Common symptoms and signs seen in Interventional Cardiology or by an Interventional cardiologist
Chest pain is a symptom which often raises concerns amongst people to seek medical attention. While it’s crucial to recognize that not all chest pain is a sign of a heart problem; however when it comes to matters of the heart, timely medical checks are important.
Chest pain symptoms can can manifest in different ways, ranging from a dull ache to a sharp, stabbing sensation. It’s essential to pay attention to related health symptoms, such as shortness of breath, nausea, or sweating. These could be signs of a heart-related issue. However, chest pain can also stem from gastrointestinal problems, muscle strain, or respiratory issues.
Cardiac chest pain is typically related with a mismatch between oxygen demand and oxygen supply to the heart. Narrowing in the vessels supplying the heart or a dysfunction of the small capillaries of the heart (aka microvascular dysfunction) are the most common mechanisms responsible of such mismatch.
Some of the most commonly cardiac related chest pain is associated with or triggered by some forms of physical activities or intense emotional stressors. Though occurrence is possible also in resting conditions, hence it is usually wise to not underestimate it.
Interventional Cardiology Tests and Procedures
Interventional cardiologists can perform many types of tests and procedures on people of all ages. It’s important to note that while interventional cardiologists perform a number of life-saving procedures, they do not do traditional “open” surgery; like a cardiac surgeon. The tests and procedures an interventional cardiologist performs or orders depend on the patient’s specific issue, and overall patient health. Diagnosing conditions that need an Interventional cardiologist, may involve the Interventional cardiologist to order and perform tests and procedures that include:
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Cardiovascular Imaging
Interventional cardiologists may order imaging studies to get a detailed look at the structure and function of the heart and cardiovascular system. This helps them to evaluate, diagnose, and manage heart and vascular concerns. -
Cardiac computed tomography (CCT, “cardiac CT”)
Uses X-ray technology, imaging, and computers to review different views of the heart’s anatomy, circulation, and the greater vessels of the cardiovascular system. Cardiac CT imaging helps doctors to assess and treat many cardiovascular issues, including aortic disease, cardiac masses, pericardial disease, and problems with myocardium, coronary arteries, and pulmonary veins. Specialized types of computed tomography used in cardiology include electron-beam CT (EBCT), multi-detector CT (MDCT), and single-photon emission CT (SPECT). -
Coronary angiography
This imaging study uses contrast dye, which is injected into the bloodstream through a catheter and is visible in X-ray images as blood flows through the arteries. This shows doctors where there are blockages and other critical cardiovascular problems.
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Digital subtraction angiography (DSA)
This fluoroscopic imaging method is used to more clearly visualize blood vessels by digitally removing (or subtracting) structures such as bones from images. -
Echocardiogram
This type of imaging uses high-frequency sound waves (ultrasound) to create images of the heart’s chambers, valves, walls, and blood vessels. “The specialized technique reveals the size and shape of a patient’s heart, as well as the thickness and movement of the heart walls as it beats. Cardiologists use echocardiogram testing to examine “how the heart moves, the pumping strength, valve function, if blood is leaking backwards through the vales (regurgitation), if the valves are too narrow (stenosis), or if there is a tumor or infectious growth. It also helps us determine if a patient had a heart attack, predict if one is developing, and monitor changes in the heart rhythm. -
Intravascular ultrasound
This catheter based diagnostic procedure uses sound waves to generate images of the inside of blood vessels, helping doctors assess the coronary arteries that supply the heart with blood.
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Magnetic resonance imaging (MRI)
Cardiac MRI creates detailed images of the structures in and around the heart. These images produced with the use of a magnetic field, radio waves, and a computer, (not radiation) are used to evaluate, diagnose, and monitor heart disease and to evaluate the heart's structure and function in both congenital and acquired heart disease. -
Myocardial perfusion imaging (MPI):
For this test, a radioactive substance called thallium is injected into the bloodstream when a patient is at maximum level of exercise, and it’s used to take images of the heart’s muscle cells. This helps to measure blood flow of the heart at rest and during stress, which helps to further determine things like the size of a coronary artery blockage; the extent of damage from a heart attack; the cause of chest pain; and a safe level of exercise for patients.
- Interventional cardiologists perform a variety of diagnostic and therapeutic procedures, including:
- Alcohol septal ablation: This catheter based procedure is typically used as a non-surgical way to treat hypertrophic cardiomyopathy (HCM), a thickening of the heart muscle. Ethanol alcohol is injected into a small artery that supplies blood to the thickened part of the heart muscle, causing the cells to die and shrinking the diseased tissue.
- Angioplasty: A minimally invasive procedure in which a device such as a balloon or stent is used to open a blocked artery and restore blood flow. Types include balloon angioplasty and cutting balloon angioplasty. Angioplasty is often a same-day or daycare procedure.
- Cardiac catheterization: This procedure is done to examine how well the heart is working. A thin, hollow tube called a catheter is inserted into a large blood vessel that leads into the heart. This procedure is used to determine if a patient has a disease of the heart muscle, heart valves, or coronary arteries.
- Atrial septal defect (ASD) closure: This procedure is used to treat atrial septal defects (holes in the heart present at birth) that do not close on their own. The holes are usually closed using special patches or plugs. Depending on the patient’s overall health, the size and location of the defect, and other factors, ASD closures may be performed with a minimally invasively cardiac catheterization or may require traditional “open” surgery.
- Aortic balloon valvuloplasty and mitral balloon valvuloplasty: This procedure is used in patients who have narrowing of the aortic valve or the mitral valve, which decreases blood flow. Balloon valvuloplasty opens up the area to restore optimal blood flow.
- Chronic total occlusion (CTO) intervention: Used to treat a complete blockage of one or more coronary arteries (chronic total occlusion), a minimally invasive stenting procedure can be performed in some patients. Other patients with CTO may require traditional coronary bypass surgery (done by a cardiac surgeon) to treat this serious cardiac problem.
- Carotid artery stenting: A minimally invasive stenting procedure may be used to open a narrowed or blocked carotid artery.
- Directional coronary atherectomy (DCA): This endovascular procedure is used to remove blockages from coronary arteries, improving blood flow to the heart muscle and relieving pain (angina).
- Endovascular thrombectomy: This minimally invasive procedure is typically used to remove a blood clot (thrombus) that is blocking an artery. Thrombectomy also may be used to treat certain strokes and other conditions.
- Exercise stress test: The electrodes of a cardiac monitor are attached to the skin on and around a patient’s chest during an exercise stress test. While the patient walks on a treadmill, information about heart function is recorded. This test can help us diagnose coronary artery disease, identify the causes of symptoms such as chest pain, and predict many dangerous heart-related conditions.
- Hemodynamic cardiac filters and hemodynamic support procedures: These devices and procedures are related to blood flow in the heart.
- Peripheral vascular interventions: Used to treat peripheral vascular disease (also called peripheral artery disease), these procedures include angioplasty, stenting, and atherectomy.
- Percutaneous coronary interventions: These minimally invasive procedures are used to treat a growing number of coronary artery conditions. They are often performed at ambulatory (same-day, outpatient) surgical centers.
- Percutaneous valve repair: Less invasive procedures can be used to repair diseased heart valves.
- Rotational atherectomy: This catheter-based procedure is used to remove complex calcified lesions in the coronary arteries that contribute to coronary artery disease.
- Stenting: Used to widen and hold open a blocked coronary artery, a cardiac stent is a tiny device implanted in a coronary artery using one of several types of minimally invasive procedures. Using tiny incisions, an interventional cardiologist inserts a catheter into an artery in the patient’s arm or groin, threads it up to the narrowed or blocked part of the artery, and places the stent, increasing blood flow to the heart and reducing the risk of heart attack. Drug-eluting stents are stents coated with medication that slowly releases into the treated area over time, preventing the formation and build-up of scar tissue.
- Transcatheter aortic valve replacement (TAVR): Transcatheter aortic valve replacement is an endoscopic heart procedure used to replace a narrowed aortic valve that doesn’t open and close correctly, resulting in aortic valve stenosis. This procedure is also known as transcatheter aortic valve implantation (TAVI).
- Ventricular septal defect (VSD) repair: This minimally invasive procedure is used to close ventricular septal defects, holes in the heart that are present at birth.