CARDIOLOGY – HEART AND VASCULAR SURGERY:

Differentiating between indigestion and a heart attack. Key factors: pain radiating to the arm/jaw, shortness of breath, cold sweats, and nausea.

Angina pectoris is chest pain, discomfort, or pressure caused by reduced blood flow and oxygen supply to the heart muscle (myocardium). It is a symptom of an underlying heart problem, most commonly coronary artery disease. Symptoms often include squeezing or tightness in the chest, neck, jaw, or arms, usually triggered by exertion or stress.

• A heart attack is a circulation problem.
• Cardiac arrest is an electrical problem.

Heart Attack:

Think of a heart attack as a “plumbing” problem.

• What it is: A heart attack occurs when a blockage, usually a blood clot, in one or more of the coronary arteries stops blood flow to a part of the heart muscle. Deprived of oxygen, that section of heart muscle begins to die.

Cardiac Arrest:

Think of cardiac arrest as an “electrical” problem.

• What it is: Cardiac arrest is the sudden, abrupt loss of heart function. The heart’s electrical system malfunctions, causing an irregular heartbeat (arrhythmia), such as ventricular fibrillation. This causes the heart to stop beating effectively and quiver instead of pumping blood.

• EKG (ECG): Measures the electrical activity at rest.
• Echocardiogram: An ultrasound to look at the structure and pumping function.
• Stress Test: Monitors the heart under exertion (usually on a treadmill) to see if blood flow is restricted.

Atrial fibrillation (AFib or AF) is the most common heart rhythm disorder (arrhythmia) characterized by a rapid, irregular, and chaotic heartbeat, where the heart’s upper chambers (atria) quiver instead of contracting effectively. It causes a, sometimes, very fast heart rate (100–175+ bpm), leading to symptoms like palpitations, dizziness, fatigue, and increased stroke risk.

Heart failure is a chronic, progressive condition where the heart muscle is too weak or stiff to pump blood efficiently, often causing fluid backup in the lungs and body. It does not mean the heart has stopped, but that it needs support to function. Key symptoms include shortness of breath, fatigue, and swollen legs/ankles.

Blood pressure is the force of blood pushing against artery walls as the heart pumps it throughout the body. Measured in millimetres of mercury (mmHg), it includes two numbers: systolic (maximum pressure when the heart beats) and diastolic (lowest pressure when the heart rests). Normal, healthy reading is typically below 120/80 mmHg.

Cardiac catheterization is a minimally invasive, diagnostic, and therapeutic procedure where a thin, flexible tube (catheter) is inserted into a blood vessel in the arm, groin, or neck and guided to the heart under X-ray guidance. It is used to measure heart pressures, take blood samples, inject contrast dye for imaging (angiography), and treat conditions like clogged arteries with stents or balloons.

Coronary artery bypass graft (CABG, pronounced “cabbage”) surgery is a common, major heart procedure used to treat coronary heart disease by bypassing blocked or narrowed arteries, enhancing blood flow to the heart muscle. It involves taking healthy blood vessels—often from the leg or chest—to create a new route, or “bypass,” around the blockage, typically for patients with severe heart artery disease.

Heart valve surgery is a procedure to repair or replace diseased heart valves that do not open or close properly. It treats conditions like stenosis or regurgitation to improve blood flow and reduce symptoms such as fatigue or chest pain. It is often performed via open-heart surgery, though minimally invasive options are available.

Transcatheter aortic valve replacement (TAVR or TAVI) is a minimally invasive procedure that replaces a narrowed, diseased aortic valve (stenosis) with a new valve, usually made from cow or pig tissue. It is primarily used for patients who are high-risk or too frail for open-heart surgery, offering a faster recovery, often allowing discharge in 1-3 days. The procedure involves inserting a catheter, typically through a small incision in the groin, and guiding it to the heart to implant the new valve.

An aneurysm in the heart region is typically a thoracic aortic aneurysm, which is a dangerous, balloon-like bulge in the wall of the main artery (aorta) as it exits the heart. Caused by weakened, inelastic artery walls, these aneurysms can grow slowly, often without symptoms, but risk rupturing or tearing (dissection), which causes life-threatening internal bleeding.

Peripheral Artery Disease (PAD) and Peripheral Vascular Disease (PVD) both involve restricted blood flow in limbs, but differ in affected vessels. PAD specifically causes narrowed arteries from plaque (atherosclerosis), causing cold, painful, crampy legs. PVD is a broader term, often referring to vein issues like varicose veins or blood clots that cause swollen, warm, achy limbs.

Coronary artery disease (CAD) and heart failure are distinct but related conditions: CAD is a structural problem involving plaque buildup that restricts blood flow (blocked arteries) to the heart. Heart failure is a functional condition where the heart is too weak or stiff to pump blood efficiently. CAD is a leading cause of heart failure.

Bypass surgery (CABG) is generally superior for complex, multi-vessel, or diabetic heart disease due to better long-term outcomes and fewer repeat procedures. Stents are less invasive with quicker recovery, making them better for less severe, single-vessel blockages. Both offer similar survival rates, though bypass provides more durable, long-term protection. 

Varicose veins are enlarged, twisted, and swollen veins, most commonly appearing as dark purple or blue bulging cords on the legs, ankles, or feet. They are caused by weak or damaged vein walls and dysfunctional one-way valves that allow blood to pool and flow backward (reflux). While often cosmetic, they can cause aching, pain, swelling, and itchiness.

Varicose vein treatments focus on closing or removing damaged veins to improve circulation and reduce symptoms. Top options include minimally invasive, walk-in/walk-out procedures like endothermal (laser/radiofrequency) ablation, foam sclerotherapy, and vein glue (cyanoacrylate). For smaller veins, phlebectomy is used, while conservative care involves compression stockings, elevating legs, and weight management.