PROMISING DEVELOPMENTS
Over 85% of angioplasty patients get stents, which reduce the need for follow-up procedures by about 33%. But complications such as blood clots and vessel scarring persist. Scientists, are hoping to bypass these problems by coating the stents themselves with medications that combat tissue growth and clots.
>A PHENOMENON KNOWN AS 'ASPIRIN RESISTANCE' has doctors perplexed. In some people aspirin doesn't adquately block thromboxane, the chemicals that gets platelets to form life-threatening blood clots. Check if this phenomenon is evident in you--and whether you may need a prescription antiplatelet medication like clopidogrel (Plavix).
If your angina doesn't ease up with beta-blockers or nitrates, your doctor may recommend a calicum channel blocker. By reducing the heart's oxygen demands and dilating its blood vessels, these drugs can give enormous relief. Such benefits have made newer cacium channel blocker such as amlodipine (Norvasc) and verapamil (Isoptin), as well as long-acting nifedipine (Adalat Oros), popular for CHD.
If your cholestrol is high and a heart-healthy diet isn't doing the trick, cholesterol-lowering drugs like the statins can make a big difference. Pravastatin (Pravachol) and simvastatin (Zocor) can
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This procedure restores blood flow to the heart. In a healthy coronary artery (1), blood flows through freely, effortlessly making its way to the heart. If plaque builds up along the inside of the artery (2), the vessel narrows, hindering circulation. During angioplasty, the surgeon inserts a ballon-tipped catheter into an artery through a small incision (usually in the groin), and guides it to the troubled coronary artery. The doctor then inflates the balloon (3), compressing the plaque against the vessel wall and widening the artery as a result. Once again, freshly oxygenated blood can course freely to the heart. In some cases, a small and permanent metal mesh tube called a stent (4) is inserted to stabilise and literally prop open the artery.
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prevent heart attacks and deaths in CHD sufferes. Researchers are hoping that the newer statins--fluvastatin (Lescol), atorvastatin (Lipitor)---will be even better LDL-lowerers.
Sometimes doctors recommend ACE (angiotensin--converting enyzme) inhibitors, especially for those with CHD-associated heart failure or who've had a heart attack. Ramipril (Tritace, Ramace) works very well in dilating blood vessels and lowering blood pressure.
IF YOU'RE HAVING SURGERY...
It is not uncommon for patients with CHD to have a heart attack or other cardiac complication during (or soon after) a non-related surgical procedure. And the risk can linger for two years or more. Certain precautions can improve your odds for a heart-happy recovery.
If your CHD becomes severe or your anginal hard to control (it comes and goes or last for more than 20 minutes), your cardiologist may recommend surgery. The two standard procedures are bypass surgery (see on next) and angioplasty (see on above). There are pros and cons to each and it may not be an easy choice. For a coronary bypass, formally known as a coronary artery bypass graft (CABG), the surgeon opens your chest wall to expose your beating heart. After connecting you to an external pump that acts like a heart, the team actually stops your heart temporarily. The surgeon stitches a healthy, plaque--free section of vessel (from your leg or chest) beside the problem artery, creating a new route for blood to flow freely. If more than one artery is congested, the surgeon may place several grafts. About 17,000 bypasses are done anually.
You'll know you're getting better when your chest pain is less frequent and energy increases. As you make a serious commitment to the positive changes that reverse heart disease, you may then mark the diagnosis of CHD as a positive wake-up call to a long and vigorous life.
Over 85% of angioplasty patients get stents, which reduce the need for follow-up procedures by about 33%. But complications such as blood clots and vessel scarring persist. Scientists, are hoping to bypass these problems by coating the stents themselves with medications that combat tissue growth and clots.
>A PHENOMENON KNOWN AS 'ASPIRIN RESISTANCE' has doctors perplexed. In some people aspirin doesn't adquately block thromboxane, the chemicals that gets platelets to form life-threatening blood clots. Check if this phenomenon is evident in you--and whether you may need a prescription antiplatelet medication like clopidogrel (Plavix).
If your angina doesn't ease up with beta-blockers or nitrates, your doctor may recommend a calicum channel blocker. By reducing the heart's oxygen demands and dilating its blood vessels, these drugs can give enormous relief. Such benefits have made newer cacium channel blocker such as amlodipine (Norvasc) and verapamil (Isoptin), as well as long-acting nifedipine (Adalat Oros), popular for CHD.
If your cholestrol is high and a heart-healthy diet isn't doing the trick, cholesterol-lowering drugs like the statins can make a big difference. Pravastatin (Pravachol) and simvastatin (Zocor) can
-----------------------------------------------------------------------------------------------------------------------------
This procedure restores blood flow to the heart. In a healthy coronary artery (1), blood flows through freely, effortlessly making its way to the heart. If plaque builds up along the inside of the artery (2), the vessel narrows, hindering circulation. During angioplasty, the surgeon inserts a ballon-tipped catheter into an artery through a small incision (usually in the groin), and guides it to the troubled coronary artery. The doctor then inflates the balloon (3), compressing the plaque against the vessel wall and widening the artery as a result. Once again, freshly oxygenated blood can course freely to the heart. In some cases, a small and permanent metal mesh tube called a stent (4) is inserted to stabilise and literally prop open the artery.
-----------------------------------------------------------------------------------------------------------------------------
prevent heart attacks and deaths in CHD sufferes. Researchers are hoping that the newer statins--fluvastatin (Lescol), atorvastatin (Lipitor)---will be even better LDL-lowerers.
Sometimes doctors recommend ACE (angiotensin--converting enyzme) inhibitors, especially for those with CHD-associated heart failure or who've had a heart attack. Ramipril (Tritace, Ramace) works very well in dilating blood vessels and lowering blood pressure.
IF YOU'RE HAVING SURGERY...
It is not uncommon for patients with CHD to have a heart attack or other cardiac complication during (or soon after) a non-related surgical procedure. And the risk can linger for two years or more. Certain precautions can improve your odds for a heart-happy recovery.
- Give up smoking if you haven't already It reduces your risk of complications.
- Ask about taking a beta-blocker drug such as atenolol (Tenormin). It can significantly lessen the risk of heart attack or death if you have CHD.
- Get checked for silent cardiac ischaemia---so-called because a lack of blood flow (and thus oxygen) to the heart muscle causes to pain. If you have it, maximise heart disease treatments before surgery.
- Take a stress test to assess your heart health.
- After stent replacement during angioplasty, put off other surgery for at least two weeks (ideally foour to six). The stent up your risk for developing blood clots in the coronary artery.
If your CHD becomes severe or your anginal hard to control (it comes and goes or last for more than 20 minutes), your cardiologist may recommend surgery. The two standard procedures are bypass surgery (see on next) and angioplasty (see on above). There are pros and cons to each and it may not be an easy choice. For a coronary bypass, formally known as a coronary artery bypass graft (CABG), the surgeon opens your chest wall to expose your beating heart. After connecting you to an external pump that acts like a heart, the team actually stops your heart temporarily. The surgeon stitches a healthy, plaque--free section of vessel (from your leg or chest) beside the problem artery, creating a new route for blood to flow freely. If more than one artery is congested, the surgeon may place several grafts. About 17,000 bypasses are done anually.
- Pros of coronary bypass: It maintains the blood flow in the affected artery for a longer time than can be exepected with angioplasty. A repeat procedure is not usually necessary (at least not for many years).
- Cons of coronary bypass: It's major open heart surgery, requiring general anaesthesia and several days in the hospital, followed by weeks of home recuperation. Complications can include heart attack, infection , postoperative confusion and thinking problems, or even a stroke from the tiny climps of plaque that can be stirred up by the procedure and caught in a narrowed brain artery.
- With an angioplasty, your cardiologist restores blood flow to the heart by inflating a balloon inside the artery to compress the plaque against the vessel walls. Over 20,000 angioplasties are done annually, with the procedure now more popular than a bypass.
- Pros of angioplasty: It takes about one hour, requires only local anaesthesia and one hospital night, and recovery is relatively quick.
- Cons of angioplasty: there's a 20 to 30 percent chance the artery will block up again (restenosis), necessitating a second procedure. Other potential risks: blood clots, artery spasms or a heart attack due to coronary artery injury. The concern about restenosis is now significantly less with the use of stents.
You'll know you're getting better when your chest pain is less frequent and energy increases. As you make a serious commitment to the positive changes that reverse heart disease, you may then mark the diagnosis of CHD as a positive wake-up call to a long and vigorous life.
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