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    Cardiothoracic:
 
 

Peripheral Angioplasty:

 

Peripheral angioplasty is a procedure that has grown rapidly in the last two decades. The same atherosclerosis that involves the heart arteries can involve any artery in the body. The most common arteries to be involved are those which supply the legs (causing cramps when walking, known as claudication), those to the brain known as the carotid arteries (causing strokes) and the arteries to the kidneys (causing high blood pressure).

The same risk factors for coronary artery disease are associated with peripheral vascular disease. Controlling these factors can help control symptoms.

There are noninvasive tests, which may help your doctor learn if the blood flow through the arteries is impeded and if so may order an angiogram. The procedure of peripheral angioplasty is performed using a catheter and a balloon to expand a narrowed artery. Stents are often used to help keep an artery opened. The procedure is performed under local anesthesia and sedation. You may have your procedure as an outpatient or stay overnight. Light activity may be resumed shortly after the procedure and full activity in about one week.

Risk Factors for Coronary Artery Heart Disease

Smoking is one of the most important risk factors for developing coronary artery disease. Smokers have a significantly increased risk of early heart attack. There are a number of factors that are important in promoting coronary artery disease. Many of these factors cause an abnormal arterial wall lining to develop and lead to hardening of the arteries (atherosclerosis). Once arteriosclerosis does develop smoking may cause a heart attack to happen.The positive effects of stopping smoking are seen within a matter of hours. It is never too late to stop smoking. Those patients who stop smoking after a heart attack, angioplasty or bypass surgery have a much better prognosis than those who continue to smoke do.

High blood pressure hypertension is one of the most common risk factors for heart disease and stroke. Hypertension can be a silent killer, for until the disease is very advanced, there are no symptoms of high blood pressure. It is important to have your blood pressure checked regularly and to follow-up with your doctor is high readings are seen. Normal blood pressure is less than or equal to 120 over 80 (120/80). High blood pressure is greater than 140/90. The top number is the systolic blood pressure and the bottom number is the diastolic. Blood pressure can often be lowered, when it is high, by exercise, weight reduction and a low salt diet. These measures should be undertaken only under the supervision of your doctor. There are a number of excellent medications to treat high blood pressure and when successful, lower the risk of heart attack and stroke.

Physical Activity: Those of us who lead a sedentary life style have a higher risk of developing heart disease than those who lead an active life style. Walking briskly for 20 minutes three times a week can have significant positive health benefits. Exercise can help control weight and lower blood pressure. You should check with your doctor before beginning an exercise program.

Age: Cardiovascular disease becomes more common with age. About 10,000 women and: 18,000 men under age 45 die of cardiovascular disease each year in the United States. Between the ages of 45 and 64, that figure climbs to about 40,000 women and 85,000 men. From ages 65 and 84, it soars to about 240,000 women and 260,000 men. That is why it becomes increasingly important as you age to pay careful attention to diet, fitness and other factors that can prevent or reduce the risk of heart disease. Years or decades of a poor diet take their toll as you age and fatty plaques that have collected along artery walls slow or impede blood flow. People who do not exercise regularly are more likely to develop other cardiovascular risk factors such as high blood pressure and diabetes. The effects of age also are felt directly by the blood vessels and the heart. As blood vessels age, they become less flexible and thus make it harder for blood to move through them. Exercise, a low fat diet and body weight control help to slow the process of hardening of the arteries (atherosclerosis).

Diabetes:Diabetes is responsible for many health complications, including an increased risk of blood vessel disease and coronary artery disease. Diabetes increases the risk of heart disease 5-fold in a woman and 2-fold in a man. In fact, about 80 percent of people with diabetes die of heart disease or stroke. Part of the reason is that diabetes raises cholesterol and triglyceride levels. In Type 2 (also called "non-insulin-dependent" or "adult-onset") diabetes, the body’s cells become resistant to insulin and the pancreas cannot produce enough insulin to overcome the resistance. Insulin is the hormone that permits blood glucose (sugar) to move into the body’s cells where it is used for energy. Insulin also reduces the amount of glucose released by the liver. When the body fails to respond to normal insulin levels, insulin production increases. Elevated levels of insulin, however, can raise blood pressure and encourage the deposition of fat in artery walls. The result is clogged coronary arteries, plus a variety of other vascular problems, such as the leg pain of peripheral artery disease. Weight loss can decrease the demand for insulin and exercise can help you to use excess blood glucose, preventing or slowing the onset of diabetes.

Sex and Menopausal Status:Men are at increased risk for coronary artery disease. While the reasons for this are not entirely known, lipid status (cholesterol and fats) seem to play a role. Premenopausal women tend to have higher levels of HDL (‘good cholesterol’) and this may have a protective effect. Premenopausal women may still develop coronary artery disease, however the risk increases significantly in postmenopausal women. Many physicians think that estrogen replacement in postmenopausal women may lower the risk of coronary artery disease, however this is not certain and this decision must be made on an individual basis.

Cholesterol and Lipids:The blood levels of cholesterol and triglycerides are also important risk factors for coronary artery disease. The level of cholesterol is directly related to the risk of coronary artery disease. Cholesterol is measured as LDL or ‘bad cholesterol’ and as HDL or ‘good cholesterol’. The level of cholesterol that your doctor will consider "good" for you will depend on many factors. Levels of total cholesterol are often best kept below 220. We can lower the level of our cholesterol by eating a diet low in fats and cholesterol. Avoiding fried and fatty foods can be an important part of controlling blood cholesterol.

 

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