Does Having a Heart Attack Mean You Will Need Open Heart Surgery?
Dr. Eric Sandwith explains symptoms of a heart attack. He will share important details on how they differ in men versus women, treatment options available, and if you will need open heart surgery, what you can expect.
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Learn more about Eric Sandwith, MD
Eric Sandwith, MD
Dr. Eric L. Sandwith earned his medical degree in 1995 from the University of Washington School of Medicine in Seattle. He continued his post-graduate work in surgery with an internship and residency at Carilion Roanoke Memorial Hospital, and then another residency in thoracic surgery at St. Luke's Hospital of Kansas City in Missouri. In 2002 he received a Fellowship in cardiovascular surgery from the Mayo Clinic/St. Mary's Hospital in Rochester, Minnesota. Dr. Sandwith is licensed in the state of Florida and is board certified by the American Board of General Surgery and the American Board of Thoracic Surgery. He is a member of the American College of Surgeons, Priestly Society (Mayo Surgical Alumni), and the American College of Surgeons.Learn more about Eric Sandwith, MD
Transcription:
Adam Ragusea (Host): About 800,000 Americans have a heart attack each year. Most people survive it, but then the question becomes what happens next. Is a big scary operation in order or is there another option? Let’s ask Dr. Eric Sandwith, cardiologist at Fort Walton Beach Medical Center.
This is Helmet of Health, the podcast from Fort Walton Beach Medical Center. I’m Adam Ragusea and Dr. Sandwith, let’s just say that a person has had a heart attack; what next?
Eric Sandwith, MD (Guest): Well Adam, the first thing that a person does when they find out that they have had a heart attack, or certainly they are afraid that they’ve had a heart attack and most people aren’t really sure. So, there’s a lot of fear involved that keeps things very fluid for the patient. Ultimately, the best first step is to call 9-1-1 when a patient is having chest pain. They are able to get to the emergency room and among all the other things that they do in the emergency room, is they provide some stability to the patient and some concrete answers as to why they are having chest pain. Once that’s recognized or identified as what we call a heart attack, which is actually many different things; then a certain protocol in order to relieve the pain is started with nitroglycerin and oxygen and morphine and things of that nature, acutely just to try to stop the event in it’s tracks.
And from that point forward, it’s all about defining exactly why did the person have that heart attack and the reasons why can be many. But really the most important part is a left heart catheterization as soon as possible to identify how extensive the pathology is. The simple answer to your question is if you have a heart attack does it lead to heart surgery and an answer to that question is no. the things that lead to heart surgery are the definitive anatomy of the blood vessels on the patient’s heart.
Now if a person has extensive heart disease and lots of blockages in different blood vessels of the heart; then it can lead to surgery. But most of the time, it’s either treated with medicine or with a stent by the cardiologist.
Host: And that stent is something that a cardiologist can just put in through a relatively minor procedure, right? They don’t have to cut open your chest. They just go in with a little device through an artery in your arm or your leg, right?
Dr. Sandwith: Yes, it is a fairly – very well documented procedure that is extremely effective in most all the situations where they undertake stenting and it’s relatively safe. It has decreased the mortality from heart disease profoundly.
Host: And that is a procedure that would replace the old style triple bypass type surgery that you would hear about people having after they had a heart attack?
Dr. Sandwith: Yes, it does, and it does in people who it is the best treatment for. Now those people again, it’s based on the anatomy and how many blocked blood vessels there are. Common reference would say that there’s three main blood vessels to the heart muscle and if all three vessels are involved or if two vessels in a diabetic patient are involved; then surgery becomes in the patient’s best interest. Because the studies over the last 30 years have shown us that with that question, surgery provides a longer life and a better quality of life than stenting intervention.
Host: So, of the people who’ve had heart attacks, for what percentage of them would that kind of more serious surgery be the best option?
Dr. Sandwith: Probably only around 20-25%. It’s not a majority. It’s really important also because my experience has been that people don’t understand heart disease and that’s one of the reasons why it’s the number one killer. The disease is in the blood vessels that bring the oxygen carrying red blood cells to the muscle. But the manifestation of the disease, as we are saying right now, a heart attack, that’s when the impacts of the disease is being manifested in the muscle itself. And when that happens; that’s the problem. Because the function of that heart muscle is the thing that keeps you alive. The disease itself that we have to treat is in the blood vessels, but the manifestation is the heart attack and the loss of heart muscle.
Host: All right so it sounds like the takeaway for folks is if they’ve had a heart attack, relax, the most likely next step is going to be a minor stenting procedure, not a big open heart surgery.
Dr. Sandwith: Yes. Exactly and it’s the majority of people are able to be treated in that fashion. I think that perception is such an important part of this disease too is that people are quite overwhelmed when we talk about major, major heart surgeries and things of that nature. But at the end of the day, it’s an extremely well proven and very successful operation that people come out of in a much better physical condition than they went in. So, the thing to remember is that major part about it is how much it will help you. If you need it, you need it and if you don’t, then you have options that are much easier to obtain.
Host: All right Doc, thank you so much. That’s Dr. Eric Sandwith, a cardiologist at Fort Walton Beach Medical Center. Thank you for listening to Helmet of Health. Got to www.fwbmc.com to get connected with Dr. Sandwith or another provider. If you found this podcast helpful, please be sure to share it on your social channels and be sure to check out all the other podcasts in the library.
Adam Ragusea (Host): About 800,000 Americans have a heart attack each year. Most people survive it, but then the question becomes what happens next. Is a big scary operation in order or is there another option? Let’s ask Dr. Eric Sandwith, cardiologist at Fort Walton Beach Medical Center.
This is Helmet of Health, the podcast from Fort Walton Beach Medical Center. I’m Adam Ragusea and Dr. Sandwith, let’s just say that a person has had a heart attack; what next?
Eric Sandwith, MD (Guest): Well Adam, the first thing that a person does when they find out that they have had a heart attack, or certainly they are afraid that they’ve had a heart attack and most people aren’t really sure. So, there’s a lot of fear involved that keeps things very fluid for the patient. Ultimately, the best first step is to call 9-1-1 when a patient is having chest pain. They are able to get to the emergency room and among all the other things that they do in the emergency room, is they provide some stability to the patient and some concrete answers as to why they are having chest pain. Once that’s recognized or identified as what we call a heart attack, which is actually many different things; then a certain protocol in order to relieve the pain is started with nitroglycerin and oxygen and morphine and things of that nature, acutely just to try to stop the event in it’s tracks.
And from that point forward, it’s all about defining exactly why did the person have that heart attack and the reasons why can be many. But really the most important part is a left heart catheterization as soon as possible to identify how extensive the pathology is. The simple answer to your question is if you have a heart attack does it lead to heart surgery and an answer to that question is no. the things that lead to heart surgery are the definitive anatomy of the blood vessels on the patient’s heart.
Now if a person has extensive heart disease and lots of blockages in different blood vessels of the heart; then it can lead to surgery. But most of the time, it’s either treated with medicine or with a stent by the cardiologist.
Host: And that stent is something that a cardiologist can just put in through a relatively minor procedure, right? They don’t have to cut open your chest. They just go in with a little device through an artery in your arm or your leg, right?
Dr. Sandwith: Yes, it is a fairly – very well documented procedure that is extremely effective in most all the situations where they undertake stenting and it’s relatively safe. It has decreased the mortality from heart disease profoundly.
Host: And that is a procedure that would replace the old style triple bypass type surgery that you would hear about people having after they had a heart attack?
Dr. Sandwith: Yes, it does, and it does in people who it is the best treatment for. Now those people again, it’s based on the anatomy and how many blocked blood vessels there are. Common reference would say that there’s three main blood vessels to the heart muscle and if all three vessels are involved or if two vessels in a diabetic patient are involved; then surgery becomes in the patient’s best interest. Because the studies over the last 30 years have shown us that with that question, surgery provides a longer life and a better quality of life than stenting intervention.
Host: So, of the people who’ve had heart attacks, for what percentage of them would that kind of more serious surgery be the best option?
Dr. Sandwith: Probably only around 20-25%. It’s not a majority. It’s really important also because my experience has been that people don’t understand heart disease and that’s one of the reasons why it’s the number one killer. The disease is in the blood vessels that bring the oxygen carrying red blood cells to the muscle. But the manifestation of the disease, as we are saying right now, a heart attack, that’s when the impacts of the disease is being manifested in the muscle itself. And when that happens; that’s the problem. Because the function of that heart muscle is the thing that keeps you alive. The disease itself that we have to treat is in the blood vessels, but the manifestation is the heart attack and the loss of heart muscle.
Host: All right so it sounds like the takeaway for folks is if they’ve had a heart attack, relax, the most likely next step is going to be a minor stenting procedure, not a big open heart surgery.
Dr. Sandwith: Yes. Exactly and it’s the majority of people are able to be treated in that fashion. I think that perception is such an important part of this disease too is that people are quite overwhelmed when we talk about major, major heart surgeries and things of that nature. But at the end of the day, it’s an extremely well proven and very successful operation that people come out of in a much better physical condition than they went in. So, the thing to remember is that major part about it is how much it will help you. If you need it, you need it and if you don’t, then you have options that are much easier to obtain.
Host: All right Doc, thank you so much. That’s Dr. Eric Sandwith, a cardiologist at Fort Walton Beach Medical Center. Thank you for listening to Helmet of Health. Got to www.fwbmc.com to get connected with Dr. Sandwith or another provider. If you found this podcast helpful, please be sure to share it on your social channels and be sure to check out all the other podcasts in the library.