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CARDIOLOGY
Djuraeva Barno Gulomovna Turdaliev Diyorbek Khasanov Sardor
https://www.doi.org/10.5281/zenodo.10578986
ARTICLE INFO
Received: 22th January 2024 Accepted: 28th January 2024 Online: 29th January 2024
KEY WORDS Cardiology, Coronary Artery Disease (CAD, Heart Failure, Arrhythmias, Valvular Heart Disease, Diagnostic Techniques, Preventive Cardiology,
Interventional Cardiology, Telemedicine.
ABSTRACT
This essay provides a comprehensive exploration of cardiology, delving into the intricate anatomy and physiology of the heart, common cardiovascular conditions, diagnostic techniques, preventive strategies, and the dynamic advancements in the field. It emphasizes the importance of understanding heart health, detailing the complexities of conditions like coronary artery disease, heart failure, arrhythmias, and valvular heart disease. The essay also highlights the evolving landscape of cardiology, incorporating telemedicine, precision medicine, and artificial intelligence. The holistic approach includes preventive cardiology, diagnostic tools, and treatment modalities, offering a nuancedperspective on maintaining and enhancing cardiovascular well-being.
The Heart Is a Pump The heart is a muscle that pumps blood around the body through a series of pipes. These pipes are called arteries. The left side of the heart receives fresh, oxygen-rich blood from the lungs and then pumps it out a large artery called the aorta that branches into smaller arteries that go to all parts of the body. The various parts of the body then take the oxygen out of the blood and the now stale, oxygen-poor blood is returned to the right side of the heart through pipes called veins. The right side of the heart pumps this stale blood to the lungs where it picks up more oxygen and the cycle begins again. The Coronary Arteries The heart muscle, like every other part of the body, needs its own oxygen-rich blood supply. Arteries branch off the aorta and spread over the outside surface of the heart. The Right Coronary Artery (RCA) supplies the bottom part of the heart. The short Left Main (LM) artery branches into the Left Anterior Descending (LAD) artery that supplies the front of the heart and the Circumflex (Cx) artery that supplies the back of the heart.
What is coronary artery disease? Coronary artery disease is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis (sometimes called "hardening" or "clogging" of the arteries) is the buildup of cholesterol and fatty deposits (called plaques) on the inner walls of the arteries. These plaques can restrict blood flow to the heart muscle by physically clogging the artery or by causing abnormal artery tone and function.
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Without an adequate blood supply, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. If blood supply to a portion of the heart muscle is cut off entirely, or if the energy demands of the heart become much greater than its blood supply, a heart attack (injury to the heart muscle) may occur.
What causes the coronary arteries to narrow? Your coronary arteries are shaped like hollow tubes through which blood can flow freely. The muscular walls of the coronary arteries are normally smooth and elastic and are lined with a layer of cells called the endothelium. The endothelium provides a physical barrier between the blood stream and the coronary artery walls, while regulating the function of the artery by releasing chemical signals in response to various stimuli.
Coronary artery disease starts when you are very young. Before your teen years, the blood vessel walls begin to show streaks of fat. As you get older, the fat builds up, causing slight injury to your blood vessel walls. Other substances traveling through your blood stream, such as inflammatory cells, cellular waste products, proteins and calcium begin to stick to the vessel walls. The fat and other substances combine to form a material called plaque. Over time, the inside of the arteries develop plaques of different sizes. Many of the plaque deposits are soft on the inside with a hard fibrous "cap" covering the outside. If the hard surface cracks or tears, the soft, fatty inside is exposed. Platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque. The endothelium can also become irritated and fail to function properly, causing the muscular artery to squeeze at inappropriate times. This causes the artery to narrow even more.
Cardiology: Navigating the Rhythms of Heart Health
Cardiology, a branch of medicine dedicated to the intricate study of the heart and circulatory system, plays a pivotal role in safeguarding the cardiovascular health of individuals. This essay explores the anatomy and physiology of the heart, common cardiovascular conditions, diagnostic techniques, preventive strategies, and the dynamic landscape of advances in cardiology.
Heart Disease. Heart disease is a broad term used to cover a number of conditions affecting the heart and blood vessels. It is also referred to as cardiovascular disease. It's a chronic illness with potentially fatal repercussions, such as a heart attack. One of the main causes of death in Canada and around the world is heart disease. Atherosclerosis-related coronary artery disease (CAD) is the most prevalent type of heart disease. atherosclerosis Plaque accumulates on the inside wall of arteries over time. Among the materials that make up plaque is cholesterol. The hardening of the arteries, or atherosclerosis, is the term for this accumulation. Risk factors are a mix of lifestyle and genetic factors that can cause it, and they can appear early in life. It can start at an early age and is caused by a combination of genetic and lifestyle factors that are called risk factors. Atherosclerosis can cause a narrowing in the arteries to various parts of the body such that blood flow is slowed or blocked. Poor blood flow to the brain can cause a stroke. Poor blood flow to the arms or legs is called peripheral artery disease (PAD). Poor blood flow to the heart is called coronary artery disease (CAD) and can cause angina or a heart attack. Angina Poor blood flow and inadequate oxygen delivery to the heart are caused by plaque accumulation in the coronary arteries. This typically happens when the heart must pump harder, like when you walk or climb stairs or when you're anxious or
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upset. Anxiety or pressure in the middle of the chest that may radiate to the jaw, neck, or arms can be indications that the heart is not getting enough oxygen. There may occasionally be sweating, nausea, or dyspnea. Angina can be treated with nitroglycerin or rest for 2 to 20 minutes, depending on the severity of the pain. It doesn't harm the heart in any way. Unsteady Angina The artery's plaque can occasionally break open suddenly. Over the broken plaque, blood clots form, but this causes the artery to suddenly narrow. The angina or chest pain may now be more frequent, require less physical activity, or persist longer than usual. Unstable angina describes this variation in the angina pattern.
Heart Attack. For more than twenty minutes, when the heart is devoid of oxygen and blood, a portion of the heart muscle dies, resulting in long-term damage. This is referred to as a myocardial infarction (MI) or heart attack. Blood tests and electrocardiograms (ECGs), which demonstrate the heart's electrical activity, are used to confirm heart attacks. Some heart attacks involve only a small area of the heart and can be managed with standard medical treatment in hospital. Some heart attacks involve a larger area of the heart and have a specific pattern on ECG. These heart attacks are called ST-elevation myocardial infarctions (STEMI) and require immediate treatment with clot dissolving drugs or opening up the artery with balloon angioplasty and stents.
Heart Damage. Some heart attacks result in very little myocardial damage, allowing the heart to continue pumping powerfully. Certain heart attacks are more severe, and the resulting muscle damage weakens the heart. A ventriculogram, which is frequently performed during an angiogram, nuclear scans like a MUGA scan, an echocardiogram—a cardiac ultrasound that examines the pumping strength of the heart and the function of the heart valves—and other cardiac tests can all be used to determine the heart's strength.
Angiogram. In order to perform this test, a tiny tube or catheter is guided to the heart by being inserted into an artery in the wrist or groin. Through this tube, a dye is injected into the coronary arteries, enabling them to be seen by an X-ray.
This indicates whether the arteries are clogged with plaque and whether angioplasty, or coronary artery bypass grafting, surgery, is also necessary to treat the blockages. Occasionally, a dye is injected into the heart's pumping chamber to measure the heart's strength and look for signs of heart muscle damage. We referred to this as a ventriculogram. After that, the catheter is taken out.
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Angioplasty and Stents. Angioplasty is sometimes used to treat coronary artery blockages. Similar to an angiography, a tiny tube or catheter is guided to the heart by being placed into an artery in the wrist or groin. In order to improve blood flow during this procedure, a tiny balloon at the end of the catheter may be briefly inflated in order to force the plaque back against the artery wall. A tiny metal mesh tube, frequently referred to as a stent, is often placed over the balloon in patients. This stent remains in place permanently where the blockage was and reduces the possibility of this area narrowing again once the balloon is deflated and removed. Bare metal stents are stents made entirely of metal. Some are coated with medication on them (drug eluting stents).
Advantages of Angioplasty. Over 90% of angioplasties are successful immediately. Blood flow through the artery returns to normal or near normal. Some people may not have complete relief, but their symptoms are improved, allowing them to be more active and comfortable. There is no incision as this is not surgery and you are not put to sleep (general anesthesia). Most people are up and walking on the same day. Some people go home the same day, but some patients are required to stay overnight and go home the following morning.
Disadvantages of Angioplasty. An artery may narrow once more following an angioplasty. We refer to this as restenosis. ought to the artery sufficiently narrow, angina may resurface. The restenosis rate has decreased as a result of stent use. Usually, a second angioplasty is used to treat restenosis; however, on occasions when medical therapy or bypass surgery are required. Angiogram and Angioplasty Risks Common procedures include angiograms and angioplasty, either with or without stent implantation. After carefully evaluating your clinical condition, your physician has concluded that the procedure will be beneficial and that the risks are going to be minimal. Nonetheless, there are risks involved with these invasive procedures. Common risks include:
• Bleeding at the catheter insertion site or other organs due to blood thinning medication (anticoagulants) Less common but potentially more serious risks include:
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• Heart attack
• Stroke
• Unknown dye allergy
• Kidney problems, including kidney failure requiring dialysis
• Emergency heart surgery
• Death
• Other rare and unpredictable complications
A wire or balloon can cause damage to the artery or cause it to collapse in 1% to 2% of angioplasty cases. This is frequently managed with a stent, but occasionally patients require urgent coronary artery bypass surgery. If a patient needs surgery, the Heart Institute's operating rooms are conveniently located.
In conclusion, cardiology encapsulates a comprehensive understanding of the heart's intricacies, offering a symphony of diagnostic, preventive, and treatment modalities. With advancements shaping the landscape and precision medicine paving the way for individualized care, the field of cardiology continually strives to harmonize the rhythms of heart health for a global audience. As we navigate the future, the heart remains at the center of this symphony, pulsating with the promise of enhanced cardiovascular well-being.
References:
1. Braunwald, E., & Mann, D. L. (Eds.). (2018). Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Elsevier.
2. Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., ... & Turner, M. B. (2015). Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation, 131(4), e29-e322.
3. Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey Jr, D. E., Colvin, M. M., ... & Wilkoff, B. L. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Journal of the American College of Cardiology, 70(6), 776-803.
4. January, C. T., Wann, L. S., Calkins, H., Chen, L. Y., Cigarroa, J. E., Cleveland Jr, J. C., ... & Page, R. L. (2019). 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 74(1), 104-132.
5. Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., ... & Smith Jr, S. C. (2012). 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal of the American College of Cardiology, 60(24), e44-e16
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6. Bonow, R. O., Mann, D. L., Zipes, D. P., & Libby, P. (Eds.). (2018). Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Elsevier.
7. Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., ... & He, J. (2016). Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation, 134(6), 441-450.
8. Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., ... & Wylie-Rosett, J. (2010). Executive summary: heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation, 121(7), 948-954.
9. Williams, B., Mancia, G., Spiering, W., Rosei, E. A., Azizi, M., Burnier, M., ... & Kjeldsen, S. E. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal, 39(33), 3021-3104.
10. Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., ... & Jessup, M. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Journal of Heart Failure, 18(8), 891-975.
