"Coronary Artery Stenosis: The Silent Threat Leading to Sudden Death" by Dr. Watcharin Prasertsud, M.D., Internal Medicine Specialist in Balloon Angioplasty and Stenting of Coronary Arteries.

Coronary artery stenosis, commonly known as the "silent threat," is the leading cause of sudden death. It may or may not present warning signs, and even individuals with good physical health, such as athletes, journalists, or young people, can suddenly collapse.

Some individuals may experience warning signs but mistake them for other conditions, such as heartburn, chest discomfort, symptoms resembling acid reflux, shoulder pain, abdominal discomfort around the upper abdomen, jaw pain, or toothache.

The risk factors for coronary artery stenosis can be divided into two categories:

1. Controllable factors include smoking, alcohol consumption, consumption of sugary, oily, and salty foods, as well as foods high in trans fats.
2. Uncontrollable factors include gender, with males being at higher risk than females. However, post-menopausal females have a similar risk to males. Additionally, the risk increases with age, and genetics also play a role.

For individuals diagnosed with coronary artery stenosis, the first step is to reduce controllable risk factors and follow the doctor's recommendations, which may include medication. In cases where coronary angiography reveals stenosis in more than one vessel with more than 70% narrowing, medication alone may not be sufficient. Balloon angioplasty is performed to expand the narrowed coronary arteries, and in some cases with more than three stenoses, heart bypass surgery may be necessary.

Prevention of coronary artery stenosis involves reducing controllable risk factors, such as regular exercise (at least 30-40 minutes per day, five days a week). Those with risk factors for heart disease should undergo annual heart health check-ups. 

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นพ.วัชรินทร์ ประเสริฐสุด

Heart disease, a risk that can be avoided!

What is heart disease? 
Heart disease is characterized by abnormalities in the functioning of the heart and can have detrimental effects on the body. It encompasses several types, including coronary artery disease, heart muscle disease, heart valve defects, arrhythmia, and congenital heart defects. 

Symptoms of heart disease The symptoms of heart disease vary depending on the specific type. However, there are five common symptoms that can aid in diagnosis:

• Chest tightness 
• Shortness of breath (easily becoming tired with exertion) 
• Swelling, such as swollen legs and feet 
• Palpitations and dizziness 
• Fainting or blackouts

Risk factors for heart disease Heart disease can be attributed to various causes, which can be categorized into two groups:

Group 1: Factors that cannot be controlled, such as:

• Congenital heart abnormalities or a family history of heart disease, which can increase the risk compared to the general population

• Aging, which can lead to decreased organ function, including the heart 

• Gender, as men tend to have a higher incidence of heart disease than women

Group 2: Factors that can be controlled, such as:

• Managing congenital conditions like diabetes, high blood pressure, or hyperlipidemia, which can reduce the risk of heart disease 

• Avoiding substances like alcohol, cigarettes, certain medications, or drugs for weight loss 

• Preventing infections, as bacterial or viral infections can lead to heart infections and subsequent heart disease

Diagnosis of heart disease?

• Medical history and physical examination 

• Electrocardiogram (ECG) 

• Echocardiography to assess the heart's structure, function, and valve condition 

• Exercise stress test to evaluate coronary artery disease 

• Imaging techniques such as X-rays or other electromagnetic waves 

• Cardiac catheterization to assess potential blood vessel problems in the heart

The treatment of heart disease

Treatment methods for heart disease vary based on the specific type and individual circumstances. Generally, the following approaches are utilized:

• Medication therapy
• Balloon angioplasty during heart catheterization
• Pacemaker implantation for arrhythmia •
  Cardiac ablation using 2D or 3D technology to treat arrhythmia
• Surgery
  

Regardless of the treatment method, continuous symptom monitoring, risk factor control, maintaining a healthy lifestyle, regular exercise, a balanced diet, adequate rest, and stress management are essential for reducing the risk of recurrent heart disease.

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นพ. ไพบูลย์ เชี่ยวชาญธนกิจ

Heart balloon therapy treatment that heart patients should know.

What is a heart balloon?

A heart balloon is used to widen the coronary artery. By introducing a device similar to a balloon into the blood vessels, it allows for better blood flow to the heart muscle. It pushes the fat in the blood vessels against the walls, facilitating the expansion of narrowed or blocked arteries. Heart balloon surgery is a relatively quick procedure, and the incision is small, ensuring safety for the patient.

The process of heart balloon treatment:

• Patients should refrain from eating for 6 hours before the treatment.
• Anesthesia is administered in the groin area, wrist, or elbow joint prior to the treatment.
• A heart catheter, a flexible tube with a tiny balloon, is inserted into the coronary artery at the narrowed or blocked area.
• When the catheter reaches the target location, the balloon is connected to a machine tool. The tool inflates the balloon, expanding and compressing the plaque on the arterial walls. This widens the blood vessels, allowing improved blood flow to the heart muscle. Afterwards, the doctor deflates the balloon and removes the catheter from the body.
• In some cases, a stent may also be inserted to reduce the risk of re-narrowing of the blood vessels.

Self-care after heart balloon treatment:

• Self-care after heart balloon treatment:
• Take antiplatelet drugs as prescribed by the doctor.
• Avoid driving and lifting heavy objects during the first week.
• Maintain a healthy diet and get sufficient rest. • Follow up with the doctor for monitoring symptoms and treatment results.
• Manage stress levels and engage in regular exercise as recommended by the doctor.
• The area where the balloon treatment was performed may have a risk of re-narrowing, depending on medication and self-care. If re-narrowing occurs, the patient may need to undergo the balloon treatment again, as advised by the doctor.

Advantages of heart balloon treatment:

• No surgery is required.
• Treatment time is relatively short.
• It is less expensive than undergoing bypass treatment.
• Recovery time is shorter, with fewer side effects.

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นพ.วัชรินทร์ ประเสริฐสุด