Heart attack/ ischemic heart disease?
What is heart attack/ ischemic heart disease?
Ischemic heart disease occurs when there's narrowing or blockage in the arteries that supply blood to the heart muscles, known as coronary arteries. If the blockages are severe, heart bypass surgery in Mumbai is often recommended to restore blood flow.
What causes the narrowing of the arteries?
The primary cause is atherosclerosis—the accumulation of cholesterol, fatty substances, calcium, and fibrin in the artery walls. Over time, it may lead to complete blockage. In such cases, coronary artery bypass grafting in Mumbai can help reroute blood flow effectively.
What are the risk factors for coronary artery disease?
The risk factors can be classified into modifiable and non-modifiable:
Non-modifiable:
- Age: Risk increases after 35 years.
- Gender: Men are at higher risk.
- Ethnicity: Southeast Asians, Hispanics, Blacks, and Latinos are more prone.
- Family History: Relatives with early heart disease increase your risk.
Modifiable:
- High blood pressure (hypertension)
- High bad cholesterol (hyperlipidemia)
- Diabetes
- Obesity
- Smoking
- Poor diet
- Sedentary lifestyle
For high-risk individuals, doctors may advise advanced cardiac surgery in Mumbai as a more reliable treatment option.
What are the symptoms?
- Chest pain (heaviness, tightness, pressure)
- Pain in the shoulders, arms, neck, jaw
- Fatigue, dizziness
- Nausea, indigestion-like discomfort
- Cold sweat
Some symptoms can be atypical. A consultation with one of the best bypass surgeons in Mumbai is crucial for early diagnosis and timely intervention.
Diagnostic Investigations:
- ECG: Detects heart rhythm issues and acute attacks.
- Stress Tests: Assesses heart function during physical exertion.
- Pharmacologic Stress Tests: Uses medication to simulate cardiac stress.
- CT Coronary Angiogram: Shows blockages and artery structure.
- Echocardiogram: Evaluates heart structure and function.
- Blood Tests: Measures heart attack markers like Troponin T/I, CPK MB.
- Nuclear Imaging: Identifies heart muscle viability.
- Angiogram: Uses contrast dye to visualize coronary arteries.
Based on your test results, your doctor may advise CABG surgery in Mumbai for better long-term management of coronary artery disease.
What is the treatment of blockages in the artery?
Treatment depends on age, severity, and presence of comorbidities like diabetes. While angioplasty is viable, bypass surgery in Mumbai often yields better long-term outcomes in complex cases.
Angioplasty or stenting is a also shown to have good results. Discuss with your doctor about the treatment plan.
What is bypass surgery
Heart bypass surgery, or coronary artery bypass graft (CABG) surgery, is used to improve blood flow to your heart if you have ischemic heart disease. A surgeon uses blood vessels taken from another area of your body to bypass the blockages in the arteries. Coronary bypass surgery redirects blood around a section of a blocked or partially blocked artery in your heart. The procedure involves taking a healthy blood vessel from your leg, arm or chest and connecting it below and above the blocked arteries in your heart. With a new pathway, blood flow to the heart muscle improves.
For some people, this procedure can improve heart function and reduce the risk of dying of heart disease.
Why is it done?
Coronary bypass surgery is one treatment option if you have a blocked artery to your heart.
You and your doctor might consider it if:
- You have severe chest pain caused by narrowing of several arteries that supply your heart muscle.
- You have high blood sugar levels and more than one diseased coronary artery.
- Your left main coronary artery is severely narrowed or blocked. This artery supplies most of the blood to the left heart.
- You have an artery blockage that can't be treated with angioplasty (balloon widening procedure).
- You've had a previous angioplasty but now there is narrowing of the stent or new blockages.
Coronary bypass surgery might also be performed in emergency situations, such as a heart attack, if you're not responding to other treatments.
Even with coronary bypass surgery, you'll need to make lifestyle changes after surgery. Medications are prescribed routinely after coronary bypass surgery to lower your blood cholesterol, reduce the risk of developing a blood clot and help your heart work as well as possible.
What you can expect
If your coronary bypass surgery isn't performed as emergency surgery, you'll likely be admitted to the hospital a day before of the surgery.
Coronary bypass surgery generally takes between three and six hours and requires general anesthesia. The number of bypasses you need depends on where in your heart and how severe your blockages are.
For general anesthesia, a breathing tube is inserted through your mouth. This tube attaches to a ventilator, which breathes for you during and immediately after the surgery.
Most coronary bypass surgeries are done through a long incision in the chest while a heart-lung machine keeps blood and oxygen flowing through your body. This is called on-pump coronary bypass surgery.
The surgeon cuts down the center of the chest along the breastbone and spreads open the rib cage to expose the heart. After the chest is opened, the heart is temporarily stopped with medication and a heart-lung machine takes over to circulate blood to the body.
The surgeon takes a section of healthy blood vessel, often from inside the chest wall or from the lower leg,or hand and attaches the ends above and below the blocked artery so that blood flow is redirected around the narrowed part of the diseased artery.
Other surgical techniques your surgeon might use include:
Off-pump or beating-heart surgery. This procedure involves doing surgery on the beating heart using special equipment to stabilize the area of the heart the surgeon is working on. This type of surgery is challenging because the heart is still moving. It's not an option for everyone.
Minimal access surgery. A surgeon performs coronary bypass through small incisions in the chest, often with the use of robotics and video imaging that help the surgeon operate in a small area. Variations of minimally invasive surgery might be called port-access or keyhole surgery.
After completing the graft, the surgeon will use wire to close your chest bone. The wire will remain in your body after the bone heals.
Expect to spend a day or two in the intensive care unit. The breathing tube will remain in your throat until you are awake and able to breathe on your own. You'll receive fluids and medications through an IV. Other tubes drain urine from the bladder and fluid and blood from the chest. You might be given oxygen through a mask or nasal prongs in your nose.
Cardiac rehabilitation often begins while you're still in the hospital. You'll be given an exercise and education program designed to help you recover. You'll continue with monitored programs in an outpatient setting until you can safely follow a home-based maintenance program.
Barring complications, you'll likely be discharged from the hospital within a week. You still might have difficulty doing everyday tasks or walking a short distance.
What things I need to look for after surgery?
If, after returning home, you have any of the following signs or symptoms, call your doctor:
- Fever
- Rapid heart rate
- New or worsened pain around your chest wound
- Reddening around your chest wound or bleeding or other discharge from your chest wound Expect a recovery period of about six to 12 weeks. If you have your doctor's OK, you can return to work, begin exercising and resume sexual activity after four to six weeks.
Results
After surgery, most people feel better and might remain symptom-free for as long as 10 to 15 years. Over time, however, it's possible that other arteries or even the new graft used in the bypass will become clogged, requiring another bypass or angioplasty.
Your results and long-term outcome will depend in part on taking your medications to prevent blood clots, lower blood pressure, lower cholesterol and help control diabetes. It's also important to follow healthy-lifestyle recommendations, including these:
- Stop smoking.
- Follow a healthy-eating plan.
- Achieve and maintain a healthy weight.
- Exercise regularly.
- Manage stress.
