Percutaneous coronary intervention Health Dictionary

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Percutaneous Coronary Intervention: From 1 Different Sources

(PCI) treatment of coronary artery disease delivered by cardiac *catheterization. This usually means *coronary angioplasty followed by insertion of a coronary *stent, but also includes more specialized procedures, such as rotational *atherectomy (rotablation). Primary PCI refers to the use of PCI as the first-line treatment to relieve coronary obstruction in S-T elevation *myocardial infarction, rather than *thrombolysis. Rescue PCI is used in the event of unsuccessful thrombolysis.

Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Coronary Thrombosis

See HEART, DISEASES OF.... coronary thrombosis

Percutaneous

Any method of administering remedies by passing them through the SKIN, as by rubbing in an ointment or applying a patch containing a drug.... percutaneous

Coronary

A term applied to several structures in the body encircling an organ in the manner of a crown. The coronary arteries are the arteries of supply to the HEART which arise from the aorta, just beyond the aortic valve, and through which the blood is delivered to the muscle of the heart. Disease of the coronary arteries is a very serious condition producing various abnormal forms of heart action and the disorder, ANGINA PECTORIS.... coronary

Coronary Angioplasty

A technique of dilating atheromatous obstructions (see ATHEROMA) in CORONARY ARTERIES by inserting a catheter with a balloon on the end into the affected artery (see also CATHETERS). It is passed through the blockage (guided by X-ray FLUOROSCOPY) and in?ated. The procedure can be carried out through a percutaneous route.... coronary angioplasty

Coronary Arteries

(See also HEART.) The right coronary artery arises from the right aortic sinus and passes into the right atrio-ventricular groove to supply the right ventricle, part of the intraventricular septum and the inferior part of the left ventricle. The left coronary artery arises from the left sinus and divides into an anterior descending branch which supplies the septum and the anterior and apical parts of the heart, and the circum?ex branch which passes into the left atrio-ventricular groove and supplies the lateral posterior surfaces of the heart. Small anastomoses exist between the coronary arteries and they have the potential of enlarging if the blood-?ow through a neighbouring coronary artery is compromised. Coronary artery disease is damage to the heart caused by the narrowing or blockage of these arteries. It commonly presents as ANGINA PECTORIS or acute myocardial infarction (see HEART, DISEASES OF).... coronary arteries

Intervention Study

Comparison of outcomes between two or more groups of patients who have been intentionally given di?erent treatments or preventative measures, for example, diets. The subjects in the trial should be randomly allocated to the groups, with patients in one group – called controls – receiving no active treatment. If possible, neither patients nor doctors participating in a study should know which patients are receiving what treatment (double blind study/trial). Furthermore, groups should exchange treatments after a prearranged time (crossover study/trial). (See CLINICAL TRIALS; RANDOMISED CONTROLLED TRIAL.)... intervention study

Percutaneous Transluminal Coronary Angioplasty

A treatment for a stenosed (restricted) coronary artery (see ARTERIES). A balloon-tipped catheter (see CATHETERS) is passed through an incision in the skin of the chest into the artery of the HEART that has developed stenosis (narrowing). The balloon is aligned with the stenosed section and then in?ated to dilate the coronary artery and allow the blood to ?ow more freely.... percutaneous transluminal coronary angioplasty

Coronary Heart Disease

The cause of: coronary occlusion, coronary blockage, coronary thrombosis. A heart attack occurs when a coronary artery becomes blocked by swellings composed, among other things, of cholesterol. Such swellings may obstruct the flow of blood leading to a blood clot (thrombus). Cholesterol is a major cause of CHD.

Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.

Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.

The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.

For cholesterol control target the liver. Coffee is a minor risk factor.

Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)

Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)

Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.

Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.

Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.

Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.

Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.

Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.

Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.

Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.

Prevention: Vitamin E – 400iu daily.

Diet. See: DIET – HEART AND CIRCULATION.

Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.

Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease

Coronary Artery Disease

Narrowing of the coronary arteries, which supply blood to the heart, leading to damage or malfunction of the heart. The most common heart disorders due to coronary artery disease are angina pectoris and myocardial infarction (heart attack). The usual cause of narrowing of the arteries is atherosclerosis, in which fatty plaques develop on the artery linings. The vessel can become totally blocked if a blood clot forms or lodges in the narrowed area. Atherosclerosis has many interrelated causes including smoking, a high-fat diet, lack of exercise, being overweight, and raised blood cholesterol levels. Other factors include a genetic predisposition and diseases such as diabetes mellitus and hypertension.

The first symptom of coronary artery disease is frequently the chest pain of angina. Treatment is with drugs such as glyceryl trinitrate and other nitrate drugs, beta-blockers, calcium channel blockers, potassium channel activators, and vasodilator drugs. If drug treatment fails to relieve the symptoms, or there is extensive narrowing of the coronary

arteries, blood flow may be improved by balloon angioplasty or coronary artery bypass surgery.... coronary artery disease

Coronary Care Unit

A specialist ward for the care of acutely ill patients who may be suffering, or who have suffered, a myocardial infarction (heart attack) or another serious cardiovascular disorder.... coronary care unit

Coronary Artery Vein Bypass Grafting (cavbg)

When coronary arteries, narrowed by disease, cannot supply the heart muscle with su?cient blood, the cardiac circulation may be improved by grafting a section of vein from the leg to bypass the obstruction. Around 10,000 people in the United Kingdom have this operation annually and the results are usually good. It is a major procedure that lasts several hours and requires the heart to be stopped temporarily, with blood circulation and oxygenation taken over by a HEART-LUNG MACHINE.... coronary artery vein bypass grafting (cavbg)

Coronary Care Unit (ccu)

A specialised hospital unit equipped and sta?ed to provide intensive care (see INTENSIVE THERAPY UNIT (ITU)) for patients who have had severe heart attacks or undergone surgery on the heart.... coronary care unit (ccu)

Early Intervention

Action at an early stage of a disease or social process.... early intervention

Intervention / Intervention Strategy

An activity or set of activities aimed at modifying a process, course of action or sequence of events in order to change one or several of their characteristics, such as performance or expected outcome. For example, it is used in public health to describe a programme or policy designed to have an impact on an illness or disease.... intervention / intervention strategy

Passive Intervention

Health promotion and disease prevention initiatives which do not require the direct involvement of the individual (e.g. fluoridation programmes) are termed “passive”.... passive intervention

Percutaneous Transhepatic Cholangiopancreatography (ptc)

A technique for displaying the bile ducts (see BILE DUCT) and pancreatic ducts (see PANCREAS) with radio-opaque dyes. These are introduced via a catheter (see CATHETERS) inserted into the ducts through an incision in the skin. An X-ray is then taken of the area.... percutaneous transhepatic cholangiopancreatography (ptc)

Coronary Artery

Either of the 2 main arteries that supply the tissues of the heart with oxygen-rich blood. These are

known as the left and right main coronary arteries and arise directly from the aorta. The term coronary artery is also applied to any of the arteries that branch off from the main coronary arteries, such as the left circumflex artery and the left anterior descending artery. Blockage of a coronary artery as a result of atherosclerosis can lead to myocardial infarction.

(See also coronary artery disease.)... coronary artery

Coronary Artery Bypass

A major heart operation to bypass narrowed or blocked coronary arteries using additional blood vessels (such as a mammary artery) to improve blood flow to the heart muscle. This operation is used when symptoms of coronary artery disease have not been relieved by drugs or balloon angioplasty.

Before surgery, sites of blockage in the arteries are identified using angiography. In some cases, minimally invasive surgery can be used, avoiding the need to stop the heart and use a heart–lung machine during the operation. The long term outlook after a bypass is good, but the grafted vessels may also eventually become blocked by atherosclerosis.... coronary artery bypass

Crisis Intervention

The provision of immediate advice or help by a variety of agencies such as social services departments to people with acute personal or sociomedical problems.... crisis intervention

Acute Coronary Syndrome

a combination of angina (unstable or stable), non-S–T elevation *myocardial infarction (NSTEMI), and S–T elevation myocardial infarction (STEMI). It implies the presence of coronary artery disease.... acute coronary syndrome

Coronary Artery Bypass Graft

(CABG) *coronary revascularization in which a segment of a coronary artery narrowed by atheroma is bypassed by an *autologous section of healthy saphenous vein or internal mammary artery at *thoracotomy. The improved blood flow resulting from one or more such grafts relieves *angina pectoris and reduces the risk of *myocardial infarction. Recently developed techniques of *minimally invasive surgery have enabled the operation to be performed without the need for thoracotomy.... coronary artery bypass graft

Coronary Revascularization

the restoration of blood flow to ischaemic heart muscle (see ischaemia) by *coronary angioplasty and *stenting or by a *coronary artery bypass graft.... coronary revascularization

Coronary Angiography

an X-ray technique for examination of the coronary arteries, often taken to also include examination of the chambers of the heart. A catheter is introduced via the radial artery at the wrist or the femoral artery at the groin and manipulated into the heart under X-ray control. *Contrast medium is then injected to outline the ventricles and coronary arteries. Digital video images are recorded during contrast-medium injection. Coronary angiography is used to diagnose cardiac disease, specifically narrowing or blockage in the coronary arteries, and plan treatment by surgery or radiological interventional techniques (see coronary artery bypass graft; percutaneous coronary intervention). It has now largely been replaced by CT coronary angiography.... coronary angiography

Interventional Cardiology

a subspecialty of cardiology concerned with the treatment of heart conditions using cardiac *catheterization techniques under local anaesthetic and X-ray control, including *percutaneous coronary intervention and percutaneous balloon mitral *valvuloplasty.... interventional cardiology

Interventional Radiology

a branch of radiology in which complex procedures are performed using imaging guidance, which avoids patients having to undergo invasive surgery to achieve the same results. This is often termed ‘pinhole surgery’. Guidance is commonly by X-ray fluoroscopy, ultrasound, or computerized tomography, and recently also by magnetic resonance imaging. Procedures commonly performed include angioplasty and stenting of vascular structures, drainage of fluid collections or abscesses, stenting of obstructions to the gastrointestinal tract, embolization, cryotherapy, and radiofrequency ablation.... interventional radiology

Percutaneous Epididymal Sperm Aspiration

see PESA.... percutaneous epididymal sperm aspiration

Percutaneous Nephrolithotomy

(PCNL) a technique of removing stones from the kidney via a *nephroscope passed into the kidney through a dilated track established from the skin surface into the renal pelvis.... percutaneous nephrolithotomy

Percutaneous Transhepatic Cholangiopancreatography

imaging of the bile duct and pancreatic duct. A catheter is carefully manipulated into the ducts via direct puncture through the abdomen under radiological guidance. Contrast material is flushed through the catheter to delineate the ducts (see also cholangiography). This procedure is often performed in cases of obstructive jaundice prior to insertion of a biliary drain or stent when *ERCP is not possible.... percutaneous transhepatic cholangiopancreatography

Six-category Intervention Analysis

a framework for exploring how care is delivered, based on the idea that there are six main styles of interaction (prescriptive, informative, confronting, cathartic, catalytic, and supportive). The analysis is widely used to help health-care professionals develop an understanding of interpersonal relationships, reflect on their own practice, and enhance their interactions with clients.... six-category intervention analysis

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