A Heart Care Primer

Sometimes heart disease strikes unexpectedly. For example, Billy Martin, 79, of Sulphur Springs, was surprised when he woke up eight years ago with pain in his arm. When medication administered at Memorial Hospital relieved the pain, he expected to go home. Instead, he was rushed to Baylor University Medical Center at Dallas via ambulance for emergency bypass surgery.

Cardiac rehab and regular exercise at Memorial Hospital helped him recover from the surgery, and his weight dropped from 289 pounds to 212. His heart troubles weren't over, but his overall good health helped him bounce back from heart valve replacement surgery six years ago and a pacemaker placement in 2005. "My doctor says if I keep exercising and taking my medication I could live to be 100," he says.

Plunging into this medical world is stressful, and the unfamiliar terms and tests can add to your anxiety. Felix Lugo-Adams, M.D., a cardiologist on the medical staff at Memorial Hospital, helps explain some of the most common cardiac procedures.

Procedure: Angioplasty

Type: Inpatient treatment
Why: Helps clear blocked arteries.
What it is: Starting at the groin, a doctor threads a small hollow tube, or catheter, to the blockage. At the blockage, the doctor inflates a small balloon to compress the blockage and improve blood flow. "More than 90 percent of the time we insert a stent as well," Dr. Lugo-Adams says.
How long it takes: 30 to 45 minutes. You'll typically be awake but sedated.
After: You will usually spend just one night in the hospital.

Procedure: Cardiac Catheterization

Type: Outpatient diagnostic
Why: Checks for arterial blockages.
What it is: Doctors insert a catheter through your groin into a blood vessel. "We inject dye to check the heart's strength and define the condition of the arteries," Dr. Lugo-Adams explains.
How long it takes: About 30 minutes. You'll typically be awake but sedated.
After: You often go home that day.

Procedure: Stent

Type: Inpatient treatment
Why: Helps clear blocked arteries.
What it is: A metal spring-like device, or stent, is inserted after the blockage is first opened with an angioplasty balloon. The stent remains in the artery and reduces the risk of additional buildup. "Nowadays, most stents are medicated, and that medication decreases the likelihood of new blockage formation," Dr. Lugo-Adams explains.
How long it takes: 30 to 45 minutes. You'll typically be awake but sedated.
After: You typically spend one night in the hospital.

Procedure: Pacemaker

Type: Inpatient treatment
Why: The heartbeat is too slow. "A pacemaker is a backup system for the person's own heart rhythm," Dr. Lugo-Adams says.
What it is: Doctors insert a small, battery-operated electronic device under the skin, with wires that travel to the heart. When the heartbeat is too slow, the pacemaker sends an electrical impulse to speed it up.
How long it takes: One to two hours, with full anesthesia.
After: You typically spend one night in the hospital.

Procedure: Coronary artery bypass graft surgery

Type: Inpatient treatment
Why: Helps clear blocked arteries.
What it is: Doctors take a blood vessel from a leg, arm or within the chest and use it to bypass the blocked blood vessel, so the blood can flow freely. Doctors open the chest, and a heart-lung machine keeps your blood pumping through your body during the operation, although some surgeries can be done without the machine.
How long it takes: Two to four hours, with full anesthesia.
After: You'll typically spend about a week in the hospital and two months recovering at home.

Procedure: Valve Repair/ Replacement

Type: Inpatient treatment
Why: A heart valve is leaking or is too tight.
What it is: Doctors cut the breastbone and stop the heart. They then repair the valve, or remove it and insert an artificial valve.
How long it takes: Two to four hours, with full anesthesia.
After: You'll typically spend about a week in the hospital and two months recovering at home.

Procedure: Heart Transplant

Type: Inpatient treatment
Why: Angioplasty or stenting are no longer options. Your other medical problems, social support system and smoking status will be considered for eligibility determination. What it is: The patient's heart is removed and replaced with a donor heart.
How long it takes: Three to six hours, with full anesthesia.
After: You generally spend about two weeks in the hospital.

By Stephanie Thurrott

For a referral to a cardiologist on the medical staff at Memorial Hospital, call (903) 439-4062 or visit hcmh.com.