Understanding and Managing Heart Blockages: Causes, Diagnosis, and Treatment Options - Dr Brajesh Kumar Mishra

Heart blockage, or obstruction of blood flow, is a serious condition that can cause strokes, heart attacks, and other cardiovascular diseases. A heart blockage takes place when coronary arteries become narrow or blocked. This can be caused by plaque buildup, a mixture of cholesterol, fat, and other substances. When blood flow is restricted by blockage, it causes chest pain, shortness of breath, or conditions like a heart attack.

Causes of Heart Blockages

Blockages ideally develop over a period of time and are related to lifestyles like:

• Bad eating habits
• Smoking
• Cholesterol
• Lack of workouts
• Blood pressure
• Diabetes
• Workouts

Diagnostic Methods

For diagnosis, doctors use various methods, like:

• Electrocardiogram (ECG or EKG): It is used to measure the electrical activity of the heart.
• Stress tests: They assess the performance of the heart under pressure.
• Echocardiogram: An ultrasound is done to see the structure and function of the heart.
• Coronary Angiography: It is a specialized X-ray in which dye is used to see blockages.

Treatment

1. Lifestyle Changes and Medications (Up to 50% and less than 70% Blockage)

For people who are suffering from blockage up to 50%, lifestyle modifications and medications are the first treatments that they are prescribed to manage the symptoms. Lifestyle changes play an important role in the improvement of cardiac health. A nutrition-rich diet rich in fruits, vegetables, and proteins while reducing consumption of fats, cholesterol, and sodium is crucial. Frequent workouts also contribute to a healthy heart. Moreover, giving up smoking is highly advisable as it helps improve cardiac function in the long term.

Another crucial part of treating heart blockages is medication. Statins are recommended to help in lowering cholesterol levels, which decreases the chances of future blockages. Beta-blockers are used for controlling heart rate and angina, while aspirin is used to lower the risk of blood clot development. A healthy heart can be achieved by combining all these changes with medication.

2. Percutaneous Coronary Intervention (PCI) or Angioplasty (more than 70% Blockage)

When the blockage in arteries ranges from 50–70%, percutaneous coronary intervention (PCI) or angioplasty is recommended. It is a minimally invasive technique in which a thin tube attached to a deflated balloon is inserted in the narrowed artery. Once it is in place, the balloon is inflated, widening the artery, and improving blood flow. Sometimes a stent is also placed during the procedure to keep the artery open and prevent it from narrowing.

PCI can be beneficial as it offers a quick recovery and patients experience fewer hospital trips as compared to traditional surgical procedures. It also immediately relieves individuals from symptoms like shortness of breath and chest pain, gradually improving the patient's life. Another benefit is that it reduces the risk of heart attacks in the future by restoring proper blood flow to the heart and preventing blockages to protect the heart and improve heart health in the long term.

3. Open-Heart Surgery (70–90% Blockage)

When the blockage increases, ranging between 70 and 90%, in multiple arteries or left main arteries which may be not suitable for angioplasty because of calcium or tortuosity then open heart surgery is recommended.

Emergency Intervention (90–100% Blockage)

At the time of a heart attack, when blockage reaches a level of 90–100%, immediate angioplasty and stenting is the gold standard treatment but when not available then medical intervention is required to improve blood flow and minimize damage. One of the immediate treatments used is thrombolytic therapy, in which clot-dissolving medications are given. These works rapidly break down blood clots and improve blood flow, reducing the damage.

Along with thrombolytic therapy, emergent surgery like open-heart surgery may be required when nothing is working or presenting complications of a heart attack.

Post-Treatment Care

Post-treatment care is crucial. Maintain heart health and avoid the recurrence of the problem.

Frequent Follow-Ups: See a cardiologist on a regular basis to monitor heart conditions.

• Medication Adherence: Take medication as directed and on time.
• Ongoing Lifestyle Changes: Continue leading a healthy life through good eating habits and frequent workouts.

Heart blockages are a serious medical condition that requires prompt diagnosis and appropriate treatment. Depending on the severity of the obstruction, different treatments are recommended, which include lifestyle modifications or prescription drugs. In situations of acute heart attack angioplasty and stenting are life-saving in special circumstances of severe blockage, surgery is recommended. People can lower their risk of heart attacks and other heart-related issues by being aware of the treatment options available and practising health management. It is always best to seek help from a trained and qualified healthcare professional while selecting the treatment needed for the condition.