CONGENITAL HEART DISEASE
The heart pumps oxygen and nutrient-rich blood to the body's cells. When the heart is unable to pump blood as it should due to narrowed arteries or high blood pressure, the cells in the body become deprived of oxygen and nutrients causing vital organs in the body like the kidney and brain to suffer. Left untreated, the lack of oxygen to vital organs may lead to heart valve problems, heart rhythm problems, organ damage and kidney damage or failure which is life-threatening.
Because heart failure develops over time and often the heart attempts to compensate for its inability to meet the needs of the body, you may not notice the problem at first. Heart failure can be chronic or acute and may involve the following symptoms:
- shortness of breath when you exert yourself
- reduced ability to exercise
- persistent cough or wheezing
- inability to lie flat
- coughing up of pink frothy sputum
- weakness & fatigue
- swelling in the legs, ankles and feet
- swelling of the abdomen
- rapid or irregular heartbeat
Diagnosis & Treatment
In order to make a diagnosis, Dr Ho may do a physical exam followed by a range of tests including a comprehensive clinical assessment, blood test, cardiac ultrasound and chest x-ray. An electrocardiogram (ECG) or exercise stress test can also be used to evaluate the electrical activity generated by the heart when it is at rest and when exercising. Dr Ho may also use coronary angiography to confirm the diagnosis of coronary artery disease. This involves a special dye being injected into the bloodstream. This dye will then outline narrow spots and blockages in the blood flow to the heart on x-ray images perhaps giving reason to sudden acute heart failure. Cardiac MRI imaging may also be used for diagnostic purposes.
Because heart failure may result from various causes, treatment may be focused on the causes as well as reducing the pressure on the heart. Heart failure and high blood pressure can be treated with various lifestyle changes and medications such as diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
Severely narrowed or blocked arteries may require cardiac catheterisation and coronary artery stenting which involves a long, thin, flexible tube called a catheter, which is threaded through the artery in the leg up to the arteries in the heart. A balloon is then deployed through the catheter and inflated where there is a narrowed area or block-age in the artery. Once inflated, a mesh tube (stent) can be placed to keep the now dilated artery open. In other cases restoring the blood flow to the organs may be done with coronary bypass surgery.
Aside from treating the underlying cause, it may be necessary to repair or replace a heart valve or treat heart rhythm problems with cardiac resynchronisation therapy (CRT), or an implantable cardioverter-defibrillator device (ICDs). Various treatment options will depend on your specific case, which Dr Ho will consider in the treatment of heart failure.