when the balloon is removed.

The stent, which your provider extends and secures into place after inserting it into your artery, remains inside your artery even after the angioplasty procedure is completed. Many stents include a medication coating that helps keep your artery from narrowing again.

If you have peripheral artery disease, your physician may utilize a balloon with a medication coating that is transferred to the arterial wall. After the balloon is removed, the medication remains.

When your provider inflates the balloon, you may feel some discomfort, but this goes away when they deflate it. After the balloon has completed its function, your healthcare professional deflates it. The balloon might be inflated several times in the same location or in a different blocked artery in your body.

Your provider can assess how well your blood flowed before and after your angioplasty using an angiogram (X-ray images of your blood arteries).

 

What Happens After Your Procedure?

Your physician will remove the catheters and apply a bandage to the area where the catheters were inserted into your skin. You could feel someone pressing on the cut to stop the bleeding. You can feel painful or bruised afterwards.

 

Is Invasive Cardiology Safe?

Although major problems from an angioplasty are uncommon, every invasive surgery has some risk. For example, during or shortly after an angioplasty, you may require an emergency coronary artery bypass graft. Complications occur in around one out of every 100 procedures, however this number may be greater or lower depending on your specific circumstances.

Other angioplasty risks include:

• Dye reaction.
• Heart attack.
• Abnormal heart rhythm.
• Stroke.
• Blood vessel or kidney damage.
• Blood clots.
• Chest pain.
• Bleeding.
• A repeat blockage if a stent isn’t placed in your artery.

The risk of angioplasty complications is higher for older adults or people who have several blocked arteries, kidney disease or heart failure.

 

What is the Recovery Time After Angioplasty?

To recover following angioplasty, you'll need to stay in the hospital for many hours, if not overnight. Your doctor will inform you what medications you'll need and how active you can be following your angioplasty. You'll need someone to drive you home from the hospital because you were sedated.

Rest at home and drink plenty of water. Don't do anything strenuous for the following 24 hours. Following your angioplasty operation, you may need to take aspirin or other blood thinners. If your doctor has prescribed blood thinners, it is critical that you take them exactly as prescribed. Don't skip any dosages. If you believe you should stop taking blood thinners, you should consult with your doctor first.

 

Conclusion

If you have coronary artery disease, heart valve disease, or peripheral vascular disease, your best chance of survival is to inform yourself about the therapeutic choices accessible to you. Treatment for these disorders often consists of stopping smoking, exercising, dieting, and taking drugs. However, these procedures may not be sufficient to alleviate symptoms, leaving surgery as the only alternative.

Invasive cardiology, as the names suggest, is employing invasive methods to obtain access to and diagnose cardiac problems. Angioplasty and stenting are frequent invasive treatments that are performed through a femoral artery catheterization. A tiny balloon is attached to a catheter and guided through the femoral artery during angioplasty. This balloon then expands, pressing plaque against the walls of a congested vein. Once the vein has been opened, a stent is implanted to provide medication to the spot while also keeping the artery open permanently.