Who Needs Heart Surgery?

Heart surgery is used to treat people who have severe heart diseases and conditions. If other treatments, such as lifestyle changes, medicines, and medical procedures, haven't worked or can't be used, heart surgery may be an option.

Heart surgery is used to treat heart failure and coronary artery disease. It's also used to fix heart valves that don't work right, to regulate heart rhythms, and to replace a damaged heart with a healthy one.

Specialists Involved

Your primary care doctor, a cardiologist, and a cardiothoracic (KAR-de-o-tho-RAS-ik) surgeon will decide whether you need heart surgery. A cardiologist specializes in treating heart problems. A cardiothoracic surgeon specializes in surgery on the heart and lungs.

These doctors will talk with you and do tests to learn about your general health and your heart problem. They'll discuss test results with you, and you will help make decisions about the surgery.

Medical Evaluation

Your doctors will talk with you about:

• The kind of heart problem you have, the symptoms it's causing, and how long you have had symptoms
• Your history and past treatment for heart problems, including surgeries, procedures, and medicines
• Your family's history of heart problems
• Your history of other health problems and conditions, such as diabetes or high blood pressure
• Your age and general health

The doctors also may do blood tests, such as a complete blood count, a cholesterol test, and other tests as needed.

Diagnostic Tests

Medical tests are done to find out more about your heart problem and your general health. This helps your doctors decide whether you need heart surgery, what type of surgery you need, and when to do it.

EKG (Electrocardiogram)

An EKG is a simple and painless test that records the electrical activity of your heart. This test is used to help detect and locate the source of heart problems.

A technician attaches sticky patches, called electrodes, to the skin of your chest, arms, and legs. The electrodes are attached with wires to a machine that records your heart's electrical signals.

An EKG shows how fast your heart is beating and whether its rhythm is steady or irregular. It also shows where in your heart the electrical activity starts, and whether it's traveling through your heart in a normal way.

Stress Test

Some heart problems are easier to diagnose when your heart is working harder and beating faster than when it's at rest. During stress testing, you exercise (or are given medicine if you're unable to exercise) to make your heart work hard and beat fast.

During the stress test, your blood pressure is checked and an EKG is done. Other heart tests also may be performed.

Echocardiography

Echocardiography is a painless, noninvasive test. "Noninvasive" means that no surgery is done and no instruments are inserted into your body.

This test uses sound waves to create a moving picture of your heart. Echocardiography provides information about the size and shape of your heart and how well your heart chambers and valves are working.

The test also can show areas of poor blood flow to your heart, areas of heart muscle that aren't contracting normally, and previous injury to your heart muscle caused by poor blood flow.

Coronary Angiography

Coronary angiography (an-jee-OG-ra-fee) uses a special dye to show the insides of your coronary arteries on x-ray pictures. An angiogram shows the location and severity of blockages in blood vessels.

To get the dye to your coronary arteries, a procedure called cardiac catheterization (KATH-e-ter-i-ZA-shun) is used. Cardiologists usually do cardiac catheterizations in a hospital. You're awake during the procedure, and it usually causes little to no pain.

During this procedure, a catheter (a thin, flexible tube) is passed through an artery in your leg or arm and threaded to your heart. The dye is injected into your bloodstream through the tip of the catheter.

Aortogram

An aortogram is an angiogram of the aorta. The aorta is the main artery that carries blood from your heart to your body. An aortogram may show the location and size of an aortic aneurysm and the arteries that are involved.

Chest X Ray

A chest x ray provides a picture of the organs and structures inside your chest, including the heart, lungs, and blood vessels. This test gives your doctor information about the size and shape of your heart. A chest x ray also shows the position and shape of the large arteries around your heart.

Cardiac Computed Tomography Scan

A cardiac computed tomography (CT) scan provides computer-generated, x-ray images of your internal organs. A liquid dye that can be seen on an x ray is injected into a vein in your arm. The dye outlines arteries and veins in your heart on the CT scan.

A cardiac CT scan can show whether plaque is narrowing your coronary arteries or whether you have an aneurysm. A CT scan also can find problems with heart function and heart valves.

Cardiac Magnetic Resonance Imaging

Cardiac magnetic resonance imaging (MRI) is a safe and noninvasive test that uses magnets and radio waves to create images of the inside of your body.

Cardiac MRI uses a computer to create images of your heart as it's beating. The computer makes both still and moving pictures of your heart and major blood vessels.

Cardiac MRI shows the structure and function of your heart. This test is very accurate at finding aneurysms and determining their size and exact location.