Preventing and Treating Heart Disease from NY's Top Doc
New York Daily News
SIGNS AND SYMPTOMS:
Atherosclerosis builds up gradually over time, and patients show a variety of symptoms. “Some patients are asymptomatic,” says Sharma, “But usually it presents as pressure or heaviness in the chest, sometimes moving to the left arm.”
Other symptoms include shortness of breath and difficulty breathing, dizziness, fatigue, and weakness.
Patients with more severe cases may feel chest pain when they walk, but when they sit down it goes away. “If the chest pain continues for 20-30 minutes, that’s usually a heart attack,” says Sharma, “Combined with shortness of breath, sweating, and sometimes vomiting, that’s a heart attack.”
Doctors are increasingly using CT angiogram, a noninvasive imaging technology, to examine patient’s blood vessels and make a diagnosis.
In some cases, diet and exercise can be enough to prevent atherosclerosis or stop it from progressing. If lifestyle changes aren’t enough, the first step is medication. “Everybody gets aspirin,” says Sharma, “Then there is cholesterol-lowering medicine, called statins, and beta-blockers that slow down the heart, so there’s less pressure on it. Calcium blockers dilate the arteries, and nitrates can open up the arteries.”
For patients whose arteries are more severely blocked, the next step is intervention. “Angioplasty gives symptom relief,” says Sharma. It opens the clogged heart arteries by inserting a tiny balloon into the vessel; the balloon is inflated for several minutes, stretching out the artery.
Usually, the doctor then places a small metal coil in the artery to prop it open. These coils, called stents, can be bare metal or coated with a medication that works to keep the artery from clogging again.
Angioplasty isn’t open surgery—it’s a minimally invasive procedure in which the doctor makes a small incision in your leg or arm, and then uses catheters to move a tiny balloon through the body to the heart.
“We use dye to see where exactly the blockage is and how long it is,” says Sharma, “We can open all the blockages very quickly, sometimes in 15 minutes.”