Cardiology

• Inherited (genetic) factors: Who is most at risk?
  • People with inherited hypertension (high blood pressure)
  • People with inherited low levels of HDL (high-density lipoproteins),high levels of LDL (low-density lipoprotein) blood cholesterol or high levels of triglycerides
  • People with a family history of heart disease (especially with onset before age 55)
  • Aging men and women
  • People with type 1 diabetes
  • Women, after the onset of menopause (generally, men are at risk at an earlier age than women, but after the onset of menopause, women are equally at risk)

• Acquired risk factors: Who is most at risk? A heart attack can happen to anyone - it is only when we take the time to learn which of the risk factors apply to us, specifically, can we then take steps to eliminate or reduce them.
  • People with acquired hypertension (high blood pressure)
  • People with acquired low levels of HDL (high-density lipoproteins), high levels of LDL (low-density lipoprotein) blood cholesterol, or high levels of triglycerides
  • Cigarette smokers
  • People who are under a lot of stress
  • People who drink too much alcohol
  • People who lead a sedentary lifestyle
  • People overweight by 30 percent or more
  • People who eat a diet high in saturated fat
  • People with type 2 diabetes

You can manage your risks for a heart attack. Here's where to start:

• Examine which of the risk factors apply to you, and take steps to eliminate or reduce them.
• Become aware of conditions like hypertension or abnormal cholesterol levels, which may be "silent killers."
• Modify risk factors that are acquired (not inherited) through lifestyle changes. Consult your doctor as the first step in starting right away to make these changes.
• Consult your health care provider soon to determine if you have risk factors that are genetic or inherited and cannot be changed, but can be managed medically and through lifestyle changes.

The following are the most common symptoms of a heart attack. However, each individual may experience symptoms differently. Symptoms may include:

• Severe pressure, fullness, squeezing, pain and/or discomfort in the center of the chest that lasts for more than a few minutes
• Pain or discomfort that spreads to the shoulders, neck, arms, or jaw
• Chest pain that increases in intensity
• Chest pain that is not relieved by rest or by taking nitroglycerin
• Chest pain that occurs with any/all of the following (additional) symptoms: sweating, cool, clammy skin, and/or paleness shortness of breath, nausea or vomiting, dizziness or fainting, unexplained weakness or fatigue, rapid or irregular pulse
• Although chest pain is the key warning sign of a heart attack, it may be confused with indigestion, pleurisy, pneumonia, or other disorders. The symptoms of a heart attack may resemble other medical conditions or problems. Always consult your health care provider for a diagnosis.

Interventional Cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery. Additionally, interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute myocardial infarction. It involves the extraction of clots from occluded coronary arteries and deployment of stents and balloons through a small hole made in a major artery.

Non-invasive cardiologists provide expertise in the detection and treatment of heart disease. Non-invasive cardiology involves tests to evaluate and diagnose disorders of the heart. A person with a history of heart disease, chest pain with unknown cause or valvular heart disease may be referred for non-invasive evaluation.

Having 24/7 Interventional Cardiology coverage at Hannibal Regional Hospital is extremely important to Hannibal Regional and to our community. For more information call 573-248-1300.

Artificial Implantable Cardioverter Defibrillator Placement (AICD or ICD) - An implantable cardioverter defibrillator can control abnormal, life-threatening heart rhythms and prevent cardiac arrest.

Balloon Angioplasty - A procedure in which a catheter equipped with a tiny balloon at the tip is inserted into an artery that has been narrowed by the accumulation of fatty deposits. The balloon is then inflated to clear the blockage and widen the artery.

Cardiac Catheterization - Pressure monitoring and imaging with contrast through a special catheter inserted through a blood vessel in the arm or leg to determine heart anatomy, function, and to diagnose & treat cardiovascular disease. Radiocontrast dye using x-ray and fluoroscopy visualize the position and condition of the heart chambers and arteries.

Cardiac and Peripheral Angioplasty - Mechanical procedures that open narrowed or clogged coronary arteries of the heart and other blood vessels.

Cardiac and Peripheral Stent Placement - Implantation of a small metal coil (stent) in the clogged heart or peripheral artery to help prop it open and decrease the chance of it narrowing again. The stent used may be bare metal or drug-eluting stent.

Fractional Flow Reserve (FFR) - A guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery. FFR is done through a standard diagnostic catheter at the time of a coronary angiogram (cardiac catheterization). The measurement of Fractional Flow Reserve has been shown useful in assessing whether or not to perform angioplasty or stenting on "intermediate" blockages. Interventional Cardiology - Medical specialty that deals with the treatment of structural heart diseases identified during angiography using modalities such as balloon, bare metal or drug-eluting stent placement

Intravascular Ultrasound (IVUS) Examination - Imaging visualization of the inside of blood vessels using special catheters attached to computerized ultrasound equipment.

Invasive Cardiology - Medical specialty that deals with procedures, such as cardiac angiography and catheterization, that lead to the diagnosis and treatment of heart and vascular diseases.

Pacemaker Placement and Management - A pacemaker is a small electrical device inserted under the skin to help regulate heat beats and managed through periodic check ups.

Cardiac Stress Testing - Electrocardiographic (EKG) examination of the heart at rest and at various levels of exercise. May reveal abnormalities of the blood supply to the heart muscle and/or abnormalities of the heart rhythm not seen at rest. May be performed on a treadmill or an IV drug may be administered to simulate the heart at exercise. Often performed in conjunction with Nuclear Cardiology or the Stress Echo.

Cardioversion - A procedure used to convert an irregular heart rhythm to a normal heart rhythm by applying electric shock or using certain medications.

Coronary CT Angiography - Coronary Computed Tomographic Angiography - (64 slice CCTA) is a new, state-of-the-art, non-invasive, diagnostic tool that visualizes the myocardium (heart), aorta, lungs and coronary circulation and may dramatically alter the way cardiac and vascular diseases such as coronary artery disease (CAD), dissections and aneurysms of the aorta, and atrial fibrillation are diagnosed, evaluated and treated.

Doppler Study - A diagnostic study using special tool that detects the presence or absence of flow in blood vessels through the skin.

ECG or EKG - Electrocardiogram - A test that records the electrical activity of the heart muscle and rhythm, usually done while the patient is lying down at rest.

Echocardiogram - Use of high frequency sound waves to visualize continuous blood and heart movements.

Event Monitoring - A small recording device, worn for up to 30 days while the patient performs their normal daily activities. When the patient experiences a symptom (or "event") that might be heart related, the patient activates a memory record button on the device. Then the device will typically store the heart rhythm that occurred 45 seconds before and 15 seconds after the record button press. The device's memory is then downloaded for the physician to examine.

Head Up Tilt Table (HUTT) Test - Test performed on a table that "tilts" the patient from a supine to standing position for various periods of time. Ordered by the physician to determine if near syncopal/syncopal (fainting) episodes might be related to cardiovascular causes.

Holter Monitoring - A small device, worn by the patient while the patient performs their normal daily activities. The device provides continuous recording of the electrical activity of the heart for 24 hours or more to determine abnormalities.

Nuclear Cardiology/Nuclear Stress Testing - Imaging of the heart at work (exercise) and at rest using injection of a harmless radioactive tracer(dye) and a gamma camera that produces comparative pictures of the blood supply to the heart muscle at work and at rest. May be performed on a treadmill or an IV drug may be administered to simulate the heart at exercise.

Stress Echocardiography - High frequency sound wave image of the moving heart, done at rest, followed by imaging after exercise on a treadmill or after an IV drug has been administered to simulate the heart at exercise.

Transesophageal echocardiography (TEE ) - A diagnostic test, using a special probe placed within the esophagus, that employs ultrasound waves to make images of the heart chambers, valves and surrounding structures.

The Critical Decision Unit is an element of the hospital's Invasive Cardiology Service. The CDU is located adjacent to the hospital's Cardiac Catheterization Laboratories.

The CDU is a ten room, short-stay unit for patients receiving scheduled invasive cardiovascular evaluations. The CDU provides patients and their families with significantly more privacy, safety, space and comfort, including a flat screen television and state-of-the-art monitoring equipment for each patient. It also includes a dedicated family waiting area, private consultation room and immediate access to other hospital services. This patient-centered area is representative of the value Hannibal Regional Hospital places on meeting the needs of the patients it serves.

Patients scheduled for a diagnostic procedure in the Cardiac Catheterization Laboratory are escorted to the CDU where they are met by a Registered Nurse and taken to the room where they are cared for throughout their stay. The CDU staff work in concert with the multidisciplinary team including the cardiologists, the interventional cardiac catheterization team, cardiac rehabilitation and HRH dieticians to provide an exceptional patient-centered care and experience to each individual patient. Hannibal Regional Hospital opened its Critical Decision Unit on July 1, 2009.

Hannibal Regional Hospital's Intensive Care Unit (ICU) specializes in the care of critically ill patients including patients with heart attacks, unstable angina and various other cardiac conditions that require continuous monitoring and treatment. Our highly competent and compassionate healthcare providers who work in the ICU provide around-the-clock intensive monitoring and treatment of patients seven days a week. The availability of telemetry and other continuous monitoring equipment is an important element that is provided in ICU. This allows early intervention with medication, cardioversion or defibrillation, thereby improving the prognosis of the illness. The other most important function of HRH's ICU is to provide life-support systems for desperately ill patients including mechanical ventilation and cardiopulmonary resuscitation.

Cardiac rehab is a program of exercise and education to help patients restore or improve heart health after a heart attack, heart procedure, or heart disease. A patient’s personalized program is arranged between the patient, the physician and the Cardiac Rehab team. Each exercise session is reviewed by the physician.

The cardiac rehab team includes R.N.s and respiratory therapists who are state licensed and have advanced medical training in cardiac care.

Cardiac Rehabilitation is offered at Hannibal Regional Hospital.

Pulmonary rehab is a program of exercise and education to help patients with chronic lung disease improve their exercise tolerance, decrease breathlessness, and generally improve their state of health. A patient’s personalized program is arranged between the patient, the physician, and the Pulmonary Rehab team. All exercise sessions are reviewed by the physician.

The pulmonary rehab team consists of respiratory therapists who are state licensed and have advanced medical training.

Pulmonary Rehabilitation is offered at Hannibal Regional Hospital.