- 1 Pacemaker, bypass and stent
- 2 Pacemaker, bypass and stent: general
- 3 Pacemaker, bypass and stent: causes
- 4 Heart disease: symptoms
- 5 Heart disease: examinations & diagnosis
- 6 Pacemaker, bypass and stent: implantation methods
- 7 Cardiological rehab
Pacemaker, bypass and stent
In the case of heart or vascular diseases, implants can help those affected to support the natural functioning of the heart or to restore the blood supply to the heart muscle. Find out everything here about the operative use of a pacemaker, bypass or stent and about the benefits of cardiological rehab.
Pacemaker, bypass and stent: general
If the heart beats irregularly or too slowly, a pacemaker can normalize the function. A cardiac bypass is used to bypass narrowed or completely closed coronary arteries so that the heart muscle can be adequately supplied with blood. A stent can expand and keep open coronary arteries that are too narrow. It is a tubular stent made of synthetic fiber or metal that is inserted into the blood vessel.
In 2013, more than 335,000 people underwent heart surgery in USA. Of these, 53,000 were bypass surgeries. The use of stents has increased steadily in recent years. In three quarters of all cases, coated stents were used to deliver medication and prevent the vessels from overgrowing again. In addition, over 70,000 pacemakers are used annually.
Pacemaker, bypass and stent: causes
The causes of using a pacemaker are usually certain types of irregular heartbeat. In these diseases, the stimulation of the heart muscle by electrical impulses is slowed down or partially suspended. A pacemaker specifies the rhythm with an electrical signal and normalizes the heart rate.
Muscles need enough oxygen to function. In the heart muscle, the coronary arteries are responsible for the supply. Arteriosclerosis ( arteriosclerosis ) can cause limescale, blood lipids and tissue to accumulate on the inside of the coronary arteries and constrict or occlude them. This affects the functioning of the heart (coronary artery disease). In more severe cases, the blood supply to the heart muscle must be surgically restored. This can be achieved by stents keeping the vessels open. Another possibility is the cardiac bypass, with which the closed vessels are bypassed and the blood can now flow over the bypass.
Heart disease: symptoms
A Coronary artery disease (narrowing of the coronary arteries) makes early stage often have no symptoms. Depending on the type of narrowing, symptoms such as pain, burning sensation behind the breastbone and tightness in the chest may develop over time. These symptoms are called angina pectoris .
Coronary artery disease or after a heart attack can lead to irregular heartbeat. Whether this has noticeable consequences depends on which region of the heart is affected and whether the heart is beating too fast or too slowly. If the heartbeat is too slow, the brain is no longer adequately supplied with blood. The result is nausea, dizziness and sometimes vision problems. Affected people often feel tired, exhausted, light-headed and can even pass out. A heartbeat that is too fast leads to a noticeable palpitations or “heart stumbling”. Anxiety, nervousness, dizziness and shortness of breath may also occur. Life-threatening conditions are possible in severe cases of cardiac arrhythmia.
Heart disease: examinations & diagnosis
If you suspect a heart disease, the doctor first clarifies in the conversation whether heart problems are already known to the patient and close relatives. During the subsequent physical examination, the heart and lungs are monitored with a stethoscope. The doctor measures blood pressure and pulse. He notes some basic data like height, weight and waist size. Then, more detailed investigations may follow.
Blood values provide information about the metabolism of fat and sugar. This makes it possible to identify circumstances that favor heart problems. Certain cardiac enzymes indicate heart disease. Liver, kidney and thyroid values as well as a blood count and the determination of electrolytes (this includes sodium and potassium, among other things) provide the doctor with important information about heart function.
With an EKG, electrodes are attached to the body that record the heartbeat. The ECG can be carried out at rest or under stress. Even after a heart operation, the ECG is important to control the course of the disease and the success of the treatment.
Cardiac catheter examination
During the cardiac catheter examination, a catheter is pushed through the aorta (main artery) into the heart under local anesthesia. A very detailed representation of the coronary arteries and the constrictions in them is possible. Thereby therapy and operations can be planned exactly.
Other special heart exams
An ultrasound of the heart (echocardiography) shows the size and function of the heart chambers. Depending on the type of heart disease, a number of other examinations can be carried out. These include, for example, imaging methods that can represent the heart, the coronary arteries or limescale deposits in blood vessels more precisely.
Pacemaker, bypass and stent: implantation methods
Read below how pacemakers, bypass or stents are used.
Implantation of a pacemaker
A pacemaker is implanted with local anesthesia. Through a small incision in the skin, one or two thin, flexible electrodes are pushed from the clavicle through a vein to the heart and placed on the heart muscle. The correct position and function is tested directly during the operation. The actual pacemaker, which emits electrical impulses, is implanted in the area of the pectoral muscles.
Heart bypass surgery
Bypass surgery bypasses constricted or closed coronary arteries by inserting healthy vessels. The body’s own blood vessels are used for this purpose, which are taken from the chest or leg. Cardiac bypass surgery always takes place under general anesthesia. The heart can be temporarily shut down and the patient connected to a heart-lung machine. Simpler operations can be performed on the beating heart.
Implant a stent
A stent can be used under local anesthesia. First, a catheter is advanced through a blood vessel to the narrowed area on the heart. The narrowing is stretched with a balloon. Then the stent unfolds in the blood vessel and forms a tubular reinforcement of the wall. It is immediately checked whether the stent is correctly positioned, has unfolded correctly, and that sufficient blood is again flowing through the treated blood vessel.
In most cases, patients with chronic heart diseases benefit from rehab. After the implantation of a pacemaker, stent or cardiac bypass, follow-up care is important to optimize healing and prevent new diseases.
Measures in rehab
Specialized rehabilitation clinics offer cardiac patients extensive facilities for examining the heart and blood vessels. Medicines and their dosage can be precisely adjusted in rehab. The most important measures in rehab include exercise therapy and a training program. Patients learn which exercises and sports strengthen the heart (cardiac gymnastics, vascular training). You regain security in dealing with physical stress. Before starting therapy, specialists determine individually how resilient they are and which measures are best suited for them.
Rehabilitation also includes information and training. Affected people learn everything about their illness, the consequences and opportunities of the therapy. If necessary, psychological support is offered. Nutritional advice, water and massage treatments, relaxation exercises and coping with stress can be just as much a part of rehab as measures and advice on returning to work.
Opportunities and benefits of rehab
A cardiac rehab is to make patients more resilient and efficient. After cardiac surgery, those affected have to regain courage to face everyday stress and to trust the performance of their heart. Rehabilitation also helps to cope with and handle the burden of heart disease and surgery. The USA Medical Association: “Cardiological rehabilitation should be an integral part of comprehensive care for cardiac patients that is geared towards long-term success”.