FAQ’s –
Cardiology
1. How the heart works?
2. What is high blood pressure
( BP )and how is it treated?
3. What is cholesterol?
4. What is atherosclerosis?
5. What are the treatment
options available for the blocked arteries
besides Bypass surgery?
6. What is arrhythmia?
7. What is an EPS?
8. What is RFA?
9. What is a Pacemaker and
how does it work?
10. What is Coronary angiography?
11. What is meant by ‘Congenital
Heart disease?
12. What is a Heart murmur?
13. What is meant by ‘Cardiac
Catheterization’?
14. What are the major risk
factors for heart disease?
15. What is an echocardiogram?
16. What is a Stress Test?
17. What is a thallium stress
test?
18. What is EECP?
19. What
is Sphygmocor?
FAQ’s
– Cardiac Surgery
1. What is coronary bypass
surgery?
2. What are common risks
of open heart surgery?
3. What are the complications
that can occur after a heart surgery?
4. What should I do to prepare
for surgery?
5. What tests are taken before
I'm admitted?
6. What about my medications?
7. May I eat and drink as
usual?
8. What should I bring with
me?
9. Will my family be allowed
to stay with me?
10. Where should I check
in for my surgery?
11. What happens before
the operation?
12. How long will the surgery
take?
13. Can I wear my glasses
and/or dentures during surgery?
14. Who will be in the operating
room with me?
15. Will I be conscious
during the surgery?
16. How will I feel when
I wake up?
17. What is the postoperative
ICU like?
18. When will I be able
to eat?
19. How long will I have
to stay in bed?
20. When can my family and
friends visit?
21 How long will I be in
the ICU?
22. What happens the next
day?
23. Will I be on a special
diet?
24. When will I be able
to walk around?
25. When will I be able
to use the bathroom?
26. Will I continue to take
medications?
27. When can I go home?
28. What medications will
I be taking after I go home?
29. What should my cholesterol
levels be?
30. How much pain will I
have after surgery?
31. When can I drive?
32. When will I be able
to get back to work?
33. When can I have sex?
34. How
long will have to stay in the hospital?
FAQ’s – Cardiology
1. How the heart works?
- Heart beats 70 – 80 times / minute;
1, 00,000 times a day.
- Heart has four chambers; two upper chambers
called Atria and two lower chambers called
Ventricles.
- Right side of the heart gets impure
blood from all parts of the body and the
left side of the heart gets purified blood
from the lung which is sent to all parts
of the body.
- Right side of the heart is separated
from the left side by a wall called septum.
- There are four valves in the heart to
prevent the backflow of blood.
- There are two major blood vessels, one
carrying impure blood from the right side
of the heart to lungs and other one carrying
pure blood from the left side of the heart
to other parts of the body.
- The blood vessels supplying heart are
called coronary arteries.
2. What is high blood
pressure ( BP )and how is it treated?
-
High blood pressure
results from the tightening of very
small arteries
-
It can be controlled
by low salt diet, regular exercise,
stress management, weight control.
-
Your doctor will
prescribe some medications if your BP
is not controlled by the above measures.
3. What is cholesterol?
-
Cholesterol is a
type of fat produced in your liver and
is found in all your body cells.
-
There are two types
of fat viz, Saturated and Unsaturated.
-
Unsaturated fat
is more harmful and is found in butter,
ghee, red meat, coconut oil.
-
Lipoproteins carry
cholesterol through blood stream.
-
Two most important
lipoproteins are HDL and LDL.
-
HDL is beneficial
and LDL is harmful.
-
HDL is found in
olive oil, sunflower oil ( they have
low levels of LDL)
4. What is atherosclerosis?
5. What are the treatment
options available for the blocked arteries
besides Bypass surgery?
A severely narrowed coronary artery needs
treatment to reduce the risk of a heart
attack. Various treatment options apart
from surgery are:
-
Angioplasty: Dilatation
of a narrowed blood vessel with a help
of a balloon.
-
Stent : It involves
insertion of a mesh or spring like metal
device inside an artery at a site of
narrowing after angioplasty. This will
prevent collapsing of the artery.
6. What is arrhythmia?
7. What is an EPS?
8. What is RFA?
- RFA is Radio Frequency Ablation. It
is an interventional procedure used for
the treatment of arrhythmias.
9. What is a Pacemaker
and how does it work?
10. What is Coronary
angiography?
-
Coronary angiography
is a diagnostic test performed to study
the blood supply to the heart, done
under local anaesthesia.
-
A small catheter
is inserted through a blood vessel in
the thigh or hand and a dye is injected
into the coronary artery through this
tube
11. What is meant by
‘Congenital Heart disease?
This refers to various
abnormalities of the heart which are present
at birth. The abnormalities can be of the
following:
- Holes in the walls ( Septum) separating
the chambers.
- Narrowing of valves or blood vessels.
- Abnormal location of blood vessels
attached to the heart.
12. What is a Heart murmur?
-
Normally when the
heart valves open and close, they make
a LUB- DUB sound that your doctor hears
using a stethoscope.
-
Any extra sound
heard is called a murmur.
-
Not all heart murmurs
require treatment.
13. What is meant by
‘Cardiac Catheterization’?
-
The term 'cardiac
catheterisation' refers to the passage
of a fine tube (called a catheter) into
the heart chambers through a vein, or
an artery, usually in the upper part
of the thing. Blood samples and pressure
measurements can be obtained from the
chambers of the heart to help make an
accurate diagnosis.
14. What are the major
risk factors for heart disease?
-
The major risk factors
for heart disease are smoking, high
cholesterol levels, high blood pressure,
lack of exercise,, obesity, diabetes,
old age, male gender, and heredity (family
history of heart disease),post menopause
incase of women.
15. What is an echocardiogram?
16. What is a Stress
Test?
-
A stress test is
a common test that doctors use to diagnose
coronary artery disease.
-
You will be made
to walk on a treadmill while ECG, BP
and heart rate will be continuously
monitored.
17. What is a thallium
stress test?
-
A thallium stress
test is a nuclear study by which a radioactive
substance is injected into your bloodstream
to show how blood flows through your
arteries.
-
Doctors can see
if parts of the heart muscle are low
on blood supply, damaged or dead.
18. What is EECP?
19. What is Sphygmocor?
FAQ’s Cardiac Surgery
1. What is coronary bypass
surgery?
-
Bypass surgery improves
the blood flow to the heart with a new
route, or "bypass," around
a section of clogged or diseased artery.
-
The surgery involves
sewing a section of vein or artery from
the leg or chest (called a graft) to
bypass a part of the diseased coronary
artery.
2. What are common risks
of open heart surgery?
-
All operations carry
risk. But with improvements in technology,
in surgical procedures and with more
surgery being performed at a younger
age, the risk of complications is continually
being reduced.
-
The possible complications
are related to the specific type of
surgery being performed and they vary
widely depending on the nature of the
problem which requires surgery.
-
The presence of
other medical conditions such as diabetes,
lung disease, or kidney disease can
increase the risk of complications in
some patients.
Anyhow you should discuss the operation
and its risks with your doctor prior
to the procedure.
3. What are the complications
that can occur after a heart surgery?
- Possible complications:
- Stroke (less than 3%)
- Heart attack during or after surgery
- Closure of new bypass grafts
- Bleeding from the tissues inside the
chest
-
Infection at incision
sites, newly placed artificial valves,
or urinary bladder. Therefore, we use
antibiotics before and after surgery.
- Irregularities of the heart beat
- Lung or kidney problems, especially
if there is history of disease in these
areas.
These problems are usually
temporary, but may require prolonged ventilator
support, or the use of kidney dialysis.
We will discuss such situations with patients
and their families before starting "extraordinary"
treatments,.Your cardiologist and cardiac
surgeon will discuss this subject with you
prior to surgery.
4. What should I do to
prepare for surgery?
Knowing what your hospital experience
will be like is one way to reduce the natural
anxiety you may be feeling when you're scheduled
for surgery.
-
Talk with your Cardiologists
and learn about what options are best
for you and your family.
-
Ask your doctor
any questions you may have about your
condition and your surgery.
-
Check with your
insurance company about preauthorization
requirements and arrange to have a friend
or family member transport you to the
hospital.
-
We have a preoperative
teaching programme everyday scheduled
between 3.30 – 4.30 pm when the
details of the surgeries will be explained
by our experienced Physician Assistants.
5. What tests are taken
before I'm admitted?
-
You will be admitted
the previous evening of your surgery
day in order to prepare you for the
surgery.
-
During the preoperative
stay , you will have a blood test, urine
test, chest X-ray , ECG, Echocardiogram
and any other specific tests necessary
for you.
6. What about my medications?
-
One week before
surgery, stop taking antiplatelet drugs
like aspirin, clopidogrel etc.
-
Your Cardiologist
will instruct you about which medications
to take.
-
You do not need
to bring any medication with you to
the hospital unless you are specifically
instructed to do so, but do bring a
list of the medications and the dosages
you take.
-
Inform your doctor
well in advance about any medications
you are allergic to.
7. May I eat and drink
as usual?
-
Do not eat anything
after midnight the night before your
surgery, unless otherwise instructed.
-
You may take water
with your usual medication if your doctor
has instructed you to take it the morning
of the procedure.
-
Anyhow, your anesthetist
and Cardiac surgeon will give you instructions
regarding the number of hours you need
to be on starvation before the procedure.
8. What should I bring
with me?
-
Once you are admitted
in the hospital we will provide you
a well cleaned and hygienically washed
hospital gown to wear during your hospital
stay and a personal kit containing toiletries
-
You may bring material
to read, your glasses and any toiletries
you plan to use.
-
Leave valuables
at home.
9. Will my family be allowed
to stay with me?
-
Your family is welcome
to stay with you until you go to the
operating room.
-
While you're in
surgery, they may wait in the visitor’s
lounge on the second floor where they
can receive updates and your surgeon
can brief them after the surgery.
10. Where should I check
in for my surgery?
-
You are required
to take a date for surgery or any procedure
in advance to facilitate us to keep
the room ready.
-
You are required
to report at the Front office on the
ground floor as soon as you arrive at
the hospital .
11. What happens before
the operation?
-
Your surgeon will
tell you about the Intensive care unit
where you will be taken after surgery.
-
He/She will also
tell you what to expect during surgery,
give you instructions on coughing and
explain how you might feel when you
wake up.
-
Our physiotherapists
will also teach you some breathing exercises
which will help you to improve your
lung function and for a smooth post
operative recovery.
-
You will also be
given preoperative medication to help
you relax.
-
Your chest area
and your leg area will be prepared.
-
You may also have
a urinary or Foley catheter to relieve
your bladder during surgery and for
a few hours after surgery.
12. How long will the
surgery take?
-
After you go to
the operating room and are asleep, you
are prepared for surgery with the insertion
of monitoring catheters and a breathing
tube. This preparation phase takes one
to one and a half hours.
-
Cardiac surgery
takes about five hours, but it may range
between three and six hours if the surgery
is uneventful. Your surgeon will be
able to give you an estimate of how
long you'll be in the operating room.
13. Can I wear my glasses
and/or dentures during surgery?
14. Who will be in the
operating room with me?
-
Your surgeon, a
surgical nurse, cardiac anesthesiologist
and a perfusionist, whose responsibility
is monitoring the heart-lung machine
that may be used in your surgery.
15. Will I be conscious
during the surgery?
16. How will I feel when
I wake up?
-
When you wake up,
you will have a breathing tube in your
throat, chest drainage tubes, IV lines
in your arm(s) and/or neck as well as
a urinary catheter to drain urine.
-
You will not be
able to speak until the breathing tube
is removed, which is generally after
12 hours or depending on your response.
-
ICU nurses are skilled
in communicating with patients who have
breathing tubes.
-
Pain medication
will be given as needed.
-
While in the ICU,
you may hear unusual sounds such as
buzzing, beeping and bubbling. These
are normal sounds for this environment,
and there's no reason for you to be
alarmed.
17. What is the postoperative
ICU like?
-
The postoperative
ICU has 18 beds specifically designed
for patients who have just had heart
and/or lung surgery.
-
You will be connected
to a device that monitors your heart,
blood pressure, respiratory rate and
oxygen level.
-
Your IVs may also
be attached to IV pumps that deliver
medications at a set rate as well as
a chest drainage device at the side
or foot of your bed that monitors drainage
from your surgical site.
18. When will I be able
to eat?
19. How long will I have
to stay in bed?
20. When can my family
and friends visit?
-
The family and friends
can visit you only during the visiting
hours between 6.00 – 8.00 pm guided
by our Public relation assistant.
-
This time restriction
is to help you to relax and to prevent
from unnecessary infection as you are
more vulnerable to acquire any infection
after a surgery.
21 How long will I be
in the ICU?
22. What happens the
next day?
-
Your care team will
continue to monitor your heart and check
your blood pressure and pulse every
two to four hours, as needed.
-
You will also cough
and deep breathe at least every two
hours.
-
Your urinary catheter,
chest tubes and IVs may be removed,
but you will continue to receive pain
medication, as needed.
-
You will also have
a chest X-ray, ECG and lab work.
-
Your physician may
order aspirin for you if you have had
bypass surgery or blood thinning medication
if you have had valve replacement surgery.
-
You will transfer
via wheelchair to postoperative ward.
23. Will I be on a special
diet?
-
You will need to
be on a heart healthy diet (low fat,
low cholesterol and low sodium). While
in the hospital, your dietitian will
calculate your calorie requirements
and a balanced diet will be provided
by the hospital.
-
They will also teach
you about changing your diet to help
reduce your chance of developing more
severe heart disease.
-
To encourage wound
healing after surgery, you may be advised
to follow the "no added salt"
portion of the heart healthy diet, but
otherwise encouraged to eat enough to
promote wound healing.
-
Once your wounds
are fully healed, you should follow
the full heart healthy diet.
24. When will I be able
to walk around?
-
Your activity will
increase each day.
-
You may sit in a
chair and walk short distances in the
corridor. The length of your walks will
increase each day.
-
You will be taught
several postoperative exercises by our
physiotherapist in our rehabilitation
department to help you to regain normal
activities.
25. When will I be able
to use the bathroom?
-
While you're in
intensive care, if your condition permits,
you'll be able to get out of bed to
a bedside commode.
-
As soon as you're
transferred to the ward you will be
able to use the bathroom in your room.
-
You may still need
help walking to the bathroom, so remember
to use your call bell and wait for help
before attempting to walk unassisted.
26. Will I continue to
take medications?
-
You will be on pain
medication and laxatives, as needed,
and aspirin or blood thinners, if ordered,
as well as any special medications prescribed
by your doctor.
-
Your doctor will
determine if you should resume the medications
you were taking prior to your hospitalization.
-
Do not take any
medications without the advice of the
doctor.
27. When can I go home?
28. What medications
will I be taking after I go home?
Listed below are common
medications that will be individually prescribed
upon discharge, depending on the nature
of your heart disease.
-
Enteric aspirin
: Gently thins the blood to avoid clot
formation
Duration: Indefinitely
-
HMG-CoA Reductase
Inhibitor: Lipid (blood fat) lowering
agent.
Examples of statins include:
o Simvastatin
o Pravastatin
o Atorvastatin
Duration: Indefinitely or as advised
by your doctor.
-
Beta blocker: Scientific
studies have demonstrated that this
medication reduces the risk of heart
attack (myocardial infarction), makes
it more likely that a patient will survive
an infarction, and reduces the risk
of developing heart failure.
Duration: Your cardiologist will determine
-
Ace inhibitor: Reverses
blood-vessel-lining dysfunction, and
lowers the risk of atherosclerosis progression
through potent vascular and cardiac
protection. Duration: Your cardiologist
will determine
-
Calcium channel blocker:
For patients who have a radial artery
graft (from forearm) Prevents spasm
Duration: Approximately 3 month’s
-
Anti-ulcer medication:
Results: Reduces acid in the stomach.
Surgery can cause stress, and stomach
irritation can result from pain medications,
antibiotics and anti-inflammatory.
Duration: 2 weeks
-
Anti-inflammatory:
Reduces inflammation and pain
Duration: 7-10 days
-
Stool softner: Softens
stools; inactivity and pain medications
can cause constipation.
Duration: Generally 1-2 weeks
29. What should my cholesterol
levels be?
Target lipid (blood fat) levels in patients
with coronary disease are as follows:
- Total Cholesterol: less than 200 mg
- LDL (bad cholesterol): less than 100
mg
- HDL (good cholesterol): greater than
35 mg
- Triglyceride: less than 200 mg
30. How much pain will
I have after surgery?
-
You can expect variable
and generalized discomfort from your
incisions, for which your nurse will
provide pain medications during your
recovery.
-
Although there is
usually some discomfort along the incisions
in the chest, leg, arm or between the
shoulder blades, as your surgical wounds
continue to heal, you should require
less and less pain medication.
31. When can I drive?
-
Your physician will
tell you when you can safely start driving
again.
-
Usually people recovering
from surgery need to wait at least four
to six weeks from the day of surgery.
-
The breastbone (sternum)
needs time to heal, and your body needs
time to regain the necessary mobility
required for safe driving.
-
Sudden turns of
the steering wheel or an impact might
disrupt that process.
-
Pain medications
you may be taking can impair your reaction
time and coordination.
-
It is fine to be
a passenger in the front or back seat,
and remember to wear your seat belt.
-
When you drive for
the first time, take someone with you
and stay out for a short time, about
a half hour.
-
Keep in mind challenges
that await you at your final destination.
For e.g will there be stairs you have
to climb? How far is the parking lot
from where you're going?
32. When will I be able
to get back to work?
-
Your ability to
get back to work is a very personal
decision made by you and your cardiologist
or surgeon.
-
This decision is
based upon the kind of work you do,
your medical condition and how stressful
your job is.
33. When can I have sex?
-
The amount of energy
expended during sexual activity is equal
to climbing two flights of stairs or
walking a city block.
-
Most patients find
they are ready to resume their sexual
activity the second week after discharge
from the hospital.
-
Avoid sexual activity
right after eating, drinking alcohol
or when feeling tired.
34. How long will have
to stay in the hospital?
-
You can expect to
stay in the hospital for about a week
after surgery, including at least 1
to 3 days in the Intensive Care Unit
(ICU).
-
You are also subjected
to cardiac rehabilitation program.
-
These programs are
designed to help you make lifestyle
changes like starting a new diet and
exercise program, quitting smoking,
and learning to deal with stress etc.
If you have any further questions or
clarifications, do not hesitate to discuss
with our expert cardiologists or cardiac
surgeons.
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