Monday Medical: Strides to keep hearts healthy
February 12, 2017
Editor's note: This article is the first in a three-part series about heart health for American Heart Month.
Heart disease remains the leading cause of death in the United States, but new treatments are making it easier to keep hearts healthy.
"The big thrust is finding ways to fix the heart and vascular system without surgery," said Dr. Will Baker, a cardiologist with YampaCare Cardiology. "These procedures are advancing and are very low risk with great long-term outcomes."
Below, Baker reviews some of the key advancements in the field.
More durable stents
When an artery leading to the heart becomes built up with fatty deposits, known as plaque, blood flow is reduced, resulting in chest pain and possibly a heart attack.
That's where a stent comes in. This tiny tube made of wire mesh is inserted in the clogged artery through use of a narrow tube or catheter that is threaded through the arteries. The stent then expands and locks in place, holding the clogged artery open.
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"After someone has a stent, the question I often get is, 'How long does it last?' Really, it lasts forever," Baker said. "Now, the risk of a stent blocking off again is less than a couple of percentage points."
Easier valve replacements
The heart has four chambers, all of which are separated by valves that must open and close properly to allow the right amount of blood to flow through at the right time. Valves can become too narrow or leaky, both of which hampers good blood flow.
Problematic aortic valves can now be replaced by accessing the heart through the arteries instead of through open-heart surgery, and a similar treatment will likely be available in the near future to replace the mitral valve without surgery. Another currently available option is the MitraClip, in which the mitral valve is clipped to improve function.
"These procedures are alternatives to open-heart surgery," Baker said. "The risk of surgery goes up as patients get older. Many people who would have been considered too high-risk to have valve surgery can now get the treatment they need."
Simpler treatment for rhythm disorders
The heart is an electrical organ, which means electrical impulses cause it to contract and relax in an organized way. But when sections become "electrically irritable," irregular heartbeats can result.
One treatment is ablation, in which the area of electrical irritability is pinpointed, then heated or frozen, helping rewire the heart to function normally. Ablation can be a good alternative to medications for people with atrial fibrillation, one common type of irregular heartbeat. Ablation has become a good alternative for almost any rhythm abnormality.
"There's just a short hospitalization period, and virtually no recovery time," Baker said. "It has a low complication rate and high relative success rate. It's not for everybody, but it's one more option and a good therapy for many."
More accurate ways to calculate risk of heart disease
Having a healthy lifestyle isn't a guarantee that your heart is healthy.
"You can be fit, you can be out there riding your bike 100 miles a day, but that doesn't mean you're free from the risk of heart disease," Baker said. "You still need to have an objective review of what your risks are."
Knowing your risk involves much more than just knowing what your cholesterol is. A good risk assessment will consider factors such as family history, blood pressure, personal habits such as smoking and more.
"Risk calculators take all these things together and provide a risk number, and we can determine a treatment," Baker said. "There's not some magical cholesterol number where you're safe on this side and at risk on that side — you have to drill down."
From leadless pacemakers that are in the process of being approved, to devices that prevent clots near the heart, treatments for heart disease are changing rapidly.
"There have been a lot of advancements in heart disease treatment," Baker said. "It's an exciting time, and there are a lot of exciting things coming in the future."
Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.