What is angina?

Heaviness or pain in the centre of the chest, which may extend to the jaw, face, arms, abdomen, or back during physical exertion or at rest, and then goes away after a few minutes of rest, is known as angina.

Angina occurs when the heart muscles does not get enough blood. It is reaching the heart muscles. It is usually a symptom of coronary artery disease. If you suspect you may have angina, it is important to consult a doctor as it may be a warning sign that you could be at risk of a heart attack or stroke. With early treatment and lifestyle changes, these medical emergencies can generally be prevented.

What is a heart attack?

Also known as cardiac arrest, a heart attack refers to a blockage in one of the coronary arteries which supply blood to your heart. A blockage in one or more coronary arteries can deprive the heart muscle in that area of blood and oxygen and cause it to die.

A blockage typically starts off as a narrowing in a coronary artery, known in medical terms as stenosis. Conditions such as high blood pressure, diabetes, an unhealthy lifestyle, and stress may result in damage to the arteries.

Damage to an artery creates a ‘foothold’ for cholesterol and fats to build up on its wall, resulting in it becoming diseased and weakened. If a little tear occurs in this cholesterol build up, which is known as a plaque, it can expose your blood to its abnormal contents and lead to the formation of a blood clot. The clot may block the already partially narrowed artery, causing a heart attack.

Repair of heart valves with TAVI

Transcatheter aortic valve intervention (TAVI) is a minimally invasive procedure used to repair heart valves. A plug is implanted through a small incision, usually in your groin area, using carefully guided catheters to reach the diseased valve and insert the plug.

Some patients may be seriously ill or have severe comorbidities — serious health conditions — that would have disqualified them from having traditional open surgery. TAVI makes it possible for these patients to have their valves repaired.

If you are seriously ill or have comorbidities – other serious health conditions – TAVI makes it possible to repair your heart valves. This would previously have been considered too high risk to attempt by means of traditional open surgery.

Up to some 15 years ago, only surgery under general anaesthetic was available for valve repair or replacement procedures. TAVI is now offered at various Netcare hospitals in Johannesburg, Pretoria, Cape Town, and Durban, and has brought a new lease of life to many elderly or severely ill individuals.

TAVI is an option if you are unable to tolerate anaesthesia, as the procedure can now be performed while you are conscious. This has the added benefit of avoiding the potential risks associated with anaesthesia for at risk individuals, providing hope for many previously untreatable patients.

Unblocking calcified arteries with ultrasound shock wave technology

If you have severe coronary artery disease (CAD), a build up of hardened calcium may develop and narrow your arteries. In severe cases, the arteries need to be cleared of these deposits before stenting can be done. Stenting is the insertion of one or more small mesh tubes to support and treat diseased and narrowed arteries.

  • Minimally invasive shockwave intravascular lithotripsy (IVL) uses ultrasound shock waves to ‘crack’ highly calcified deposits and blockages within your coronary arteries. This is an especially beneficial option if traditional surgery is not a viable option for you, due to risk factors such as advanced age or the presence of comorbidities.

  • The shockwave IVL system uses a special integrated balloon with attached electrodes. These electrodes produce localised sonic pressure waves to ‘hammer’ at the calcium on the arterial wall and break it up. As the technology safely selects and fractures the calcium, any trauma to the soft tissue is minimised.

  • Once this is done, the IVL system’s integrated balloon is expanded, making stent placement considerably easier and safer.