Advances in Cardiac Care Provide New Lease on Life
for Patients

By Kenneth Adams, MD, FACC

Heart disease remains a major threat to the health of many Americans - in fact, it is the #1 killer of adults in the United States. Over the years, much emphasis has been placed on research and diagnosis aimed at the prevention of cardiac disease. Key advances have also been made in technology and in diagnostic techniques that have helped to improve the care today’s physicians are able to provide to their cardiac patients. Some of the most exciting developments include:

  • Advances in the treatment of cholesterol. It is widely known that lowering “bad” cholesterol and raising “good” cholesterol make a significant difference in the prevention of heart disease. Education on this front been widespread and effective, as has the development of successful drug therapies. Today’s statins and other cholesterol lowering agents provide positive results for millions.
  • More accurate predictors and prevention methods.  Research points to inflammation as a significant part of arteriosclerosis and heart attack. As a result, blood tests have been developed identifying markers as predictors of heart attack and stroke. One of the most important is C reactive protein or CRP. This test allows us to make better predictions and determine how aggressive to be with prevention   
  • New stents that keep arteries open.  A stent is a thin tube or sleeve that is inserted into a “clogged” artery that has been opened by balloon angioplasty. With balloon angioplasty alone, 35-40% of arteries might restenosis or clog within 6 months. There has been a great improvement in this with stents/aspirin and plavix, reducing the restenois rate to 10-15%. With the recent discovery of sirolimus - a chemical coating added to the stent- nearly 100% remain open. This greatly reduces the need for repeat angioplasty and bypass surgery.
  • Irregular heartbeats can now be corrected permanently. With the development of new techniques including the use of radio waves aimed at the heart, physicians are often able to permanently correct disturbances in the beating of the heart.  In the past, drug therapies produced unpredictable results and had serious side effects.
  • Mass access to defibrillators. Many public areas and nearly all first responders now have effective defibrillators.  Compact, easy to use models are also available for in-home use. These devices shock the heart and restore normal rhythm patterns, and are true life-savers for heart attack victims. A defibrillator wire can also be inserted into the heart of a vulnerable patient shocking the heart into a normal rhythm if needed. Implanted devices save valuable time in critical situations.
  • Improvements in the treatment of acute heart attacks.  Emergency department personnel are much more aggressive and sophisticated in the treatment of cardiac arrest. We understand, for example, that time is muscle - the quicker patients are treated, the less heart muscle is damaged.  Treatment methods have also improved. Today’s ER staff is equipped with effective clot busting thrombolytic agents that  help open culprit arteries. With reduced “door to needle time,” and the option of primary angioplasty, more patients are surviving acute heart attacks.
  • Surgery is now safer, quicker and less traumatic. Years ago, heart surgery was almost always “open” involving extensive trauma and long recoveries. Today, valve repair and replacement as well as bypass surgery can be performed using small incisions in the chest wall. Patients recovery faster and have far fewer complications.
  • Advances in the treatment of congestive heart failure.  Congestive heart failure (CHF) is the #1 diagnosis for hospital admissions. Research has provided us with a better understanding of the causes of CHF as well as some very good treatment regimens and surveillance programs. Today, we are better at identifying the early warning signs of CHF and have better treatment choices.
  • Women and Heart Disease. In the 1960’s, heart disease was viewed as a men’s disease. It is now abundantly clear that heart disease is the number one cause of mortality for both men and women. Women tend to develop heart disease later in life than men but when it develops, it can be more severe.  Today, we are taking just as aggressive an approach in diagnosing and managing heart disease in women as in men.  Many heart research studies are including more women.

While diagnosis and treatment options continue to improve, it should be no surprise that prevention continues to be the first line of defense in cardiac care.  Eating well, exercising and managing stress are all key components for good heart health.