The passage of time has done little to threaten heart disease’s solid position as one of the world’s leading killers. But that may be changing. In just the past few years, new technologies have delivered significant advances in the way heart disease is diagnosed and treated.
Heart disease is a simple term for a number of complex medical conditions with many possible causes and a variety of treatment options. Diagnosing heart disease often requires doctors to employ a combination of testing methods.
The stress test is one of the most widely used tools to help detect heart-related problems. The test requires a patient to walk or run on a treadmill while sensors monitor the performance of the heart, coronary arteries, and other areas of the body. According to Dr.Pitsanu Kerdsinchai
, a board-certified cardiologist, the stress test is an important diagnostic tool because the movement on the treadmill forces the heart to work increasingly harder to deliver more blood throughout the body. The electrocardiogram (EKG) and blood pressure monitors
used in the stress test are able to spot many existing and potential heart problems.
The cardiologist is responsible for adjusting different components of the test based on a patient’s age, current health status and medical history. ”There isn’t a pre-set duration for the test,” Dr.Pisanu explains. “Running may not be required in a particular patient's stress test, as fast walking may be sufficient for reaching the target heart rate. The EKG reveals signs of potential problems.”
A stress test is usually included as part of the annual check-up for patients 40 years of age and older, as well as for younger people who may be considered at greater risk for heart disease. Heart disease risk factors include family history, smoking, diabetes, obesity and high blood pressure. A stress test may not be suitable for patients with arthritis of the knee, nor for patients who have been diagnosed with an abnormal EKG.
“Some patients may need to stop taking certain medications for a period of time before their check-up or stress test,” notes Dr.Pisanu. “Be sure to talk to your doctor before making any changes to your medication schedule.”
Dr.Tanyalak Chaiseree ECHOCARDIOGRAPHY
Though not as well known as the stress test, echocardiography is another important hi-tech tool for diagnosing serious heart problems. According to Dr.Tanyalak Chaiseree
, a medical cardiologist, echocardiography is a sonogram of the heart. “Echocardiography provides highly-detailed images of the heart,” says Dr.Tanyalak, “in similar fashion to how ultrasound is used to see other organs. Echocardiography shows the heart’s anatomy, including the size of each chamber, the thickness of the heart wall, and the strength of heart contractions.”
“This technology helps detect inadequate blood supply (ischemic event),” Dr.Tanyalak continues, “and it can reveal signs of heart muscle weakness or damage. To help doctors check blood circulation, echocardiography technology can now colorize images to show the speed and velocity of blood as it flows to and from the heart.”
“This advanced technology has several other important benefits.” adds Dr.Tanyalak. “It has improved detection of leaks and blockages of heart valve, allows doctors to determine the severity of a patient's heart disease more precisely, and it is being used to detect congenital heart defects such as holes in the wall of the heart.”
has been shown to be highly effective and very safe. It is being used extensively to help diagnose nearly every type of heart disease, including valvular, congenital and pericardial heart disease. Echocardiography is also used to locate blood clots and tumors in the heart. Current echocardiography technology is not able to produce direct images of the coronary arteries; a coronary angiogram or other procedures would be needed for artery imaging.
While prevention is always best, advances in technology are delivering more effective and less traumatic treatments for heart disease patients.
Dr.Chotikorn Khunnawat PACEMAKER
is a tiny device that keeps the heart beating at a steady, healthy rate. Its main components are a generator and tiny wires called leads. A surgeon implants the pacemaker in the left side of the chest, under the collarbone.
Pacemakers are commonly used to treat cardiac arrhythmia patients, especially those with weak heart rates. The weak heart rate can cause dizziness, nausea, fainting spells and even heart attacks. “Slow heart rate is one of the results of heart disease,” says Dr.Chotikorn Khunnawat
, an experienced cardiologist. “It can also be a side effect of taking medication for other medical problems.”
“There are many non-invasive treatments, including medication, for patients with slow heart rates,” Dr.Chotikorn explains. “A pacemaker is usually only considered after non-invasive treatments have been unsuccessful.” Pacemaker implantation is a surgical procedure. Patients usually spend one or two nights in the hospital following the procedure for healing and recovery. The doctor will monitor pacemaker functioning through periodic follow-up appointments. Most pacemakers have a lifetime of five to 10 years.
Dr.Chad Wanishsawad BALLOON STENTING
is one of the most effective, less-invasive procedures to open clogged coronary arteries and restore healthy blood flow. Dr.Chad Wanishsawad
, a board-certified cardiologist, describes the stenting procedure: “Balloon stenting does not require surgical incisions. With the help of real-time X-ray imaging, the doctor positions an ultra-thin catheter tube carrying the deflated balloon to the constricted artery. The balloon is then inflated to expand the artery until normal blood flow resumes. The stent is then locked in place and remains inside to keep the artery open.”
Most stents are made of stainless steel or chromium, which doesn’t set off metal detectors. Some stents are coated with anti-constriction medication to offer more protection against artery constriction.
“Balloon stenting offers the advantages of less trauma and lower risk than conventional bypass surgery, with equally good results,” adds Dr.Chad. “Balloon stenting
is usually more effective than the balloon-only procedure, because the stent stays in the artery to offer future protection against constricting arteries.”