(Cardiac catheterization (1st part / قسطرة القلب ( الجزء الأول ) (بالانجليزية والعربية)
Coronary Artery Diseases (CAD) are a diseases that affect the blood vessels supplying the muscles of the heart. It is caused by the build-up of fatty deposits in the arteries, which can restrict blood flow to the heart. Depending on the severity of this blockage and the characteristics of the plaque, patients may experience chest pain or have no symptoms until a plaque ruptures and causes a blood clot to form. CAD is a leading cause of death globally, highlighting the importance of accurately assessing the extent and impact of the disease on heart function. While there are non-invasive tests available, cardiac catheterization is still considered the most reliable method for diagnosing and treating CAD, as well as other heart conditions like arrhythmias and issues with the cardiac valves.
Cardiac catheterization typically takes between 30 minutes and 1 hour. It is a minimally invasive procedure where a thin tube called a catheter is inserted through blood vessels in the arm or leg and guided into either the left or right side of the heart. This catheter is then used to assess the heart's hemodynamic, including measuring pressure, cardiac output, and oxygen saturation. It provides doctors with important information about the heart's muscles, valves, and blood vessels. There are two types of cardiac catheterization - left heart and right heart. Left heart catheterization tests blood flow in the coronary arteries and assesses the function of the mitral, aortic valves, and left ventricle. Right heart catheterization evaluates the tricuspid and pulmonary valve function, measures blood pressure, and collects blood samples from various areas. This type of catheterization is usually used for patients with heart failure, valvular diseases, congenital heart diseases, and cardiomyopathies.
Cardiac catheterization involves a technique known as coronary angiography or arteriography, where dye is injected into the heart or arteries. Coronary angiography helps to map out the anatomy of the coronary arteries, identify blockages, assess blood flow, and detect collateral vessels. It is used for various conditions such as stable angina, heart attacks, and chest pain due to reduced blood flow to the heart muscle. In some cases, a revascularization procedure may be recommended, such as coronary artery bypass surgery or percutaneous coronary intervention, which includes techniques like balloon angioplasty, stent placement, atherectomy, and laser treatment. These minimally invasive procedures are often preferred over open-heart surgery for managing certain heart conditions.
Cardiac catheterization is generally safe, but it is important to address and treat any underlying illnesses or conditions before undergoing the procedure to ensure its safety. Some examples of contraindications include uncontrolled ventricular irritability, uncorrected electrolyte imbalances, congestive heart failure, severe renal insufficiency, active gastrointestinal bleeding, infection, and severe hypertension. When proper measures are implemented, cardiac catheterization is a safe procedure. While issues are rare, they can occur and have the potential to be fatal. The most common complications include bleeding or blockage of the artery used for catheter insertion. Less common complications include the formation of a hematoma, cardiac arrhythmias, allergic reactions, heart attacks, vasovagal episodes, and kidney failure.
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