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Providing a speedy diagnosis, followed by proper treatment allows our patients to receive the best possible prognosis in their recovery to full health. Determining what type of cardiac condition a patient is experiencing is vital in expediting suitable treatment.
CHD is the most common type of heart disease and a leading cause of death in the U.S. It can largely be prevented with healthy lifestyle choices.
The coronary arteries supply blood directly to the heart and are a vital element in the function of the heart muscle. As fatty material and plaque build up in the coronary artery, blood flow is slowed or even completely stopped, resulting in chest pain (stable angina), shortness of breath, heart attack or other related symptoms. This can quickly become a life-threatening emergency.
Any type of damage or blockage to a coronary artery directly affects the heart. As plaque builds and narrows the artery's passageway, the danger of a complete blockage greatly increases. A small clot of blood may attempt to pass through the narrow pathway and become lodged, leading to a lack of oxygen to the heart.
Coronary Artery Disease is caused by a condition called atherosclerosis, or the hardening of the arteries due to plaque buildup. Cholesterol in the bloodstream is the main cause of the plaque buildup. Cholesterol enters the bloodstream a couple of ways: through liver production and consumption of meat and dairy products.
As the plaque collects along the artery wall, it begins to narrow and harden the artery passageway. Eventually, blood flow is slowed and cannot properly feed the heart, which reduces the effectiveness of the heart muscle. The heart muscle attempts to compensate for the lack of oxygen-rich blood by increasing outflow until the muscle becomes fatigued and can no longer function properly.
Another risk of atherosclerosis is embolization, the breakaway of a piece of plaque that can travel to a smaller blood vessel and cause a blockage. This is a common cause of heart attack and stroke. If the plaque finds its way to the heart, lungs or brain, it can cause a stroke, heart attack and pulmonary embolism or contribute to the weakening of an artery wall leading to an aneurysm.
Studies are being conducted on patients with high levels of inflammation-related substances including C-reactive protein and fibrinogen. Increased levels of homocysteine have also been linked to heart attack risk.
It is possible to suffer from coronary artery disease and not experience any symptoms. For others, symptoms are obvious with the most common being chest pain and discomfort (angina). The pain is an indication that the heart is not receiving the proper amount of blood or oxygen. It can be particularly noticeable during increased activity. Patients experience varying levels of discomfort and symptoms including:
Women, the elderly and diabetics are more likely to have fatigue, shortness of breath and weakness as symptoms of coronary artery disease.
If it is suspected that a patient may be suffering from coronary artery disease, a number of physical exams and diagnostic tests can be performed. Lifestyle changes may be recommended to reduce symptoms, prevent further complications and improve heart functioning. The following are helpful in treating and preventing the effects of coronary artery disease:
Cholesterol and triglyceride levels should be checked regularly to avoid the progression of coronary artery disease. It is recommended that adults keep their LDL "bad" cholesterol levels below 130-160 mg/dL. The balance between "good" and "bad" cholesterol levels is important for overall health.
If treatment is recommended, a cholesterol-lowering drug may be prescribed, however, few medications have been found to clear plaque. Some patients may benefit from aspirin or anti-platelet drugs to prevent blood clots. Hormone replacement therapy is sometimes used for menopausal patients. It is important to consult a physician before beginning any type of treatment regimen whether using over-the-counter or prescription drugs.
If necessary, surgery can be performed to treat the condition. Examples of possible surgical treatments include angioplasty, stent placement, abdominal aortic aneurysm repair, coronary artery bypass surgery, carotid artery surgery and minimally-invasive heart surgery.
Contact your health care provider if you are at risk for atherosclerosis, especially if symptoms are present. Consult your physician when starting any type of exercise plan. This is particularly important for patients with coronary heart disease or those who have experienced a heart attack.
A recipient of the American Heart Association's "Get With the Guidelines" Heart Failure and Stroke Gold Performance Achievement Award in 2012, Littleton Adventist Hospital ensures that each patient receives excellent care and treatment in cardiac services.
Heart failure may affect only one side of the heart, however, the condition more commonly affects both sides. As the heart works to provide enough blood to feed the body, it overextends itself and eventually becomes weakened. The kidneys respond to this condition by causing the body to retain
water and sodium. Fluids collect in the arms, feet, ankles and other organs and the body becomes congested - and is termed congestive heart failure.
Heart failure occurs when disease affects the heart in one of the following three ways:
1. Weakening the heart muscle.
2. Stiffening the heart muscle.
3. Increasing the demand for oxygen by the body's tissues beyond what the heart can supply.
Your heart fills and empties with each beat. The filling process is called diastole and the emptying process is called systole. When the lower chambers (ventricles) of the heart contract, blood pumps out to the rest of the body. After emptying, the
heart muscles relax and blood flows from the upper chambers (atria) of the heart into the ventricles.
Both systolic and diastolic heart failure result in the deficiency of oxygen-rich blood throughout the body. The effects are particularly noticeable during exercise or increased activity.
Some patients show no symptoms prior to heart failure.
If congestive heart failure is suspected, a full evaluation may be performed to determine the condition of the heart.
The following are tests that may be ordered:
These, along with urine, blood chemistry and other lab tests can provide further information on the severity of the condition and help physicians determine the best care for the patient.
Centura Health at Home is the first in Colorado to implement a
telehealth system that allows us to monitor patients through the use of a two-way video monitoring station. This ability to see patients in-between regular home visits allows Centura Health at Home to reinforce the education process and to maintain closer contact with patients.
If the heart is in danger of heart failure, exams will be scheduled every three to six months to monitor the progression of the disease. One way to track the condition at home is to watch for weight gain - increased water retention can be a sign that
the heart is worsening.
Other helpful suggestions include:
Some cases may require heart valve surgery, coronary bypass surgery (CABG) or angioplasty to improve the functioning of the heart.
Certain devices may be recommended including:
When heart failure is severe or a patient is awaiting a heart transplant, the following my be required:
These devices are not permanent solutions but can be life saving. If a patient becomes dependent on circulatory support, a heart transplant will be necessary.
Contact a physician if experiencing weakness, increased cough or sputum production, sudden weight gain or swelling or unexplained symptoms.
It is the leading cause of
death in the U.S., however, up to 95% of patients hospitalized due to a heart attack survives. Littleton Adventist Hospital is more than 30 minutes faster than the national standard for heart attack intervention.
Myocardial infarction, commonly referred to as a heart attack, occurs when the blood supply to the heart has been blocked and prevents oxygen from reaching the heart. A mild form of myocardial infarction is called acute myocardial infarction (AMI).
An ST-segment elevation myocardial infarction (STEMI) is a type of heart attack that takes place when the coronary artery is completely blocked off by a blood clot. While the signs and symptoms are similar to a non-STEMI, a STEMI is more severe with a larger portion of the heart already in danger of damage or death.
A heart attack is often caused by a blood clot in one of the coronary arteries, which slows or stops the amount of blood and oxygen to the heart. When the blood flow to the heart is blocked, the cells in the heart begin to die.
A second cause of a heart attack is a condition referred to as atherosclerosis, when plaque builds up in the walls of the coronary arteries. A heart attack may be induced by sudden, significant emotional or physical stress. Other contributing factors of a heart attack may include:
Symptoms of a heart attack are often slow to progress and may even come and go. It is important to recognize them and seek medical attention immediately. Men and women experience different symptoms of a heart attack .
If any of the above symptoms are present, it is important to call 911 immediately. Every minute counts. Giving symptoms five minutes to subside may be too long to wait if you are experiencing an actual heart attack. Dialing 9-1-1 is the fastest way to receive medical attention, as an EMS team is
prepared to care for a patient experiencing heart failure and has lifesaving equipment on board. A patient riding in an ambulance will receive medical care up to one hour before a patient riding in a car to the hospital.
While a heart attack may not always be stopped, there are ways to assist in preventing one.
A heart attack is a serious condition. If symptoms of a heart attack are experienced, it is important to seek medical attention immediately.
Tests a physician can provide to examine the heart include:
There are also blood tests that can be given:
While traditional heart attacks are generally caused by a physical blockage of an artery resulting from plaque buildup, these types of heart attacks occur from sudden, reduced blood flow to the heart produced by a surge of stress hormones. X-rays
of Takotsubo patients reveal a bulging of the left ventricle created by increased levels of fight-or-flight hormones such as adrenaline and epinephrine.
Drawing media attention in the month of February, and on Valentine's Day, this condition is often referred to as Broken Heart Syndrome because of its connection to lost love. First discovered in Japan, it is also termed Octopus Heart, as the ballooning of the left ventricle of the heart
takes the shape of the "Tako-tsubo," a pot used by Japanese fishermen to trap octopus.
Most commonly occurring in post-menopausal women, this stress cardiomyopathy, or sudden weakening of the heart, is often triggered by the unexpected death of a loved one, a relationship break-up, a startling medical diagnosis or a severely stressful emotional situation. Most patients survive this type of heart attack with a rapid recovery of about one
week to full health, and no lasting side effects, as the patient is generally in good health and lacks physical indications of heart problems; thus the mystery behind this condition.
Takotsubo mimics a heart attack with similar symptoms, such as chest pain and shortness of breath. It should be treated as a serious medical emergency - dial 911 immediately.
Some side effects of the condition may include an irregular heart beat and fluid in the lungs. A short hospital stay may be necessary to monitor these symptoms. A second occurrence of Takotsubo is also a risk, particularly if the patient is still
experiencing an increased amount of stress.
Many diagnosis of Takotsubo are performed in an emergency setting, however, if the appointment is made ahead of time and symptoms can be explained in detail, it can be helpful. Patient journals of stress and symptoms should be detailed as to the types of
symptoms experienced, as well as the emotional state of the patient before, during and after.
Because this condition may first appear to be a traditional heart attack, it is treated as such until a diagnosis is confirmed. Treatments used for arterial blockage, such as angioplasty or stent placement, which would be performed for a regular heart
attack, will not help patients suffering from Takotsubo. Blood pressure medications may be prescribed as the patient recovers in the hospital and beta-blockers are sometimes used long-term to help reduce the effect of stress hormones on the heart muscle. A one-week hospital stay to
monitor a complete recovery is often the extent of the treatment required.
What are the Signs of Sudden Cardiac Arrest?A person suffering SCA immediately loses consciousness. The affected person does not have a pulse and signs of breathing are not present.
What are the Risk Factors?An individual may be at risk if he/she has a family history of heart disease, smokes, drinks too much alcohol, has high blood pressure or high cholesterol, obesity and diabetes. The chance of experiencing sudden cardiac arrest is increased with age, especially after age 45 for
men and 55 for women. A person may be at risk for SCA if he/she has or is currently experiencing any of the following:
Early Diagnosis and ScreeningAlthough sudden cardiac arrest cannot be anticipated, there are several steps and invasive and non-invasive tests to determine if someone is at risk:
PreventionWhile there are factors contributing to sudden cardiac arrest that cannot be controlled, there are preventative measures that can help reduce the chances of suffering sudden cardiac arrest:
Automated External Defibrillator (AED)
An automated external defibrillator (AED) is a medical, mobile device used to check an individual's heart rhythm. An AED also recognizes when a person's heart rhythm needs a shock and advises the rescuer that the patient's heart needs a shock. Typically,
an AED is used when a person suffers from cardiac arrest and the heart's activity is disrupted or unusually fast (ventricular tachycardia) or irregular (arrhythmia). A normal resting heart rate is 60 - 100 beats per minute.
Today, AEDs may be found in common community locations including police and emergency vehicles, shopping centers, office buildings, sports arenas, schools and airplanes. Most cardiac arrests occur in private homes where AEDs are not readily available.
Keeping an AED in private homes is greatly encouraged, as it has proven to save thousands of lives.
How Does an AED Work?An AED is an emergency, portable device. It offers step-by-step voice-automated instructions to guide a user through the process. The rescuer places electrode pads on the person's chest, and the AED measures the heart rhythm. The AED will determine whether or not the
patient's heart needs a shock. If the patient requires a shock, the AED will instruct the user to push the button that sends the shock.
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