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Cardiac Treatments

Introduction

Heart disease describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects), among others. The term "heart disease" is often used interchangeably with the term "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease. Many forms of heart disease can be prevented or treated with healthy lifestyle choices.

Types of Cardiac Disease

There are many types of heart disease that affect different parts of the organ and occur in different ways:

  • Congenital heart disease This is a general term for some deformities of the heart that have been present since birth. Examples include: a) Septal defects: There is a hole between the two chambers of the heart. b) Obstruction defects: The flow of blood through various chambers of the heart is partially or totally blocked. c) Cyanotic heart disease: A defect in the heart causes a shortage of oxygen around the body.
  • Arrhythmia. Arrhythmias occur when the electrical impulses in the heart that coordinate the heartbeat do not work properly. These make the heart beat in a way it should not, whether that be too fast, too slowly, or too erratically. Irregular heartbeats are common, and all people experience them. They feel like a fluttering or a racing heart. However, when they change too much or occur because of a damaged or weak heart, they need to be taken more seriously and treated.
  • Coronary artery disease. The coronary arteries supply the heart muscle with nutrients and oxygen by circulating blood. Coronary arteries can become diseased or damaged, usually because of plaque deposits that contain cholesterol. Plaque buildup narrows the coronary arteries, and this causes the heart to receive less oxygen and nutrients.
  • Dilated cardiomyopathy. The heart chambers become dilated as a result of heart muscle weakness and cannot pump blood properly. The most common reason is that not enough oxygen reaches the heart muscle, due to coronary artery disease. This usually affects the left ventricle.
  • Myocardial infarction. This is also known as a heart attack, cardiac infarction, and coronary thrombosis. An interrupted blood flow damages or destroys part of the heart muscle. This is usually caused by a blood clot that develops in one of the coronary arteries and can also occur if an artery suddenly narrows or spasms.
  • Heart failure. Also known as congestive heart failure, heart failure occurs when the heart does not pump blood around the body efficiently. The left or right side of the heart might be affected. Rarely, both sides are. Coronary artery disease or high blood pressure can, over time, leave the heart too stiff or weak to fill and pump properly.
  • Hypertrophic cardiomyopathy. This is a genetic disorder in which the wall of the left ventricle thickens, making it harder for blood to be pumped out of the heart. This is the leading cause of sudden death in athletes. A parent with hypertrophic cardiomyopathy has a 50 percent chance of passing the disorder on to their children.
  • Mitral regurgitation. Also known as mitral valve regurgitation, mitral insufficiency, or mitral incompetence, this occurs when the mitral valve in the heart does not close tightly enough. This allows blood to flow back into the heart when it should leave. As a result, blood cannot move through the heart or the body efficiently. People with this type of heart condition often feel tired and out of breath.
  • Mitral valve prolapse. The valve between the left atrium and left ventricle does not fully close, it bulges upwards, or back into the atrium. In most people, the condition is not life-threatening, and no treatment is required. Some people, especially if the condition is marked by mitral regurgitation, may require treatment.etc.

Risk Factors

Risk factors include:

  • The most common type of cardiovascular disease - ischemic heart disease -affects men and women equally. While arteries may stiffen with age, thus contributing to risk of cardiovascular disease in older Canadians, and while heredity may also play a part, the majority of cases of cardiovascular disease relate to modifiable risk factors. The major modifiable risk factors include:
  • Smoking contributes to the development of blocked arteries, increases the risk of blood clots, reduces oxygen in the blood and increases blood pressure. Smoking and/or exposure to other people smoking are harmful to health in general and increase the risk of a person developing ischemic heart disease and stroke. More than 37,000 Canadians die prematurely each year from tobacco use. Non-smokers can also die prematurely from second-hand smoke, and smoking nearly doubles the risk of a person having a stroke.
  • People who are physically inactive have twice the risk of having heart disease and a stroke. Unfortunately more than half of Canadians report being inactive. Physical activity after a heart attack is important because it reduces the risk of having another such event and it improves the chances of survival.
  • A minority of Canadians report eating fresh fruits and vegetables in the amounts that are recommended in Canada's Food Guide. Some 56% of Canadians eat less than 5 servings of fresh fruit and vegetables per day. Fresh fruits and vegetables can protect the heart and blood vessels. They provide fibre and contain anti-oxidants, substances which work against the development of blockage in the arteries.
  • Cholesterol is one of the fats in the blood that contribute to the growth of all cells in the body. Cholesterol is manufactured by the body in the liver, with a smaller amount coming from fatty food. Too much cholesterol can lead to blockage of arteries.

Procedure

Procedure include:

  • Angioplasty. Percutaneous transluminal coronary angioplasty (PTCA, or balloon angioplasty) helps restore a healthy blood flow to the heart by reopening arteries that are narrowed by fatty plaque.
  • Stent placement. A stent is a small metal coil or tube that is placed in a narrowed artery to hold it open. To place the stent, your healthcare provider first performs angioplasty or atherectomy to compress or cut away plaque buildup in the artery.
  • Ablation. Ablation is a technique typically used to treat abnormal heart rates and rhythms (arrhythmias). It involves ablating (destroying) a very small, targeted area of the heart muscle.
  • Pacemakers and implantable cardioverter defibrillators (ICDs). To correct abnormal heart rhythms (arrhythmias) and help your heart beat more efficiently, your doctor may recommend a device implant. The most common device implants are pacemakers and implantable cardioverter defibrillators (ICDs).
  • Open heart surgery. Most often, open heart surgeries treat blockages in the coronary arteries or correct problems with the heart valves. Open heart procedures can also repair heart defects and help correct heart rhythm problems.
  • Coronary artery bypass grafting (CABG). Coronary artery bypass grafting (CABG, often pronounced "cabbage") is one of the most commonly performed open heart surgeries. In this procedure, a vein from your leg - or an artery from your chest wall or arm - is used to bypass a coronary artery that is narrowed or blocked by fatty plaque buildup.
  • Heart valve repair or replacement. If your heart valves have been damaged or diseased, they may fail to open and close correctly. This puts extra strain on your heart muscle. In this case, your healthcare providers may recommend open heart surgery to repair or replace your heart valve(s).
  • Ventricular assist devices. A ventricular assist device is an implantable heart pump that is used to treat heart failure.
  • Heart transplant. A heart transplant replaces a severely diseased or malformed heart with a new heart from a human organ donor. This procedure is considered for late-stage heart failure after other attempts have failed.

Range of Treatment Cost

Procedure Duration In Hospital Min Cost
(INR)/$
Max Cost
(INR)/$
Angiography (Including Non-Ionic Contrast) 1 23000/350 30000/450
Angioplasty (Including Non-Ionic Contrast) 2 250000/3450 350000/4815
Angioplasty with one medicated stent (Cypher) 2 410000/5640 450000/6190
Coronary Angioplasty (Including Two Stent) Depends upon the treatment 660000/9090 700000/9650
Open Heart Surgery (CABG) 9 330000/4550 400000/5500
Single Valve Replacement (with St. Jude Valve) 9 350000/4815 400000/5502
Double Valve Replacement (with 2 St. Jude Valves) 9 450000/7000 500000/6870
Pediatric Cardiac Surgery - Conduit Repair / ASO/AV Canal Repair / TCPC/Fontan/ASO/AV Canal Repair /TCPC/Fontan 9 250000/3450 350000/4850
Pediatric Cardiac Surgery - ASD/VSD/AV Repair, MV Repair/Paediatric TOF 9 250000/3450 400000/5502
EPS 1 45000/650 55000/750
EPS & RFA 2 150000/3050 200000/3750
Pacemaker Implant Single Chamber 3 200000/2751 250000/3450
Pacemaker Implant Double Chamber 3 370000/5090 400000/5550
ICD Combo Device Implant 3 1040000/14650 1200000/16580
Aortic Valve Replacement AVR or Mitral Valve Replacement MVR (including one valve)   Depends upon the treatment 600000/8254 900000/12380
AVR and MVR with two valves Depends upon the treatment 750000/10350 950000/13350
Pacemaker Installation Depends upon the treatment 180000/2470 200000/2750
Cost of the Pacemaker device(depends upon patients condition) Depends upon the treatment 480000/6650 1200000/16500
Valvuloplasty Depends upon the treatment 150000/2060 200000/2750
RadioFrequency Catheter Ablation Treatment Depends upon the treatment 180000/2480 280000/3850
Robotic Heart Surgery 4-7 days 720000/9900 900000/13350
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