7 ms·

Explain

AnimalMuppet 1y ago
There is a procedure called a "catheterization" (hence "cath lab"). I have two stents in my heart. They went in with a catheter through an artery in my wrist. They found the places in my heart where the arteries were 80% to 90% blocked, and placed stents there. They said I was five years from a heart attack. This was an outpatient procedure. I went home that night. The worst part of it, for me, was that they put a serious tourniquet on my wrist, because once they took the catheter out, I had an open artery. My wrist felt like I lost a bar fight. It ached for a month. This is so much better than having a heart attack. How did they know I needed this? I talked to a cardiologist. He told me that, as you age, your athletic performance drops slowly, over decades. That's normal. What's abnormal is when you suddenly can't do something you were able to do a month ago. So I paid attention when I realized, hey, a month ago I didn't get this winded playing ultimate frisbee. A month ago I recovered faster when I was winded. So I told that to my GP. He ordered a cardiac stress test for me. This basically is hooking you up to an EKG, putting you on a treadmill, running the treadmill faster and harder until you drop, and watching what your EKG does. If the shape stays the same except faster, you're good. If the shape changes, that's part of your heart not getting enough blood under load. My shape changed. So they ordered the catheterization for me. So cath labs are about preventing the heart attack, not keeping you from dying once you have one. Not dying is good. But not having it at all is better. I think that may have been the GP's point.
- khuey 1y ago
  > So cath labs are about preventing the heart attack, not keeping you from dying once you have one. Cath labs *are* (also) about keeping you from dying once you have one. Inserting a stent into someone with an active MI can restore blood flow and minimize tissue damage.
- duskwuff 1y ago
  Catheterization is the mode of access to the heart, not the entire procedure. Stenting is one procedure that can be carried out that way, but there are other procedures which can be performed that way as well, such as imaging, cardiac ablation, pacemaker or defibrillator installation, or valve replacement.
- dogmatism 1y ago
  If someone told you you were "five years from a heart attack" they lied that's not how it works in a stable person (ie, not actually having a heart attack) stents help symptoms (a little better than medicines, but even that is debatable -- see Orbita trial). Medicines and lifestyle changes prevent heart attacks -- see Courage and Ischemia trials cath labs are in fact about keeping you from dying once you have a heart attack. The other stents for stable disease like you had are nice -- you feel better faster with fewer medicines that without, but not main thing source: not going to appeal to authority. See trials mentioned above, or ACC guidelines on management of CAD
pfannkuchen 1y ago
Which part needs to be explained? I think I understood the comment and I’m not in the industry. AED is an initialism for the electrical shock device you can use to (maybe) reboot the heart’s OS when it locks up. Catheters are some kind of tube that gets implanted to bypass a non-functional part of the heart. Catheter procedures improving caused the change, not AEDs (apparently), so it’s somewhat misleading to show an AED instead of something about catheters.
roryirvine 1y ago
PCI (Percutaneous Coronary Intervention, performed in a catheterization laboratory) has become the usual first-line treatment for acute heart attacks. It's much more effective than previous treatments (essentially clot-busting drugs, blood thinners, and bedrest), particularly since Drug-Eluting Stents arrived in the early 2000s.

Explain

There is a procedure called a "catheterization" (hence "cath lab"). I have two stents in my heart. They went in with a catheter through an artery in my wrist. They found the places in my heart where the arteries were 80% to 90% blocked, and placed stents there. They said I was five years from a heart attack. This was an outpatient procedure. I went home that night. The worst part of it, for me, was that they put a serious tourniquet on my wrist, because once they took the catheter out, I had an open artery. My wrist felt like I lost a bar fight. It ached for a month. This is so much better than having a heart attack. How did they know I needed this? I talked to a cardiologist. He told me that, as you age, your athletic performance drops slowly, over decades. That's normal. What's abnormal is when you suddenly can't do something you were able to do a month ago. So I paid attention when I realized, hey, a month ago I didn't get this winded playing ultimate frisbee. A month ago I recovered faster when I was winded. So I told that to my GP. He ordered a cardiac stress test for me. This basically is hooking you up to an EKG, putting you on a treadmill, running the treadmill faster and harder until you drop, and watching what your EKG does. If the shape stays the same except faster, you're good. If the shape changes, that's part of your heart not getting enough blood under load. My shape changed. So they ordered the catheterization for me. So cath labs are about preventing the heart attack, not keeping you from dying once you have one. Not dying is good. But not having it at all is better. I think that may have been the GP's point.

khuey 1y ago
> So cath labs are about preventing the heart attack, not keeping you from dying once you have one. Cath labs *are* (also) about keeping you from dying once you have one. Inserting a stent into someone with an active MI can restore blood flow and minimize tissue damage.
duskwuff 1y ago
Catheterization is the mode of access to the heart, not the entire procedure. Stenting is one procedure that can be carried out that way, but there are other procedures which can be performed that way as well, such as imaging, cardiac ablation, pacemaker or defibrillator installation, or valve replacement.
dogmatism 1y ago
If someone told you you were "five years from a heart attack" they lied that's not how it works in a stable person (ie, not actually having a heart attack) stents help symptoms (a little better than medicines, but even that is debatable -- see Orbita trial). Medicines and lifestyle changes prevent heart attacks -- see Courage and Ischemia trials cath labs are in fact about keeping you from dying once you have a heart attack. The other stents for stable disease like you had are nice -- you feel better faster with fewer medicines that without, but not main thing source: not going to appeal to authority. See trials mentioned above, or ACC guidelines on management of CAD

pfannkuchen 1y ago

Which part needs to be explained? I think I understood the comment and I’m not in the industry. AED is an initialism for the electrical shock device you can use to (maybe) reboot the heart’s OS when it locks up. Catheters are some kind of tube that gets implanted to bypass a non-functional part of the heart. Catheter procedures improving caused the change, not AEDs (apparently), so it’s somewhat misleading to show an AED instead of something about catheters.

roryirvine 1y ago

PCI (Percutaneous Coronary Intervention, performed in a catheterization laboratory) has become the usual first-line treatment for acute heart attacks. It's much more effective than previous treatments (essentially clot-busting drugs, blood thinners, and bedrest), particularly since Drug-Eluting Stents arrived in the early 2000s.