Tuesday, June 26, 2018

New Surgical Methods for Problem Hearts

New Surgical Methods for Problem Hearts

Heart repair methods are changing with technology, and you or someone you love may benefit from one of these new treatments.

If you experience fatigue, shortness of breath, a rapid heartbeat and lightheadedness, it could be due to mitral valve regurgitation (MVR). This condition stems from the failure of the heart’s mitral valve to close completely, allowing blood to flow backward into the heart. If MVR is significant, blood can’t efficiently move through the heart or to the rest of the body.  

How to Lower Your Risk of a Heart Attack


Are you among the mere 3 percent of Americans who follow the four recommendations, below, for preventing a heart attack?

  1. Don’t smoke.
  2. Get your body mass index below 25.
  3. Eat at least five fruits and vegetables a day.
  4. Exercise vigorously at least 150 minutes a week.

Watch this video to get more tips from the Mayo Clinic on heart attack prevention:

Mild regurgitation can generally be left untreated, but more severe cases can lead to heart failure or arrhythmias (abnormal heart rhythms). Your doctor may prescribe drugs or recommend replacing or clipping shut the valve. While the clipping procedure isn’t new, it used to take place in an operating room under general anesthesia.

Now, a new type of mitral valve clip can be inserted via a catheter. “This procedure is appropriate for high-surgical-risk MVR patients,” Tabrizchi says. “It may involve a short hospital stay to assess the effectiveness of the procedure. Patients tend to feel better right away and have an improved quality of life.”

Atrial Fibrillation

Warning Signs of a Woman’s Heart Attack


Women do not experience heart attacks like their male counterparts. Women may not have chest pressure, but instead may experience “shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue,” according to Nieca Goldberg, M.D. and medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center. “Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure.”

That may be because a woman’s heart attack may be triggered by a temporary coronary artery spasm or minor blood clot. Either can stop blood flow to the heart.

The signs of a woman’s heart attack may be subtle. Although heart disease is the No. 1 killer of women in the U.S., women may attribute their symptoms to acid reflux, the flu or normal aging. But in the event of a heart attack, you need help right away. If you or someone you love experiences any of the following symptoms, dial 911 or go to the nearest hospital emergency room immediately:

  1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest that lasts for more than a few minutes, or goes away and comes back.
  2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  3. Shortness of breath with or without chest discomfort.
  4. Breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Nine percent of Americans over age 65 have arrhythmia, according to the CDC. The most common type is atrial fibrillation (AFib).

“AFib is an irregular beating of the upper heart chambers, which causes clots to form within those chambers,” says Tabrizchi. “The clots can leave the heart and become lodged anywhere in the body, but the primary risk is to the brain, which results in ischemic strokes.”

Ischemic strokes are responsible in about 87 percent of stroke cases, according to the American Heart Association, and the risk of stroke increases with age.

Treatment for AFib usually includes anticoagulants to prevent clots. However, such blood thinners involve risk. “Some patients tend to have significant bleeding as an adverse effect of these medicines to the point where they require blood transfusions,” Tabizchi says. “People with severe arthritis who have to take anti-inflammatory medication, for example, are at a very high risk for bleeding.”

That bleeding can happen anywhere in the body, but if it's in the brain, it causes a hemorrhagic stroke.

Catheters come to the rescue once again, delivering a safe alternative shown to reduce strokes in clinical trials. Dubbed the WATCHMAN device, this type of catheter resembles a tiny umbrella and is placed in the left atrial appendage, the pouch in the atrium where clots tend to form. The procedure is called left atrial appendage closure (LAAC).

The patient requires general anesthesia for doctors to insert a catheter into the upper leg and thread it up to the heart. The procedure takes an hour on average, and patients spend a day in the hospital. They also initially need anticoagulants, but these can usually be tapered off after about six months.

However, the procedure isn’t for everyone. “The WATCHMAN is very expensive,” admits Tabrizchi. “There are strict criteria in place regarding which patients are candidates for this procedure.”

People who don’t tolerate anticoagulants well are candidates, and so are people with a history of falling. “People who fall may hit their head or cause serious injury to other parts of the body that result in bleeding,” Tabrizchi clarifies.

Post-Procedure Heart Care

Any heart procedure requires special care afterward. Be sure to follow your doctor’s advice, and take good care of your heart muscle. Improving your diet and exercising (with your doctor’s approval) are the most common recommendations for pampering your heart and boosting your health



Sources

http://www.annalsthoracicsurgery.org/article/S0003-4975(17)31406-6/abstract

https://www.ericksonliving.com/tribune/articles/2018/02/new-surgical-solutions-old-heart-problems

https://www.washingtonpost.com/national/health-science/when-it-comes-to-heart-attacks-women-are-different-from-men/2017/02/17/b5d298e2-ea38-11e6-80c2-30e57e57e05d_story.html?utm_term=.e451cb1add18

http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-in-Women_UCM_436448_Article.jsp#.Wte0dy7waM8

https://newheartvalve.com/tavr-treatment/is-tavr-right-for-you/?gclid=CjwKCAjw2dvWBRBvEiwADllhn7Guej8IMrNVV2azdsdVKwqc3hPlAXDL0YDsPPcNQHgvXkjT1KRi7RoC324QAvD_BwE

https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/symptoms-causes/syc-20350178

http://www.strokecenter.org/patients/about-stroke/ischemic-stroke/

https://www.webmd.com/heart-disease/tc/coronary-artery-bypass-surgery-minimally-invasive-methods-topic-overview#1

https://www.washingtonpost.com/national/health-science/once-scary-heart-bypass-surgery-has-become-common-and-safer/2018/02/23/4b7459a4-157f-11e8-8b08-027a6ccb38eb_story.html?noredirect=on&utm_term=.7ee891f0eacf

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