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Treatments

Angioplasty/Stenting
Aginoplasty/Stenting 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 Ablations
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 (bypass surgery/valve repair or replacement)
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 Lukeís Hospital.

Implantable Devices
Implantable Devices

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.

Medications
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 medication.

  • 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 heart failure.

  • 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.

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