Interventional cardiology is a field of medicine that uses imaging and diagnostic tools to monitor coronary disorders in heart patients. The cardiologist – a physician who treats disorders of the heart – evaluates blood flow and blood pressure in the heart valves using imaging tools and equipment as well as other diagnostic techniques.
These tests and monitoring devices, sometimes combined with medication, help the cardiologist treat patients with heart valve disorders, coronary artery disease, endocarditis and other heart conditions.
What conditions do interventional cardiologists treat?
Interventional cardiologists may treat any of the following conditions:
Coronary heart disease
Heart valve disorders
Once heart disease has developed – whether from genetic or lifestyle factors – a cardiologist has several options to intervene before the condition becomes more serious. These could include medications or procedures such as angioplasty, stenting or bypass surgery.
What are thrombolytics?
The most common cause of a heart attack is a blood clot (thrombus) at a point in a coronary artery where there is excessive plaque buildup. When those blood clots completely block blood flow in the artery, the section of heart muscle deprived of that blood can begin to die. If you reach the hospital within 30 minutes of the onset of chest pain, a class of medications called thrombolytics may be used to dissolve the clot, restore blood flow, save the heart muscle and improve your chance of surviving.
Some people may not be candidates for thrombolytics – those with a recent stroke, surgery, trauma, bleeding peptic ulcers, very high blood pressure or very advanced age. An alternative may be angioplasty.
What is balloon angioplasty?
In balloon angioplasty, the cardiologist inserts a balloon catheter over a very thin wire and threads it through the coronary artery to the site of the blockage. As the balloon is inflated, it compresses and breaks apart the plaque in order to make more room for the blood to flow. The process may need to be repeated.
A risk of angioplasty is that it stretches the artery, causing tiny tears in the artery wall and encouraging the formation of blood clots. This could bring on a heart attack or require repeat angioplasty or emergency coronary bypass surgery. It could even result in death.
New medicines have been developed to reduce the formation of blood clots after angioplasty.
What is stenting?
Often the cardiologist will opt to insert a stent inside a blocked coronary artery. A stent is a small mesh tube, usually made of stainless steel or other metal alloy that acts like a scaffold to hold open the coronary artery. Usually it is put in place by a balloon angioplasty catheter.
Stents are a good way to keep the coronary arteries from getting another blockage, and can seal off tissue flaps caused by balloon catheters inside the artery. But stents don't eliminate the risk of blood clots or a heart attack. Newer stents have less chance of getting clogged because they are treated with medicines that reduce inflammation and scar tissue.