A healthy heart is essential to a long and healthy lifestyle. There are many things that can go wrong with the heart, and sometimes the symptoms that something is wrong are not always obvious. A cardiologist is a doctor who specializes in diagnosing problems with the heart and surrounding arteries.
Though cardiology is a field of specialty in itself, within this branch of medicine there are three main types of cardiology–invasive, non-invasive and interventional.
A cardiologist is a physician trained in the study, diagnosis and care of the cardiovascular system. These physicians have completed their bachelor’s degree and medical school followed by a 3-year residency program focused on internal medicine and a cardiology fellowship program.
It is important to note that a cardiologist is not a surgeon. While they can evaluate heart function and identify what may be wrong through the use of testing and other procedures, only a cardiac surgeon can perform actual physical heart surgery. Cardiac surgeons complete a 5-year general surgery residency and a 2-3 year specialized cardio or cardiothoracic fellowship.
Physicians and surgeons who specialize in pediatric cardiology, versus adult, undergo additional training.
Interventional cardiology is a branch of cardiology that deals with catheter-based invasive treatment to repair damaged or weakened blood vessels, narrowed arteries, or other parts of the heart. This specialty requires additional fellowship training beyond that of a traditional cardiologist.
Some of the most common conditions that can be treated by an interventional cardiologist include:
- Coronary artery disease: Coronary artery disease is the most common type of heart disease. It occurs when the arteries that are responsible for supplying blood to the heart muscle harden and narrow.
- Peripheral vascular disease: Peripheral vascular disease occurs when blood vessels outside of the heart narrow, block, or spasm. This condition can occur in the veins or arteries. Narrowed blood vessels can occur in multiple sites such as in the neck, arms, abdomen, kidneys, and legs.
- Heart valve disease: Heart valve disease occurs when the valves which control blood flow into the heart’s chambers are unable to work properly.
Common Cardiovascular Interventions
The minimally-invasive treatments associated with interventional cardiology have been proven to result in less pain, shorter hospital stays and improved recovery times. Some of the most common cardiovascular interventions include:
- Coronary atherectomy: This procedure is used to clean out clogged heart arteries to restore and improve blood flow. Depending on the patient’s unique needs, there are several methods of performing a coronary atherectomy including rotational, laser, orbital and cutting balloon.
- Cardiac catheterization: Cardiac catheterization is commonly used to give physicians a visual of diseases that affect the heart, cardiac valves or coronary arteries. A cardiac catheter is inserted using the guidance of an X-ray. Depending on which side of the heart is affected, this procedure is done in different ways.
- For left heart catheterization, the catheter may be inserted through an artery in the groin, elbow or wrist, then directly into the heart’s left ventricle. A contrast dye is injected in order to examine the left ventricle and aorta, as well as to evaluate blood circulation and the performance of cardiac valves.
- For right heart catheterization, a flow-directed catheter is inserted through a vein in the groin or elbow then into the right ventricle and pulmonary artery. This type of catheter has a small inflatable balloon at the tip allowing it to be carried by the flow of blood. This is used to measure the blood pressure in the right ventricle and pulmonary artery. Like with a left heart catheterization, contrast is injected to examine the right chamber, the circulation of blood and the function of the cardiac valves.
- Percutaneous Coronary Intervention (PCI): Formerly known as angioplasty with stent, a catheter is inserted through the blood vessels in either the groin or arm then threaded into the heart where the coronary artery is narrowed using the guidance of fluoroscopy (X-ray). Once in place, a balloon tip covered with a small structure called a stent is inflated. The balloon tip works to compress the plaque as the stent expands to hold it open. Once the stent is in place, the balloon is deflated and removed.
- Complex Percutaneous Coronary Intervention is used to treat left main disease, bifurcation lesions, vein graft lesions, calcified lesions and chronic total occlusions.
- Coronary mechanical aspiration thrombectomy: Most heart attacks are caused by coronary artery disease–a condition that includes the formation of blood clots around plaque buildup. Through a small incision, a catheter is used to aspirate these clots. This procedure is called a thrombectomy. If the clot is large, it is first broken up then removed using aspiration. Once the clot is removed, the affected section is treated using a balloon catheter and/or stent.
- Transvenous pacemaker placement: Transvenous pacemaker placement, or transvenous pacing, is used in cases where a pacemaker is only needed for a short time when the heart needs help in regulating its function such as when you have a change in heart rate from open-heart surgery, heart attack, infection, medication or other issues. Under X-ray guidance, a catheter is inserted in a neck or groin vein to guide wire to the heart. Once the needle is removed, the wire is then attached to an external pacemaker and the insertion site is covered with a dressing. Your cardiologist may recommend a permanent pacemaker be implanted if your symptoms do not improve after a few days.
- Endomyocardial biopsy: An endomyocardial biopsy, or heart biopsy, uses a small catheter to remove small amounts of heart muscle for diagnostic, therapeutic or research purposes. It is most often used following a heart transplant to determine if a donor heart is being rejected, but it may also be performed as a diagnostic tool for some heart diseases.
- Pericardiocentesis: Also referred to as a pericardial tap, a pericardiocentesis procedure involves using a catheter and needle to drain excess fluid that has built up in the sac around the heart. This cardiovascular intervention can also be used to help diagnose the cause of extra fluid.
About PULSE: The Heart, Valve and Vascular Institute
Founded by Dr. Farhan Majeed, an interventional cardiologist, PULSE: The Heart Valve and Vascular Institute provides comprehensive and state-of-the-art care in the areas cardiac, vascular, and structural heart disease to patients in Port Charlotte, Florida and the greater Charlotte county area.
Dr. Majeed specializes in performing all of the above listed cardiovascular interventions and others including selective coronary angiography, advanced coronary imaging, intravascular coronary brachytherapy, hemodynamic support device placement, and vascular closure devices.
If you would like further information on interventional cardiology at PULSE, call (941) 629-2111 to request an appointment today.