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Department of Surgery Referrals Patient Clinician Researcher

Cardiac Diseases

Diseases of the Heart

Columbia surgeons treat a wide variety of cardiac diseases and disorders, ranging from valve repair for prolapse to transplant for heart failure. A brief summary of some common conditions follows. To learn more about a specific condition, click on the links. For more information on the surgical management of these conditions, please go to Surgical Procedures and Innovations.

Dr. Emile Bacha - What types of heart diseases are treated with surgery?

Congenital Heart Disease refers to disorders of the heart that are present at birth and that can affect adult patients in many ways. This term encompasses a range of cardiac defects, including atrial septal defect (miscommunication between the right and left atrium), ventricular septal defect (a hole in the muscle which separates the right and left ventricles), and pulmonary stenosis (a narrowing of the valve between the right ventricle and the pulmonary artery).

Aortic Aneurysms are weaknesses or balloonings in the wall of the aorta. Aortic aneurysms require surgical treatment, since they can dissect (tear) or rupture (break open), both potentially fatal conditions.

Aortic Dissections are tears in the inner lining of the aorta that allow blood to flow through the walls of the aorta rather than remaining in the central channel (lumen). Type A dissections (beginning in the ascending aorta) require emergency surgery, while type B dissections (located under the collarbone) may be treated medically or surgically, depending on the severity of the complications.

Arrhythmia is a common form of defect in which the heart experiences an abnormal heart rhythm. Arrhythmias are known by where they occur in the heart and by their effect on heart rhythm. The two major types of heart arrhythmias are tachycardia (fast arrhythmia) and bradycardia (slow arrhythmia).

Cardiac Tumor is an abnormal growth of tissue in the heart, and may be either cancerous (malignant) or non-cancerous (benign). Primary cardiac tumors are extremely rare, and 75% are benign.

Cardiomyopathy or heart muscle disease affects approximately 500,000 new patients per year in the United States. This group of disorders directly damages the heart muscle, impairing its ability to pump blood to other parts of the body. There are two major categories of cardiomyopathy: primary cardiomyopathy, defined as changes in the structure or function of the heart muscle that cannot be attributed to a specific cause, and secondary, which is associated with disorders of the heart or other organs.

Congestive Heart Failure occurs when the heart is unable to maintain an adequate circulation of blood in the tissues of the body or to pump out the venous blood returned to it. This weakening of the heart prevents it from circulating a sufficient quantity of oxygen to the body's tissues. Common symptoms associated with heart failure are fatigue, shortness of breath, joint swelling and weight gain.

Coronary Artery Disease is the number-one killer of men and women in the United States. Also known as coronary heart disease, this disorder involves the progressive narrowing of the arteries that nourish the heart muscle. Often this disease is asymptomatic, but if one or more of these arteries become severely narrowed angina may develop during exercise, stress, or other times when the heart muscle is not getting enough blood.

Endocarditis is an infection involving the valves in the heart. A serious infection, endocarditis can have serious consequences if left untreated. The infection is typically caused by colonies of microorganisms, such as streptococcus or staphylococcus, that form wartlike growths on the surface of the heart valves. The infection progressively destroys heart valves, leading to heart failure.

Long QT Syndrome is a rare disorder of the heart's electrical system that can affect otherwise healthy people. Although the heart's mechanical function is normal, there are defects in ion channels, which are cell structures in the heart muscle. These electrical defects can cause a very fast heart rhythm (arrhythmia) called torsade de pointes. This abnormal rhythm (a form of ventricular tachycardia) is too fast for the heart to beat effectively, and so the blood flow to the brain falls dramatically, causing sudden loss of consciousness, or syncope.

Myocarditis is an inflammation of the heart muscle, usually as a result of a generalized infection or inflammatory disease. Viruses are the most common cause of this disorder, however, other potential causes include bacteria, rickettsiae, parasites, adverse drug reaction, or other complicating diseases.

Pericarditis is an inflammation of the pericardium, the membrane forming the outer covering of the heart. The inflammation causes a thickening and roughening of the membrane and an accumulation of fluid in the sac surrounding the heart. Most pericarditis in this country is caused by a viral infection. The disease also may be caused by bacteria, fungi, or parasites. There is also a noninfectious pericarditis; causes include disease of the underlying heart muscle, injury, and other diseases, such as rheumatoid arthritis, lupus erythematosus, or kidney failure.

Valvular Disease in the heart is caused by a number of conditions including congenital defects, such as rheumatic fever, or rheumatic heart disease. In heart valve disease, problems arise when a valve fails to close properly (mitral valve prolapse) or open properly (valvular stenosis). In either case, the heart has to work harder to pump enough blood to the body, eventually leading to heart muscle damage. Congestive heart failure, syncope (fainting), and arrhythmias are common signs of valve disease.

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