Heart and vascular services
Circulatory system; Vascular system; Cardiovascular system
The body's cardiovascular, or circulatory system, is made of the heart, blood, and blood vessels (arteries and veins).
Heart and vascular services refers to the branch of medicine that focuses on the cardiovascular system.
Information
The heart's main job is to pump oxygen-rich blood to the body after it pumps oxygen-poor blood to the lungs. It normally does this 60 to 100 times a minute, 24 hours a day.
The heart is made of four chambers:
- The right atrium receives oxygen-poor blood from the body. That blood then flows into the right ventricle, which pumps it to the lungs.
- The left atrium receives oxygen-rich blood from the lungs. From there, the blood flows into the left ventricle, which pumps blood out of the heart to the rest of the body.
Together, the arteries and veins are referred to as the vascular system. In general, arteries carry blood away from the heart and veins carry blood back to the heart.
The cardiovascular system delivers oxygen, nutrients, hormones, and other important substances to cells and organs in the body. It plays an important role in helping the body meet the demands of activity, exercise, and stress. It also helps maintain body temperature, among other things.
CARDIOVASCULAR MEDICINE
Cardiovascular medicine refers to the branch of health care that specializes in the treatment of diseases or conditions dealing with the heart and vascular systems.
Common disorders include:
- Abdominal aortic aneurysm
- Congenital heart defects
- Coronary artery disease, including angina and heart attack
- Heart failure
- Heart valve problems
- High blood pressure and high cholesterol
- Irregular heart rhythms (arrhythmias)
- Peripheral artery disease (PAD)
- Stroke
Physicians involved in the treatment of circulatory or vascular diseases include:
- Cardiologists -- Doctors who have received extra training in the treatment of heart and vascular disorders
- Vascular surgeons -- Doctors who have received extra training in blood vessel surgery
- Cardiac surgeons -- Doctors who have received extra training in heart-related surgery
- Primary care doctors
Other health care providers who are involved in the treatment of circulatory or vascular diseases include:
- Nurse practitioners (NPs) or physician assistants (PAs), who focus on heart and vascular diseases
- Nutritionists or dietitians
- Nurses who receive special training in the management of patients with these disorders
Imaging tests that may be done to diagnose, monitor or treat diseases of the circulatory and vascular system include:
- Cardiac CT
- Cardiac MRI
- Coronary angiography
- CT angiography (CTA) and magnetic resonance angiography (MRA)
- Echocardiogram
- PET scan of the heart
- Stress tests (many different types of stress tests exist)
- Vascular ultrasound, such as carotid ultrasound
- Venous ultrasound of the arms and legs
SURGERIES AND INTERVENTIONS
Less invasive procedures than heart or vascular surgery may be done to diagnose, monitor or treat diseases of the heart and vascular system.
In most of these types of procedures, a catheter is inserted through the skin into a large blood vessel. In most cases, such procedures do not need general anesthesia. Patients often do not need to stay in the hospital overnight. They recover in 1 to 3 days and can most often return to their normal activities within a week.
Such procedures include:
- Ablation therapy to treat cardiac arrhythmias
- Angiogram (using x-rays and injected contrast dye to evaluate blood vessels)
- Angioplasty (using a small balloon to open a narrowing in a blood vessel) with or without stent placement
- Cardiac catheterization (measuring pressures in and around the heart)
- Valve interventions/replacement
Heart surgery may be needed to treat certain heart or blood vessel problems. This may include:
- Heart transplant
- Insertion of pacemakers or defibrillators
- Open and minimally invasive coronary artery bypass surgery
- Repair or replacement of heart valves
- Surgical treatment of congenital heart defects
Vascular surgery refers to surgical procedures that are used to treat or diagnose problems in a blood vessel, such as a blockage or rupture. Such procedures include:
- Arterial bypass grafts
- Endarterectomies
- Repair of aneurysms (dilated/enlarged portions) of the aorta and its branches
Procedures may also be used to treat arteries that supply the brain, kidneys, intestines, arms and legs.
CARDIOVASCULAR PREVENTION AND REHABILITATION
Cardiac rehabilitation is therapy used to prevent heart disease from getting worse. It is usually recommended after major heart-related events such as a heart attack or cardiac surgery. It may include:
- Cardiovascular risk assessments
- Health screenings and wellness exams
- Nutrition and lifestyle counseling, including smoking cessation and diabetes education
- Supervised exercise
Millions of Americans are living with heart disease and some of them don't even realize they have it. Heart disease is the number one cause of death; above cancer, diabetes, and injuries. That's why it's important to get it diagnosed and treated quickly. Fortunately, we doctors have a lot of tests and treatments at our disposal to combat heart disease. One procedure that is both a test AND a treatment is called cardiac catheterization. It can show your doctor how healthy your heart and blood vessels are, and treat heart valve problems, clogged arteries, and heart defects. Let's talk today about cardiac catheterization. So, why would you even need cardiac catheterization? Well, doctors use cardiac catheterization to diagnose and evaluate common heart and blood vessel problems, like chest pain or an abnormal stress test due to coronary artery disease, heart valve conditions like a leaky or narrowed valve, a high blood pressure condition in the lungs, blood clots in the lungs from an embolism, and an enlarged heart. You'll need to have this procedure in a supervised hospital setting. You may need to stay overnight at the hospital the night before the test, or you may be admitted the morning of the procedure. The whole cardiac catheterization procedure takes about 30 to 60 minutes. You'll be given medicine to help you relax, but you'll be awake during the procedure. First, the doctor will insert an intravenous, or IV line into one of the blood vessels in your groin or neck. Through this IV line, your doctor will pass a thin, flexible tube called a catheter. That tube will be threaded into either the left or right side of your heart. The doctor will use an x-ray as a guide to see where the catheter is going. While the catheter is in place, your doctor can check how well the blood is flowing into and out of your heart, and through the arteries around your heart, collect blood samples from your heart, measure the oxygen level in your heart, and even take a tiny piece of heart tissue, called a biopsy, when there's a situation of unexplained heart failure. Cardiac catheterization is a safe procedure when performed by an experienced medical team. But, some possible risks include bleeding, infection, and blood clots. A heart attack or a stroke can happen in very rare situations. But, remember, it's done in a closely supervised setting in a hospital. After a cardiac catheterization, your doctor should have a pretty good idea of what's causing your heart, valve, or blood vessel problem. Knowing exactly what the problem is can help your doctor find just the right way to treat your particular problem.
References
Go MR, Starr JE, Satiani B. Development of a multispecialty practice and operation of multispecialty cardiovascular centers. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 197.
Herrmann HC. Transcatheter mitral valve repair and replacement. In: Otto CM, Bonow RO, eds. Valvular heart disease: A companion to Braunwald's Heart Disease. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 20.
Japp AG, Din JN, Robson JMJ. The cardiovascular system. In: Dover AR, Innes JA, Fairhurst K, eds. Macleod's Clinical Examination. 15th ed. Philadelphia, PA: Elsevier; 2024:chap 4.
Patel A, Kodali S. Transcatheter aortic valve replacement: indications, procedure, and outcomes. In: Otto CM, Bonow RO, eds. Valvular heart disease: A Companion to Braunwald's Heart Disease. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 12.
Version Info
Last reviewed on: 10/23/2023
Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
