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Ischemic heart disease

 Ischemic heart disease caused by a narrowing of the coronary arteries that supply blood to the heart muscle. During this process- called atherosclerosis- calcium and fats accumulate on blood vessel walls causing considerable arteries narrowing and decreasing the ability to move oxygenated blood to the heart.

 In situations where the heart work increases, the oxygen consumption of the heart muscle increases as well, so in cases of significant arteries narrowing, the lack of oxygen in blood results in chest pressure also known as "angina pectoris." Angina causes a typical feeling of pressure in the chest, but can sometimes also manifest itself as heartburn, feeling of choking, shortness of breath, sweating and nausea.

The pace of development of arteriosclerosis depends on several risk factors, some of them are permanent and can not be treated such as age or familial tendency. Other risk factors such as smoking, hypertension, diabetes, overweight and fat increasing in blood – can be treated by means of drugs or by behavioral changes.

What is a myocardial infarction?

When atherosclerotic layer on the artery wall is torn, a blood clot is formed in the area. The clot can block the artery and cause myocardial infarction, also known as a "heart attack". Sudden complete blockage one of a coronary artery results in a drop of blood supply in a certain area of the heart muscle. This causes the necrosis of part of the muscle and the developing of a scar. In the early stage of blockage the clot can be dissolved via a medicine treatment or the blockage can be opened by urgent cardiac catheterization. Therefore, treatment as soon as possible is very important. After a 4-6 hours the damage to the heart muscle is not reversible.

What is coronary heart catheterization?

Cardiac catheterization is an investigation with the purpose of examining the flow of blood in the coronary arteries. By catheterizing the heart we can see narrowing or blockages of the coronary arteries, and, if necessary, to open them with the aid of a balloon. The catheterization is performed in an operating room with devices for monitoring heart rate and blood pressure. At a catheterization the doctor inserts a cuff into the femoral artery and advances the catheter through it up to the opening of the coronary artery. A contrast dye is then injected through the catheter and an image of the arteries is obtained using X-rays. The doctor can then examine the image to see the state of the arteries and diagnose narrowing or blockage.

Prof. Chaim Lotan

Born in Hadera, completed his medical studies at Hadassah Hospital in Jerusalem and his specialization in cardiology in 1985. Between 1987-1989 Professor Lotan was a research fellow of Cardiology Department at the University of Alabama, USA, where he performed research on heart imitation using magnetic resonance imaging (MRI). Upon his return to Israel in 1990, Prof. Lotan was a senior physician of the cardiology department. As the manager of the intensive care unit in 1991,he had a significant contribution to improvement of therapeutic and nursing approach and to establishment a computerized database. In 1995 he became a professor at Hadassah Hospital, and then he also founded the Department of Interventional Cardiology Later Professor Lotan was appointed as the director of the heart catheterization rooms at Hadassah, where under his management catheterizaton rooms of Hadassah became the leading center as well as the leading center for Interventional Cardiology research. Currently he is the director of the Heart Institute at Hadassah Medical Center in Ein Kerem.

(Translation by Dr. Izabella Zevin)

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