There was a time when people in their 60s, 70s, or 80s had cardiac arrests. But today, a growing number of young people have been succumbing to heart attacks. The tragic part - these people usually...
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Coronary artery disease | Dr Raghu
There was a time when people in their 60s, 70s, or 80s had cardiac arrests. But today, a growing number of young people have been succumbing to heart attacks. The tragic part - these people usually...
There was a time when heart attacks were restricted to older people (in their 50s, 60s, or 70s). However, in today's day and age, heart attacks are becoming increasingly common in individuals under the...
Heart disease is a leading cause of death worldwide. Various factors, such as stress, underlying medical conditions, and a sedentary lifestyle, make an individual more vulnerable to heart disease.
What Is Coronary Angiography?
Coronary angiography is a procedure that uses X-rays to visualize and inspect arteries. It shows if there are any blocked arteries and how well your heart muscle is working.
During this procedure, a catheter is inserted into an artery in your arm or groin and advanced into one of your coronary arteries. Thereafter, contrast dye is injected into the coronary artery to make it visible on X-ray images.
The procedure can help identify blockages in the heart’s blood vessels and guide treatment decisions for patients at risk of developing heart disease or having a heart attack due to narrowed or blocked blood vessels that supply oxygenated blood to various organs.
When Is Coronary Angiography Performed?
Coronary angiography is typically performed if you have chest pain or other symptoms that suggest the presence of heart disease. If you have had a heart attack or have been diagnosed with coronary artery disease. It can be used in conjunction with an exercise stress test.
How Is Coronary Angiography Done?
If you’re scheduled for coronary angiography, here’s what you can expect:
- The doctor will give you a sedative, usually in the form of an injection, at the start of your procedure.
- They’ll insert a catheter into one of your arteries, either in your groin or wrist, and guide it through your blood vessels to reach your heart.
- They’ll inject a special dye (contrast agent) into the coronary arteries that supply blood to your heart muscle so that they can see them clearly on X-rays taken after injecting this contrast agent.
Where Is Coronary Angiography Performed?
Coronary angiography is performed in a cath lab (catheterization laboratory). The cath lab is a room with special equipment for performing coronary angiography and other procedures that entail inserting a long, thin tube (called a catheter) into the blood vessels of your heart.
Why Is Coronary Angiography So Common Nowadays?
Advancements in medical science have made coronary angiography more accessible to patients. The procedure has become simple and the risk has reduced significantly. Also, unhealthy diets and lifestyle choices put more people at risk of developing cardiac ailments. That’s why coronary angiography is commonly performed now-a-days.
What are the risks involved in Coronary angiography?
In expert hands coronary angiography is a near-zero risk procedure. The risk of complications can be broadly categorized into:
Less severe complications
- bleeding under the skin at the wound site (haematoma) – this should improve after a few days, but contact your Cardiologist if you’re concerned. Application of ice packs would be helpful.
- bruising – it’s common to have a bruise in your groin or arm for a few weeks. Application of ice packs would be helpful.
- allergy to the contrast dye used, causing symptoms such as a rash and a headache – this is uncommon, but you should discuss any allergies with your cardiologist before having the procedure
Severe complications
The chance for developing a serious complication during coronary angiogram is 1 in 1000. People with serious underlying heart problems are most at risk. Discuss with your cardiologist about the risks before the procedure.
- damage to the artery in the arm or groin in which the catheter was inserted, with the blood supply to the limb possibly being affected
- heart attack – a serious medical emergency where the heart’s blood supply is suddenly blocked
- stroke – a serious medical condition that occurs when the blood supply to the brain is interrupted
- damage to the kidneys caused by the contrast dye
- tissue damage caused by X-ray radiation if the procedure is prolonged
- death
In Conclusion
Coronary angiography is used to diagnose and treat heart diseases, before cardiac surgery, angioplasty-stent procedures as well as other conditions such as aneurysms in blood vessels. It helps doctors identify underlying causes of heart failure and determine the proper course of treatment.
Dr. C Raghu is a renowned cardiologist with decades of experience in interventional cardiology. He is one of the pioneers of trans-radial procedures in India. Consult him if someone is in need for coronary angiogram.
Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. It’s a serious condition that requires treatment by your doctor, but there are several options available. If you’re concerned about heart failure and want to know more about your options for treatment, keep reading.
What Is Heart Failure?
Heart failure occurs when your heart doesn’t pump blood as well as it should due to one or more problems with its cardiac function. The heart can’t pump blood as well because it has to work harder than normal just in order to keep up with the body’s needs for oxygen and nutrients. The extra effort causes structural changes in the heart over time.
Types of Heart Failure
Although there are many specific types of heart failure, the two broad categories are as follows:
- Heart failure with preserved ejection fraction or diastolic heart failure
- Heart failure with reduced ejection fraction or systolic heart failure
Heart failure can also be categorized depending on the side of the heart that’s affected. These include:
- Left-sided heart failure
- Right-sided heart failure
The treatment of heart failure depends on the type of heart failure you’ve developed. The most common treatment options include:
Beta-Blockers
Beta-blockers are a class of drugs that slow your heart rate, lower blood pressure, and reduce the force of contraction in your heart muscle. They work by blocking the effect of certain hormones that cause the heart to beat quickly.
Beta-blockers can help you feel better if you have high blood pressure or chest pain (angina) due to coronary artery disease or atherosclerosis. But they’re not recommended for people who have low blood pressure (hypotension).
ACE Inhibitors
ACE inhibitors are a class of drugs that lower blood pressure and reduce the workload of the heart. They are used to treat high blood pressure, heart failure, and kidney problems.
ACE inhibitors include:
- Captopril
- Enalapril
- Lisinopril
- Ramipril
Digoxin
If you have heart failure, your doctor may prescribe digoxin. This medication is used to slow the heart rate and increase its force of contraction in order to improve blood flow to the body.
Diuretics
Diuretics, such as hydrochlorothiazide (HCTZ), furosemide and torsemide help your kidneys get rid of excess fluid. If you have heart failure or high blood pressure, your doctor may prescribe a diuretic.
Diuretics can cause side effects like dehydration and electrolyte imbalances. They also interact with other medications. Be sure to talk to your doctor about any drug interactions before taking them.
Aldosterone Antagonists
Aldosterone antagonists work by blocking the effect of aldosterone, a hormone that causes your body to hold on to sodium and water. This excess fluid can cause heart failure symptoms, including swelling and shortness of breath.
Aldosterone antagonists are used to treat primary hypertension (high blood pressure) or heart failure. They work best when combined with other medications that block the action of angiotensin II (a hormone secreted by the kidneys).
In Conclusion
Heart failure can be managed with a variety of medications, and in some cases, it may even go away on its own. If you have heart failure, talk to your doctor about what treatments might help you feel better and live longer. We hope this article has given you some insight into the different types of treatments available and how they work!
If you or anyone you know has been experiencing symptoms of heart failure, feel free to reach out to Dr. C Raghu, one of India’s leading cardiologists.
Coronary angiography is a common diagnostic test used by doctors to identify conditions, such as coronary artery disease and aneurysms. In our previous blog, we discussed how the procedure is carried out and when it’s used. Click here to check it out.
Angiography is a minimally invasive procedure, which makes it extremely safe. However, it can involve a few minor side effects. The benefits outweigh the risks for most patients. However, in some cases, coronary angiography can result in serious complications.
In this article, we’ll delve deeper into the risks and side effects associated with coronary angiography.
Common Side Effects of Coronary Angiography
If you’re planning to visit the doctor for an angiography, you can expect one or more of the following side effects:
- Bruising
- Swelling
- A buildup of blood (resulting in a bump)
All these symptoms are localized to the area where the cut was made for inserting the catheter. Most patients experience a gradual improvement in these side effects without medical intervention. You can take painkillers to relieve discomfort after the procedure.
Complications of Coronary Angiography
If you’re lucky, you’ll come out of coronary angiography with minor bruising and swelling. However, some patients develop the following complications:
- An infection near the cut :- It makes the area around the cut red, swollen, and tender.
- An allergic reaction to the dye :- It usually results in an itchy rash.
In both cases, proper use of medications can help control the side effects. For instance, antibiotics can be used in the case of an infection. Similarly, your doctor might prescribe antihistamines if you experience an allergic reaction.
It’s worth mentioning that coronary angiography comes with a few potential serious complications. These include:
- Kidney damage (from the dye)
- Cardiac arrest or stroke
- Internal bleeding (due to damaged blood vessels)
- Anaphylaxis (due to severe allergic response to the dye)
The good news is that these complications are extremely rare (affecting less than one in every 1000 patients). Also, kidney damage due to angiography is usually temporary. Moreover, internal bleeding can be contained with the help of catheter based approaches.
Seeking Medical Help
Complications from coronary angiography are rare. Nevertheless, it’s a good idea to consult your doctor if you notice anything unusual after the procedure. For instance, if the leg or arm where the cut was made looks pale or feels numb, it’s a cause for concern. Similarly, if you notice bleeding, redness, or a firm lump near the cut, it could indicate a potential infection. It’s always a good idea to watch out for these signs and consult your doctor for timely treatment.
In Conclusion
Coronary angiography is a safe and minimally invasive procedure. It can cause minor side effects, such as pain and swelling. However, in extreme cases, it can also lead to a heart attack or kidney damage. It’s crucial to talk to your doctor about the potential risks before going in for the procedure.
Dr. C Raghu has more than two decades of experience in treating patients with different heart conditions. If you have queries or concerns about coronary angiography, feel free to reach out to Dr. Raghu today.
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Heart failure is an umbrella term for a set of physical symptoms arising due to the gradual deterioration in the heart’s pumping ability. The term “congestive heart failure” was traditionally used because the condition resulted in fluid buildup and congestion in the lungs.
However, doctors and medical researchers have found that it causes a wide array of other symptoms. That’s why they now refer to the condition as heart failure.
What Happens in Congestive Heart Failure?
A healthy human heart relaxes and contracts nearly 100,000 times a day and pumps more than 2,000 gallons of blood throughout the body. The cardiovascular system also includes a network of arteries and veins to transport deoxygenated and oxygenated blood to and from the heart. If any part of the system falters, it can disrupt the flow of blood to vital organs.
Heart failure is characterized by a progressive decline in the heart’s power to pump blood. When that happens, the heart goes through a series of structural changes (knowns as cardiac remodeling) and beats faster to pump more blood.
Also, the blood vessels constrict to stabilize blood pressure and restrict blood supply to non-critical organs like the skin and kidneys. When blood flow to the kidneys reduces, it compels the body to retain more fluid and sodium.
All these short-term fixes result in more damage and cause even more stress to the heart muscles. That, in turn, results in further deterioration of the heart’s pumping action.
Congestive Heart Failure Symptoms: A Closer Look
The symptoms of heart failure vary depending on whether they’re caused due to a lack of oxygen or an increase in fluid build.
Lack of oxygen supply results in the following symptoms :
- Confusion
- Weight gain
- Fatigue
- Discolored or bluish skin
Excess sodium and fluid buildup in the body causes the following symptoms:
- Lung congestion
- Shortness of breath
- Coughing and wheezing
- Loss of appetite
- Swelling of feet and abdomen
Causes and Types of Congestive Heart Failure
The most common causes of heart failure include:
- Coronary artery disease (Narrowing of arteries due to cholesterol buildup)
- Damaged or dying heart tissue due to a heart attack
- Cardiomyopathy (damage to the heart muscles)
- Heart rhythm disturbances due to atrial fibrillation
- Underlying medical conditions like hypertension and diabetes
There are various ways to categorize congestive heart failure. Depending on the part of the heart’s pumping that’s affected due to heart failure, it can be of the following types:
- Systolic heart failure or heart failure with a reduced ejection fraction
- Diastolic heart failure or heart failure with a preserved ejection fraction
Also, depending on the side of the heart that’s affected, heart failure can be categorized as left-sided failure and right-sided failure. The treatment approach a doctor will use depends on the type of heart failure a patient has developed.
Stages of Heart Failure
The American College of Cardiology and the American Heart Association has outlined four stages to denote the progression of heart failure. While Stage A is characterized by risk factors like underlying medical conditions, stage B shows structural changes in a patient’s heart. The more advanced stages (C and D) present visible symptoms.
In Conclusion
Heart failure (also known as congestive heart failure) is a progressive condition caused by the heart’s inability to pump blood adequately. It results in symptoms like shortness of breath, fatigue, weight gain, and brain fog.
Dr. C Raghu is an eminent cardiologist with more than two decades of experience. If you or someone you know has developed congestive heart failure symptoms, consult Dr. Raghu to explore your treatment options.
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DR. RAGHU
MD, DM, FESC, FACC, FSCAI
Cardiology Coronary, Vascular and
Structural Interventions
Cardiology Coronary, Vascular and
Structural Interventions
Conditions & Diseases
Angioplasty
Aortic Stenosis
Atrial Fibrillation
Atrial Septal Defect
There are many scenarios where you might want to see a doctor and find out whether you’ve developed heart failure. Perhaps you have a history of heart disease in the family and would like to assess your risk levels.
Or you might have developed symptoms, such as shortness of breath, chest pain, and swollen feet, that are indicative of heart failure. (Check out our previous article for a detailed glimpse of heart failure symptoms.)
Or you might have completed an initial round of investigation and want a closer look at the root cause of heart failure. In any case, it’s essential to have a fair idea of the steps involved in diagnosing heart failure. Let’s take a look.
Family History and Medical Background
Diagnostic efforts for heart failure serve two primary purposes :
- To determine the underlying cause
- To assess the extent of the heart’s malfunction
The first thing a doctor will do is get a complete picture of your medical history. They’ll want to know the details of any symptoms you might have been experiencing. Also, they’ll ask about your diet and lifestyle, including your habits pertaining to exercise, smoking, and alcohol consumption.
Additionally, they’ll ask one or more of the following questions:
- Do you have pre-existing conditions like high cholesterol levels, hypertension, diabetes, etc.?
- Have you undergone treatments like chemotherapy?
- Do you have a family history of cardiovascular diseases?
Your answers to these questions will give your doctor a better idea of your current physical condition.
Physical Examination
Next, the doctor will perform a thorough physical exam to analyze your heart activity. They’ll likely start by calculating your BMI and body fat percentage. Also, they’ll measure your vitals, including blood pressure and heart rate.
Additionally, they might use a stethoscope to identify abnormal heart sounds or murmurs that indicate a faulty heart valve. They’ll also watch out for soft noises or bruits to identify the narrowing of arteries.
They’ll examine your skin to see if it feels cold or looks discolored. They’ll also check your feet and abdomen for signs of fluid buildup. By the end of the physical exam, the doctor will have a better idea of your cardiovascular health.
Related : High Blood Pressure – Symptoms & Treatment
Diagnostic Tests
While a physical exam can indicate abnormal heart function, your doctor will likely run a few diagnostic tests to confirm the underlying cause of heart failure.
The most common tests include:
- Blood tests, such as complete blood count, lipid panel, liver and kidney function tests, and a fasting glucose test
- Brain natriuretic peptide (BNP) test to determine the risk of hospitalization and death due to heart failure
- Chest X-ray to detect enlarged heart muscle or fluid buildup around the heart
- 12-lead ECG to monitor the heart’s electrical activity and identify signs of a heart attack or irregular heartbeat
- Echocardiography for a closer look at the heart’s chambers and pumping action in real time
- Coronary angiography to identify coronary artery disease
Other tests like radionuclide ventriculography, exercise testing, and endomyocardial biopsy may also be prescribed.
Related : What is Coronary Angiogram?
In Conclusion
Diagnosing heart failure involves a combination of physical examination, blood tests, and non-invasive procedures like X-rays and ECG. The key is to identify the underlying cause of heart failure, so that your doctor can decide the right course of treatment.
Dr. C Raghu is an experienced cardiologist who specializes in interventional cardiology. If you or anyone you know is at risk of developing heart failure, reach out to Dr. Raghu for a thorough diagnosis.
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In our previous articles, we’ve discussed the symptoms of heart failure and the steps to diagnose the same. However, the course of treatment varies for every patient based on the type of heart failure they’ve developed.
Depending on the part of the heart’s pumping cycle that’s been affected, there are two types of heart failure. In this blog, we’ll take a closer look at diastolic dysfunction and its symptoms.
What Causes Diastolic Dysfunction?
The diastolic phase refers to the part of the heart’s pumping cycle when the ventricles (lower chambers) relax and let blood flow in from the atria (upper chambers). Diastolic dysfunction is a condition in which the ventricles don’t relax enough. That, in turn, prevents the normal amount of blood from entering the heart.
Diastolic dysfunction is caused when the heart muscles become thicker and stiffer than usual. It’s more common in older women with hypertension and diabetes. If left untreated, it can lead to diastolic heart failure (also known as heart failure with preserved ejection fraction).
Related : Understanding Congestive Heart Failure Symptoms
What Does Preserved Ejection Fraction Mean?
Ejection fraction refers to the volume of blood pumped out from the heart’s left ventricle with each contraction. For a healthy heart, the number falls in the range of 55% to 65%. A lower ejection fraction is one of the most common indicators of heart failure.
However, it’s worth noting that many people with diastolic dysfunction have an ejection fraction of 50% or more (which is known as preserved ejection fraction). That means the left ventricle expels an adequate amount of oxygenated blood.
However, the heart muscle doesn’t relax enough to let a sufficient quantity of blood in. That, in turn, causes the excess blood to back up in the lungs and results in fluid buildup in the feet and abdomen.
How to differentiate systolic from diastolic dysfunction ?
In contrast to systolic dysfunction where the heart muscle is “weak”, in diastolic dysfunction the heart is “stiff”. This means that the heart is unable to pump blood out of the heart in systolic dysfunction whereas the heart is unable to accept further blood in diastolic dysfunction. Both conditions lead to congestion or fluid accumulation in various organs of the body. Differentiation of heart failure from systolic and diastolic dysfunction is not possible as both diseases present with similar symptoms.
Which conditions lead to Diastolic dysfunction?
- Diastolic dysfunction appears consequent to uncontrolled or long-standing diabetes
- Hypertension
- Obesity as well as elderly people
- Women and atrial fibrillation
The best way to prevent and treat diastolic dysfunction is by effective control of the diseases mentioned above.
Symptoms of Diastolic Dysfunction
The most common symptom of diastolic dysfunction is congestion and shortness of breath due to the buildup of blood and fluid in the lungs. Breathing difficulties can get particularly worse during exertion or when lying.
Other symptoms of diastolic dysfunction include:
- Coughing and wheezing (due to lung congestion)
- Loss of appetite and nausea (due to fluid buildup around the liver and in the stomach)
- Swollen feet, legs, and abdomen (due to fluid accumulation)
If you experience any of the given symptoms, it’s crucial to consult a doctor for a proper diagnosis.
Treatment of Diastolic Dysfunction
Treatment of diastolic dysfunction involves a combination of medications (diuretics or water pills) and lifestyle changes. In severe cases, a patient might need left ventricular assist devices or a heart transplant.
Is Diastolic Dysfunction Serious?
In the long run, diastolic dysfunction can lead to diastolic heart failure. That, in turn, increases your risk of hospitalization and death. Therefore, you should pay close attention to your symptoms and reach out to a doctor whenever you notice anything unusual.
Dr. C Raghu is a renowned cardiologist who specializes in interventional cardiology. He has decades of experience in treating patients with different heart conditions. If you or anyone you know has developed symptoms like shortness of breath, swollen feet, loss of appetite, etc., contact Dr. Raghu to explore your treatment options.
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Heart failure is a common condition with no known cure. However, proper treatment can control the disease progression and thus improve a patient’s quality of life and longevity. To decide the proper course of treatment, a doctor must first determine the type of heart failure a patient has developed.
Depending on the part of the heart’s pumping cycle that’s been affected, heart failure can be of two types – diastolic and systolic. You can learn more about the symptoms, causes, treatment of diastolic dysfunction and differentiation from systolic dysfunction in our previous article.
In this blog, we’ll delve deeper into systolic heart failure and understand its causes and symptoms.
Systolic Heart Failure: A Closer Look
Systolic heart failure occurs due to a problem in the heart’s contraction (or systolic) phase. It’s characterized by stretching and weakening of the left ventricular muscle, due to which the heart pumps out less oxygenated blood to the body.
It’s also known as heart failure with reduced ejection infraction. As the condition worsens, it can also weaken the right ventricle and take a toll on its pumping power too.
Related: What Are the Symptoms of Diastolic Dysfunction?
Causes of Systolic Heart Failure
Systolic heart failure is caused by underlying medical conditions that damage the left ventricle. The most common causes include :
- Hypertension (the left ventricle has to use increased pressure to pump blood through the body)
- Coronary artery disease (buildup of cholesterol in the arteries) – with or without a heart attack.
- Dilated cardiomyopathy (weakening of the left ventricle due to an infection or long-term exposure to alcohol and narcotics)
- Abnormal heart rhythm (also known as atrial fibrillation)
- Previous heart attack
Additionally, people who are older or have diabetes are at a higher risk of developing systolic heart failure.
Related: Understanding Congestive Heart Failure Symptoms
Symptoms of Systolic Heart Failure
In systolic heart failure, an adequate amount of oxygen-rich blood doesn’t reach all organs. The most common indicator of the condition is a lower ejection fraction.
It can result in the following symptoms:
- Breathlessness – initially on exertion and in later stages even at rest or lying down.
- Swelling of feet, face, abdomen – due to fluid accumulation in various organs
- Engorged and pulsatile neck veins
- Confusion (due to a lack of oxygen supply in the brain)
- Weight gain (due to a buildup of excess fluid in the body)
- Fatigue (due to reduced blood supply to the muscles)
- Pale or bluish skin tone (due to restricted blood supply to the skin and other vital organs).
Diagnosis and Treatment Options
Typically, a doctor prescribes various tests, such as chest X-ray, ECG, and echocardiography, to diagnose systolic heart failure and its root cause. The treatment plan depends on the underlying cause.
In most cases, systolic heart failure is treated using one or more of the following medications:
- Beta-blockers
- Diuretics or water pills
- ACE inhibitors
- Digoxin
- Anticoagulants
Additionally, doctors recommend a healthy diet and lifestyle changes to improve cardiac health and manage underlying conditions, such as hypertension and diabetes.
Related: Diagnosing Congestive Heart Failure
In Conclusion
If left untreated, systolic heart failure can damage vital organs and even lead to death. It’s crucial that patients watch out for symptoms like swollen feet, mental confusion, and bluish skin color and seek medical treatment at the earliest.
Dr. C Raghu is an experienced cardiologist who specializes in interventional cardiology and TAVR. If you or anyone you know is experiencing symptoms of systolic heart failure, connect with Dr. Raghu for proper diagnosis and treatment.
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