Heart and vascular services
The body's cardiovascular, or circulatory system, is made of the heart, blood, and blood vessels (arteries and veins).
Heart and vascular services refers to the branch of medicine that focuses on the cardiovascular system.
Heartbeat - Animation
The heart is a four-chambered organ with four main vessels, which either bring blood to or carry blood away from the heart. The four chambers of the heart are the right atrium, the right ventricle, the left atrium, and the left ventricle. The great vessels of the heart include the superior and inferior vena cava, which bring blood from the body to the right atrium, the pulmonary artery, which transports blood from the right ventricle to the lungs. The last of the great vessels is the aorta, the body's largest artery, which transports oxygen-rich blood from the left ventricle to the rest of the body. If we remove some of the tough fibrous coating of the heart and great vessels, you can get a better look at the heart beating. If you look carefully, you can see a series of one-way valves that keep the blood flowing in one direction. If we inject dye into the superior vena cava, you can watch it pass through the heart as it goes through the cardiac cycle. The blood first enters the heart into the right atrium. Blood passes from the right atrium through the tricuspid valve and into the right ventricle. When the right ventricle contracts, the muscular force pushes blood through the pulmonary semilunar valve into the pulmonary artery. The blood then travels to the lungs, where it receives oxygen. Next, it drains out of the lungs via the pulmonary veins, and travels to the left atrium. From the left atrium, the blood is forced through the mitral valve into the critically important left ventricle. The left ventricle is the major muscular pump that sends the blood out to the body systems. When the left ventricle contracts, it forces the blood through the aortic semilunar valves and into the aorta. From here, the aorta and its branches carry blood to all the tissues of the body.
Information
The heart's main job is to pump oxygen-rich blood to the body after it pumps oxygen-poor blood to the lungs. It normally does this 60 to 100 times a minute, 24 hours a day.
The heart is made of four chambers:
- The right atrium receives oxygen-poor blood from the body. That blood then flows into the right ventricle, which pumps it to the lungs.
- The left atrium receives oxygen-rich blood from the lungs. From there, the blood flows into the left ventricle, which pumps blood out of the heart to the rest of the body.
Together, the arteries and veins are referred to as the vascular system. In general, arteries carry blood away from the heart and veins carry blood back to the heart.
The cardiovascular system delivers oxygen, nutrients, hormones, and other important substances to cells and organs in the body. It plays an important role in helping the body meet the demands of activity, exercise, and stress. It also helps maintain body temperature, among other things.
CARDIOVASCULAR MEDICINE
Cardiovascular medicine refers to the branch of health care that specializes in the treatment of diseases or conditions dealing with the heart and vascular systems.
Cardiac catheterization - Animation
Millions of Americans are living with heart disease and some of them don't even realize they have it. Heart disease is the number one cause of death; above cancer, diabetes, and injuries. That's why it's important to get it diagnosed and treated quickly. Fortunately, we doctors have a lot of tests and treatments at our disposal to combat heart disease. One procedure that is both a test AND a treatment is called cardiac catheterization. It can show your doctor how healthy your heart and blood vessels are, and treat heart valve problems, clogged arteries, and heart defects. Let's talk today about cardiac catheterization. So, why would you even need cardiac catheterization? Well, doctors use cardiac catheterization to diagnose and evaluate common heart and blood vessel problems, like chest pain or an abnormal stress test due to coronary artery disease, heart valve conditions like a leaky or narrowed valve, a high blood pressure condition in the lungs, blood clots in the lungs from an embolism, and an enlarged heart. You'll need to have this procedure in a supervised hospital setting. You may need to stay overnight at the hospital the night before the test, or you may be admitted the morning of the procedure. The whole cardiac catheterization procedure takes about 30 to 60 minutes. You'll be given medicine to help you relax, but you'll be awake during the procedure. First, the doctor will insert an intravenous, or IV line into one of the blood vessels in your groin or neck. Through this IV line, your doctor will pass a thin, flexible tube called a catheter. That tube will be threaded into either the left or right side of your heart. The doctor will use an x-ray as a guide to see where the catheter is going. While the catheter is in place, your doctor can check how well the blood is flowing into and out of your heart, and through the arteries around your heart, collect blood samples from your heart, measure the oxygen level in your heart, and even take a tiny piece of heart tissue, called a biopsy, when there's a situation of unexplained heart failure. Cardiac catheterization is a safe procedure when performed by an experienced medical team. But, some possible risks include bleeding, infection, and blood clots. A heart attack or a stroke can happen in very rare situations. But, remember, it's done in a closely supervised setting in a hospital. After a cardiac catheterization, your doctor should have a pretty good idea of what's causing your heart, valve, or blood vessel problem. Knowing exactly what the problem is can help your doctor find just the right way to treat your particular problem.
Common disorders include:
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Abdominal aortic aneurysm
Abdominal aortic aneurysm
The aorta is the main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm (AAA) occurs when an area of t...
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Coronary artery disease, including angina and heart attack
Coronary artery disease
Coronary heart disease is a narrowing of the blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also called co...
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Heart failure
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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- High blood pressure and high cholesterol
- Irregular heart rhythms (arrhythmias)
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Peripheral artery disease (PAD)
Peripheral artery disease
Peripheral artery disease (PAD) is a condition of the blood vessels that supply the legs and feet. It occurs due to narrowing of the arteries in the...
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Physicians involved in the treatment of circulatory or vascular diseases include:
- Cardiologists -- Doctors who have received extra training in the treatment of heart and vascular disorders
- Vascular surgeons -- Doctors who have received extra training in blood vessel surgery
- Cardiac surgeons -- Doctors who have received extra training in heart-related surgery
- Primary care doctors
Other health care providers who are involved in the treatment of circulatory or vascular diseases include:
- Nurse practitioners (NPs) or physician assistants (PAs), who focus on heart and vascular diseases
- Nutritionists or dietitians
- Nurses who receive special training in the management of patients with these disorders
Imaging tests that may be done to diagnose, monitor or treat diseases of the circulatory and vascular system include:
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Cardiac CT
Cardiac CT
A computed tomography (CT) scan of the heart is an imaging method that uses x-rays to create detailed pictures of the heart and its blood vessels. Th...
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Cardiac MRI
Cardiac MRI
Heart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...
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Coronary angiography
Coronary angiography
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....
Read Article Now Book Mark Article - CT angiography (CTA) and magnetic resonance angiography (MRA)
Magnetic resonance angiography
Magnetic resonance angiography (MRA) is an MRI exam of the blood vessels. Unlike traditional angiography that involves placing a tube (catheter) int...
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Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
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PET scan of the heart
PET scan of the heart
A heart positron emission tomography (PET) scan is an imaging test that uses a radioactive substance called a tracer to look for disease or poor bloo...
Read Article Now Book Mark Article - Stress tests (many different types of stress tests exist)
- Vascular ultrasound, such as carotid ultrasound
Carotid ultrasound
Carotid duplex is an ultrasound test that shows how well blood is flowing through the carotid arteries. The carotid arteries are located in the neck...
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SURGERIES AND INTERVENTIONS
Less invasive procedures than heart or vascular surgery may be done to diagnose, monitor or treat diseases of the heart and vascular system.
In most of these types of procedures, a catheter is inserted through the skin into a large blood vessel. In most cases, such procedures do not need general anesthesia. Patients often do not need to stay in the hospital overnight. They recover in 1 to 3 days and can most often return to their normal activities within a week.
General anesthesia
General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...
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- Ablation therapy to treat cardiac arrhythmias
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Angiogram (using x-rays and injected contrast dye to evaluate blood vessels)
Angiogram
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....
Read Article Now Book Mark Article - Angioplasty (using a small balloon to open a narrowing in a blood vessel) with or without stent placement
- Cardiac catheterization (measuring pressures in and around the heart)
- Valve interventions/replacement
Heart surgery may be needed to treat certain heart or blood vessel problems. This may include:
- Heart transplant
- Insertion of pacemakers or defibrillators
- Open and minimally invasive coronary artery bypass surgery
- Repair or replacement of heart valves
- Surgical treatment of congenital heart defects
Vascular surgery refers to surgical procedures that are used to treat or diagnose problems in a blood vessel, such as a blockage or rupture. Such procedures include:
- Arterial bypass grafts
- Endarterectomies
- Repair of aneurysms (dilated/enlarged portions) of the aorta and its branches
Procedures may also be used to treat arteries that supply the brain, kidneys, intestines, arms and legs.
CARDIOVASCULAR PREVENTION AND REHABILITATION
Cardiac rehabilitation is therapy used to prevent heart disease from getting worse. It is usually recommended after major heart-related events such as a heart attack or cardiac surgery. It may include:
- Cardiovascular risk assessments
- Health screenings and wellness exams
- Nutrition and lifestyle counseling, including smoking cessation and diabetes education
- Supervised exercise
Reviewed By
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Patel A, Kodali S. Transcatheter aortic valve replacement: indications, procedure, and outcomes. In: Otto CM, Bonow RO, eds. Valvular heart disease: A Companion to Braunwald's Heart Disease. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 12.
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