In cardiologist, Cardiology is an extensive branch of medicine dealing with the study of the human cardiovascular system: the structure and development of the heart and blood vessels, their functions, as well as diseases, including the study of the causes of their occurrence, development mechanisms, clinical manifestations, diagnostic issues, as well as the development of effective methods of their treatment, rehabilitation, and prevention.
The scientific advisory department (NCO) is one of the key links in public health after cardiac surgery in reducing risk factors for complications and adhering to the principles of evidence-based medicine. A multifactorial approach to treatment based on clinical guidelines, both in medical and economic aspects, is a necessary component of stage 3 of the rehabilitation of cardiac surgery patients.
3 Stage of the Rehabilitation of Cardiac Surgery Patients
Best Houston Cardiologistto analyzes the possibilities of improving the long-term results of surgical treatment of coronary artery disease based on the performance indicators of non-profit organizations for 16 years.
Material and Methods
the work is based on the analysis of the results obtained during the doctoral dissertation “Multifactorial approach to achieving optimal therapy after surgical treatment of coronary artery disease” (710 patients) and follow-up (from 2002 to 2018).
The main task of a cardiologist is to make an accurate diagnosis, if necessary, to carry out differential diagnostics between various diseases of the cardiovascular system. It is no secret that some diseases of the heart and blood vessels are, at first glance, very similar in their clinical manifestations. And only a cardiologist can focus on certain nuances that play a huge role in making the correct diagnosis. For the final diagnosis, it is necessary to carry out additional (laboratory, instrumental) examination methods, the technique of which must be perfectly mastered by each specialist.
The main research methods in cardiology are electrocardiography, angiocardiography, phonocardiography, and echocardiography. When should you go to the cardiology office? The answer is obvious – when a person has complaints. They can be varied – pain in the region of the heart of an aching or pressing character, as well as sharp, stabbing pains that occur when walking or at rest. Discomfort, heaviness in the chest on the left side, a feeling of interruptions in the work of the heart, palpitations – all this is also the reason for contacting the cardiological center. After all, it is no secret to anyone that any disease, including a disease of the cardiovascular system, is easier to prevent or treat in the early stages than to wait for complications that threaten a person’s life.
low follow-up rate of patients by cardiologists (57%) at the place of residence and adherence of patients to drug therapy with statins (40%), beta-blockers (49%), ACE inhibitors and / or angiotensin II receptor blockers (61.6%) , antiplatelet agents (89.7%), optimal drug therapy, including 4 classes of drugs (11.09%). A low frequency of target levels of blood pressure (20%), CStotal (40.3%), LDL-C (34.63%), body weight control (4.3%) was revealed. 35% of patients continued to smoke. On the other hand, patients’ lack of motivation for continuous therapy, self-control skills, and lack of patient awareness play a special role, as does the competence of medical personnel.
The introduction of a multifactorial program for monitoring the course of the disease allows to optimize the results of cardiac surgery, in a proven shorter time (after 3 months), to reduce the need for repeated hospitalizations; improve the quality of life, blood pressure, blood lipids, body weight and increase the physical activity of patients. Smoking cessation measures are ineffectively introduced.
The data obtained objectively show an unrealized reserve in the treatment of this category of patients, so the program includes routing of prehospital examination of patients, specialized field teams of cardiologists and cardiac surgeons have been created, which made it possible to make up for the lack of certified specialists in the field, telephone interviews for feedback, teleconsultations, training programs ” Advice from a cardiologist to a patient with coronary artery disease who underwent heart surgery. Improvement of reporting on the volume and quality of medical care and primary medical documentation was carried out.
Conditions have been created to ensure monitoring of patients in NGOs, as well as the availability and timeliness of medical care to each patient.