Cardiac Glossary

A

Aneurysm:
 A balloon-like bulge in the wall of a vein, artery, or the heart, caused by disease, injury or birth defect. Surgical correction before rupture avoids possible damage.

Angina Pectoris: A brief, intermittent, chest pain that can also be felt in the left arm, shoulder, neck or jaw. Pain occurs when the heart suddenly demands more blood than is being supplied by the blood vessels. Rest or nitroglycerin pills or patches can bring relief.

Angiography: Part of an angiogram procedure in which cardiologists inject a dye into the body through a thin, flexible tube called a catheter, inserted into an artery. The dye shows up on X-rays to reveal abnormalities of blood flow and narrowing of coronary arteries. Requires a local anesthetic and post-procedure rest to allow the insertion opening to close.
Arrhythmia: an irregular heartbeat. When the heart beats slower, faster, or skips beats, a problem may be indicated.

Atherectomy: A procedure to improve blood flow in an artery narrowed by plaque buildup using a laser catheter or rotating blade to shave off plaque.

Atherosclerosis: Known as the hardening of the arteries. A condition in which excess deposits of calcium, fibrous tissue, or fats (plaque) cause artery walls to thicken and lose elasticity. If the coronary artery is affected, the risk of heart attack increases.

Automatic Implantable Cardioverter Defibrillator (AICD): Implanted under the skin, this device continuously monitors the heart, delivering one or more electrical shocks to restore normal rhythm when it senses serious rapid heart rhythm. Most often used with individuals who have had life-threatening rapid ventricular heart rhythm.

B

Balloon Angioplasty: Technically, percutaneous transluminal coronary angioplasty (PTCA). An invasive procedure in which a specially designed catheter with a small balloon tip is guided through an artery to a point of narrowing. Once in place, the balloon is inflated to compress the fatty matter into the artery wall and widen the artery, increasing blood flow to the heart. About 70 to 90 percent of PTCA procedures also involve the placement of a stent (see coronary stenting).

Batista Procedure: Operation involves removing a piece of living heart muscle from an enlarged heart and sewing the remaining heart back together. Dr. Batista developed this operation to treat patients whose hearts were enlarged and failing due to a parasitic infection known as Chagas’ disease.

C

Cardiac Arrest: Occurs when the heart does not pump enough blood to produce a pulse. If the lack of blood supply lasts for an extended time, this may cause permanent damage to the brain and heart or result in death if the patient cannot be resuscitated

Cardiac Catheterization: A procedure in which a thin tube, or catheter, is inserted into an artery to reach the right or left heart and detect functions such as blood flow, blood pressure, and oxygenization. Performed on an inpatient or outpatient basis, it can be used for diagnosis, to implant electrodes for a pacemaker, to administer a drug, or to perform coronary angioplasty, atherectomy, valvuloplasty, stenting or catheter ablation.

Cardiac Enzyme Blood Test: Used to detect whether a heart attack occurred and how much damage was done. During a heart attack, heart cell enzymes are released into the blood stream, rising and falling in a predictable pattern which can be spotted in this test.

Cardiomyopathy: The deterioration or weakening of the heart muscle, causing it to become enlarged and greatly impairing function

Carotid Endarterectomy: Carotid endarterectomy is a surgical procedure designed to prevent strokes. Although there are some variations in the technique, in general, the artery is exposed through an incision in the side of the neck. The major branch coming into and going away from the area of narrowing are temporarily clamped, and the artery is opened. The material that is causing the narrowing, called atherosclerotic plaque is removed, and the vessel is sewn back together, and the clamps are removed.

Carotid Ultrasound Scan: A procedure that allows doctors to image the carotid arteries in the neck to check blood flow to the brain. Using high frequency electrical signals and computer technology to measure time, distance, and frequency, the scan provides an accurate image of artery walls and reveals any blockages.

Cineangiography: Similar to angiography, except that instead of still x-ray pictures, cineangiography creates motion pictures of the heart, making it easier for cardiologists to visualize how it is functioning.

Congestive Heart Failure (CHF): Occurs when the heart loses normal pumping power, causing fluid to accumulate in the lungs, abdomen, legs, hands, ankles, or other parts of the body. Symptoms include shortness of breath and leg swelling

Coronary Artery Bypass Surgery (CABG): A surgical procedure that reroutes blood around clogged arteries to improve the supply of blood and oxygen to the heart. This new path is created by reattaching the artery at the open end of the blockage, or grafting a vein from a leg. This procedure can be conducted using a or without it. In the newest version of this technique, Off-Pump Coronary Artery Bypass Surgery, the procedure is done on a beating heart, without a heart lung machine.

Coronary Stenting: A procedure used to open a narrowed coronary artery. The stent, a section of fine metal mesh similar to a scaffold, is guided into the narrowed artery on an unexpanded balloon. The balloon is then expanded at the point of narrowing and withdrawn, leaving the stent in place to support the wall of the artery and maintain its opening. Stents can be used in conjunction with angioplasty (PTCA) and atherectomy.

CT (Computer Tomography) Scan: Uses X-rays 100 times more sensitive than ordinary x-rays, rotating in a 360º arc around the body, to show abnormalities in soft tissue. These images are particularly useful in identifying blood clots and disease in major blood vessels.

E

Echocardiogram:
 A quick, painless, safe ultrasound test that provides invaluable information about the heart. Sonar-like waves are beamed at the heart to produce an image of how it is functioning, the size of the chambers, condition of the valves, and the presence of any excess fluid.

Electrocardiogram (EKG/ECG): A simple test that uses a series of electrodes to measure the heart’s electrical activity and record it on a strip of graph paper moving at a constant rate. Abnormal rhythms, heart enlargement and coronary artery disease all cause recognizable change in the normal EKG pattern.

Electrolyte Panel: Analyzed from a blood sample, it will indicate whether there are abnormal levels of four electrically charged minerals or electrolytes (bicarbonate, sodium, potassium, and chloride) in your body. Such levels can be caused by heart disease or heart medications.

Electrophysiology Mapping (Intra Cardiac Mapping): Charting the heart’s electrical conduction and discovering the nature and origin of rhythm disturbances.

Endomyocardial Biopsy: A procedure where doctors remove a small piece of the heart through a special instrument called a biotome to check for certain diseases of the heart muscle. Often conducted on heart transplant patients to check for signs of rejection.

Endoscopic Vein Harvesting: A procedure used to harvest healthy veins for use in myocardial revascularization (coronary artery by-pass surgery). With this technique, a lighted endoscopic video scope is inserted into a one-half-inch incision made just above the patient’s knee.

Event Recorder: A small, patient-activated device that records cardiac events over a period of days or weeks to evaluate symptoms such as palpitations or fainting spells. Captures data before and after the patient experiences these symptoms.

H

Heart Disease (coronary heart disease):
Caused by a range of factors, from controllable ones like diet, activity and smoking to age, gender, ethnicity and heredity. It’s likely to produce angina pectoris (chest pain), heart attack or both.

Heart failure, also called congestive heart failure: A condition in which the heart can no longer pump enough blood to the rest of the body. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. The condition may affect the right side, the left side, or both sides of the heart.

  • Right-sided heart failure means the right ventricle of the heart loses its pumping function.
  • Left-sided heart failure means the heart’s ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body.

Heart failure is often classified as either systolic or diastolic.

  • Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well.
  • Diastolic heart failure means that your heart’s pumping chamber does not fill up with blood.

Both of these problems mean the heart is no longer able to pump enough blood out to the rest of your body, especially when you exercise or are active.

As the heart’s pumping action is lost, blood may back up in other areas of the body, producing congestion in the lungs, the liver, the gastrointestinal tract, and the arms and legs. As a result, there is a lack of oxygen and nutrition to organs, which damages them and reduces their ability to work properly.

Perhaps the most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. For information on this condition and its risk factors, see: Coronary artery disease.

Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies

Heart Scan: One of three nuclear medicine studies of the heart. They include the thallium myocardial perfusion study, which evaluates the blood flow to the heart muscle; the multiple gated acquisition (muga) study, which evaluates the mechanical pumping action of the heart; and the infarct study, which evaluates areas of injured myocardium.

Holter Monitor: A small, portable tape recorder that tracks the heart’s electrical activity, like an EKG, for 24 hours. Used when a chest pain or arrhythmia is intermittent and difficult to detect.

I

Intracardiac echocardiography (ICE): A useful tool for guiding transseptal puncture during electrophysiological mapping and ablation procedures. Left-sided accessory pathways (LSAP) can be ablated by using two different modalities: retrograde approach through the aortic valve and transseptal approach with puncture of the fossa ovalis. We shall report two cases of LSAP where transcatheter radiofrequency ablation (TCRFA) was firstly attempted via transaortic approach with ineffective results. Subsequently, a transseptal approach under ICE guidance has been performed. During atrial septal puncture ICE was able to locate the needle tip position precisely and provided a clear visualization of the “tenting effect” on the fossa ovalis. ICE allowed a better mapping of the mitral ring and a more effective catheter ablation manipulation and tip contact which resulted in a persistent and complete ablation of the accessory pathway with a shorter time of fluoroscopic exposure. ICE-guided transseptal approach might be a promising modality for TCRFA of LSAP.

L

Laser Angioplasty:
 A technique used to open coronary or peripheral arteries blocked by plaque, a buildup of cholesterol and other fatty substances. A catheter with an eximer laser at the tip is inserted into an artery and guided through the blood vessels to the location of the blocked artery in the heart. Pulsating beams of light from the laser vaporize the plaque.

M

Magnetic Resonance Angiography (MRA): Permits imaging of the blood vessels in several parts of the body with diagnostic accuracy, similar to contrast angiography (the injection of x-ray dye directly into blood vessels, usually with a catheter inserted into the artery in the upper thigh), but at a fraction of the time and cost, and with none of the risk. The most frequent vessels studied include the brain and the neck.

Magnetic Resonance Imaging (MRI): A test that produces high-quality still and moving pictures of the heart and large blood vessels. Unlike an X-ray machine, MRI uses large magnets and radio-frequency waves to produce pictures of internal structures. MRI delivers information about the heart as it is beating by creating moving images throughout the pumping cycle.

MAZE Procedure: A surgical procedure that can cure atrial fibrillation (a type of irregular heartbeat) by interrupting the circular wavelets of electrical energy that are typical of this arrhythmia. Strategic placement of multiple incisions in both atria stops the formation of errant electrical impulses and channels the normal electrical impulses in one direction from the top of the heart to the bottom.

Myocardial Infarction (MI): Heart attack. Results in permanent damage to the heart muscle caused by a lack of blood supply to the heart for a limited period of time.

P

Pacemaker: The heart’s natural pacemaker is the sinoatrial node, a group of special muscle fibers in the right atrial tissues that regulates the heart’s rhythm. When the natural pacemaker is defective, making the heartbeat too fast, too slow or irregular, a small, battery-operated device is permanently implanted under the skin. It sends electrical impulses to the heart muscle to maintain a suitable heart rate. There are also temporary external pacemakers.

Patent Foramen Ovale (PFO): The foramen ovale is a small opening located between the atria that is used during fetal circulation to speed up the flow of blood through the heart. A fetus does not use its own lungs for oxygen, it relies on its mother to provide oxygen rich blood from the placenta through the umbilical cord to the fetus. Therefore, blood can travel from the veins to the right side of the baby’s heart and cross to the left side of the heart through the foramen ovale and skip the trip to the baby’s lungs. Normally the foramen ovale closes at birth when increased blood pressure on the left side of the heart forces the opening to close. If the atrial septum does not close properly, it is called a patent foramen ovale or PFO. This type of defect can be problematic in adults, and can cause strokes or heart attacks.

Permanent Pacemaker Implantation: Describes the long-term use of an internal (versus external, as in temporary pacing) pacemaker as the primary (or back-up) electrical stimulus for the heart.

R

Radiofrequency Catheter Ablation:
In this procedure, performed in the cardiac catheterization laboratory by a cardiac electrophysiologist, an electrode catheter is introduced into a blood vessel, threaded to the heart, and positioned close to an abnormal electrical pathway. Radiofrequency energy is passed through the catheter, heating up heart tissue and destroying abnormal tissue. The procedure has a success rate of over 90 percent and a low risk of complications. The patient can return to normal activities within days.

Ross Procedure: An option when the aortic valve needs to be replaced. The patient’s pulmonary valve is removed and used to replace the malfunctioning aortic valve, which is removed and discarded. This allows the patient’s own tissue to be used in the more-stressful aortic position. The excised pulmonic valve is replaced by a cadaveric valve, which serves in the less-stressful pulmonic position.

S

Stress Echocardiogram:
An echocardiogram taken before, during and after exercise on a treadmill or stationary bike. This test is useful in detecting the presence of coronary artery disease and evaluating its progression.

Sutureless Coronary Artery Bypass Surgery: Allows saphaneous vein grafts to be attached to the aorta without sutures. In most other coronary bypass surgeries, the anastomosis, or the suturing of the graft to the aorta, is usually the most difficult, time consuming and critical part of the bypass procedure.

T

Transesophageal Echocardiography (TEE):
a specialized ultrasound involving an endoscopic technique (a visual inspection of a cavity in the body using a specialized instrument) that produces high quality cardiac images unobstructed by lung tissue or ribs. It can be performed as a diagnostic test in an outpatient procedure, or used to monitor patients during open-heart surgery.

Transmyocardial Revascularization (TMR): A laser procedure used to create channels through the heart muscle directly into the heart chamber. Used to improve blood flow to areas of the heart not receiving adequate blood supply due to blocked coronary arteries.

V

Valve Repair & Replacements: Heart valve repair and heart valve replacement operations are done to improve the health, quality and longevity of life for those who have heart valve disease. Heart valves may either be repaired or replaced, depending on the damage. Sometimes the surgeon can restore the valve to function normally by remodeling the tissue-removing stretched tissue or sewing the edges. Prosthetic or artificial rings are used to narrow a dilated valve and to reinforce valve repairs. One advantage of a heart valve repair operation is that a person’s own valve tissues are used.

Valvuloplasty: A procedure similar to the angioplasty, except the balloon-tipped catheter is guided to a narrowed heart valve. As the balloon is inflated, the valve’s fused leaflets open and allow blood to flow more freely.