Coronary Artery Disease (CAD) is a growing menace in India, due to our lifestyles, food habits, and predisposition for diabetes and hypertension. In simple terms, it means heart disease with blockage in the blood vessels. CAD not only gives rise to angina and heart attack but could get way more complicated in its severe form. These complications manifest in the form of heart rupture, post infarct ventricular defect (hole in heart), leak in the mitral valve, complete heart block, aneurysm of heart chamber and severe damage to the contractility of heart giving rise to cardiac failure. These manifestations have a very high mortality, even upto 90% if the patient is on a medical treatment. The only hope of survival of the patient is by surgical treatment, which is a high risk operation (due to the complications involved). Unless the surgery is carried out, the heart usually succumbs to the disease. Most of the times, such hearts need mechanical support in the form of intra-aortic balloon pump, since their contractility is very poor.
Rupture of the heart is a grave emergency and requires immediate operation. In fact the only chance of survival of patient is getting operated without losing any time. Post infarct ventricular defects are treated by an open heart surgery (surgery involves closing the defect), along with coronary artery bypass. Leak in the mitral valve is treated by either repair, if possible, or replacement of damaged valve through an open heart operation with CABG; depending upon the coronary angiographic findings. When the heart attack involves the tissue of the conduction bundle of heart, it gives rise to complete heart block, resulting in extremely low heart rate, which is not compatible with life. In such cases, help of temporary cardiac pacemaker is required that sometimes results in permanent pacemaker implantation. Similarly, dilatation (enlargement) of the heart gives rise to severe heart failure, wherein the heart is unable to pump adequate blood, patients have severe breathlessness due to low cardiac output. The treatment of this condition is by repair of the aneurysm if there is sufficient healthy heart tissue or heart transplantation.
NH Jaipur is fully equipped with latest technology & state-of-the-art infrastructure to support all kinds of complex heart conditions. These fatal conditions are being operated for the last few years with most satisfying results. It is very important to receive timely and appropriate action for these conditions in order to achieve the positive results, which is usually wasted in process of thinking, deferring and referring the patients. During this period patients can go into irreversible damage and at this stage performing the operation proves a futile exercise. Hence timely recognition and treatment (operation) of these fatal complications of heart attack is the only ray of hope for the survival of these patients.
Dr. C.P. Srivastava
Chief Consultant & HOD Cardiac Surgery
Narayana Multispeciality Hospital, Jaipur