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Cardiovascular Health
Here you can learn more about Suburban Hospital's new cardiac surgery program and cutting-edge innovations that are improving cardiovascular health.
In July 2005, Suburban Hospital received state approval to initiate a cardiac surgery and elective angioplasty program in collaboration with the National Heart, Lung, and Blood Institute (NHLBI) of the NIH and Johns Hopkins Medicine. In September 2006, the NIH Heart Center at Suburban Hospital was launched, led by Dr. Keith Horvath, Suburban Hospital Chief of Cardiothoracic Surgery, and Dr. Kenneth Kent, Suburban Hospital Chief of Cardiology.
Recently, Suburban Hospital was recognized by the Centers for Medicare and Medicaid Services through a survey conducted by the Hospital Quality Alliance as one of 17 hospitals in the nation with better than the national average mortality rates for heart attack. We are the only hospital in Maryland and the Washington DC metropolitan area recognized for this above-average performance.
How is Suburban Hospital's cardiac surgery program different from others in the area?
We provide high quality, accessible, and cost-effective surgery and therapeutic angioplasty, while fulfilling an important role in research and training. In addition to the surgical component, the program involves research of national significance, bringing the clinical and scientific excellence of NIH and Hopkins to the general population. It will also provide training for a new generation of cardiac surgeons and cardiologists.
What other cardiovascular services does Suburban Hospital offer?
Suburban Hospital's comprehensive cardiac services already include emergency angioplasty for heart attack victims, a cardiac care unit, three state-of-the-art catheterization laboratories, research programs in stroke and cardiac diagnosis in collaboration with NIH, a cardiac rehabilitation center, an active community outreach and education program, and the innovative HeartWell Program targeted to those at high risk of illness due to cardiovascular disease. One of the newest and most innovative pieces of cardiac diagnostic technology is the new 64-slice GE LightSpeed Volume CT scanner that is able to produce amazingly vivid 3D images of the entire body in 10 seconds. Suburban Hospital is one of the first hospitals with this technology in the Washington area.
How does the CT scanner benefit patients with cardiovascular disease?
Though CT coronary angiography has been available since the late 1990s, the clinical practicality of scanning an organ in motion has remained a significant challenge. Now that the new technology can deliver a comprehensive view of the heart and surrounding vessels with heightened resolution within five seconds, CT coronary angiography shows great promise in being able to non-invasively diagnose clinically significant coronary disease. In addition, CT will likely be used in partnership with NIH's existing cardiac MRI research program at Suburban Hospital. This will help determine the effectiveness of different imaging modalities for diagnosing life-threatening clinical conditions in chest pain patients who arrive in the Emergency Department
Why are so many people having open-heart surgery these days?
Atherosclerosis, involving a narrowing of the coronary arteries due to the build-up of plaque in the vessels, is a very common disorder, particularly in older people. The baby boomer generation is aging, now entering their 60s, when cardiovascular disease becomes symptomatic. Particularly in Montgomery County, we are seeing a rapidly aging population and expect a boost for the demand in open-heart surgery and therapeutic cardiology procedures such as angioplasty. Additionally, with a better understanding of the deleterious effects of long-term valvular disease and an increasing incidence in atrial fibrillation, more patients are undergoing valve repairs and arrhythmia operations. Minimally invasive techniques have made these operations safer and less traumatic, which also increases the number of patients who are candidates for surgery. Finally, new procedures for the treatment of heart failure, severe coronary artery disease and aortic disease provide more options for patients who were previously considered inoperable.
What is cardiovascular disease?
The term cardiovascular disease refers to a collection of diseases and conditions within the cardiovascular system, which consists of the heart and all the blood vessels. Cardiovascular disease encompasses stroke, high blood pressure, aneurysm, heart attack, varicose veins, coronary artery and heart valve diseases and more.
How common is cardiovascular disease?
According to the Centers for Disease Control and Prevention, cardiovascular disease is the leading cause of death in the US, accounting for nearly 40 percent of all deaths. About 950,000 Americans die of cardiovascular disease each year, which amounts to one death every 33 seconds. In addition, about 61 million Americans — almost one-fourth of the population — have some form of cardiovascular disease, which is responsible for almost 6 million hospitalizations each year.
Are there any known risk factors for cardiovascular disease?
Yes. There are two categories of risk factors for cardiovascular disease. People may be born with some types of cardiovascular disease (congenital) or acquire others later on, usually from an unhealthy lifestyle, such as tobacco use or a diet high in fat. Some types of cardiovascular disease can even cause other types of cardiovascular disease. Other risk factors include high blood pressure, high blood cholesterol, diabetes, and physical inactivity.
How can I prevent cardiovascular disease?
Research shows that by encouraging healthier lifestyles and increasing intervention and early detection, it is possible to reduce the chances of heart disease and stroke in people who are healthy. It is also possible to improve the health of people who have already experienced a cardiac or vascular incident by stopping smoking or improving nutrition. The strategy is to limit the amount of saturated fats and cholesterol in your diet and to increase your intake of fruits/vegetables/low-fat dairy products and grains. In addition, you should limit portion size and maintain a healthy weight. It is quite possible to enjoy a varied and tasty diet and to limit your risk of cardiovascular diseases.
How do I know if I am headed down the path of heart failure? Can I do anything about it if I have already caused damage?
Heart failure is the inability of the heart to pump blood sufficient to meet the demands of the body. This inability is most commonly sensed as shortness of breath with activity or at rest, and fatigue. These two symptoms can also be caused by other problems that doctors can sort out by examination and tests such as echocardiography — a non-invasive test that images the heart by sound to see how well the heart is pumping.
It is clear that careful management of heart failure by medication and healthy lifestyle can reduce symptoms and improve survival and reduce the need for hospital admission. The medications that have been most helpful in this regard are ACE inhibitors and beta-blockers. You should talk to your physician about whether you have congestive heart failure and about the best strategies for prevention the problem from getting worse.
Are there any new scientific developments in cardiovascular medicine?
There are several areas of research being conducted at the NIH laboratory that we plan on carrying across the street to the Suburban Hospital operating rooms. One is the use of cellular transplant to provide regeneration of heart muscle cells and restoration of heart function for patients who have suffered myocardial infarctions. Initially, we have been employing adult mesenchymal stem cells and are working on understanding the mechanisms and requirements that these cells have to grow and replicate.
A second area of interest is the use of intraoperative MRI imaging to guide surgical procedures. For these studies we will be using the MRI as our eyes and robotics as our hands to perform operations while the patient is in the scanner. This will allow the performance of beating heart valve repairs and replacements with minimal trauma and risk for the patient.
Finally, as there are a growing number of heart failure patients and as there are too few donor hearts available for transplantation, we are looking to xenotransplantation as a method to solve this problem. The plan is to use porcine hearts as the donor organs and to induce tolerance in the recipients. While the transplant presents an immunologic challenge, recent work in this field is promising and we hope to add significant contributions to make these transplants a reality.