Restenosis refers to the re-narrowing of the coronary artery after an Angioplasty procedure. It literally means reoccurrence of the stenosis (narrowing of the blood vessel). Restenosis occurs within 3-6 moths in 40-50% of people who have undergone an Angioplasty.
During the procedure of angioplasty a balloon is inserted into the blocked artery and inflated so as to allow the blood to flow normally to all portions of the heart. During this procedure the surrounding tissues undergo trauma and become susceptible for damage. Restenosis may set in during thrombosis or due to fresh tissue growth at the site of the surgery. Restenosis does not indicate progression of the heart disease but may be an indication that the body's immune system is responding to the injury caused during angioplasty.
Modern medicine has seen the use of stents to keep the artery open. Usage of stents has brought down restenosis considerably. Usage of drug-eluting stent allows slow seepage of medication that reduces proliferation of cells thus reducing re-clogging.
Restenosis causes and treatment
Restenosis is mainly caused due to a surgery that unblocks or widens a blood vessel. Treatment depends on the clinical condition:
Cardiac catheterization is a test which is performed to obtain certain diagnostic information about the heart. Patients may require this medical therapy rather than undergo angioplasty or bypass surgery when they suffer from rare or easily controlled episodes of angina. Alternatively, cardiac catheterization is not performed in patients who have infrequent episodes of angina and in whom angina can be easily controlled. When a patient has heart failure due to suspected coronary artery disease or there is suspected coronary artery disease, cardiac catheterization is conducted. Cardiac catheterization can help:
The patient is asked not to drink or eat anything, except a small amount of water, for at least 6 to 12 hours before the test. The patient is tested for allergy to iodine or other medications. Patients suffering from kidney disease or diabetes or bleeding disorders must keep the cardiologist informed. The cardiac catheterization test is performed in a cath lab by a cardiologist. The actual catheterization procedure takes about 15 - 30 minutes. The patient's electrocardiogram that continuously records the electrical activity of the heart is taken.
A pulse oximeter device that measures the oxygen levels of the patients' blood is monitored. An intravenous needle is inserted into the patients' vein to give fluids or medicine during the catheterization procedure. A sedative is also given through this IV line which helps the patient to relax.
Cardiac catheterization procedure involves passing a catheter, a thin flexible tube, into the right or left side of the heart. The doctor inserts this thin plastic tube into the groin - femoral artery. Other places where in the catheter may be inserted are the elbow- brachial artery or the wrist - radial artery. From there it is slowly advanced into the chambers of the heart or into the coronary arteries. The doctor watches the progress of the catheter into the heart's vessels and chambers on the imaging screen. Pressures within the heart chambers are measured and the blood and tissue samples are also removed through the catheter. A small amount of dye is also injected through the catheter into the heart chamber or into one of the coronary arteries.
Therapeutic catheterization: Certain types of heart defects can be repaired using catheterization. For instance, if the coronary arteries are blocked, the cardiologist can use a catheter, guide wire and balloon to open and improve blood flow to the heart. This is termed as percutaneous coronary intervention (PCI).
Normal result indicate that there is no significant narrowing or blockage in the coronary arteries. Abnormal results may suggest that the heart does not pump blood normally or the valves in the heart may be weak. There may be leakage between heart chambers. There is a possibility of aortic aneurysm. Some complications with cardiac catheterization include heart attack or stroke, hematoma, puncture of the heart or arrhythmia.
Cardiologists are physicians who diagnose and treat ailments related to the cardiovascular system that comprises of the heart, arteries, and veins. Pediatric cardiologist is a physician who focuses on diagnosing and treating heart problems in infants, children and young adults. Cardiologists specialize in treatment of angina (chest pain), heart attack, heart failure, high blood pressure and irregular heart beats. A cardiologist has to complete medical school and undergo residency in internal medicine for a period of three years. Further three years of specialization in the field of cardiology is required. For pediatric cardiologists a specialization in pediatrics is required prior to cardiology specialization. Cardiologists are specialists who provide complete heart care; they can determine the working condition of a person's heart by means of different tests. The responsibilities of the cardiologist include:
Modern techniques used in the field of cardiology
With the advancement in the field of medicine, cardiologists have the access to the latest technologies like:
Auscultation: A stethoscope is used to identify and detect heart abnormalities and murmur in the heart.
Echocardiography: Ultrasonic waves are used to visualize the heart.
Electrocardiography: EKG instruments are used to monitor the electrical activity of the heart.
Holter monitor: Records the EKG for 24 hours and more non-stop.
Modern blood tests: Determining the levels of HDL, LDL, triglycerides, homocysteine, and C-reactive protein helps in easy identification of heart problems.
Stress testing: Determines the levels of stress and cardiac function of the heart.
Coronary catheterization: Functioning of the heart is determined by inserting a catheter into the heart.
Bibliography / Reference
Collection of Pages - Last revised Date: March 23, 2019