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Quick Facts About Kaweah Delta:
• 400 Open-Heart Procedures Each Year
• 4,200 Cath Procedures Each Year
• 4,000 Babies Delivered Each Year
• 60,000 Treated In Our Emergency Department Each Year
• 3,200 People Employeed by the District
• 400,000 People In Our Regional Population
 Brochure
Since 1996, Kaweah Delta Hospital, in partnership with the world renowned Starr-Wood Cardiac Group, has offered the communities of the Central Valley the very best in cardiac services. Since the inception of the program, more than 3000 cardiac surgery procedures have taken place at Kaweah Delta's state-of-the art facility. Our cardiac surgery suites, intensive care facilities, and specially focused cardiac care floor offer the patient leading edge technology and well trained staff. The program has been recognized as one of the 100 Top Cardiovascular Hospitals in the nation. Coronary Artery Bypass Grafting (CABG), heart valve repair and replacement, and a variety of heart defect repairs are routinely performed by our highly skilled staff of surgeons, physician assistants, perfusionists, nurses, and technicians.
With a nationally recognized cardiac program so close to home, South Valley patients now have the benefit of staying close to home while having access to state-of-the-art medical care.
Heart Disease: Treatment And Diagnosis
It is important to have your cardiac or heart status checked at regular intervals. Initially, this is part of your annual physical examination with your physician. During your visit, you should tell the physician about any family members who had or have heart disease.
Your physician will determine which tests are necessary for you to have to determine the present status of your heart. The most common tests check the function of your heart and the flow of blood in your body.
For example, you may be asked to have blood drawn and have an electrocardiogram (EKG) done. Other tests maybe ordered by your doctor.
The best treatment for heart disease is prevention. There are identified risk factors, which if avoided can prevent heart disease.
In other words you need to change unhealthy habits. Making changes to reduce risks can help your heart from getting worse and in some cases even improve the health of you heart.
Lifestyle styles changes are focused on decreasing or eliminating risk factors.
- If you smoke, stop
- If you have high blood pressure, eat heart healthy foods and exercise
- If you have high blood cholesterol, eat heart healthy food and exercise
- If you do not exercise, start
- If you are overweight, lose it, eat healthy and exercise
- If you are under stress, explore ways to decrease stress and exercise
- If you have diabetes, follow the treatment plan prescribed for you.
Medical Treatment
Your physician may determine that your heart disease can be treated with a combination of diet, exercise, and possibly medication.
Your diet will be changed so that you can lower your cholesterol, improve your blood pressure, and lose weight. Eating less fat and salt, and eating more fiber is essential. Your doctor may suggest that you see a dietician to assist you with meal planning.
Your exercise routine can be a simple as walking regularly, for example 30 minutes daily. You should build up slowly and begin exercising at least 3 times per week. Your final goal should be exercising four to five times per week for 20-40 minutes.
Should your physician prescribe medication for you to take, be sure to follow the directions. Ask your physician if there are any side effects you should be aware of.
Interventional Treatment
Procedures can be used to treat chest pain or angina, and coronary artery disease. These include balloon angioplasty, atherectomy (rotoblation), and stent placement
Surgical Treatment
Coronary Artery Bypass surgery is the most common heart surgery performed. The surgery creates a new route for blood to flow to your heart.
Diagnostic Cardiology
Cardiac catheterization is a procedure accomplished by passing small tubes or catheters into the heart from arteries and veins in the groin or arm. A cardiologist with specialized training performs it. The study includes the observation of the heart's pumping function and the visualization of the coronary arteries, which supply the heart muscle with blood.
Echocardiogram (echo) and Doppler ultrasound are tests use ultrasound waves sent to the body and are returned through a microphone. An echo study provides an image of the moving heart and allows examination of the movement of blood through the heart.
Stress echocardiogram (stress echo) is an echocardiography examination conducted during exercise. Exercise will be done using a treadmill or if walking is difficult, medication can be infused to simulate exercise. An echocardiogram is performed immediately exercise. An echo study provides an image of the moving heart and allows examination of the movement of blood through the heart.
Stress Test (Treadmill) is an electrocardiogram (ECG) study conducted during exercise. Exercise will be done using a treadmill or if walking is difficult, medication can be infused to simulate exercise. During exercise, the ECG measures and records these electrical impulses as they travel through the heart muscle. It indicates if there is damaged heart tissue interfering with the normal flow of electrical impulses through the heart.
Thallium Stress Test is a type of nuclear scanning test for myocardial perfusion (blood flow in the heart). This test shows how well blood flows to the heart muscle. Done with conjunction an exercise stress test on a treadmill.
Electrocardiogram (ECG) is a test in which several electronic sensors are placed on the body to monitor electrical activity associated with the heartbeat.
Chest X-Ray is one of the simplest diagnostic tools. It will tell the size, shape of the heart, and the condition of the lungs.
Holter Electrocardiogram (ECG) is a continuous recording of your heart's rhythm for 24 or 48 hours; The Holter ECG will provide your physician with a record of how your heart reacts to situations during rest, activity, and stress while in your home environment.
Permanent Pacemaker is an electronic device consisting of an electrode connected to the heart muscle and a regulatory device and power source implanted in the skin. It provides regular, mild electric shocks that stimulate the heart muscle and maintain normal heartbeat.
Interventional Cardiology
Balloon angioplasty
is a procedure performed by cardiologists to help open narrowing in the coronary arteries. This procedure requires passing a catheter with a balloon into the artery. The balloon is then inflated in the artery to eliminate the narrow area.
Atherectomy (Rotorooter)
a procedure for opening coronary arteries blocked by plaque. Atherectomy uses a rotating shaver, ("burr" device on the end of a catheter). The catheter is inserted into the body the same way as in angioplasty. The burr then shaves the plaque, opening the artery.
Stent
is a wire mesh tube used to keep clear an artery, opened using angioplasty. The stent is collapsed placed over a balloon catheter. It is placed in the area of the blockage; inflating the balloon then deploys the stent. The stent forms to the artery like scaffolding, keeping it from closing.
Heart Surgery
Coronary artery bypass
Coronary artery bypass graft surgery is a procedure used to correct severe coronary artery obstruction. Veins and arteries from other parts of the body are grafted onto the diseased coronary artery both above and below the blockage. Saphenous vein grafts from the leg, radial artery grafts from the forearm, left or right internal mammary artery may be used as grafts
The upper segment of the vein graft is sutured into the aorta and the lower segment is sutured beyond the blockage onto the coronary artery itself. When arteries (most commonly from the thoracic cavity) are used, the upper segment remains in its place of origin and the lower end of the artery is sutured beyond the blockage on the obstructed coronary artery. Therefore, blood flow “by-passes” the obstructed area of the coronary artery entirely by being rerouted through the added “graft.”
Often with severe coronary artery disease, more than one coronary artery is grafted. The terms double bypass, triple bypass and quadruple bypass indicate how many grafts are necessary. These grafts restore blood circulation to the areas of the heart that have been deprived of oxygenated blood flow.
Valve Surgery
Heart valves control the flow of blood from one chamber to another. Normally, each of the valves opens wide enough to let blood flow through it, then closes tightly to stop leaking backward.
When one or more valves are not working the way they should, you have valve disease. Valve disease may be a condition you were born with, or it may occur in valves that were once healthy. Rheumatic heart disease or infections can scar valves. The natural aging of your body can cause valves to become thick or hardened.
Two common problems caused by valve disease are narrowing of the valve opening and leaking of a valve. When a valve narrows or leaks, blood flow is restricted. This puts strain on the heart and can lead to heart failure and irregular heart rhythms.
Sometimes medication can improve heart function, but often surgery is needed to repair or replace diseased heart valve.
Ascending Aortic Aneurysm
Ascending Aortic Aneurysm occurs when the aorta, the large vessel leading out of the left ventricle, may become enlarged and dilated. Such areas are called aneurysms.
Depending on the severity of the aneurysm, it may require surgical repair.
Septal Defects
An Atrial Septal Defect (ADS) occurs when there is a hole in the wall or septum between the right and left atrium, the upper chambers of the heart. The hole in the wall allows blood to flow both directions between the right and left atrium.
This is caused by an interruption in development of the septum during fetal development. An Atrial Septal Defect is repaired surgically by patching or closing the opening with sutures.
A Ventricular Septal Defect (VSD) occurs when a hole develops between the right and left ventricle. This allows blood to flow from the left ventricle to the right ventricle and to recirculate through the lungs. VSD may occur during fetal development or after a myocardial infarction (heart attack). A Ventricular Septal Defect may be repaired surgically with sutures or by patching the hole.
Endoscopic Vein Harvesting
During bypass surgery, a portion of the saphenous vein is removed from the leg for use on the heart. Just talk to anyone who has ever had this surgery and they'll probably tell you that the most uncomfortable part of the surgery was the leg incision. Up until recently, the vein was removed by making a series of long incisions along the inside of the leg. The wound was closed with up to three layers of suture and possibly skin staples. In patients with certain risk factors like diabetes, peripheral vascular disease or other circulation problems, poor healing and infection were common problems.
Endoscopic vein harvesting utilizes a television camera and specialized instruments to free and remove the vein through small incisions. While not everyone is a candidate for endoscopic vein harvesting, most people are. Initial results show comparable vein quality, reduced healing complications, less pain, and better cosmetic appearance utilizing this technique. The Starr-Wood Cardiac Group Physician Assistants have received special training and have been providing this service since August of 1999.
A Healthy Heart
The heart’s main job is to pump the right amount of blood to all parts of the body. The heart is a muscle, which contracts and relaxes as the blood cycles and recycles throughout the body.
The heart has four chambers. The upper chambers or atrium collect blood returning from the body to the heart. The upper chambers empty into the lower chambers when the valves between the two chambers open. The lower chambers or ventricles pump blood out of the heart to the body. There are two more valves that control blood flow from the ventricles.
While the blood is passing through the heart, it flows into the lungs to pick up a supply of oxygen. The oxygen rich blood is then passed to the lower left chamber and leaves the heart via the aorta, a large blood vessel, carrying blood and oxygen to the body.
The heart muscle needs its own supply of blood and oxygen in order to keep pumping. The coronary arteries, which lie on the surface of the heart, are essential in providing the nourishment and oxygen for the heart.
Keeping Your Heart Healthy
Several of the most important risk factors for heart disease are within your control.
Cigarette Smoking. The nicotine causes blood vessels to narrow, which can greatly increase the chance of having a heart attack.
Diet. A diet high in fat and cholesterol can add pounds and contribute to atherosclerosis. Increase fiber (fruits, vegetables, grains) and reduce fats to improve your heart health.
High Blood Pressure. Hypertension can lead to blood vessel damage because the heart has to work harder to pump the blood through narrowed or hardened vessels affected by atherosclerosis. This damage can lead to the formation of blood clots inside the blood vessels, which can cause heart attacks.
Limited Physical Activity. Regular exercise will keep you young at heart. Any kind of physical activity is beneficial.
Stress. Relieve stress through exercise, soothing music, relaxation techniques or a warm bath. Stress is a part of life and learning to control it could prolong your life.
What is a Heart Attack
A heart attack occurs when a coronary artery becomes clogged with a clot or plaque. The heart muscle cannot receive the oxygen and nutrients it needs. The area of the heart supplied by this artery begins to die. If steps are taken to open this blockage, cardiac muscle can be preserved.
Cardiac Warning Signs
Shortness of breath, chest pain, arm or neck pain and reduced ability to exercise are possible signs of cardiac problems. Anyone experiencing these symptoms should call their family physician right away.
If you believe you are having a heart attack, a trip to the emergency room where the patient can be treated with "clotbusters" and can quickly undergo a catheter procedure or surgery is warranted. Quick response can reduce the damage from the heart attack and result in a better outcome for the patient.
Symptoms of a Heart Attack
- Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting several minutes.
- Pain spreading to the shoulders, neck or arms. It may be located in the chest, upper abdomen, jaw or inside the arms or shoulders.
- Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.
- Anxiety, nervousness and/or cold, sweaty skin.
- Increased or irregular heart rate.
- Feeling of impending doom.
Heart Disease: What You Need to Know
There are many kinds of heart disease. Some common ones are:
Coronary Artery Disease
A narrowing of the coronary arteries due to a build up of plaque on the artery wall.
Valvular Disease
The heart has four values that control the flow of blood through the heart. These valves have two or three leaflets that open and close as blood passes through. Valves can become thick and hard leading to narrowing (stenosis) or weakened leading to leaking (regurgitation). This decreases the efficiency of the heart by making it work harder to circulate the blood.
Congestive Heart Failure
When the heart if forced to work harder (hypertension, malfunctioning valves, weakened heart muscle from heart attack) the heart enlarges to compensate. Eventually this leads to a stretched muscle that looses its ability to contract. Like old elastic, it does not work well.
Angina
When the heart muscle does not receive adequate oxygen and nutrients, the muscle begins to ache. Nitroglycerine opens the coronary arteries to allow greater blood flow to the heart muscle.
Shortness of breath, chest pain, arm or neck pain and reduced ability to exercise are possible signs of cardiac problems. Anyone experiencing these symptoms should call their family physician right away.
Common Arrhytmias (Irregular Hearbeats)
Bradycardia
A slow heartrate of 50 beats per minute or slower. If your heart rate is too slow, you may feel tired, lighted-headed or short of breath.
Tachycardia (Also known as Tach)
A fast heart rate from 160 – 200 beats per minute or more. Atrial tach arises in the atria and occurs usually in normal hearts. Ventricular tach occurs in hearts where disease or damage is present.
Atrial Fibrillation
Irregular contraction of the atrium, which results in poor filling of the ventricles.
Ectopic Beats
Premature atrial contractions (PACS) are common and no cause for alarm in healthy hearts. Premature ventricular contractions (PVCs) are not dangerous in healthy hearts but may indicate more serious problems in diseased hearts.
Heart Block
When the electrical pathway in the heart is interrupted (heart attack, cardiomyopathy, cardiac nerve degeneration and others) the electrical impulses slow. Patients may experience fainting episodes or light-headedness. A permanently implanted pacemaker is used to correct this condition.
Hypertension (High Blood Pressure)
Hypertension usually has no symptoms. It may be caused by genetic factors, smoking, being overweight, sedentary lifestyle, eating a diet high in fat and elevated cholesterol levels. You should see your doctor if your blood pressure is greater than 140 over 90.
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