Coronary heart disease median clinics

Coronary artery disease (CAD), or coronary artery disease, is a calcification of the vessels that supply the heart muscle with blood and thus also with oxygen.

The calcification of arterial vessels is also called atherosclerosis. It can basically occur in all arterial vessels of the body and thus also damage all organs. If the coronary vessels are affected (coronary arteries), this is known as coronary heart disease. Risk factors The main risk factors for vascular calcification are smoking, high blood prere, diabetes mellitus and elevated cholesterol levels; a hereditary predisposition can also play a role.

Angina pectoris and heart attack

If the calcifications reduce the cross-section of the vessels and thus impair the oxygen supply to the heart muscle, symptoms may occur. This typically manifests itself as a Tightness in the chest, called angina pectoris, which can radiate to the shoulders and upper arms, jaw or back. But also shortness of breath, upper abdominal pain or nausea are possible. If a vessel is completely blocked, part of the heart muscle is cut off from the oxygen supply Heart attack. This is always a medical emergency. Often leads to typical changes in the ECG (ST elevation myocardial infarction or STEMI). However, some myocardial infarctions proceed without these typical changes and are then usually detected by blood sampling (non-ST elevation myocardial infarction or NSTEMI).Modern treatment methods have reduced the mortality rate due to a heart attack in recent decades. But even today, a heart attack is dangerous. The cause of death is usually an acute cardiac arrhythmia (ventricular fibrillation).

Balloon dilatation and stent

The most important goal of treatment for coronary heart disease is to improve the restricted blood supply to the heart muscle (myocardial revascularization). Especially in the case of myocardial infarction, this should be done as quickly as possible. For this reason, patients with acute circulatory disturbances are immediately subjected to cardiac catheterization. A long, thin tube is inserted through an artery in the groin or at the wrist and advanced to the heart. The coronary vessels can then be made visible on the X-ray screen via this tube with the aid of a radiopaque fluid (contrast medium). If a narrowing (stenosis) of the vessels is identified in this way, a balloon can be inserted into the vessel via the same catheter and the narrowing expanded and thus eliminated (balloon dilatation). To prevent a recurrence of the stenosis at the same site, a small vessel support called a stent is usually inserted. This is a type of wire mesh in the form of a tube that is folded and inserted into the coronary vessel and expanded to the desired width in the area of the constriction with the help of a balloon. Nowadays, these stents are almost always coated with a drug to prevent later overgrowth (drug-eluting stents, or DES).

Bypass surgery

In the case of pronounced vascular calcifications, treatment via cardiac catheterization is sometimes insufficient or not possible. Then, as an alternative, a bypass operation can be considered. In this procedure, the constriction or occlusion is not removed, but instead the blood is bypassed (bypass = bypassing). The heart surgeon opens the chest under general anesthesia through a sternotomy and exposes the heart. The body's own vessels are used as a bypass, which are taken from the leg or arm. In the area of the anterior wall, an artery that runs in the chest is often also diverted to the coronary artery. After heart surgery, mobility is usually still significantly limited as a result of the sternotomy in the beginning. Until the sternum is stable again, it must be spared by special rules of behavior. For example, many clinics prescribe a special corset for a limited period of time. Initially, it is also only possible to sleep on the back. The training program in rehabilitation is specially adapted to the situation.

Aims of the rehabilitation

In the Rehabilitation after a heart attack with catheter treatment or after bypass surgery, it is important to restore confidence in one's own ability to cope with stress and to bring one's performance back to the level to which one is accustomed. In addition, there is a lot that can be learned about the disease and its development at lectures and in discussions with doctors, nutritionists, therapists and psychologists. This helps in the processing and in stopping or at least slowing down the further progression of the vascular calcification together with the treating physicians.

A special meaning comes thereby an optimal Control of risk factors to. For smokers, the most important measure is to stop nicotine consumption – you will also find support in rehabilitation in this respect. Finally Blood prere, blood sugar and cholesterol are optimally controlled become. The central element is a healthy lifestyle with regular exercise and a healthy diet –the foundation is laid in rehabilitation. Often, supplementary medications are also useful, which can be optimally adjusted with the help of regular checks of the laboratory values, ultrasound findings and blood prere values.

All our clinics with a focus on cardiology are optimally equipped in terms of personnel and equipment for these tasks and have a great deal of experience with patients treated for circulatory disorders. We see it as our most important task to prepare you for your life with coronary heart disease and to discharge you well equipped to go home. We are looking forward to you!

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