Coronary angioplasty (PCI)
A coronary angioplasty is also called percutaneous coronary intervention (PCI). The aim of this procedure is open narrowings in arteries that can cause chest pains or heart attacks. This allows blood to flow more freely and supply the heart muscle with enough oxygen. Usually, it is combined with the insertion of a Stent which is a small stainless steel mesh tube which keeps the artery open and prevents re-narrowing from occurring.
Coronary angioplasty is used to treat atherosclerosis (when the arteries become narrowed and hardened) which can lead to angina and heart attacks.
Currently, coronary angioplasty is only available to private patients at Duchy Hospital but we hope to extend this treatment to NHS patients in the future if we can secure local funding for this.
Coronary angiography or arteriography is an investigation that provides detailed images of the coronary arteries. X-rays pictures of the heart are taken while a special contrast agent is injected into the heart, usually from the wrist, to produce a series of images of the coronary arteries called angiograms.
Coronary angiography is used to investigate a variety of heart conditions.
A pacemaker is a small electrical device that sends electrical pulses to your heart to keep it beating regularly and not too slowly.
Pacemaker implantation is one of the most common types of heart surgery carried out in the UK. It’s a relatively straightforward procedure that’s usually performed under local anaesthetic and should take about an hour.
Once implanted, a pacemaker can significantly improve the quality of your life if you’ve problems with a slow heart rate.
Loop recorder implantation
A loop recorder is a small cardiac recording device that is placed under the skin on the chest to continuously monitor your heart rate and rhythm. It’s inserted under the skin just below the collarbone.
Patients are given a small hand-held activator to carry around that will trigger the device to store information when they experience symptoms such as palpitations or fainting. All recordings of the heart rhythm can be downloaded by our cardiology department.
If a heart rhythm related cause of your symptoms is found, your consultant may recommend treatment based on the exact cause. If your heart rhythm can be ruled out as a cause of your symptoms, your consultant can focus on other potential causes.
Echocardiography is one of the most widely used diagnostic tests for heart disease and valve problems. It uses ultrasound to produce moving, real-time images of your heart. These images allow your clinician to check your heart’s structure and to see how well it’s functioning. It can show the size and shape of your heart, if a wall or section of heart muscle is weak and not working correctly, if you’ve problems with your heart’s valves or, if you’ve a blood clot.
An echocardiography normally takes 30 to 40 minutes and is performed by a sonographer or your consultant.
Stress or exercise echocardiography looks at your heart whilst it’s working harder or under stress. It may be that you’re asked to exercise, such as walk on a treadmill, or you may be asked to take medicines to make your heart beat faster and harder.
Trans-oesophageal echocardiography (TEE) is a test that uses ultrasound to produce detailed pictures of your heart and the arteries that lead to and from it.
Unlike a standard echocardiogram, the echo transducer that produces the sound waves for TEE is attached to a thin tube that passes through your mouth, down your throat and into your oesophagus. As the oesophagus is so close to the upper chambers of your heart TEE can give clearer pictures of the upper chambers of the heart, and the valves between the upper and lower chambers of the heart, than standard echocardiograms.
Your doctor can see the size of your heart and how thick its walls are, how well your heart is pumping, any abnormal tissue around the heart, if blood is leaking backwards through your heart valves (regurgitation), if your valves are narrowed or blocked (stenosis) and if blood clots are in the chambers of your heart.
Cardiac resynchronisation therapy
Cardiac resynchronisation therapy (CRT) is used to improve your heart’s rhythm and muscle coordination between the left and right ventricles so that they contract simultaneously and improves the overall function of your heart. It’s used in patients with poor ventricular function, for example patients with heart failure or patients with arrhythmia (irregular heart rhythms).
The small CRT device is usually implanted with a local anaesthetic just under your collarbone.
Implantable cardioverter defibrillator implantation
An implantable cardioverter-defibrillator (ICD) is a small device that is placed in your chest to reduce your risk of sudden death if the lower chambers of your heart assume a dangerous rhythm and stop beating effectively, known as cardiac arrest.
If you have a dangerously fast heartbeat, known as ventricular tachycardia, or a chaotic heartbeat that keeps your heart from supplying enough blood to the rest of your body, called ventricular fibrillation, an ICD might be recommended.