EDITOR’S NOTE: Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in HEALTHWISE MAUI, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

Q: How does cardiac catheterization clear blocked heart arteries?

Dr. Jason Call, Interventional Cardiologist, Pacific Permanente Group: Cardiac catheterization is a procedure performed by interventional cardiologists. These are doctors who specialize in treating blocked arteries and certain heart problems, often using medical devices called catheters.

A catheter is a small tube that can be threaded through your blood vessels to reach your heart. This tube is used to take pictures of your arteries and as a conduit to deliver stents to fix blocked arteries.

In a heart catheterization, you will first be given a local anesthetic to numb the area of insertion which is typically the wrist or groin. A large IV known as a sheath will be inserted into the artery. Through this sheath a small wire is inserted and goes up through the arteries to your heart. Then the small tube known as a catheter is advanced over the wire to reach your heart.

Contrast is injected through the long tube and into your heart arteries. An X ray machine takes pictures of your artery with the contrast in them. This is how a blocked artery is found. The blockage can then be fixed by advancing a very small wire through the long tube and then down your artery passed the blockage. Over this wire a deflated balloon is advanced to the blockage and then inflated to move the blockage aside. The balloon is removed and then a stent is advanced over the very small wire to the blockage. The stent comes crimped on a balloon and the stent balloon is inflated to expand the stent which holds the blockage open. The balloon is then deflated and the expanded stent stays in place, restoring normal blood flow to your heart.

If you have chest pain or other symptoms, make an appointment right away. Getting treatment for a blocked artery quickly can resolve the problem and prevent it from becoming an emergency.

At Maui Health, our interventional cardiologists are experts in coronary interventions and other specialized heart procedures. Our multidisciplinary team works together to diagnose and treat a variety of heart conditions, so you can get the care you need without having to travel off island.

To make an appointment with a heart specialist, call the Maui Memorial Medical Center Outpatient Clinic at 808-442-5700.

Q: What is nuclear medicine imaging, and how is it different from other scans?

Dr. Rosaleen Parsons, FACR, FSAR, Chair of Radiology, Maui Health: Nuclear medicine imaging is a non-invasive scan that uses tiny amounts of radioactive material to create images of tissues in the body. In some cases, it can also help show how well certain organs are functioning and check blood circulation. This can help diagnose different diseases and conditions.

Unlike other types of imaging tests, nuclear medicine works by introducing a radioactive tracer into the body, either by injection or by mouth. A special camera then detects the radiation coming from the tracer and uses this information to create images of your internal organs and tissues. These images can show details like where the tracer accumulates, how it moves through the body, and where organs may be failing to absorb it normally.

Nuclear medicine imaging is safe. Tracers have an extremely low level of radiation, and your total radiation exposure will be similar to an X-ray. All the radiation will leave your body within a day.

Nuclear imaging can be used to look at many different parts of the body, including the heart, kidneys, thyroid, blood vessels, bones, breasts, and brain.

Some of the conditions it can be used to diagnose include cancer, thyroid disease, kidney disease, gallbladder disease, heart disease, blood disorders, bone and joint problems, infections, and more. Nuclear imaging can also be used to monitor the progress of cancer treatment and see if a tumor is growing or shrinking over time. For advanced imaging needs, such as positron emission tomography (PET) scans–a specialized form of nuclear medicine often used in cancer diagnostics–we work with other trusted facilities to ensure patients have access to the necessary diagnostic care.

The bottom line is that nuclear medicine imaging is a safe technology that can help doctors quickly and correctly diagnose your condition so you can start treatment.

Maui Health’s imaging department offers the latest and most advanced imaging technology and tests, including nuclear medicine. Learn more about our services at mauihealth.org/imaging.