Cardiology

The heart is a four-chamber organ that pumps oxygen and blood to all the other organs and muscles in the body. The heart needs its own oxygen and blood supply to perform this demanding job. Coronary arteries feed the heart muscle its oxygen and blood supply. Plaque deposits, usually made of cholesterol, fats, fibrous tissue and white blood cells, can develop on the wall of these coronary arteries. These plaque deposits can become unstable and rupture due to high-blood pressure, smoking and a high-cholesterol, high-fat diet. When the plaque deposits crack or rupture, white blood cells and fat leak into the blood stream forming a clot. Because the blood clot stops blood flow through the artery, the heart muscle is deprived of oxygen and blood. After 20 minutes of no blood flow to a certain area of heart muscle, that area of muscle dies. This is called a heart attack or myocardial infarction.

A stroke is an injury to the brain that may also severely affect the body. A stroke happens when blood supply to part of the brain is cut off or when there is bleeding into or around the brain. This can happen if a blood clot blocks an artery in the brain or neck or if a weakened artery bursts in the brain. Risk factors for stroke include high-blood pressure, smoking, heart disease, diabetes and a high red blood cell count. The risk of stroke also increases with age. Heavy alcohol use increases your risk of bleeding (hemorrhagic) strokes. The warning signs for a possible stroke may include a sudden, temporary weakness or numbness in your face or in your arm or leg; trouble talking or understanding others who are talking; temporary loss of eyesight, especially in one eye; double vision; unexplained headaches or a change in headache pattern and temporary dizziness or staggering when walking.

Coronary angioplasty, also called PCI and PTCA is a treatment for coronary heart disease. It can help improve the blood supply to your heart muscle by widening any narrowed parts of a coronary artery. People who have had a heart attack sometimes have an angioplasty as an emergency treatment.

1. You will be given a local anaesthetic in your wrist or at the top of your leg (groin) to numb the area.

2. The doctor will put a narrow flexible tube called a catheter into an artery in your wrist or groin. It will have a small balloon at the end.

3. The catheter is carefully pushed up to your heart and into the coronary arteries.

4. The doctor will inject some dye into the tube so your heart arteries show up on an x-ray screen. It’s normal to feel a hot flushing sensation when the dye is injected.

5. The tip of the catheter is moved into the narrowed section of the artery.

6. The balloon is gently blown up so that it squashes the fatty deposits against the artery wall. This widens the artery so the blood can flow more easily.

7. A stent (a small hollow tube of stainless steel mesh) may need to be placed inside the artery. This means putting in another tube, which has a stent in position on the balloon. As the balloon is blown up the stent opens up inside the artery.

8. The balloon is let down and the tube is removed. The stent is left in place to keep the artery open.

It’s unusual for anyone to have a reaction to the dye, but a small number of people are allergic to it. If you’ve already had any test that uses dye and you’ve had a reaction, tell the doctor before you have an angiogram or angioplasty.

Atherectomy is a procedure to remove fatty plaque from the arteries. This is a minimally-invasive vascular treatment that may be used for patients who are diagnosed with Peripheral Arterial Disease (PAD).

An angioplasty uses a special catheter with a balloon that can inflate to open blockages in the artery and then placing a stent to restore blood flow. An atherectomy uses a laser or a sharp blade to remove the plaque build up.

It is a minimally invasive procedure and requires no hospital stay with a short recovery period. Other benefits include:

• Small incisions

• Less pain

• Low risk of infection

• Quick recovery time

• Less scarring

• Reduced blood loss

• Lower rate of complications

Any procedure that involves the placement of a catheter inside a blood vessel carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. The chance of any of these events occurring is less than one percent. the experience of vascular doctors help minimize risk.

Coronary bypass surgery is one treatment option if you have a blocked artery to your heart. You and your doctor might consider it if:

• You have severe chest pain caused by narrowing of several arteries that supply your heart muscle, leaving the muscle short of blood during even light exercise or at rest.

• You have more than one diseased coronary artery, and the heart's main pumping chamber — the left ventricle — isn't functioning well.

• Your left main coronary artery is severely narrowed or blocked. This artery supplies most of the blood to the left ventricle.

• You have an artery blockage that can't be treated with a procedure that involves temporarily inserting and inflating a tiny balloon to widen the artery (angioplasty).

• You've had a previous angioplasty or placement of a small wire mesh tube (stent) to hold the artery open that hasn't been successful. Or you've had a stent placement, but the artery has narrowed again.

Coronary bypass surgery might also be performed in emergency situations, such as a heart attack, if you're not responding to other treatments.

Varicose veins are actually quite common and affect up to 30% of the population. They are more often seen in women who have had children although there is also a strong genetic component as well. Most patients with varicose veins have either a mother or father with a history of varicose veins. Patients that are obese and have spent long hours standing can also have a higher incidence of varicose veins as well.

Varicose veins can cause a whole spectrum of disease including pain, itching, swelling, heaviness and fatigue. In the most severe cases they can bleed or cause ulceration (skin tears) which can be quite difficult to heal.

Aside from weight loss, there really is no way to prevent varicose veins. The symptoms however are quite easily treated with simple compression stockings. These come in a variety of sizes, shapes and colors and can be either prescription or over the counter. Only knee high compression stockings are needed in the vast majority of patients and they only need to be worn during the day. Being vigilant with them is oftentimes enough to improve symptoms and prevent them from worsening.

The most common form of treatment in contemporary practice is either radio frequency ablation or laser ablation of the varicose vein. This procedure is typically done in the office without sedation or anesthesia. A small needle is inserted into the vein after the skin in numbed and a catheter (about the size of a piece of spaghetti) is placed in the vein. The area around the vein it is numbed and the catheter is then turned on which treats the entire vein. There is minimal discomfort during the procedure and after the procedure is over the leg is wrapped up with a wrap for support.

Another treatment option involves injecting a medicine into the vein that chemically treats the vein. The medicine is very safe (it is essentially a soap like substance) and only takes about 5 minutes.

Although varicose veins aren’t usually dangerous, you should visit your healthcare provider for an exam. If you’re concerned about how varicose veins look, or if they’re uncomfortable, treatments can help. You should see your provider as soon as possible if the skin or veins are:

• Bleeding.
• Discolored.
• Painful, red or warm to the touch.
• Swollen.

Millions of people live with varicose veins. For most people, varicose veins don’t cause serious health problems. Lifestyle changes and at-home remedies can relieve symptoms and prevent them from getting worse. Talk to Tour for Cure about safe, minimally invasive treatments that can reduce pain and improve the appearance of varicose veins.

Varicose veins and spider veins are both types of venous disease, but they look different. Spider veins are smaller and thinner than varicose veins. They look like red or blue spider webs or branches of a tree, and they are close to the skin’s surface.

Spider veins aren’t usually painful. They can appear anywhere on your body, most often behind your knee, on your feet or on your face. Varicose veins usually appear on your feet and legs.

You may not be able to prevent varicose veins. You can reduce your chances of developing them by living an active, healthy lifestyle. Healthcare providers recommend many of the same measures to prevent and treat varicose veins:

• Avoid long periods of standing: To encourage blood flow, take regular breaks to stretch and walk around, especially if you have a job that requires you to be on your feet.

• Elevate your legs: Raising your feet above your waist helps blood flow to your heart.

• Maintain a healthy weight: Getting rid of excess pounds reduces pressure inside your blood vessels.

• Quit tobacco use: Smoking damages blood vessels, decreases blood flow and causes a wide range of health problems.

• Stay active: To improve circulation, move frequently and avoid sitting still for prolonged periods.

• Try compression stockings: Support socks and pantyhose compress your veins and help blood circulate, which can prevent varicose veins from getting worse.

• Wear clothes that fit properly: To encourage blood flow, make sure your waistband isn’t too tight.

Varicose veins are close to the surface of your skin and easy to see. Healthcare providers can diagnose the condition during a physical examination. They’ll feel your veins and examine them while you’re sitting and standing.

To see detailed images of your veins and check for complications, your provider may recommend an ultrasound. This safe, painless test uses sound waves to produce pictures of tissues inside your body. Ultrasounds can show blood clots and how your valves are working.

• Which treatment is best for me?

• Can you do treatments in your office?

• What’s the most cost-effective treatment?

When varicose veins go untreated, the veins continue to get more damaged, which ends up making the pain worse and the legs swollen.