Did you know that the use of narrow, hollow tubes has revolutionized the treatment of heart disease? Such tubes, called catheters, are a key part of interventional cardiology, which involves the use of minimally invasive procedures and tools to diagnose and treat heart disease and cardiovascular problems. In this medical specialty, catheters give doctors a way into the heart so that the complications and pain of open-heart surgery can be avoided. Interventional cardiologists are experts at threading a catheter through blood vessels to access the heart to diagnose and treat problems.
The most common interventional cardiology procedures are angioplasty, stenting, and thrombectomy:
- Balloon angioplasty. Inflating a small balloon in a blocked artery to widen it and improve blood flow.
- Stent placement. Inserting a small, metal-mesh tube into an artery to hold it open.
- Removing a blood clot, or thrombus, from an artery or vein.
Interventional cardiology procedures can often be performed on an outpatient basis or with a short hospital stay, and they generally have a quicker recovery time compared to traditional open-heart surgery.
Interventional cardiology has transformed the treatment of many heart diseases and has improved patient outcomes and quality of life. Let’s look at some of the most common heart conditions that can be helped by interventional cardiology.
Coronary Heart Disease
Coronary heart disease (CHD)—also referred to as coronary artery disease (CAD)—is the leading cause of death in men and women in the U.S. It develops when plaque builds up in the coronary arteries that supply blood to the heart. The buildup of these fatty deposits is called atherosclerosis. Eventually, atherosclerosis narrows or blocks the arteries so much that it reduces blood flow and oxygen to the heart muscle.
CAD falls in the category of obstructive coronary artery diseases.
Symptoms include chest pain or discomfort (angina), shortness of breath, or a heart attack.
Risk factors for CHD include smoking, high blood pressure, high cholesterol, diabetes, obesity, and a family history of heart disease.
Diagnosis of obstructive CAD may involve a physical examination, medical history review, and diagnostic tests such as electrocardiogram (ECG), stress testing, coronary angiography, or cardiac computed tomography (CT) scan.
Treatment options. Interventional cardiologists use procedures like angioplasty and stenting to open up narrowed or blocked coronary arteries, restore blood flow to the heart, and reduce the risk of heart attack. Other treatments include lifestyle changes; medications such as statins, aspirin, and beta-blockers; and bypass surgery in severe cases. The goal of treatment is to restore blood flow to the heart, relieve symptoms, and reduce the risk of serious complications such as heart attacks.
Non-obstructive coronary artery disease
Non-obstructive coronary artery disease is sometimes referred to as coronary microvascular disease, or small vessel disease.
In these cases, spasms occur or blood flow is restricted in the tiny blood vessels that branch from main coronary arteries. This is caused by damage to the lining of the blood vessels, inappropriate restrictions, squeezing from adjacent heart muscle, and other other malfunctions. It’s more common in women than men.
While non-obstructive coronary artery disease is generally considered less severe than obstructive disease, it can still increase the risk of heart attack and other cardiovascular events.
The symptoms are similar to those of obstructive coronary artery disease, such as chest pain or discomfort, shortness of breath, palpitations, and fatigue.
These risk factors have been tied to non-obstructive CAD: Excess weight, diabetes, smoking, high blood pressure, high cholesterol.
Treatment may involve a minimally invasive procedure or surgery. Doctors also may call for lifestyle changes, such as exercise and a healthy diet, and medications to manage symptoms and reduce the risk of complications.
Spontaneous coronary artery disease
Spontaneous coronary artery dissection (SCAD) is a rare condition in which a tear or separation develops in one or more of the layers inside the coronary artery wall. Blood can flow between the layers, narrowing the artery or causing complete blockage.
The symptoms of SCAD include, chest pain, racing heart or heart flutter, shortness of breath, sweating, extreme tiredness, and pain in the arms, shoulders, back or jaw.
Risk factors. SCAD affects women more than men, and tends to occur in the first weeks after delivery. It also is associated with fibromuscular dysplasia, and hormone use.
Treatment may involve the use of stents, balloon angioplasty, and medications.
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Peripheral artery disease
Peripheral artery disease (PAD) causes the arteries that supply blood to the limbs, usually the legs, to become narrowed or blocked due to a plaque buildup in the artery walls. This type of artery disease blood flow to the affected limb. If left untreated, PAD can lead to serious complications, including infections, ulcers, and even limb amputation.
Symptoms. Pain or cramping in the legs, buttocks, or feet during physical activity, which eases with rest; coldness or numbness in the lower legs or feet; and slow-healing wounds or sores on the feet or legs. However, someone with PAD might experience no symptoms.
Risk factors. Smoking, high blood pressure, high cholesterol, diabetes, and a family history of the condition.
Treatment for PAD may include lifestyle changes, such as quitting smoking, exercising regularly, and eating a healthy diet. Physicians may prescribe medications to manage symptoms and reduce the risk of complications, such as blood thinners and cholesterol-lowering drugs. In severe cases, procedures may be necessary to restore blood flow to the affected limb, such as angioplasty, stenting, or bypass surgery.
Functional PVD, or functional peripheral vascular disease, is a group of conditions that affects blood vessels in the arms and legs. PVD is characterized by symptoms that occur during exercise or physical activity, and are caused by a temporary reduction in blood flow to the extremities.
Functional PVD is often caused by an underlying condition that affects the blood vessels or the muscles, such as arterial spasm, vasculitis, or muscle inflammation. Examples of PVD include:
- Varicose veins
- Chronic venous insufficiency
- Raynaud’s disease
Symptoms caused by the reduced blood flow can include pain, cramping, numbness, or weakness in the affected limb.
Treatment for functional PVD depends on the underlying cause of the condition. Lifestyle changes like regular exercise, weight loss, and smoking cessation can improve symptoms. Medications such as blood thinners or medications that dilate blood vessels may also be used. In some cases, procedures such as angioplasty or stenting may be necessary.
It is important to seek medical attention if you have symptoms of functional PVD, as they can be a sign of a more serious underlying condition.
Structural heart disease
Structural heart disease refers to any abnormality of the heart’s structure, such as problems with the valves, chambers, walls, or blood vessels. These abnormalities can be present at birth or can develop over time due to a variety of factors, such as aging, infection, or injury. There are many types of structural heart disease, including:
Heart valve disease. This stops the valves of the heart from functioning properly, causing blood to flow backwards or pool up in the heart’s chambers. Interventional cardiology procedures like balloon valvuloplasty, transcatheter aortic valve replacement (TAVR), and mitral valve repair can be performed to treat heart valve disorders without open-heart surgery.
Cardiomyopathy. When the heart muscle becomes enlarged, thickened, or stiff, affecting its ability to pump blood effectively. Procedures like alcohol septal ablation and implantation of left ventricular assist devices (LVADs) can be used to treat certain types of cardiomyopathy.
Congenital heart disease. When the heart does not form properly before birth, leading to abnormalities in its structure or function.
Aortic disease. When the walls of the aorta, the largest artery in the body, become weakened or enlarged, increasing the risk of aneurysms or dissections. Aortic valve disease involves defects in the valve that regulates blood flow from the left ventricle. An interventional cardiologist might treat patients with this condition by performing a percutaneous valve repair.
Symptoms of structural heart disease vary depending on the specific condition.
An interventional cardiologist also can treat structural heart conditions like atrial septal defect (ASD), patent foramen ovale (PFO), and left atrial appendage (LAA) closure.
Treatment. Options include medications, lifestyle changes, heart bypass surgery, and several types of minimally invasive procedures.
Interventional Cardiology Treatment in the Tampa Bay Area
If you are concerned about your heart health, are experiencing symptoms or a have history of heart disease, we can help. Our team of interventional cardiologists offers prevention and treatment for cardiovascular disease. Contact us today to schedule an appointment by calling 1-813-780-8440, or request an appointment online.
Meet Dr. Sameer H. Nagamia, MD
Dr. Nagamia is a board certified cardiologist in internal medicine and interventional cardiology. His areas of specialty include Cardiac Catheterization and Intervention, Peripheral Arterial Disease, Structural Heart Disease, Aortic Stenosis, and Congestive Heart Failure.
He is a Tampa native whose interests include playing outdoor sports, doing volunteer work and auto restorations, and public speaking and debate.