Who Needs Heart Surgery?

Heart surgery is used to treat many heart problems. For example, it's used to:

• Treat heart failure and coronary heart disease (CHD)
• Fix heart valves that don't work well
• Control abnormal heart rhythms
• Place medical devices
• Replace a damaged heart with a healthy one

If other treatments—such as lifestyle changes, medicines, and medical procedures—haven't worked or can't be used, heart surgery might be an option.

Specialists Involved

Your primary care doctor, a cardiologist, and a cardiothoracic (KAR-de-o-tho-RAS-ik) surgeon will work with you to decide whether you need heart surgery.

A cardiologist specializes in diagnosing and 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 the test results with you and help you make decisions about the surgery.

Medical Evaluation

Your doctors will talk with you about:

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

You also may have blood tests, such as a complete blood count, a lipoprotein panel (cholesterol test), and other tests as needed.

Diagnostic Tests

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 painless, noninvasive test that records the heart's electrical activity. "Noninvasive" means that no surgery is done and no instruments are inserted into your body.  

The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart.

An EKG can show signs of heart damage due to CHD and signs of a previous or current heart attack.

Stress Test

Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise to make your heart work hard and beat fast. If you can't exercise, you may be given medicine to raise your heart rate.

As part of the test, your blood pressure is checked and an EKG is done. Other heart tests also might be done.

Echocardiography

Echocardiography (echo) is a painless, noninvasive test.  This test uses sound waves to create a moving picture of your heart. Echocardiography shows 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 working well, and previous injury to your heart muscle caused by poor blood flow.

Coronary Angiography

Coronary angiography (an-jee-OG-rah-fee) is a test that uses dye and special x rays to show the insides of your coronary arteries.

To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-shun).

A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream.

Special x rays are taken while the dye is flowing through the coronary arteries. These
x rays are called angiograms.

The dye lets your doctor study blood flow through the heart and blood vessels. This helps your doctor find blockages that can cause a heart attack.

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.

Chest X Ray

A chest x ray creates pictures of the structures inside your chest, such as your 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 (to-MOG-rah-fee) scan, or cardiac CT scan, is a painless test that uses an x-ray machine to take clear, detailed pictures of the heart.

Sometimes an iodine-based dye (contrast dye) is injected into one of your veins during the scan. The contrast dye highlights your coronary (heart) arteries on the x-ray pictures. This type of CT scan is called a coronary CT angiography, or CTA.

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 the heart's function and valves.

Cardiac Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a safe, noninvasive test that uses magnets, radio waves, and a computer to create pictures of your organs and tissues.

Cardiac MRI creates images of your heart as it is 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 can show the size and location of an aneurysm.  

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