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What is Heart Disease? How it is Treated?

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Synopsis

1. Coronary Artery Disease is one of the major heart diseases. It is due to blockage happens in coronary artery.

2. Two types of treatment options available for patients with coronary artery disease.

  • Invasive treatment
  • Non-invasive treatment

3. Invasive includes

  • a) CABG - Surgical procedures with high risk and complications.
  • b) Angioplasty – Invasive procedure inserting balloon into the blocked coronary Artery.

4. Non-Invasive - EECP treatment without risk restores the blood supply beyond blocked arteries naturally.

The heart is one of the most important parts of our body, which pumps continuously from the day you are born to your last breath. The heart is the organ which continuously pumps from the day of your birth. For pumping it requires more energy. So that nature has provided three main vessels we call as a coronary artery which supplies blood to the heart itself. The heart is the organ which supplies blood to the entire body. These coronary arteries are the main artery which supplies blood itself to the heart muscle. There are many diseases which affect your heart. In that, the most common and deadliest is what we call as the coronary artery diseases.

So what is coronary artery disease? It is the blockage which happens in the coronary artery, so that blood flow to the heart muscle is completely stopped or it is partially blocked. Wherever there is an obstruction which can happen in the coronary artery the blood to the proximal part or the distal part of the vessels is blocked. So there is a deficiency of the blood flow to the heart muscle. When there is a deficiency of blood flow to the heart muscle we call it as ischemia and the patient develops symptoms called chest pain or Angina.  Whenever the patient exerts himself, walking it causes a chest pain because of the deficiency of blood flow. This deficiency of the blood flow is identified by many investigation procedures. But once they identify that the patient has coronary artery blockage by simple non-invasive investigations like an ECG or treadmill, the physician put him on, what we call as medical management.

There are a lot of other options available for these patients, who have a blockage in the coronary artery and their medical management even though it is optimal or maximal still the patient complaints of chest pain and poor quality of life.  In that case, there are other treatments which are available for this kind of patient called as invasive and non-invasive treatment options. In the non-invasive option available to the patients, one of the important treatment options is called enhanced external counterpulsation. It is absolutely a non-invasive treatment.  Other options the patients might be offered are bypass surgery or angioplasty.  So let ’s look at what is done in the bypass surgery. Now, we know the problem is lack of blood flow beyond the blocked artery. so what is done in bypass surgery is they open the chest. It is a major surgical procedure, which does have a lot of complication and risk. The chest cavity is opened and they take a graft or a vein or artery either from your leg and it called as a saphenous vein graft or it is an artery which is taken from the chest called internal mammary artery graft. 

These grafts are positioned so that the blood can detour through these vessels and supply the area with lack of blood supply. So it can able to restore the blood supply to the area which is deficient because of the blockage in the coronary artery.  Once the blood flow is restored the patient’s chest pain comes down and he can walk more distance. Now for some patients, the cardiologist offers what we call is an angioplasty procedure. Angioplasty involves inserting the balloon in to the blocked artery, so that the block is open or block is pressed against the vessel wall and then to prevent it by reclosure they put wire mesh, which is called a stent and now again the blood is restored to the deficiency area and the patient is free of symptom.

Now the third method which is coming up which we want to go in details is Enhanced External Counter Pulsation (EECP). This is absolutely a non-invasive procedure which acts similarly to what an aggressive exercise does. So it pushes the blood from leg towards the heart. There is the high blood flow volume, velocity and pressure because of this high blood flow the blood tends to find some way across these blocked arteries and we call as collateral. By angiogenesis, new vessels are formed over the blocked arteries. So that the blood can able to detour the blocked arteries by naturally formed new vessels or microvessels. These vessels are able to carry blood to the deficient area and restore the blood supply.  EECP is an absolutely a non-invasive treatment option. It does not carry any of the risk involved in CABG or PTCA and the quality of life improvement patients attained is almost seen in 95% of the patients.  So these are all the options available and one thing I want to point is whether it is CABG or PTCA both are invasive and they required to do an angiogram before these procedures are done and EECP is absolutely a non-invasive treatment Where you able to take the treatment even without undergoing an angiogram and the main important thing is all this treatment work in a similar principle of restoring the blood supply beyond the blocked arteries.

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