Greater risk reduction with modern treatment of heart disease
Greater risk reduction with modern treatment of heart disease
Introduction
Significant strides have been achieved in outcomes as a result of modern treatment of heart disease. For instance, dietary changes reduce risk by 30%, lifestyle changes by 25%, and medications for cholesterol and blood pressure reduce risk by 25%. Advanced surgical procedures like CABG, CRT, LVAD, and conventional procedures of angioplasty and stenting also significantly reduce risk. Let us take a good look at options presently available.
Information about various modern treatments on heart disease
In addition to effective outcomes, survival rates and quality of life have improved with modern treatment of heart disease. Here is how these options have made a huge change in the overall heart health and prevention of adverse events.
- Lifestyle modifications – such as weight management, routine exercising, and heart healthy diet reduce the risk of heart disease. This brings about a reduction in blood pressure and cholesterol levels, while improving cardiovascular function.
- Medications – help by controlling risk factors like high blood pressure, high cholesterol, and abnormal heart rhythms. Medicines used as part of treatment include statins to lower cholesterol, antihypertensives to lower blood pressure and antiplatelets to reduce risk of blood clots.
- Procedures – such as angioplasty, stenting, and bypass surgery help restore flow of blood to the heart.
- New therapies – such as Cardiac Resynchronization Therapy, helps to improve heart function, while LVAD is a life-saving option in end-stage heart failure.
- Screening – early screening, helps to prevent complications, in a preventive manner, improving long-term health outcomes. Survival rates improve when screening helps early detection. One such screening is genetic testing which helps reveal if the person is genetically predisposed to heart disease or other factors that contribute to heart disease risk.
What is medical management of rheumatic heart disease?
This refers to treating symptoms, preventing complications, and focusing on the underlying causes of RHD, such as:
- Symptomatic treatment – through medicines like nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to reduce inflammation and pain as a result of rheumatic fever. Other medicines include diuretics to reduce fluid buildup in the body.
- Preventive measures – use of long-term antibiotic treatment with penicillin helps prevent repeat episodes of rheumatic fever. When RHD results in heart failure, suitable medications for managing heart failure are part of the treatment regimen. This includes ACE inhibitors to relax blood vessels, Beta-Blockers to reduce heart rate, blood pressure and digoxin to increase force of heart contractions.
- Periodic checkups – to assess heart function and make changes to treatment when required. Checkup involves echocardiograms to assess the heart valve functioning.
- Lifestyle changes – such as a heart-healthy diet, routine physical activity, and quitting smoking.
What is surgical management of rheumatic heart disease?
As part of modern treatment of heart disease, surgical management of RHD is undertaken when medications are not enough. This involves the following procedures:
- Valve repair – to correct a damaged heart valve by removing scar tissue, fixing valve flaps, or reshaping the valve.
- Valve replacement – to replace a severely damaged heart valve with mechanical valves made with titanium or carbon. Similarly, biological valves made with animal tissues are also used where applicable.
- Valve reconstruction – involves reconstructing the affected valve or structures around, including repairing valve leaflets, chords, or annulus.
- Types of surgery – include open-heart surgery by temporarily stopping the heart to replace/repair the valve. During this period, a heart-lung machine is used in place of the temporarily stopped heart. The other type of surgery is minimally invasive procedure using advanced techniques to repair/replace the valve.
What is chelation therapy for heart disease?
Chelation therapy refers to a treatment that is used for removal of heavy metals from the body. This therapy involves use of chelating agents that bind to heavy metals, following which the body flushes it out through urine. While this cannot be technically considered as part of modern treatment of heart disease, it is, at times used, despite being a controversial and less conventional option.
- Goal of chelation therapy:
The main goal of chelation therapy is to treat heavy metal poisoning, for instance, removal of lead, mercury, or arsenic. Chelating agents have the quality of binding to such heavy metals, followed by elimination from the body.
Chelation therapy has been suggested as an option for improving heart health by removing calcium deposits from arteries. This could technically reduce atherosclerosis and improve blood flow.
- Chelating agents:
This therapy is achieved through use of EDTA (Ethylene Diamine Tetraacetic Acid) for heavy metal poisoning. DMSA (Dimercaptosuccinic Acid) and DMPS (Dimercaptopropane Sulfonate) are the other commonly used chelating agents chosen for specific metal poisoning treatments.
- Relation to heart disease:
This is presently part of ongoing research with new theories suggesting that the therapy might also reduce oxidative stress and inflammation. In addition to removing heavy metals and reducing calcium deposits in the arteries, this may theoretically help improve heart health.
- Risks, possible side effects:
There are possible risks that can arise due to chelation therapy. For instance, there are possible side effects, such as kidney damage, potential allergic reactions, and imbalance in electrolytes. It is therefore necessary for careful monitoring of patients undergoing chelation therapy to tackle any adverse effects.
- Present recommendations:
Presently, chelation therapy is used to treat heavy metal poisoning, while for heart disease, it is not part of standard treatment. Ideally, conventional measures like lifestyle changes, medications, and surgical interventions are the recommended options for heart disease.
Genetic testing can be considered as a good option to check for genetic reasons or risk of heart disease. There are various reasons for heart disease, including a genetic component. By ruling out or confirming genetic risks, it is possible to take suitable preventive or mitigating treatment as required to reduce risk.
Chelation therapy is not medically recommended as a substitute for established treatment regimen. Its use for managing cardiovascular conditions continues to be controversial.
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Shetty B s a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU).