Cardiology

Heart diseases and especially coronary artery disease are among leading cause of death in Turkey and around the world. Organs need nutrients and oxygen in order to sustain viability and fulfill functional requirements. The required oxygen and nutrients are carried to organs through arteries. Heart pumps blood to arteries.

Our heart requires nutrients to function. Coronary artery is the vessel that supplies blood to the heart. Our heart cannot receive oxygen and nutrients sufficiently and cannot function properly, when stenosis or occlusion develops in coronary arteries secondary to atherosclerosis. Since the function of pumping blood to the body impairs, amount of oxygen and nutrients carried into our organs decrease over time and various organs show symptoms of failure.

Why should Coronary Angiography be performed?

Early diagnosis and treatment of atherosclerosis is crucial for people with risk factor(s) for heart disease. Here, the aim is to protect the patient against devastating effects of myocardial infarction. For patients with suspicion of coronary artery disease in cardiologic tests such as ECG, echocardiography and cardiac stress ECG (treadmill), a certain diagnostic procedure, called coronary angiography, may be required to verify the diagnosis.

Coronary angiography is a diagnostic method rather than a type of surgery. Coronary angiography images cardiac vessels (coronary arteries) using a special imaging system, after a contrast agent is instilled. Coronary angiography is done at advanced laboratories equipped with an angiography device by well-trained and experienced cardiologists and healthcare personnel. Patient doesn’t need to be anesthetized for this procedure. The patient stays alert and can talk throughout the procedure. Right femoral artery is usually punctured to access coronary arteries in coronary angiography. Inguinal area is anesthetized before the right femoral artery is punctured and a plastic sheath is inserted into the artery. Patient may feel a mild ache in this process. Patient feels nothing in the rest of the procedure. Next, a thin and flexible tube (catheter) is advanced through a plastic sheath into the greatest artery (aorta) from which vessels originate; and it is deployed to origins of coronary arteries in aorta and a contrast agent is instilled into the coronary artery. This allows coronary arteries to be visualized at different projections and location and grade of stenosis can be determined. Administration of contrast agent doesn’t cause pain. However, transient hot flash, redness and nausea can be felt for 20 to 30 seconds, while the contrast agent is administered.

What is arrhythmia (cardiac rhythm disorder )? How is it diagnosed and treated ?

A healthy heart beats 60 to 80 times per minute at rest. The time between each beat is equal or rhythmic, in other words. Heart beats per minute increases when a person is engaged in physical activities such as walking, sports, strenuous work or stress. However, the time between beats is still equal and rhythmic. In the heart, a certain point regulates the rhythm; this point, which generates electric stimulation, may itself produce beats in an abnormal rhythm, or the healthy rhythm stimulations generated by this point are abnormally conducted to myocardium by cardiac fibers. Both scenarios can cause heart beats with abnormal rhythm. Patients may, occasionally, visit their doctors by feeling such abnormal beats, but heart beats with abnormal rhythm can be accidentally detected by the doctor in a routine ECG that is ordered for a reason whatsoever.

Arrhythmic heart beats disrupt blood pumping function of the heart, depending on severity of the problem, and causes formation of blood clots which occlude vessels of heart, lungs, brain and other organs, resulting in acute and fatal problems. Therefore, arrhythmia must be regarded as a crucial cardiac problem which must be treated.

Electrophysiology laboratories are established that are specially developed for patients with rhythm disorder due to a reason whatsoever. Heart beats are examined in detail in these laboratories and diagnosis of arrhythmia is established. Next, efforts are made to clarify whether the rhythm disorder originates from the stimulatory point or conduction pathways. After this procedure, called mapping, is completed, the precise location to intervene at conduction pathways in the heart is determined. Radiofrequency energy is delivered to these abnormal conduction points using catheter technique in coronary angiography laboratory and the foci that generate abnormal rhythm are destructed, and thus, normal cardiac rhythm is restored.

Tags: Cardiology, Cardiac Rhythm, Cardiologist, Coronary Angiography