Coronary heart disease (CHD)
Coronary heart disease (CHD) – a narrowing of the coronary arteries and blood vessels that supply blood to the heart muscle. Typically, this is due to the accumulation of plaque in the artery walls causing atherosclerosis. Plaques are made up of fatty deposits of cholesterol – rich collagen and other proteins.
Atherosclerosis which usually progresses very slowly throughout life, thickens and narrows the artery walls, impeding the flow of blood, causing oxygen starvation of the heart (ischemia) and lack of vital nutrients. This can cause muscle cramps, chest pain (angina). Israel has developed a number of modern methods of diagnosis and treatment of coronary heart disease by which the disease can be successfully treated and uncontrollable.
If you or any of your relatives were diagnosed with such disease, please contact us. We accept patients of any age for the treatment of all disease stages.
We provide examination program focused on your problem, according to which, you will clearly understand before coming to Israel, on what day and at what time you scheduled for a consultation and procedures.
One of the best specialists in Israel for treatment of coronary heart disease are:
Dr. Ariel Finkelstein – specialist in intervention cardiology, Director of Cardiac Catheterization Dpt, Tel Aviv Medical Center (Ichilov)
Professor Shmuel Banai– a specialist in the field of cardiology, catheterization, Director of Interventional Cardiology, Tel Aviv Medical Center (Ichilov).
Dr. Victor Guetta – specialist in the field of cardiology, catheterization, Deputy director of the Heart Institute and Director of Lab Services, Sheba Medical Center Tel Hashomer.
Professor Ran Kornovski – specialist in the field of cardiology and cardiac catheterization, Director, Department of Cardiology, Beilinson.
Dr. Amit Segev – specialist in interventional cardiology, senior doctor in the department of cardiac catheterization, Sheba Medical Center Tel Hashomer.
Dr. Samuel Rath – specialist in the field of cardiology, catheterization, Director of Cardiac Catheterization Dpt, Sheba Medical Center Tel Hashomer
Method of treating coronary heart disease depends on the integrated result of diagnosis, which comprises:
- ECG (fixing electrical activity of the heart during rest, in order to identify abnormal heart rhythms).
- Holter cardiac monitoring (for recording the electrical activity of the heart during the 24 – hour period).
- Blood necessary to measure the circulating levels of cholesterol and of triglycerides (fats). In the analysis of such non-standard also evaluated factors such as homocysteine, HS-CRP (C-reactive protein), lipoprotein (LPLA) and apolipoprotein (ApoB), kidneys and liver function.
- Stress test (ECG on a treadmill), which helps determine cardiac arrhythmia during exercise. Test cardiac electrical activity by means of small sensors attached to the patient’s skin. In the last minute of this diagnosis is introduced into the body radioactive substance (thallium), in order to evaluate blood flow to the heart. Before and after exercise ECHO in order to determine whether the heart muscle more energetic after exercise.
- Echocardiography to assess heart function. In pictures echocardiography specialist may reveal abnormal heart size, variations in form and movement. Echocardiography also used for calculating the ejection fraction or of blood volume during cardiac contractions.
- Coronary angiography, or X-rays of the heart vessels is performed in order to evaluate the possible narrowing of the coronary arteries. During this procedure under local anesthesia a catheter is input through small artery in your leg or arm and guided into the coronary arteries. Then the catheter is inserted in the contrast agent, which also penetrates into the coronary arteries, that provides a clear picture of the blood vessels on the monitor and x-ray.
- Depending on the patient’s history, in some cases, our specialists also recommend that electron – beam computed tomography (EBCT), which allows you to perform up to 40 pictures of the heart between beats. Images of the heart within 5 minutes shows the early accumulation of calcium in the arteries plaques or in walls of arteries. Then measured the amount of coronary calcium compared with the age and sex of the patient.
Coronary heart disease treatment
At an early stage of atherosclerosis usually receive treatment (nitrates, beta-blockers, calcium channel blockers, aspirin or drugs to lower cholesterol (statins). These drugs can slow the progression of the disease or alleviate its symptoms.
Bypass Coronary heart bypass
Bypass Coronary heart bypass (CABG , CABG – Coronary Artery Bypass Graft) is artificially creating a new path for blood flow to the heart. During this operation a heart surgeon takes part in a healthy vessel legs, chest or hands of man. Then this vessel is connected to a coronary artery and is held by the blockage. This creates a new path for blood flow to the heart (bypass), bypassing the blocked artery. The operation is performed under general anesthesia.
Minimally invasive procedures
For some patients minimally invasive surgery is an alternative to coronary artery bypass surgery. Currently there are three minimally invasive treatment of coronary heart disease (CHD)
Coronary balloon angioplasty also known as percutaneous coronary intervention (PCI), wherein the inner cylinder is inserted into an artery channel for expansion of the artery. This allows blood to flow cylinder at normal or near normal rate, restoring the functional capacity of the artery.
Stenting – a procedure which uses a device called a stent to restore blood flow in the coronary artery. A stent is a very small, flexible mesh tube made of metal, such as stainless steel or cobalt alloy. As with angioplasty, a stent mounted in a cylinder, which opens inside the artery, the plaque moves thereon (atherectomy), and blood flow is restored. One of the newest technologies is a recently developed in America bioabsorbable stent (bioresorbable).
Minimally invasive coronary artery bypass grafting (MICS CABG) – surgery on a beating heart, which can not be performed by open way (via median sternotomy), and through a small incision under the rib. In some cases, the stents and balloons used together in a procedure called angioplasty and stenting. If on the survey results other treatments are not suitable and the heart muscle is too badly damaged, the patient may need a heart transplant.
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