Coronary Interventions – a subspecialty that involves using non-surgical approach to treat narrowing of arteries of the heart found in coronary artery disease. (Photo: A close-up on narrowed artery)
By Dr Muhammad Bin Idu Jion, Consultant, Department of Cardiology, National Heart Centre SingaporeWhile many people with coronary artery disease can manage the disease with lifestyle changes and medications, others with severe conditions may need interventions such as coronary angioplasty to improve the health of the heart and blood vessels.Cardiovascular disease encompasses ischaemic heart disease and cerebrovascular disease (stroke) and is a leading cause of mortality globally which accounts for up to 32% of all deaths. In Singapore, ischaemic heart disease is the third most common cause of death and hospitalisation.
Ischaemic heart disease occurs due to a build-up of plaque in the heart arteries (coronary artery disease), and the risk increases with age and presence of other chronic diseases such as diabetes, hypertension and dyslipidaemia (abnormal levels of lipids in blood), or other risk factors such as smoking, a sedentary lifestyle and a family history of myocardial infarction (heart attack).Symptoms of ischaemic heart disease can present in several ways. Patients may present with an insidious onset of chest pain or breathlessness which occurs on exertion, termed stable angina, or they may present with heart failure signs and symptoms such as breathlessness on exertion or on lying flat, and water retention in the lungs and the lower limbs. Ischaemic heart disease can also present suddenly as an acute coronary syndrome, which range from unstable angina, nonST elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI). Acute coronary syndrome carries an average threemonth mortality rate of 5%. Patients with acute coronary syndrome may present with sudden or worsening chest pains and need to be hospitalised for treatment with medications such as antiplatelets, anticoagulants and statins, and undergo coronary evaluation and revascularisation if suitable. NHCS sees about 1,000 hospitalisations for acute coronary syndrome in a year that require coronary angiography for detecting narrowing in the arteries in the heart or angioplasty (minimally invasive, nonsurgical procedure for opening narrowed arteries).
A coronary angiography in progress.This article is from Murmurs Issue 34 (May – Aug 2019). Click here to read the full issue.
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