Last time on Heart Health, the focus was what you need to do if you think there might be something wrong with your heart.
This week, we're turning the focus to what happens when something's not quite right.
Kristie VerMulm: Now the test shows the person has actually abnormal test then what?
Dr. Ramin Artang: We have situation where the person has either high risk or actually has symptoms plus abnormal stress test. The next step is to do an angiogram. An angiogram is an invasive procedure where we access the arterial system with catheters. The purpose to visualize all the coronary artery vessels and see if there is a truly a blockage, which vessel, how narrow. Based on the result we plan how to open the blockage, either with balloon and stints, or if there is multiple vessel disease considering bypass surgery.
Kristie VerMulm: Is it dangerous or risky to have this procedure done?
Dr. Ramin Artang: It is considered an invasive procedure. So every time we go from a non invasive such as stress testing to an invasive procedure, the risk of having complication related to the procedure gets slightly higher. That is the reason why we don't send everybody to the catheterizing and only select them who really need to have it, where the benefit from having it done outweighs the risk on possible complications. Usually every time a needle and catheter is involved the is risk of bleeding and vascular complication. The overall risk of any bad thing happening is still low and somewhere between 1 in 500 to 1 in 1000 cases according to most text books.
Kristie VerMulm:Now a blockage is found, what next?
Dr. Ramin Artang: Depending on the location and size of the vessel, we plan to open it back up. In about 8 out of 10 cases, this can be done by using balloon and stint. The older the patient and if there are more risk factors involved then it is likely that there may be more than 2 vessels involved. In patient with multiple vessel blockage, then open heart surgery with coronary bypass may be a better long term solution. That of course is a bigger deal, usually a 4 hour surgery where the chest is opened up. The technology however has changed significantly since we started doing these surgeries and these days patients will recover from surgery in 4-7 days.
Kristie VerMulm: Lets say, patient had a stint and it looks nice and open, then what?
Dr. Ramin Artang: Usually they stay in the hospital overnight where we make sure that groin where we accessed the vessel heals nice and we usually discharge the patient the next morning. The real work starts after discharge where the changes in the lifestyle, diet, activity, and medication are crucial for keeping the person free of disease over the foreseeable future. If that does not happen, the person will be back within a year or so with similar problem.
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