Coronary Artery Disease: Getting to the Heart of a 21st Century Epidemic

Cardiovascular diseases are the world’s biggest killers, with 17.9 million succumbing each year, accounting for 31% of annual mortalities. The good news though is that these rates are slowing down due to decreasing incidences of coronary atherosclerosis, or coronary artery disease.

Secondary prevention measures are also lowering the figures through the use of medications such as statins and beta-blockers, as well as aspirin, nitrates and also antiplatelets. The prescriptions vary according to what health issue is being targeted, such as high cholesterol and/or high blood pressure.

Lifestyle changes also have a considerable impact, giving individuals an active role in prevention and management of cardiac disease. At the same time, effective, timely treatment is key to reducing fatality rates as well.

While heart disease may be common, Bumrungrad International Hospital’s medical solutions are individual, based on expertise and experience so that different options than patients may expect can be offered. This can, in some cases, mean avoiding invasive heart bypass surgery.

Avoiding Heart Bypass Surgery

Since early diagnosis and effective treatment is crucial to manage coronary artery disease, connecting with the hospital’s pioneering cardiac team can be a lifeline. At the helm, Dr. Visuit Vivekaphirat explains how the hospital takes a unique approach to complex cardiology issues.

“Around half of our patients have multiple obstructions and would be considered by many heart specialists to be only suitable for heart bypass surgery. This is often the case when there’s a narrowing of three vessels that need medical attention. However, at Bumrungrad International Hospital’s specialist Complex Coronary Artery Intervention Center our experience means we can often offer catheter laboratory procedures instead.

The implications of potentially avoiding a major surgery in terms of patient experience, recovery time and, of course, expense is a real plus point. With medical advances, there are a variety of options to consider first and the hospital’s six-doctor team are at the forefront of cardiac understanding.

Diagnosing & Treating Coronary Artery Disease

Build-up of plaque in the coronary arteries, creating a condition called atherosclerosis, causes them to narrow as well as harden. The result is a decreased blood flow to the heart, leading to a raft of issues from chest pain to cardiac arrest. An electrocardiogram, exercise stress test and a cardiac ultrasound can investigate coronary artery disease, while advanced CT scans, cardiac MRI and a coronary angiography offer more advanced diagnostic tools.

Meanwhile, a cardiac coronary angioplasty can often be performed under local-anesthetic. A catheter is used to inflate a balloon or stent inside a blocked artery, in essence opening-up the blood flow. This effectively flattens any plaque against the artery wall, with the whole procedure taking just an hour or two.

Managing & Tackling Non-Complex Coronary Artery Disease

A stent may be recommended, yet this is not a solution that tackles the coronary artery disease itself. Instead, it seeks to solve an immediate issue, whereas lowering cholesterol, maintaining a healthy weight and low-fat diet, as well as exercising and quitting any dangerous habits such as smoking tackle the disease itself.

While an angioplasty may offer a minimally invasive procedure, some cases require a coronary artery bypass graft. This operation effectively bypasses compromised arteries by diverting blood flow around these clogged areas. The result is more oxygen being supplied to the heart.

Advanced Ways to Tackle Complex Cases

The Complex Coronary Artery Intervention Center can also use a special catheter technique for challenging or complex cases. Traditional treatments are not always available, perhaps due to the extent of the blockage, the number of arteries that are narrowed or their position. Patients identified as high-risk, possibly due to age, other health issues or heart failure may also be excluded too, along with some of those who have undergone angioplasty or bypass surgery in the past.

These more problematic situations require a multi-disciplinary approach to treatment with the professional support of Bumrungrad International Hospital’s highly skilled cardiology teams. Options include ‘drilling’ coronary artery calcification with a rotablator procedure; cardiac failure support using an ECMO machine; and an intra-aortic balloon pump therapy (IABP) to reduce the load on the heart. Additionally, an intravascular ultrasound inserted into the coronary arteries via a catheter promises a more in-depth exploration of how to treat individual issues and offer holistic cardiac care.

When getting to the heart of cardiac issues it is of paramount importance to look into and yet beyond usual treatments at advanced possibilities and specialist care. 

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