In this article, we will compare and contrast these two types of procedures used in cardiology. The word comes from Greek – kardia (heart) and logia (study).
First, a brief explanation of the specialty of cardiology is in order. As you know, it is the branch of medicine that includes the diagnosis and treatment of conditions related to the heart. Examples are congenital heart defects, coronary heart disease, valvular heart disease, hypertension, arrhythmia, and more.
There are subspecialties within the field of cardiology, such as pediatrics, cardiothoracic surgery, clinical cardiology, and interventional cardiology. The latter involves the use of catheters as a treatment of structural diseases of the heart. This form of diagnosis and therapy applies to pediatric, as well as adult cardiology.
Invasive Cardiology
The term applies to many types of medical procedures. For example, in cosmetic or plastic surgery, an invasive procedure refers to a facelift, rhinoplasty, breast augmentation, arm lift, and many more. Simply stated, invasive involves incisions in the skin as the means to perform a particular procedure.
In cardiology, two common types are angioplasty and stenting. The former’s more technical name is a percutaneous coronary intervention. The procedure requires the insertion of a tube or catheter into the groin or wrist, which the surgeon threads towards a clogged artery. Typically, the catheter has a tiny inflatable balloon attached, which, when inflated, displaces the plaque or clot in the affected artery. The minimally invasive surgery can be life-saving, and it is relatively safe. Also, despite being an invasive procedure, general anesthesia is not necessary in many cases.
The cardiologist may perform a stent placement in conjunction with the balloon angioplasty. The stent is a wire mesh designed to prevent the artery from narrowing or clogging following the previous procedure.
Another invasive procedure with minimal incision is the insertion of a pacemaker. This small electronic device regulates a slow heartbeat through the leads connected to the heart. The device replaces or supplements the heart’s natural pacemaker: the sinoatrial or sinus node. The cardiologist may place the pacemaker externally or internally, just below the skin. The procedure requires only a local anesthetic at the insertion site. Therefore, the patient usually returns home the same day.
Minimally invasive heart surgery or robotic surgery involves one or more small incisions made on the right side of the chest. This method contrasts with open-heart surgery that entails cutting through the breastbone and separating the rib cage to access the heart. Coronary bypass, valve surgery, and aneurysm repair are examples of robotic heart surgery.
Non-invasive cardiology
Some of the procedures above can be performed with local anesthesia, making them appear to be non-invasive. However, this category addresses diagnostics that have no incisions, insertions, or punctures of the skin. Instead, the cardiologist uses fluids, needles, or other instruments externally to diagnose heart diseases. Non-invasive procedures can be as easy as listening to a heartbeat, taking blood pressure readings, and monitoring vitals during a stress test on a treadmill. These assessments are useful in cases where patients experience chest pain, which could be due to a clogged artery, or other heart ailments.
A standard test done in a cardiologist’s or internal medicine doctor’s office by a technician or nurse is an electrocardiogram (EKG or ECG). The patient has several electrodes attached to the body from the chest to the ankles. Wires from each one connect to the EKG machine. The readout is almost instantaneous after the push of a button. The physician reads the squiggly lines on the tape to determine any abnormalities in the patient’s heart rhythm.
Computer imaging is a type of non-invasive procedure that uses diagnostic equipment to see a patient’s heart condition. Examples are the CT scan and the MRI. The computer tomography (CT) produces images of the heart with or without the intravenous injection of contrast or dye. The dye creates a better visual representation of the heart anatomy, as well as the aorta, pulmonary veins, and arteries. A CT scan has various types of which the main ones are a calcium-score scan, coronary angiography (CTA), and total body scan. The cardiologist uses the calcium-score screening heart scan to detect calcification from atherosclerosis (hardening of the arteries). The test will also evaluate the risk of future coronary artery disease.
The only part invasive about the non-invasive procedure is the injection of contrast for specific scans. However, this puncture of the skin is much less painful and anxiety-provoking as the invasive methods requiring incisions and robotic surgery. Many of the non-invasive tests may lead to one of the invasive procedures, as the purpose of the former techniques is diagnostic tools – in contrast to the invasive practices, which are corrective strategies.
Additional Resources
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What exactly is a pacemaker and how does it help someone?
What is Interventional Cardiology?
What are some of the typical non-invasive, invasive, and interventional surgeries in cardiology?