Treatment

Treatment

Aortic Aneurysm: If the aneurysm is small, it is treated with help of medication so that the aneurysm can be relived. Medicines administered lower blood pressure, relax blood vessels and decrease the risk that the aneurysm will burst. Surgery is recommended when the aneurysm is not treatable with medicines. The first type of surgery is called Open Abdominal or Open Chest Repair surgery. This type of surgery involves a major incision made in the chest or the abdomen. The aneurysm is removed, followed by replacement of the section with a graft made of material like Dacron or Teflon. If required, the aortic valve of the heart is also repaired during the open chest or abdominal surgery. Another surgical procedure related with this disease is Endovascular Repair in which the aneurysm is not removed but a graft is inserted in the aorta to give it strength. The procedure involves insertion of a catheter in the groin which is then threaded to the location of the aneurysm. Using an x-ray to see the artery, a graft is then threaded into the aorta and guided to the aneurysm. The graft is then expanded and secured in place to form a stable passage for blood to flow preventing the rupture of the blood flow.

Myocardial Infarction: This term is commonly known as heart attack. The surgical intervention in this type of disease is called Aorto-coronary bypass surgery. The purpose of this surgery is to bring oxygen rich blood flow to the muscles of the heart. In this procedure, healthy blood vessel is taken from another part of the body and used to form a bypass around the sick artery supplying blood to the heart.

Cardiomyopathy: Treatment for this disease is spanned across lifestyle changes, medicines, surgery, implanted devices to correct irregular beating and/or a non-surgical procedure. A healthy diet consisting of balanced nutrients is prescribed keeping saturated fats and cholesterol at the minimum. Also intake of sodium (salt) is reduced to prevent high BP. Food low in processed sugars should be preferred. Complete avoidance of alcohol and smoking is advised. Medicines administered for treatment are ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers that lower blood pressure. Beta blockers, calcium channel blockers, and digoxin are prescribed to slow the heart rate. To prevent irregular heart-beats, antiarrhythmics are used. Diuretics are prescribed to remove excess fluids in the body. Anti-coagulants are used to prevent blood from clotting. As far as surgery is concerned Septal Myectomy is performed on patients who have obstructive hypertrophic cardiomyopathy and severe symptoms. During this surgery, the doctor removes the part of thick septum that is protruding into in the left ventricle. This improves the blood flow through the heart and the removed tissue does not grow back. The mitral valve can too be repaired or replaced at the same time. The procedure is often successful and the patient returns back to normal life with no symptoms. Surgically implanted devices are used to treat this disease; one example is a pacemaker that is inserted under the skin of chest or abdomen which prompts through electrical impulses the heart beats. There is also the CRT (cardiac resynchronization therapy) that coordinates between the heart’s left and right ventricles. A left ventricular assist device is used to help the heart pump blood into the body. It is used as both long term therapy and for short term in patients waiting for a transplant. Implantable cardioverter defibrillator is used to disrupt life threatening arrhythmias and shock the heart when there are dangerous rhythms developing. Heart transplant is used to treat patients who have end-stage heart failure that is, when none of the treatments above are working. In this procedure the patient receives a healthy heart from a deceased donor.

Atrial Fibrillation: Treatment of this disease depends upon the nature and frequency of symptoms. Treatment objectives are prevention of formation of blood clots reducing the risk of stroke, controlling how many times ventricles contract, restoring a normal heart rhythm and treatment of any underlying disorders that are causing atrial fibrillation. Blood clot prevention comes first which is achieved by blood thinning medications like warfarin, dabigatran, heparin, and aspirin. Medication is prescribed to control the rate of heart beats. These medications include beta blockers such as metoprolol and atenolol, calcium channel blockers (diltiazem and verapamil), and digitalis (digoxin). Controlling heart rhythm works for patients who are not benefitted from rate control medications. These include amiodarone, sotalol, flecainide, propafenone, dofetilide, and ibutilide or older medication like quinidine, procainamide, and disopyramide. The administration of medication for atrial fibrillation can cause arrhythmias of several types. These medications can also cause harm to patients who have an underlying disease of the heart or other organs. This is especially true for individuals who suffer from the unusual heart rhythm disease called Wolff-Parkinson-White syndrome. The dosage in these cases is determined on the basis of reaction to the medication. As far as procedures are concerned, there are several of them that restore a normal heart rhythm. One such procedure utilizes electrical cardioversion for treatment of fast or irregular heart rates. In this procedure, low energy shocks are administered to restore normal heart rhythm while the patient is put to a temporary sleep. This is not same as the emergency heart shocking procedures one sees on TV programs. Transesophageal echocardiography (TEE) is done before this procedure to rule out the possibility of there being a clot in the heart in which case blood thinning medications are given. Catheter ablation is the procedure that is done in cases where medication and electrical cardioversion do not work. In this procedure a wire is inserted in a vein in the leg or arm and threaded to the heart. A pulse of radio wave energy is transmitted through the wire enabling the destruction of the abnormal tissue that is obstructing the normal flow of electrical signals. This procedure is usually carried out by an electrophysiologist in the hospital where TEE may be carried out before the procedure to rule out the possibility of a blood clot in the atria. Sometimes, doctors use catheter ablation to destroy the atrioventricular node. The AV node is the location from where the heart’s electrical signals pass from the atria to the lower ventricles of the heart. This procedure also involves a surgical implantation of a device called a pacemaker, which helps to maintain the normal rhythm of the heart. Another method to restore a normal heart beat is through maze surgery in which the surgeon makes small cuts and or burns in the atria which prevents the spreading of the disorganized electrical signals. Maze surgery requires an open heart surgery and is usually done when a person is being operated upon for other reasons such as heart valve disease.