Cardiothoracic and Vascular Surgery

Overview

The Cardiothoracic and Vascular Surgical team in Aster RV has the right blend of skill and experience to perform almost the whole range of Surgical procedures in the specialty. The team is available to full time and has dedicated operation theatres and a team of technical support staff. This makes the care of the patient undergoing Cardiothoracic surgical procedures better and hence the outcomes are superior.

Key Procedures

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FAQs:

What is a heart attack?

In some patients, the blood supply to a part of the heart muscle stops suddenly. This happens most often due to the formation of a clot inside one of the three coronary arteries supplying blood to the heart muscle. When this happens, the heart muscle that receives blood from the respective coronary artery gets damaged. This is termed as a heart attack.
It is advised to quickly visit the Best Cardiology Hospital in Bangalore nearby to get treated by a cardiologist. 

Are heart attacks hereditary or can they be age-dependent?

Family history plays an important role in the causation of heart attacks. The risk of a heart attack in a person more than doubles if a first-degree relative (parents, siblings, or children) has had a heart attack in the past. 

While there are exceptions, heart attacks are generally seen in older adults. The typical age for a man to have a heart attack is 55 years and above and for a woman it is 65 years and above.

When heart attacks are seen in men younger than 55 years and women younger than 65 years it is termed as Premature Heart Attack or Premature Coronary artery disease.

In India, during the last two decades, more and more adults who are younger have been noted to have heart attacks. Studies have shown that between 15-22% of all heart attacks are seen in adults younger than 40 years of age.

Are there different types of heart attacks? If so, what are they?

Based on the variation in the ECG during a heart attack, doctors recognize two types of heart attacks. 

  • ST-elevation Myocardial Infarction (STEMI) 
  • Non-ST-elevation Myocardial infarction (NSTEMI). 

STEMI and NSTEMI differ not only in the variation in the ECG but also in their severity. In general, STEMI is more likely to be immediately fatal or disabling than NSTEMI. Consequently, STEMI requires more urgent treatment than NSTEMI in most instances.

However, this is just a thumb rule: Some NSTEMIs can be equally ominous and may require emergency treatment just like STEMI.

Do all types of heart attacks have the same symptoms?

Of course not. Symptoms of heart attack can vary from case to case. The commonest symptom of a heart attack is chest pain. This is seen in about 70% of all heart attack patients. The remainder can present with breathlessness, arm or back pain, cold sweats, loss of consciousness, or palpitations. Some patients may have no symptoms at all and are said to have a Silent Heart attack.

If you experience any of these symptoms, then immediately consult the Best Cardiologist in Bangalore.

What are the specific tests required to diagnose heart disease?

Patients suspected to have a heart attack require to undergo ECG or electrocardiogram immediately. If the initial ECG is not diagnostic but the symptoms and signs are highly suggestive of a heart attack, repeating the ECG after 30-60 minutes and performing a blood test to detect high levels of cardiac enzymes such as Cardiac Troponins or CK-MB are additionally useful. Old heart attacks are often diagnosed based on ECG or Echocardiography.

How do a heart attack and stroke differ?

A lot of people use these terms interchangeably.

Heart attack refers to damage to the heart muscle. Stroke refers to paralysis of limbs or face or any other neurological function due to damage to the brain resulting from clotting or bleeding in the blood vessels of the brain. They are clinically different and the terms should ideally not be interchanged.

What time of the day does one usually get a heart attack?

Heart attacks can occur at any time of the day. However, due to various neuro-hormonal variations associated with the circadian rhythm, some clustering of heart attacks is noted in the mornings between 6 am and 12 noon. Some physicians have noted more heart attacks in the wee hours, i.e., between 3 and 6 am.

What should I do if I have symptoms suspicious of a heart attack?

First, seek help. Make any person in proximity aware of your situation. The most important step to ensure a safe outcome in a heart attack is to see that you reach a hospital with appropriate facilities as soon as possible. It is a good practice to be aware of the hospitals around you and the facilities they provide.

When someone has chest pain or other symptoms suggestive of a heart attack, the immediate first aid should be to take 350 mg of the soluble form of Aspirin (common trade names Disprin or Aspisol in India). Ideally, the tablet should be chewed because the medicine is absorbed from the mucosal membrane of the oral cavity and starts to act immediately. If the patient cannot chew the tablet for some reason, the tablet can be dispersed in a small quantity of water and taken orally. 

If I see someone who is having a heart attack, what can I do to ensure he survives till help arrives?

Call the nearest hospital with cardiac facilities as soon as you recognise that someone around you might be having an ongoing attack. Shift the person to a comfortable position and reassure them. If possible, give them an Aspirin tablet to chew. While waiting for help to arrive, monitor their breathing and pulse. If they lose consciousness, initiate Cardiopulmonary resuscitation (CPR).

What are the common causes of heart disease?

Various risk factors increase the chances of a person having a heart attack. Smoking, High Blood pressure, Diabetes. physical inactivity, high cholesterol levels, obesity, and poor diet are important risk factors. These can be potentially controlled to reduce heart attack risk. Therefore, these are termed Modifiable Risk factors.

Older age, male sex, family history, Post-menopausal state in women are factors that can increase heart attack risk but cannot be altered. These are called non-modifiable risk factors.

South Asians appear to have a very high risk of having heart attacks at a younger age, compared to Caucasians and Asians such as Japanese.

How can I reduce my risk of developing heart disease?

A disciplined lifestyle would not only take care of the heart but also keep other diseases at bay. The key changes are

  • Quit smoking
  • Exercise regularly
  • Maintain a healthy weight
  • Control blood pressure and diabetes well
  • Keep cholesterol levels in check
  • Manage stress 

How are heart attacks treated?

As soon as a diagnosis of heart attack is made, blood-thinning medications (Aspirin, Clopidogrel are common ones) are administered. The definitive treatment is Coronary angiography followed by primary coronary angioplasty to restore blood flow in the coronary artery causing the attack.

However, if for some reason, angioplasty cannot be performed, certain medicines (thrombolytic drugs, or clot busters) are administered in the form of injections. Primary Angioplasty is a more effective and safer form of treatment for a heart attack, but in some circumstances (e.g., remote areas) these drugs can be life-saving.

What is Coronary Angiography?

It is a procedure to detect blockages in the blood vessels of the heart. A thin hollow tube or catheter is inserted via the artery of the forearm or the thigh. Through this catheter, a special contrast dye is injected into the coronary arteries and X-ray images are obtained to visualize the blood flow in the coronary arteries.

What is Coronary Angioplasty?

Coronary angioplasty is a procedure performed to widen narrow or blocked sections of the coronary vessels thereby restoring the blood flow. A thin balloon is inserted into the coronary artery and inflated at the site of the block to widen the narrowed artery. This makes a way for the opening of the blockages. A stent is generally then placed to prevent future blockages.

Can a stent get blocked again? Is it possible to insert another stent in the same place?

Yes. In about 5-10% of patients, especially those who are not on medication, have uncontrolled diabetes, develop kidney failure, or continue to smoke, stents can show narrowing (restenosis). If a disciplined lifestyle is not followed, new blockages can appear in other areas of the vessels too. 

Stent restenosis can be treated by balloon angioplasty, a second stent, drug-coated balloons, or by Bypass surgery.

What is Coronary Artery Bypass Grafting (CABG) Surgery?

Coronary Artery Bypass Grafting (CABG) is a procedure where a surgeon makes new routes (bypass) around blocked or narrowed coronary arteries with one or more grafts allowing increased blood flow to the vessel past the blockage. These grafts are typically healthy blood vessels from the chest, arm, or leg of the patient.

Is bypass surgery a permanent solution for heart blocks? 

No treatment for coronary blocks can be considered a permanent solution. A small number of patients can have the failure of bypass surgery very early. In a majority, Bypass surgeries can help to feel better and prolong life for over 10-15 years. Again, lifestyle and adherence to medical advice after bypass surgery are of paramount importance in keeping the procedure durable. Visit Best Heart Hospital in Bangalore to avail of advanced heart surgeries or procedures. 

What are the precautions to be taken post a heart surgery or angioplasty?

It is important to maintain a healthy lifestyle post a heart surgery includes: Quit smoking. Eat a healthy diet that is low in saturated fat. Lower your cholesterol levels. Try to maintain a healthy weight. Exercise regularly. Control other conditions, such as diabetes and high blood pressure. Do not skip any medications prescribed by your doctor.

What are the various types of heart diseases?
There are various types of disorders related to the heart.

  • Congenital heart disease is a defect of the heart which are present since birth.
  • Arrhythmias are abnormal heart rhythm or irregular heartbeat affecting the electrical conduction.
  • Coronary artery disease is caused by the narrowing of the coronary arteries leading to the decreased blood supply to the heart.
  • This can potentially lead to angina,  heart attacks, weakening of the heart muscle, or sudden death.
  • Cardiomyopathy refers to diseases affecting the heart muscle. Some types of cardiomyopathy are genetic, while others occur because of an infection or reasons that are less well understood. 
  • Heart failure happens when the heart is not properly pumping blood throughout the body. In this condition often the heart's pumping capacity is reduced.
  • Valvular heart disease affects how the valves function to regulate blood flow in and out of the heart chambers. 
  • Hypertension is a condition in which the blood vessels have persistently increased pressure, putting them under increased stress. It is often known as high or raised blood pressure,
  • Pericardial diseases affect the outer layer (pericardium) of the heart. It can be affected by a variety of conditions that include inflammation (pericarditis), stiffness (constrictive pericarditis), and fluid accumulation (pericardial effusion). 

What is Normal blood pressure?

Normal blood pressure is defined as blood pressure of 120 mmHg systolic, 80 mmHg diastolic. Blood pressure of 140/90 or higher is termed as hypertension.

What causes high BP or hypertension? 

The cause of high blood pressure is unclear in most people. However, older age, physical inactivity, poor diet, obesity, kidney problems, alcohol use, certain birth control pills, and persistent stress can all contribute to the development of hypertension.

People with high blood pressure usually have no signs when their blood pressure is excessively high, or if they have already had high blood pressure.

Why is high blood pressure dangerous?

Higher the blood pressure, higher is the risk of damage to the heart and blood vessels in major organs such as the kidney and brain. 

Uncontrolled hypertension can lead to an enlargement of the heart, heart attack, and eventually heart failure. Hypertension can also lead to blindness, stroke, and kidney failure. 

How to prevent high blood pressure?

  • High blood pressure can be prevented and controlled by maintaining a healthy diet. 
  • Reduce your salt intake. Increase the intake of vegetables and fruits. Avoid saturated fats. 
  • Engage yourself in moderate exercises. Aim for a minimum of thirty minutes of aerobic activity, such as brisk walks for five days a week.
  • Avoid and stop smoking and other tobacco products and avoid alcohol abuse.
  • Reduce stress levels by engaging with fun activities and meditation.
  • If advised medications, please take them regularly.

Does erratic sleep over the long run lead to a potential heart attack? Are the professionals working night shifts at a higher risk of a heart attack?

Yes. Every individual needs at least 6-8 hours of undisturbed sleep. Studies have shown that working night shift meddles with the body’s circadian rhythm, putting it under stress and making it more susceptible to heart problems like irregular heartbeats and heart attack.

What is heart failure?

Heart failure is a condition in which your heart is not pumping normally and is unable to deliver oxygen-rich blood throughout the body. It does not mean the heart has stopped working. It means that it is working at lower efficiency. 

The heart muscle is either too weak and cannot pump blood to the rest of the body with enough force (systolic failure) and/or has trouble relaxing and becomes stiff (diastolic failure). This causes a build-up of fluid (congestion) in the lungs, feet, and other body tissues. This generally develops slowly but can also present very rapidly. 

What is valvular heart disease?

The heart’s valves keep blood flowing through the heart in the right direction. But a range of conditions can result in valvular damage. Valves may narrow (stenosis), not close properly (prolapse) or leak (regurgitation or insufficiency). This can cause your body to be disrupted by the blood flow through your heart.

Is there a link between blood sugar and heart attack?

Anything in excess or deficiency is a problem. The same applies to blood sugar. High blood sugar levels can increase the risk of heart diseases like heart attack and heart failure. Low blood sugar (Hypoglycaemia) can precipitate arrhythmias and heart attacks. Long term uncontrolled blood sugar can lead to blocks in the peripheral arteries like in the brain, legs, and abdomen.

Is there a link between obesity and heart disease?

Yes. Being overweight and obese can cause a high risk of multiple heart problems. It can lead to high blood pressure. Excess weight also increases the chance of atherosclerosis (cholesterol deposits in the arteries causing blocks), abnormal heart rhythms, heart attacks and significantly increases the risk of heart failure.

Visit Aster RV which is one among the Best Cardiac Hospital in JP Nagar, Bangalore to avail advanced treatments and facilities for comprehensive care

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