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FAQ Coronary Artery Disease

What is this “coronary artery disease” that I keep hearing about?

Coronary artery disease is the leading cause of heart disease, and refers to a buildup of cholesterol and calcium plaque (atherosclerosis) that leads to progressive narrowing of the arteries that supply the heart with blood and oxygen.  If this gets bad enough it can lead to a heart attack and death of parts of the heart muscle.

Coronary Artery Disease

What is cardiac catheterization?

This is a procedure involving a small wire threaded up through an artery in the arm or leg to inject dye into the arteries of the heart directly.  It can help in the diagnosis of coronary artery disease (CAD) and also can help treat CAD for example with the placement of a “stent” to open a blocked artery.  It is an outpatient surgical procedure that usually involves an overnight hospital stay and very little recovery time.

What is heart bypass surgery?

Heart bypass, or CABG, is an open-heart surgical procedure in which veins or arteries from other parts of the body are removed and attached  to arteries of the heart before and after a blockage to “bypass” blockages in the coronary arteries caused by coronary artery disease (CAD).  This is not the same as being “put on heart bypass” which refers to placing your body on a heart-lung machine that takes over the function of your heart and lungs while the heart is stopped for surgery.  Being on heart bypass can involve CABG surgery but also is done for some valve replacement surgeries.

I am having surgery (not on the heart).  Do I need a cardiovascular evaluation?

Most people having elective surgery (i.e. other than emergency surgeries) should have a routine outpatient cardiovascular evaluation.  Depending on the risk and complexity of the surgery and your individual cardiac and vascular risk, this may involve simply a consultation or more extensive testing prior to your surgery.

Heart Attack

What is a heart attack?

A heart attack is a sudden interruption of blood supply to an area of the heart, caused by a blocked artery in the heart.  This is usually due to a blood clot in an area of the heart’s blood supply where there are narrowed arteries or cholesterol plaque deposits.  If not treated immediately, it can lead to permanent damage to an area of the heart and even death.  We focus on prevention of a heart attack with our testing, but we also educate you on the signs and symptoms of a heart attack that should prompt you to immediately seek help and call 911.

I know someone who was told their “heart was fine” but a few days later died of a heart attack.  How can this happen?

Unfortunately many patients who die of a heart attack never have any obvious heart problems or symptoms up until their heart attack.  We aim to minimize the chance of this because we stress not just finding obvious heart disease, but screening tests to determine your risk of getting heart disease even in apparently “healthy” patients and attempting to find early signs of heart disease that can lead to early treatment and prevention of a heart attack or other heart disease.

I was told I have a leaky heart valve? What does this mean?

The 4 valves of the heart are designed to pass blood one way only to and from the 4 chambers of the heart.  When the valves close, sometimes they do not close all the way and some blood can leak back into the previous chamber.  If this is severe enough it can put a lot of stress of the heart muscle and lead to an enlarged heart and congestive heart failure.  The treatment for severe valve leakage or regurgitation is surgical repair or replacement of the valve.

What other kind of valve problems are there?

Other than a leaking valve, a valve can also become too narrowed and not be able to pass blood properly.  This can also put stress on the heart and lead to enlarged heart and heart failure.  It is also often treated with surgery to replace the valve if it is severe enough.