Angioplasties and stentings are two common types of treatment procedures
done via catheterization. During an angioplasty, a catheter with a balloon
at the tip is passed into a narrowed coronary artery and the balloon is
inflated to open the blockage in the artery. Stenting involves placing
a tiny metal scaffolding in the artery, and leaving it there to help keep
the artery propped open. Angioplasties and stenting procedures on women
are best handled by cardiologists who specialize in treating womenís heart
disease since women are at a slightly greater risk for bleeding complications
and vascular complications from these procedures.
Cardiac ablation is an effective treatment for many types of arrhythmias,
eliminating the need for long-term medication therapy. Cardiac ablation
is used to either destroy electrical short-circuits and restore normal
heart rhythm, or block damaged electrical pathways from sending faulty
signals to the rest of the heart. This is done by sending energy through
catheters to destroy a small amount of tissue at the site. Cardiac ablations
often immediately follow electrophysicological testing, when the location
of the short circuit is identified.
Cardiac surgery refers to a variety of open heart surgical procedures
that are used to treat a vast array of heart conditions. These surgical
procedures include bypass surgery, valve surgery, and correction of congenital
heart disease. Cardiac surgery for women is slightly different than surgery
on men because womenís vessels are smaller and may require special skills
to bypass the arteries. In addition, women are at a slightly greater risk
for bleeding complications following surgery; therefore cardiac surgery
for women is best handled by experts in treating womenís heart disease.
Cardiac surgery services are available at Mount Sinai Beth Israel and St
Implantable devices such as pacemakers and implantable cardioverter defibrillators
(ICDs) are used to monitor the heart and assist in maintaining a heart's
rhythm. Defibrillators are special devices that provide an electrical
current (which can be lifesaving) when the heart develops a life threatening
rhythm. These devices are inserted below the patientís collar bone and
are generally outpatient procedures. The US Food and Drug Administration
(FDA) recently approved a special type of pacemaker for certain patients
with congestive heart failure, called cardiac resynchronization therapy
that has been shown to be especially effective in women.
Sometimes, medications may be needed to help prevent or control symptoms
of heart disease. Categories of heart medications include:
- Anti-anginal agents or anti-ischemics
relax the arteries of the heart or decrease the amount of work done
by the heart and relieve chest pain.
- Anti-arrhythmic medications are used to treat, prevent
or lessen the frequency or severity of abnormal heart rhythms or arrhythmias
- Anti-hypertensive drugs are used to reduce high
blood pressure and, thus, relieve the heartís work. Some of these
antihypertensive medications may also be used to treat patients with
chest pain, and congestive heart failure.
- Anti-platelet agents, such as aspirin, clopidogrel,
and Prasugrel, which inhibit clotting and reduce the incidence of heart
attacks and strokes.
- Anti-thrombotics or anticoagulants help to thin
the blood and decrease clot formation. These agents can be given intravenously
or by injection when a patient is hospitalized or orally for some chronic
conditions. These agents are commonly used in the treatment of patients
with heart attacks. Some oral agents include Coumadin (warfarin) and
Pradaxa (dabigatran). Patients taking warfarin require periodic blood
tests to ensure that the blood is appropriately thinned.
- Cholesterol-lowering drugs decrease the likelihood
of coronary artery disease and heart
attacks by stabilizing plaques in the arteries of the hearts and
reducing further build-up of plaque. Cholesterol lowering drugs may
also be helpful in preventing some arrhythmias.
Statins are the most common agents used; they decrease cholesterol synthesis
in the liver and increase the uptake of cholesterol by the liver. Individuals
taking statins and other cholesterol medications often require periodic
blood tests to check the liver enzymes and the bodyís response to the
- Digoxin is a medication that can slow the heart rate
and improve the strength of the heart. It can be used to treat atrial
fibrillation and sometimes congestive
- Diuretics decrease salts in the body and relieve
the build-up of fluids in the body. These are used to reduce the heart's
workload in congestive heart failure
and can help lower high blood pressure.
They are sometimes referred to as "water pills." People taking water
pills often require periodic blood tests to check electrolyte levels
in the body, and may need to take extra potassium to maintain safe levels
in the blood.
- Inotropic and cardiotonic drugs stimulate the heart
muscle contractions, and may be helpful for patients with congestive
heart failure. These drugs are generally given in the hospital to
patients with severe congestive heart failure.
- Thrombolytic agents or clot-busting drugs are administered
in the early stages of a heart attack or stroke to break up a blood
clot and restore blood flow.
To make an appointment with a Womenís Heart NY physician, please call
(877) WOMEN-00/(877) 966-3600.