2.17 Diagnosis of Cardiovascular Disorders

Modern research has significantly advanced the diagnosis, treatment, and prevention of Cardiovascular Disorders (CVD). These diagnostic tools are essential for identifying issues related to the Phases of Heartbeat→ and Cardiovascular Disorders→.

a. Principles of Angiography

Cardiac Catheterization

Cardiac catheterization is a diagnostic technique involving the insertion of a specially designed catheter into a vein or artery. The catheter is advanced into the heart under radiographic fluoroscopic guidance. This technique is used to obtain angiograms by injecting contrast media into a specific area.

Purpose: Cardiac catheterization evaluates diseases of the mitral valve, aortic valve, and aorta. It also determines the size and function of the left ventricle.

Coronary Angiography

Coronary angiography is a specific application of angiography used to detect stenosis (narrowing of a blood vessel, especially coronary arteries). This procedure guides revascularization procedures such as balloon angiography and stenting.

b. Coronary Bypass (Coronary Artery Bypass Graft - CABG)

Coronary artery bypass graft (CABG) is a surgical procedure designed to relieve the effects of obstruction in the coronary arteries, often seen in Heart Problems→. Healthy segments of blood vessels (e.g., a vein from the leg or an artery from the thorax) are taken from other parts of the patient's body. These segments are then grafted to create new pathways, bypassing the obstructed sections of the coronary arteries.

c. Angioplasty (Percutaneous Coronary Intervention - PCI)

Angioplasty, also known as Percutaneous Coronary Intervention (PCI), is a minimally invasive procedure to widen narrowed or obstructed blood vessels, often due to plaque buildup.

Procedure: A plastic tube (catheter) is threaded into an artery (e.g., arm or leg) and guided through a major blood vessel towards the heart. When the tube reaches the region of plaque in a coronary artery, a balloon attached to its end is inflated, forcing the vessel open.

Stents

To prevent the artery from closing again, slotted tubes called stents are expanded inside the artery. Stents are coated with heparin (an anticoagulant to prevent blood clotting) and other chemicals to prevent arterial re-narrowing.

d. Open Heart Surgery

Open heart surgery is a surgical procedure where the patient's chest is opened (an incision made through the breastbone/sternum), allowing direct access to the heart. The term "open" refers to the chest, not necessarily the heart itself, which may or may not be opened.

Purpose: This procedure corrects various heart problems in both children and adults.

Procedure: Open heart surgery is performed under general anesthesia.

Heart-lung bypass machine: Tubes are used to re-route blood through this machine. The machine adds oxygen to the blood, keeps the blood warm and moving through the rest of the body. This allows the heart to be stopped safely.

With the heart stopped, the surgeon can repair the heart muscle itself, heart valves, and blood vessels outside the heart. After repair, the heart is restarted, the machine is removed, and the breastbone and skin incision are closed.

Additional Diagnostic Tools

In addition to surgical interventions, several non-invasive tests are used to monitor heart health and Blood Pressure→.

Electrocardiogram (ECG)

An ECG records the electrical activity of the heart over a period of time using electrodes placed on the skin.

Echocardiography

This uses ultrasound waves to create images of the heart, allowing doctors to see the heart beating and pumping blood.

Cardiac Stress Test

This test measures the heart's ability to respond to external stress in a controlled clinical environment.

Blood Tests (Biomarkers)

Certain proteins, such as Troponin, are released into the blood when the heart muscle is damaged.