Developments in diagnosis and treatment
Not all diseases can be prevented and cured, but science does not stand still. What are the most hopeful developments in diagnosis and treatment of cardiovascular disease?
Prof. dr. Dr. Martin Schalij is a cardiologist specialized in cardiac arrhythmias and professor of cardiology at the Leiden University Medical Center. The LUMC is a national and international leader in diagnosing and treating heart disease. In addition, Schalij is chairman of the Dutch Cardiology Association.
Get more out of scans
Prof. dr. Dr. Martin Schalij: “The image quality of CT and MRI scans has been further improved in recent years. That means we can now detect damaged or deoxygenated heart tissue. This was not clearly visible before. Three-dimensional ultrasounds also help to map heart problems as accurately as possible. We use the combined CT, MRI and ultrasound images to determine exactly how we should operate in advance. That is becoming more and more precise. In addition, we can also make live 3D images during heart surgery, on which we can see what we are doing better than when we only look inside the patient’s body.”
Benefit for the patient: “Anomalies are detected earlier and we can make a better assessment of whether surgery is necessary or not. Furthermore, the effectiveness of operations increases.”
A predictive blood test
“We are working hard on a blood test that can predict with a high degree of certainty whether someone is at increased risk of a… heart attack has. I expect such a test to be commonplace within five years. We are already screening relatives of people who may have a hereditary heart disease for the same abnormality. With a comparable test, we also hope to predict in the future which medicines will work for whom.”
Benefit for the patient: “If you have an increased risk of heart problems, you can do preventive angioplasty or place an internal defibrillator. The disadvantage of that kind of knowledge is that you saddle patients with the idea that they are a walking time bomb.”
Surgery prevents drug use
“Like with cardiac arrhythmias medicines have insufficient effect or cause many side effects, in many cases a catheter ablation is a solution. With this relatively new technique, the pieces of tissue that cause many rhythm problems in the heart wall are switched off by making small scars in them. The symptoms almost always disappear completely. The operation is performed under local anaesthetic, through a catheter that is inserted into a vein in the groin. Every year, 2200 Dutch people undergo this procedure.”
Benefit for the patient: “He is often permanently relieved of his complaints with a relatively minor procedure. Because you remove the cause of the problem, usually no more medication is needed.”
Nerves shut down in high blood pressure
“Sometimes it’s not possible to high bloodpressure controlled with medication. In that case, an operation offers a solution, in which the nerves that control the kidneys are closed. For reasons that are still unclear, this appears to be a very effective way to lower blood pressure. The procedure is performed under local anesthesia via a catheter in the renal artery and takes only 45 minutes. At the moment, the treatment is still experimental, but because it works so well, many institutions in the Netherlands are already performing it. The hospital then pays for the costs itself. To date, the procedure is only performed on people with untreatable high blood pressure – a few percent of the total – but if the results remain as good, it may also be suitable for other groups in the future.”
Benefit for the patient: “The operation permanently lowers the risk of cardiovascular disease and makes medicines for high blood pressure unnecessary.”
Continuous heart monitoring at home
“People with a dangerous, unpredictable heart rhythm disorder are sometimes given an internal defibrillator (ICD), which constantly checks whether the heart is still good. If the patient has an arrhythmia, the device delivers shocks until the rhythm returns to normal. Today, many ICDs are equipped with a home monitoring or telemonitoring system. The system continuously transmits data from the patient’s home via a transmitter or a mobile phone to the hospital. There it is checked daily whether everything is still working properly and whether there have been any arrhythmias.”
Benefit for the patient: “Many patients find it a calming idea that their heart is constantly monitored. If everything goes well, they don’t have to go to the hospital for check-ups as often. In case of problems, we intervene faster and adjust the treatment if necessary.”
“Women, take complaints seriously!”
Prof. dr. Dr. Martin Schalij: “Cardiovascular diseases are the number one cause of death among women. Unfortunately, their complaints are far from always being recognized and recognized in time. Not by doctors, but not by women themselves either. Hence my advice: ladies, take complaints seriously! If you are tired for a long time, if you get cramps in the jaws during exertion or if you become nauseous, have your heart checked by your doctor.”
Sources):
- Plus Magazine