Cardiac Catheterization
Cardiac catheterization is a test which is performed to obtain certain diagnostic information about the heart. Patients may require this medical therapy rather than undergo angioplasty or bypass surgery when they suffer from rare or easily controlled episodes of angina. Alternatively, cardiac catheterization is not performed in patients who have infrequent episodes of angina and in whom angina can be easily controlled. When a patient has heart failure due to suspected coronary artery disease or there is suspected coronary artery disease, cardiac catheterization is conducted. Cardiac catheterization can help:
Measure blood pressure within heart.
Know the amount of oxygen in the blood.
Check the pumping ability of the heart muscle.
Check blood flow through the heart after surgery.
Collect blood samples from the heart.
Inject dye into the coronary arteries.
To provide treatment in certain types of heart conditions like congenital heart defects and how severe it is.
To find out a coronary artery disease and if found to pinpoint the size and location of fat and calcium deposits that have built up in coronary artery from atherosclerosis.
To determine whether the patient needs bypass surgery or angioplasty.
Examine the arteries of the heart with an x-ray technique called fluoroscopy.
The patient is asked not to drink or eat anything, except a small amount of water, for atleast 6 to 12 hours before the test. The patient is tested for allergy to iodine or other medications. Patients suffering from kidney disease or diabetes or bleeding disorders must keep the cardiologist informed. The cardiac catheterization test is performed in a cath lab by a cardiologist. The actual catheterization procedure takes about 15 - 30 minutes. The patient's electrocardiogram that continuously records the electrical activity of the heart is taken. A pulse oximeter device that measures the oxygen levels of the patients' blood is monitored. An intravenous needle is inserted into the patients' vein to give fluids or medicine during the catheterization procedure. A sedative is also given through this IV line which helps the patient to relax.
Cardiac catheterization procedure involves passing a catheter, a thin flexible tube, into the right or left side of the heart. The doctor inserts this thin plastic tube into the groin - femoral artery. Other places where in the catheter may be inserted are the elbow- brachial artery or the wrist - radial artery. From there it is slowly advanced into the chambers of the heart or into the coronary arteries. The doctor watches the progress of the catheter into the heart's vessels and chambers on the imaging screen. Pressures within the heart chambers are measured and the blood and tissue samples are also removed through the catheter. A small amount of dye is also injected through the catheter into the heart chamber or into one of the coronary arteries.
Therapeutic catheterization: Certain types of heart defects can be repaired using catheterization. For instance, if the coronary arteries are blocked, the cardiologist can use a catheter, guide wire and balloon to open and improve blood flow to the heart. This is termed as percutaneous coronary intervention (PCI).
Normal result indicate that there is no significant narrowing or blockage in the coronary arteries. Abnormal results may suggest that the heart does not pump blood normally or the valves in the heart may be weak. There may be leakage between heart chambers. There is a possibility of aortic aneurysm. Some complications with cardiac catheterization include heart attack or stroke, hematoma, puncture of the heart or arrhthmias.
Trigeminal Neuralgia
Trigeminal Neuralgia is a painful condition wherein a patient suffers attacks of facial pain. The pain associated with trigeminal neuralgia is shooting and jabbing, much like sudden burst of live wires on the face. While these episodes of pain may be few and far between in the initial stages, the attacks are more frequent and painful as the disease progresses. It can be felt on a small portion of the face or the larger area. In most cases, it affects just one side of the face. The trigeminal nerve, originating from deep in the brain serves the facial area. Any disturbance in its function leads to trigeminal neuralgia or tic douloureux. The possible causes for the pain are stroke, tumor or multiple sclerosis. Usually this disorder is noticed in persons over 50 years and women seem to be more affected by it than men.
The pain associated with trigeminal neuralgia is so intense that it affects the day-to-day life of the patient. Activities like eating, drinking, shaving, brushing the teeth and talking can become agonizing. Consequently, it leads to anxiety and irritability and nutritional deficiencies since the patient is likely to avoid eating. A patient may need to be hospitalized if the pain is acute. An MRI of the head may be suggested to aid diagnosis.
Trigeminal Neuralgia is treated with carbamazepine - a drug used to treat seizures and convulsions. Other drugs include baclofen, gabapentin, clonazepam, lamotrigine, topiramate and sodium valporate. But these drugs are not without unpleasant side effects. Percutaneous stereotactic radiofrequency thermal rhizotomy (PSRTR) is a procedure whereby a doctor passes electric current to damage the nerve fibers that cause pain. Alternatively MVD (Microvascular decompression) can also ease pain without damaging any part of the trigeminal nerve. But there are inherent risks such as facial weakness or reduced hearing. High dose radiation is used to damage the root of the trigeminal nerve. This can be successful in reducing pain.
Percutaneous glycerol rhizotomy (PGR) is a surgical procedure involving injection of small amounts of sterile glycerol into the skin to block pain signals.
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