HKSH Health Series

Know about the Heart - Dr. WONG Yiu Tung, Anthony




Q1. What are cardiovascular diseases? Can all of them be treated by angioplasty?
Cardiovascular diseases refer to a group of conditions related to the heart and blood vessels, including the most common ones like hypertension, coronary artery diseases, arrhythmia, congenital heart disease, structural heart disease, problems with cardiac muscle, heart failure, etc.
 
Coronary heart disease is also known as “heart disease”. Some of them need surgery but not necessarily angioplasty. Others can be treated by medications.
 
Q2. Do I need angioplasty when blood vessel narrowing occurs?
If you have chest pain or are short of breath, and investigation shows that your coronary artery has a narrowing of 70% or more, you should consider angioplasty.  
 
If narrowing occurs in the left main coronary artery or there is multiple vessels involvement, or you suffer from heart failure, angioplasty may be required.
 
Sometimes doctor will use intracoronary imaging or fractional flow reserve results to further assess the need for angioplasty.
 
Q3. What is arrhythmia? What are the treatments?
Arrhythmia means the heart rate is too fast, too slow, or sometimes irregular. One of the most common and dangerous types is atrial fibrillation. It increases the risk of stroke and therefore needs blood thinner, i.e. anticoagulant, to reduce the risk.  
 
Pacemaker implantation can help if your heart is beating too slowly. Thanks to medical advances, the latest pacemakers are leadless. The procedure is minimally invasive and safe, reducing the risk of bacterial infection.
 
If the heartrate is too fast, medications are mostly used for treatment. Sometimes minimally invasive radiofrequency ablations are needed.
 
Q4. Does heart valve replacement need open-heart surgery? Is it a major surgery?
We all have 4 valves in our heart. They keep the blood moving forward. Problems with heart valves may occur for different reasons, the most common of which are degeneration or rheumatic heart disease. Under these circumstances, the heart valves may fail to open widely causing valvular stenosis or fail to close properly causing valvular regurgitation. Patients may have difficulty in breathing, leg swelling, fatigue, etc. Surgery is required.
 
We used to perform open-heart surgery to repair or replace the valves in the past. In recent years, minimally invasive surgery is adopted to replace or repair the heart valves, especially for those, for different reasons were once considered not suitable for open-heart surgery.
 
Q5. My doctor said I have high cholesterol, but I don’t want to take medication.
Will I be fine by avoiding certain foods and doing exercises?
Both dietary changes and exercises are just the basics. The liver produces about 70 to 80% of the body’s cholesterol. Only 20 to 30% comes from diets. Therefore the effect of mere non-pharmacological treatment is often limited.
 
If you are prescribed with lipid-lowering drugs, you’d better follow your doctor’s advice. It helps to prevent the occurrence or deterioration of cardiovascular diseases.
 
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