Competence Center for Cardiovascular Medicine
The fact that cardiovascular diseases are already responsible for almost every other death in modern industrial societies is, on the one hand, due to lifestyle factors such as smoking and poor nutrition. On the other hand, this is also an accompanying factor of steadily increasing life expectancy. One hundred or two hundred years ago, people often simply did not grow old enough to develop cardiovascular diseases.
Cardiovascular medicine not only deals with congenital and acquired heart diseases, but also circulation and blood vessels the heart’s vicinity. The term “cardiovascular disease” also includes high blood pressure (hypertension), strokes, arterial occlusive disease, and related diseases.
The Competence Centre for Cardiovascular Medicine at the Wiener Privatklinik specializes in the diagnosis and therapy of cardiovascular diseases. State-of- the-art methods and technology in relation to heart medicine and vascular medicine are offered here, as well as a fully equipped catheter laboratory.
Cardiac examination - the diagnosis of heart diseases
The heart and the control of its functions are the subject of Cardiology. In this field of Internal Medicine, there is now a wide range of resources for cardiac examination and the diagnosis of heart defects and heart diseases.
Cardiac examinations serve to detect and treat congenital and acquired diseases of the heart, circulatory system, vessels around and near the heart and the pericardium. Beside ECG, common methods of cardiac examination primarily include the echocardiogram test, cardiac catheter examination and myocardial scintigraphy.
- ECG (electrocardiogram) registers the electrical currents of the heart muscle with every heartbeat. The recording of these impulses can show deviations from the normal function and thus provide important information on heart diseases or cardiac arrhythmia within minutes and with very little effort. The stress test and long-term ECG, as well as spiroergometry, which carefully examines the respiratory tract in addition to cardiac function, are special forms of ECG for thorough clarification.
- In the echocardiogram test (cardiac ultrasound, UCG), heart structures (e.g. heart muscle, heart valves) are made visible by means of ultrasonic waves. Thus, diseases of the heart (valvular defects, muscular disorders, scars) can be shown and, in addition, the extent of the malfunctions of the heart can be recorded.
- The cardiac catheter examination should clarify the suspected constriction of the coronary vessels, the weakening the heart muscle pump, unexplained causes or a valvular defect. In the process, after local anesthesia, a thin tube, the so- called catheter, is led up through the aorta to the heart and the coronary arteries are made visible by using a contrast agent through radioscopy.
- The myocardial scintigraphy is a cardiac examination with the help of contrast agents to examine circulation, vitality and function of the heart muscle (myocardium). It is often carried out upon suspicion of the existence of coronary heart disease or for checking purposes after operations..
Vascular investigations - Diagnosing vascular diseases
Vascular diseases are a collective term for pathological changes in blood or lymphatic vessels. They have a number of causes, many manifestations and various, but often very dangerous consequences.
- The most common form of vascular investigation is the angiography. It is used for all vessels filled with fluid (arteries, veins and lymphatic vessels). This vascular investigation involves the introduction of a contrast agent in the vessel to be examined so that x-rays can be taken.
- Coronary angiography is the vascular investigation of the coronary vessels.
- Venous angiography is also called phlebography and is mainly used for vein problems in the lower legs.
Such investigations are generally pain-free and they allow the diagnosis of deformities, occlusion and damage to vessels.
Treating vascular diseases
Vascular diseases can affect the blood vessels leading away from the heart, the arteries, the blood vessels leading to the heart, the veins, or lymphatic vessels.
The most common vascular diseases are arteriosclerosis and diabetic angiopathy, which arise in connection with diabetes mellitus and cause many massive long-term consequences, e.g. retinopathy, glomerulosclerosis or neuropathy.
- In nine out of ten cases, arterial vascular diseases are arteriosclerosis combined with the formation of constricted areas (stenosis) or occlusions. The most common and serious diseases are arterial occlusive disease of the pelvic and leg arteries, constriction of the carotid arteries, renal arteries and intestinal arteries. In addition to such constrictions, arteriosclerosis also causes the weakening of vessel wall structures and the widening of vessels, so-called aneurysms, which can lead to embolisms or the tearing of the vessel wall.
- Häufige venöse Gefäßkrankheiten sind das häufig erblich bedingte Krampfaderleiden, die chronische venöse Insuffizienz bei angeborener Schwäche des tiefen Leitvenensystems und die Venenthrombose. Als Folge von Krampfadern oder auch als Symptome einer anderen zugrundeliegenden Erkrankung kann es zur Entzündung und Gerinnselbildung in oberflächlichen Hautvenen kommen, was als Thrombophlebitis bezeichnet wird
- Primary and secondary lymphedema are diseases of the lymphatic vessels. The former is the result of congenital weakness or agenesis of the lymph channels and it usually manifests itself in the third to fourth decade of life, and the latter occurs as a result of another disease, which also damages lymphatic circulation.
- Angiodysplasia are vascular malformations of arteries, veins or lymphatic vessels, which can be extremely complex with a variety of symptoms.
The specialist field of Internal Medicine, which deals with all vascular diseases, is called Angiology. It strongly overlaps with other disciplines based on the diversity of conditions, causes of disease and required treatments: Diseases of the coronary vessels are the domain of Cardiology; vascular diseases, which affect the central nervous system, also concern neurologists and neurosurgeons. The treatment of diseases of the venous vascular system and the lymphatic vessels overlaps with Dermatology and Phlebology. Vascular surgery is at the profession of specialized surgeons.
With regard to the treatment of many angiological conditions, there is a general need for close cooperation between different medical fields. This is a particular strength of the Wiener Privatklinik, which combines the highest competences from all specialist fields in its competence centers.
Treating heart diseases
The heart is a complex system and it can become diseased for various reasons and in very different ways. The most common heart diseases and heart defects treated at the Competence Centre for Cardiovascular Medicine at the Wiener Privatklinik are:
Coronary heart disease
It is by far the most common heart disease in industrial nations. In addition to medicinal treatment, there is a range of surgical procedures, especially the bypass operation and the minimally invasive balloon dilatation, which is now mostly combined with the implantation of a stent.
Heart failure is the pathological inability of the heart to pump the volume of blood required by the body in the atria without any increase in pressure. It should be referred to as a heart defect rather than a weakness of the heart, as not only the pathologically reduced pump function, but also the impaired filling of the heart with an unimpaired pump function can lead to heart failure. A distinction is made between chronic and acute heart failure.
- Acute heart failure develops within hours to days due to heart rate disturbances or arrhythmia, mechanical obstruction to the filling of the ventricles, heart valve failure, acute heart muscle inflammations, pulmonary embolisms or heart attacks.
- Chronic heart failure develops over months or years, often without any noticeable symptoms, as the organism compensates for the under-supply by quickening the heartbeat, thickening the heart muscle, contracting the blood vessels or increasing the volume of blood. Pathological water accumulations (edema) and breathlessness (dyspnea) begin to develop at a later stage.
As varied as the causes are the approaches to treatment, whereby the collaboration of specialists in various fields here at the Vienna Private Hospital represents a great advantage.
The third most common problem in modern cardiology is cardiac arrhythmia, most often occurring as atrial fibrillation, ventricular tachycardia and ventricular fibrillation.
These are disturbances of the normal heart rate caused by irregular excitation-conduction processes in the heart muscle. The cause may be congenital or acquired.
ECG (electrocardiogram), and particularly long-term ECG, is especially helpful for detecting the different types and forms of cardiac arrhythmia. In cases of doubt, a so-called electrophysiological examination may be necessary. Not all cardiac arrhythmia requires therapy. If treatment is indicated, it is carried out with heart rate regulating and stabilizing medication, by implanting a pacemaker or implantable defibrillator (AICD), by cardiac catheter or bypass operations.
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