The Advanced Cardiovascular Life Support (ACLS) algorithm is a systematic, evidence-based approach designed to guide healthcare providers in the urgent treatment of: Cardiac arrest. Arrhythmias. Stroke. Other life-threatening cardiovascular emergencies.

1. PRESENTED BY : DR. PALLAVI PATHANIA

2. CARDIAC FAILURE
Introduction
Objectives
Review of anatomy of the heart
Definition
Epidemiology
Causes
pathophysiology

3. Clinical manifestation
Classifications
Diagnostic process
Medical management
Complications
conclusion

4. INTRODUCTION
 Cardiac failure(CF) ,often referred to as
congestive heart failure; is the inability of the
heart to pump sufficient blood to meet the
needs of the tissues for oxygen and nutrients.
The term congestive heart failure is most
commonly used when referring to left-sided
and right-sided heart failure.

5.  The underlying mechanism of cardiac
failure involves impairment of the
contractile properties of the heart, which
leads to a lower than- normal cardiac
output.

7. REVIEW OF ANATOMY AND PHYSIOLOGY
OF THE CVS
1. Structure of the heart.
2. Cardiac circle:-conducting system of the heart.
3. Heart sound
4. Electrocardiogram
5. The circulatory system
6. Factor controlling BP

8. STRUCTURE OF THE HEART
 Is a hollow muscular pumping organ
 Location-mediastinum in the thoracic cavity
 Shape-cone shape with the base upward and the apex
downward
 Pericardial membrane; fibrous pericardium, serous
pericardium, myocardium and the endocardium

9. STRUCTURE OF THE HEART

10. CHAMBERS /VALVES OF THE HEART
 Four chambers;
 Left and right atria- separated by interatrial septum
 Left and right ventricles – separated by the interventricular
septum
 Valves- tricuspid, bicuspid, aortic, pulmonary valve

11. BLOOD SUPPLY TO THE HEART
Coronary artery and vein system
 Right and left coronary arteries branch off the aorta
 Branch into smaller vessels
 Cardiac veins deliver blood to coronary sinus, and back to
the right atrium

12. Coronary artery

13. COORDINATION OF CHAMBER CONTRACTION
AND RELAXATION

14. CONDUCTION SYSTEM OF THE HEART
 The cardiac cycle is a series of mechanical events that
is regulated by the electrical activity of the
myocardium.
 Nerve impulse are not required to cause contraction of
the heart. The heart generates its own beat.

15. CONDUCTING SYSTEM OF THE HEART

16. HEART SOUNDS
 There are two sound per heart beat
Lub-Dup
 1st sound is created by the closure of the AV valves(tri &
bicuspid )
 2nd sound is created by the closure of the aortic and the
pulmonary valves.
Improper closure of any valve result in heart murmur

17. ELECTROCARDIOGRAM (ECG)
 When the cardiac impulses passes through the
heart, electrical current also spread to adjacent
tissues and this spread to the surface of the body.
Electrodes placed on the skin can record the
current generated by the heart
 Normal ECG comprises of ;PQRS and T waves

18. ECG Con’t
 P-Q interval-atria contraction (0.16 sec)
 Q-T interval-ventricular contraction (0.35 sec)

19. ELECTROCARDIOGRAM

21. FACTORS CONTROLLING BP
1. Cardiac out put
2. Venous return
3. Blood volume
4. Heart rate
5. Peripheral resistance
6. Elasticity of the large arteries
7. Hormones – ADH, Aldosterone, etc.
8. Viscosity of the blood

22. Definition
 Heart failure is the inability of the heart to maintain an
output adequate to meet the metabolic demands of the
body.
or
 The inability of the heart to pump out completely it’s
blood leaving behind about 40% of the blood in it’s
chambers

23. Epidemiology
 It is a common syndrome in both developed and
developing countries
 It is increasing in incidence and prevalence
 About 5million cases of heart failure are prevalent in
the US
 Incidence is estimated at 550,000 cases per year
 The 5 year mortality rate following diagnosis with
heart failure is almost 50%.

24. CAUSES
• Hypertension
• Severe anaemia
• Myocardial infarction
• Coronary atherosclerosis
• Rheumatic heart disease
• Thyrotoxicosis
• Congenital heart disease e.g. Ventricular septal
defect

25. RISK FACTORS

26. Types of Heart Failure
1. Acute and chronic heart failure
2. High output and low output HF
3. Left sided, right sided and biventricular HF
4. Forward and backward HF
5. Systolic and diastolic HF

27.  Acute HF: its develops suddenly, sudden reduction
in CO results in systemic hypotension without
peripheral oedema
ex: Acute MI, rupture of a cardiac valve
 Chronic HF: its develops gradually, here systemic
arterial pressure is well maintained but oedema
accumulates
ex: dilated cardiomyopathy, multivalvular disease

28.  High output HF: Heart fails to maintain sufficient
circulation despite an increased CO.
ex: anaemia, pregnancy
 Low output HF: Associate with a low cardiac
output means heart fails to generate adequate
output .
ex: ISD, cardiomyopathy, valvular disease

29.  Left sided ( left ventricular ) HF: Excess fluid
accumulates upstream behind the failing left
ventricle, there is reduction in left ventricular
output, increase in left atrial pressure and increase
in pulmonary venous pressure
 Acute increase in left atrial pressure causes pulmonary congestion
and pulmonary oedema
Ex: MI
 Gradual increase in left atrial pressure causes reflex pulmonary
hypertension but no pulmonary oedema
Ex : aortic stenosis

30.  Right sided (right ventricular) HF: Excess fluid
accumulates upstream behind the failing right
ventricle, there is reduction in right ventricular
output which results in systemic venous
congestion.
Ex: pulmonary valvular stenosis, multiple
pulmonary emboli

31.  Systolic HF: Its characterized by an abnormality of
ventricular contraction.
 Diastolic HF: Its characterized by an impaired
ventricular relaxation and incresed ventricular
stiffness resulting in diastolic dysfunction.
Ex: Ischaemia left ventricular hypertrophy

32. PATHOPHYSIOLOGY

35. CHRONIC HEART FAILURE

36. CHRONIC HEART FAILURE

39. LEFT Heart Failure

41. RIGHT Heart Failure

43. Diagnostic process

46. TREATMENT

51. Nursing management using the
nursing process approach
 ASSESSMENT
History taking
Assess patient for dyspnoea, fatigue, palpitation and
dizziness
Assess patient for oedema, oliguria, tenderness of the
calf of the legs. Cyanosis. Cough and haemoptysis
Assess the patient’s vital signs

52. Nursing management
IDENTIFIED NURSING DIAGNOSIS
Altered cardiac output related to weakness of the
cardiac muscle
Ineffective breathing pattern related to pulmonary
congestion
Fluid volume excess related to systemic congestion

53. Nursing diagnosis
Altered body comfort related to ascitis
Altered nutrition related to change in dietary regimen
Anxiety related to out come of illness
Self care deficit related to restriction of activity
Altered family process related to the disease and
hospitalization

54. COMPLICATIONS
 Cardiac dysrhythmias.
 Myocardial failure and cardiac arrest.
 Digoxin toxicity from decreased renal function and
potassium depletion.
 Pulmonary infarction, pneumonia, and emboli

86. DEFINITION
 A heart block is a disease in the electrical system of the
heart. This is opposed to coronary artery disease,
which is disease of the blood vessels of the heart.
While CAD can cause angina or MI, heart block can
cause lightheadedness, syncope{ fainting}, and
palpitations.

87. TYPES OF HEART BLOCK
 First degree heart block { first degree AV block}
 Type –I Second degree heart block { second degree AV
block}
 Type-II Second degree heart block
 Third degree heart block { complete heart block}

89. RISK FACTORS
 History of cardiac disease
 Medications
 Other prior illness
 Hypertension
 Diabetes

90. Sign & symptoms
 Syncope
 Dizziness
 Lightheadedness
 Chest pain
 Shortness of breath
 Very slow heart & pulse rate
 Irregular heart beat
 Anorexia, nausea
 Impaired thinking
 Fluid retention, swelling

91. DIAGNOSTIC TEST
 ECG
 ECHOCARDIOGRAM
 HOLTER MONITORING: To detect irregular heart
rhythms, patient wear a walkman size recording box
attached to their chest by five adhesive electrode patches
for 24-48 hours.
 CARDIAC CATHETERIZATION
ETC.

92. MANAGEMENT
 LIFE STYLE CHANGES
 MEDICATION
 ELECTRONIC DEVICE LIKE DEFIBRILATOR SHOCK
 ICD’S IMPLANTED CARDIOVERTER
DEFIBERILLATORS: PACEMEKRS
 SURGERY
 Cardioversion: Chemical cardioversion uses
medications that can relax an overactive
heart. Electrical cardioversion uses one or more quick
electric shocks to the heart. The shock is delivered
through electrodes attached to the chest.

98.  An arrhythmia disrupts the way heartbeat signals normally travel through
heart.
 The faulty signaling causes the heart to beat too fast (tachycardia), too slow
(bradycardia) or irregularly.
 Both arrhythmia and dysrhythmia refer to an abnormal rhythm of heartbeat.
If experience an arrhythmia, the rhythm of heartbeat is too fast or too slow.
If experience dysrhythmia, the rate of heartbeat is irregular, but it's still
within a normal range.
 Heart arrhythmias may feel like a fluttering or racing heart and may be
harmless. In general, heart arrhythmias are grouped by the speed of the heart
rate. For example:
 Tachycardia (tak-ih-KAHR-dee-uh) is a fast heart. The resting heart
rate is greater than 100 beats a minute.
 Bradycardia (brad-e-KAHR-dee-uh) is a slow heartbeat. The resting
heart rate is less than 60 beats a minute.

99. Fast heartbeat (tachycardia): Types of tachycardias include:
 Atrial fibrillation (A-fib). Chaotic heart signaling causes a rapid, uncoordinated
heart rate. The condition may be temporary, but some A-fib episodes may not stop
unless treated. A-fib is associated with serious complications such as stroke.
 Atrial flutter. Atrial flutter is similar to A-fib, but heartbeats are more organized.
Atrial flutter is also linked to stroke.
 Supraventricular tachycardia. Supraventricular tachycardia is a broad term that
includes arrhythmias that start above the lower heart chambers (ventricles).
Supraventricular tachycardia causes episodes of a pounding heartbeat (palpitations)
that begin and end abruptly.
 Ventricular fibrillation. This type of arrhythmia occurs when rapid, chaotic
electrical signals cause the lower heart chambers (ventricles) to quiver instead of
contacting in a coordinated way that pumps blood to the rest of the body. This
serious problem can lead to death if a normal heart rhythm isn't restored within
minutes. Most people who have ventricular fibrillation have an underlying heart
disease or have experienced serious trauma.
 Ventricular tachycardia. This rapid, regular heart rate starts with faulty electrical
signals in the lower heart chambers (ventricles). The rapid heart rate doesn't allow
the ventricles to properly fill with blood. As a result, the heart can't pump enough
blood to the body. Ventricular tachycardia may not cause serious problems in people
with an otherwise healthy heart. In those with heart disease, ventricular tachycardia
can be a medical emergency that requires immediate medical treatment.

100.  Slow heartbeat (bradycardia); Although a heart rate below 60 beats a minute
while at rest is considered bradycardia, a low resting heart rate doesn't always signal
a problem. If you're physically fit, your heart may still be able to pump enough
blood to the body with fewer than 60 beats a minute at rest.
 If you have a slow heart rate and your heart isn't pumping enough blood, you may
have a type of bradycardia. Types of bradycardias include:
 Sick sinus syndrome. The sinus node is responsible for setting the pace of the heart.
If it doesn't work properly, the heart rate may alternate between too slow
(bradycardia) and too fast (tachycardia). Sick sinus syndrome can be caused by
scarring near the sinus node that's slowing, disrupting or blocking the travel of
impulses. Sick sinus syndrome is most common among older adults.
 Conduction block. A block of the heart's electrical pathways can cause the signals
that trigger the heartbeats to slow down or stop. Some blocks may cause no signs or
symptoms, and others may cause skipped beats or bradycardia.

101.  Premature heartbeats: Premature heartbeats are extra beats that
occur one at a time, sometimes in patterns that alternate with the
normal heart beat. The extra beats may come from the top chamber of
the heart (premature atrial contractions) or the bottom chamber
(premature ventricular contractions).
 A premature heartbeat may feel like your heart skipped a beat. These
extra beats are generally not concerning, and they seldom mean you
have a more serious condition. Still, a premature beat can trigger a
longer-lasting arrhythmia, especially in people with heart disease.
Occasionally, very frequent premature beats that last for several years
may lead to a weak heart.
 Premature heartbeats may occur when resting. Sometimes premature
heartbeats are caused by stress, strenuous exercise or stimulants, such
as caffeine or nicotine.

102. ARRHYTHMIA?
 An arrhythmia (also called dysrhythmia) is an abnormal heartbeat.
Arrhythmias can start in different parts of heart and they can be too fast, too
slow or just irregular.
 Normally, heart beats in an organized, coordinated way. Issues with various
parts of heart — or even the blood heart pumps — can affect heart’s normal
rhythm. Having a normal heart rhythm matters because heart supplies whole
body with nutrients and oxygen through the blood it pumps.
 Some types of arrhythmia are harmless and don’t require treatment. Others
can put at risk for cardiac arrest.

103. What are the types of arrhythmia?
 Healthcare providers describe arrhythmias by where in your heart they
start.
 Supraventricular arrhythmias: These begin in your atria (your heart’s
upper chambers). “Supraventricular” means above your ventricles or
lower chambers of your heart.
 Ventricular arrhythmias: These begin in your heart’s ventricles or
lower chambers.
 Bradyarrhythmias and junctional rhythms: These can happen
because of issues in your heart’s conduction system, such as the
sinoatrial (SA) node, atrioventricular (AV) node or His-Purkinje
network.

104. What causes arrhythmia?
 Arrhythmia causes include:
 Coronary artery disease.
 Irritable tissue in your heart (due to genetic or acquired causes).
 High blood pressure.
 Changes in your heart muscle (cardiomyopathy).
 Valve disorders.
 Electrolyte imbalances in your blood.
 Injury from a heart attack.
 The healing process after heart surgery.
 Other medical conditions.
 Main cause of arrhythmia: Most arrhythmias happen because of an
issue with your heart’s arteries, valves or muscles.

105. Risk factors for arrhythmia include:
 Using tobacco products.
 Drinking alcohol.
 Consuming drinks and foods that have caffeine.
 Taking stimulants like cold medicines or herbal supplements.
 Having high blood pressure.
 Having a BMI (body mass index) higher than 30.
 Having high blood sugar.
 Having sleep apnea.

106.  SYMPTOMS : Heart arrhythmia symptoms may include:
 Heart palpitations.
 Dizziness or lightheadedness.
 Fainting episodes.
 Shortness of breath.
 Chest discomfort.
 Weakness or fatigue.
 A cardiac arrhythmia may be “silent” and not cause any symptoms.

107.  DIAGNOSIS AND TESTS: A healthcare provider can find an irregular heartbeat during an
examination by taking your pulse and listening to your heart.
 After assessing your symptoms and performing a physical examination, they may order diagnostic
tests to help confirm that you have an arrhythmia. This can also help find the cause.
 Electrocardiogram (ECG or EKG).
 Blood tests to check your electrolyte levels or look for a genetic issue.
 Stress test.
 Echocardiogram.
 Cardiac catheterization.
 Electrophysiology study (EPS).
 Computed tomography (CT).
 Heart MRI (magnetic resonance imaging).

108. MANAGEMENT AND TREATMENT: Treatment depends on the type and severity of your arrhythmia. In
some cases, no treatment is necessary. Heart arrhythmia treatment options include:
 Medications.
 Lifestyle changes.
 Therapies.
 Devices.
 Surgery.
 Medications: Many medications can treat arrhythmias. Because everyone is different, you may have
to try several medications and doses to find the one that works best for you. Heart arrhythmia
treatments include:
 Antiarrhythmic drugs that convert the arrhythmia to sinus rhythm (normal rhythm) or prevent an
arrhythmia.
 Medicines that control your heart rate.
 Anticoagulant or antiplatelet therapy drugs (such as warfarin or aspirin) that reduce the risk of blood
clots forming.
 Medications that treat related conditions that may be causing an abnormal heart rhythm.

109.  Lifestyle changes: Simple changes to the way you live can help with
arrhythmias. These changes may include:
 Managing blood pressure and blood sugar levels.
 Avoiding tobacco products.
 Cutting back on alcohol intake.
 Avoiding caffeine and stimulants.
 Working toward a healthy weight.
 Therapies: In addition to medicine, some people need therapies to treat or
eliminate irregular heart rhythms. Your healthcare provider will determine the
best treatment for you and discuss the benefits and risks of these therapies
with you.
 Cardioversion: An electrical impulse synchronizes your heart and allows your normal rhythm to
restart.
 Catheter ablation: A catheter sends high-frequency electrical energy to a small area of tissue inside
your heart to “disconnect” the abnormal rhythm’s pathway. Ablation can treat most SVTs, atrial
flutter, atrial fibrillation and some atrial and ventricular tachycardias.
 Pulmonary vein isolation: This type of ablation creates rings of scars to isolate areas that may cause
atrial fibrillation. This can help people with frequent, paroxysmal or persistent atrial fibrillation.

110.  Devices: A cardiologist may insert certain devices during a procedure in the
electrophysiology lab. Devices to treat a heart arrhythmia include:
 Permanent pacemaker: This device sends small electrical impulses to your heart
muscle to maintain a normal heart rate and keep your heart from beating too slowly.
 Implantable cardioverter defibrillator (ICD): This device constantly monitors your
heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to
your heart muscle to make it beat in a normal rhythm. This device treats ventricular
tachycardia and ventricular fibrillation, two life-threatening heart rhythms.
 Biventricular (B-V) pacemakers and defibrillators (also called cardiac
resynchronization therapy or CRT): These devices help to synchronize the contraction
of your left ventricle. In addition to the leads that go to the right side of your heart, they
have a lead that goes to your left ventricle. People with heart failure and uncoordinated
left ventricle contractions may need this.

111.  Surgery: People with arrhythmias may require heart surgery for any of
these reasons:
 To treat heart disease that may be causing the arrhythmia, including
valve surgery or coronary artery bypass surgery.
 A maze procedure can correct atrial fibrillation that doesn’t respond to
medications or nonsurgical treatment methods.
 In some cases, a provider may place biventricular pacemaker leads (tiny
wires) on your heart using minimally invasive or surgical techniques.

113.  CARDIAC ARREST (SCA) is the sudden loss of all
heart activity due to an irregular heart rhythm.
Breathing stops. The person becomes
unconscious. Without immediate treatment,
sudden cardiac arrest can lead to death.
 Emergency treatment for sudden cardiac arrest
includes cardiopulmonary resuscitation (CPR)
and shocks to the heart with a device called an
automated external defibrillator (AED). Survival
is possible with fast, appropriate medical care.
 Sudden cardiac arrest isn't the same as a heart
attack. A heart attack happens when blood flow to
a part of the heart is blocked. Sudden cardiac
arrest is not due to a blockage. However, a heart
attack can cause a change in the heart's electrical
activity that leads to sudden cardiac arrest.

115. Causes
A change in the heart's electrical activity causes sudden cardiac arrest. The change makes the
heart stop pumping blood. No blood flow goes to the body.
Chambers and valves of the heart Enlarge
To understand sudden cardiac arrest, it may help to know more about the heart's signaling
system.
Electric signals in the heart control the rate and rhythm of the heartbeat. Faulty or extra
electrical signals can make the heart beat too fast, too slowly or in an uncoordinated way.
Changes in the heartbeat are called arrhythmias. Some arrhythmias are brief and harmless.
Others can lead to sudden cardiac arrest.

116.  Heart conditions that can lead to sudden cardiac arrest: The most common cause of
sudden cardiac arrest is an irregular heart rhythm called ventricular fibrillation. Rapid, erratic
heart signals cause the lower heart chambers to quiver uselessly instead of pumping blood.
Certain heart conditions can make you more likely to have this type of heartbeat problem.
 Coronary artery disease. Sudden cardiac arrest may occur if the heart arteries become
clogged with cholesterol and other deposits, reducing blood flow to the heart.
 Heart attack. If a heart attack occurs, often as a result of severe coronary artery disease, it can
trigger ventricular fibrillation and sudden cardiac arrest. Also, a heart attack can leave scar
tissue in the heart. The scar tissue can cause changes in the heartbeat.
 Enlarged heart called cardiomyopathy. This condition usually happens when the walls in the
heart muscle stretch. The heart muscle gets bigger or thicker.
 Heart valve disease. Leaking or narrowing of the heart valves can lead to stretching or
thickening of the heart muscle. When the chambers become enlarged or weakened because of
stress caused by a tight or leaking valve, there's an increased risk of developing a heart rhythm
problem.
 Heart problem present at birth, called a congenital heart defect. Sudden cardiac arrest in
children or adolescents is often due to a heart problem that they're born with. Adults who've
had repair surgery for a congenital heart defect also have an increased risk of sudden cardiac
arrest.
 Long QT syndrome (LQTS) and other heart signaling problems.

117.  The same things that increase the risk of heart disease can raise the risk
of sudden cardiac arrest. These include:
 A family history of coronary artery disease.
 Smoking.
 High blood pressure.
 High blood cholesterol.
 Obesity.
 Diabetes.
 An inactive lifestyle.
 Other things that might increase the risk of sudden cardiac arrest include:
 A previous episode of sudden cardiac arrest or a family history of it.
 A previous heart attack.
 A personal or family history of other forms of heart disease such as heart rhythm
problems, heart failure and heart problems present at birth.
 Growing older — the risk of sudden cardiac arrest increases with age.
 Being male.

119. Symptoms of sudden cardiac arrest are immediate
and severe and include:
 Sudden collapse.
 No pulse.
 No breathing.
 Loss of consciousness.
 Sometimes other symptoms occur before sudden
cardiac arrest. These might include:
 Chest discomfort.
 Shortness of breath.
 Weakness.
 Fast-beating, fluttering or pounding heart called
palpitations.
 But sudden cardiac arrest often occurs with no
warning.

120. Diagnostic investigation

121. Here are some common signs of cardiac arrest:
 Sudden loss of consciousness or responsiveness
 Lack of pulse
 Not breathing
 No response to shaking or tapping on shoulders
 Sudden collapse
 Complaint of chest pain, discomfort, or pressure
 Dizziness
 Nausea or vomiting

122. Treatment for sudden cardiac death includes:
 CPR. Immediate CPR is needed to treat sudden cardiac arrest If a pulse is not identified within 10
seconds, immediately begin administering CPR, starting with chest compressions. Compressions
should occur at a rate of 100 to 120 compressions per minute, with a depth of 2 inches. Use a
compression-to-ventilation ratio of 30 compressions to 2 breaths.
 Resetting the heart rhythm. The AED should be used as soon as it arrives or is ready. Follow the
prompts on the AED to check for a shockable rhythm. If the AED advises that the patient has a
shockable rhythm, follow the prompts, clear the patient, and deliver the shock. Immediately resume
CPR, starting with compressions, for 2 minutes or until the AED prompts you to check the patient’s
rhythm again. Compressions should not be discontinued for more than 10 seconds. Continue
providing CPR and following the AED prompts until ALS providers can take over or the victim begins
to breathe, move, or react.
 If the AED advises that the patient’s rhythm is non-shockable or no shock is advised, immediately
resume CPR, starting with compressions. Continue CPR for 2 minutes, or until the AED prompts you
to check the patient’s rhythm again. Compressions should not be discontinued for more than 10
seconds. Continue providing CPR and following the AED prompts until ALS providers can take over
or the victim begins to breathe, move, or react.
 Medicines to treat irregular heartbeats and to manage symptoms.
 Heart procedure or surgery to place heart devices or to treat a blockage.
 At the emergency room, health care providers run tests to check for the cause, such as a possible heart
attack, heart failure or changes in electrolyte levels. Treatments depend on the causes.
 Beta blockers.
 Angiotensin-converting enzyme (ACE) inhibitors.
 Calcium channel blockers.

128.  Surgeries and other treatments may be needed to correct a heart rhythm problem, open a blockage, or
place a device to help the heart work better. They may include:
 Implantable cardioverter-defibrillator (ICD). An ICD is a battery-powered unit that's implanted
under the skin near the collarbone — similar to a pacemaker. The ICD continuously monitors the
heart rhythm. If the device finds an irregular heartbeat, it sends out shocks to reset the heart's
rhythm. It can stop a potentially life-threatening change in the heartbeat.
 Coronary angioplasty. Also called percutaneous coronary intervention, this treatment opens
blocked or clogged heart arteries. It can be done at the same time as a coronary catheterization, a test
that doctors do to find narrowed arteries to the heart.
 The health care provider inserts a thin, flexible tube into a blood vessel, usually in the groin, and
moves it to the area of the blockage. A tiny balloon on the tip of the tube is widened. This opens the
artery and improves blood flow to the heart.
 A metal mesh tube called a stent may be passed through the tube. The stent stays in the artery and
helps keep it open.
 Coronary artery bypass surgery. Also called coronary artery bypass grafting or CABG, this surgery
creates a new pathway for blood to flow around a blocked artery to the heart. This restores blood flow
to the heart.
 Radiofrequency catheter ablation. This treatment is done to block a faulty heart signaling
pathway. A problem with heart signaling can cause an irregular heartbeat. One or more flexible tubes
called catheters are threaded through the blood vessels to inside the heart. Heat, called
radiofrequency energy, on the end of the catheter is used to create small scars in the heart. This
blocks the irregular heart signals.
 Corrective heart surgery. Surgery may be done to correct heart problems present at birth, heart
valve disease or diseased heart muscle.

129. Lifestyle and home remedies
 Preventing sudden cardiac arrest starts with keeping the heart and
blood vessels in good shape. To live a heart-healthy lifestyle:
 Don't smoke.
 Achieve and maintain a healthy weight.
 If you drink alcohol, do so in moderation — no more than one drink a
day for women and men older than 65 and no more than two drinks a
day for younger men.
 Eat a heart-healthy diet.
 Get regular exercise.
 Manage stress.

130. I SINCERELY
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