c l i n i c a l f o l i o s : n a r r a t i v e





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Informed Patient's FAQ on Coronary Artery Disease: 16

A D V E R T I S E M E N T

   
 

How does coronary occlusion lead to a heart attack? 

The complete cessation of blood flow to the heart muscle supplied by the blocked coronary vessel results in the death of that tissue, a condition called myocardial infarction and commonly called a heart attack

Early treatment of a heart attack with substances that dissolve blood clots can decrease the damage to the heart. The danger of early death from heart attack is from interference with the electrical rhythm of the heart, a condition called arrhythmia, which may result in a stoppage of the heartbeat known as cardiac arrest.

A secondary consequence of myocardial infarction can be decreased pumping efficiency, which results in build-up of fluid in the body's tissues, most critically in the lungs. This condition is called congestive heart failure.

If balloon angioplasty is unsuccessful or unfeasible (e.g. if the blockage returns after repeated angioplasties, or if it is too far removed from the origin of the coronary artery), a bypass procedure may be required before coronary artery disease progresses to myocardial infarction. 

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Informed Patient's FAQ on Coronary Artery Disease: 17

A D V E R T I S E M E N T

   
 

How does a coronary-artery bypass work? 

To prevent a myocardial infarction, or to prevent further damage after a heart attack, a narrowed or blocked coronary artery can be surgically bypassed. In a coronary artery bypass procedure, the chest is opened through the sternum (sternotomy) to gain access to the heart, and vein- or artery grafts are used to divert blood from the aorta to the undamaged portion of the coronary artery beyond the blockage.

 By restoring the heart's blood flow, coronary bypass usually relieves the pain of angina. A third goal of coronary bypass is to maintain the efficiency of the remaining heart muscle, thereby preventing congestive heart failure.    

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Informed Patient's FAQ on Coronary Artery Disease: 18

A D V E R T I S E M E N T

   
 

Are there other types of bypass procedures? 

A nearby artery, the internal mammary, may also be used to bypass a restricted coronary artery by diverting one end to flow into the coronary artery beyond the blockage. In many cases, bypass can now be performed with minimally invasive surgery.     

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This page was last modified on 6/3/1999.