Cardiology

We are on the busiest cardiac centres in the country. Senior cardiologists are available for Outdoor consulting from 9am to 8pm and for any emergency 365x24x7.

You can schedule an OPD appointment with us for any of our cardiologist. We are fully equipped to handle any cardiac ailment under one roof. 

 

Medical Evaluation

Your doctors will talk with you about: 

 

·        The kind of heart problem you have, the symptoms it'''''''''''''''''''''''''''s causing, and how long you'''''''''''''''''''''''''''ve had symptoms

·        Your history and past treatment of heart problems, including surgeries, procedures, and medicines

·        Your family'''''''''''''''''''''''''''s history of heart problems

·        Your history of other health problems and conditions, such as diabetes or high blood pressure

·        Your age and general health

·        You also may have certain radiological test such as Chest X-ray, blood tests such as a complete blood count, a lipoprotein panel (cholesterol test), and other tests as needed.

 

 

Diagnostic Tests 

Any of the following specific diagnostic tests are done to find out more about your heart problem and your general health. This helps your doctors decide whether the line of treatment.

 

ECG (Electrocardiogram)  

An ECG is a simple, painless test that records the heart'''''''''''''''''''''''''''s electrical activity. This test is used to help detect and locate the source of heart problems.

A technician attaches sticky patches, called electrodes, to the skin of your chest, arms, and legs. The electrodes are attached with wires to a machine that records your heart'''''''''''''''''''''''''''s electrical signals.

An ECG shows how fast your heart is beating and whether its rhythm is steady or irregular. The test also shows where in your heart the electrical activity starts, and whether it'''''''''''''''''''''''''''s traveling through your heart in a normal way.

An ECG also can detect previous heart injury and whether your heart muscle is getting enough oxygen. In case you have any previous heart attack or other cardiac event it would reflect in your ECG.

 

Stress Test 

Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (or are given medicine if you'''''''''''''''''''''''''''re unable to exercise) to make your heart work hard and beat fast.

As part of the test, your blood pressure is checked and an ECG is done. Other heart tests also may be done.

 

Echocardiography

Echocardiography is a painless, noninvasive test. 

This test uses sound waves to create a moving picture of your heart. Echocardiography shows the size and shape of your heart and how well your heart chambers and valves are working.

The test also can show areas of poor blood flow to your heart, areas of heart muscle that aren'''''''''''''''''''''''''''t working properly, and previous injury to your heart muscle caused by poor blood flow.

 

 

In case the medical evaluation and diagnostics test indicate a heart problem then the doctor will recommend a coronary angiography.

 

Coronary Angiography

 

Coronary angiography uses contrast dye to make your coronary arteries visible on an x-ray image (called an angiogram). This test shows the location and severity of blockages in the blood vessels.

To get the dye to your coronary arteries, a procedure called cardiac catheterization is used. During this procedure, a thin, flexible tube called a catheter is passed through an artery in your arm, groin (upper thigh), or neck and threaded to your heart. The dye is injected into your bloodstream through the tip of the catheter. Cardiologists usually do cardiac catheterizations in a hospital. You'''''''''''''''''''''''''''re awake during the procedure, and it usually causes little to no pain. Special x rays are captured while the dye is flowing through your coronary arteries. Dye would not flow through the areas where the arteries are blocked.

After the angiography you would be counseled as to the extent of blockages and the options available to open / bypass the blockages to restore blood supply to all parts of the heart.

The primary two options recommended would be Coronary angioplasty or Coronary Artery Bypass Surgery (CABG). Coronary angioplasty can be done immediately after the angiography. However if the recommendation is for Bypass surgery then the patient would have to go through pre-operative evaluation before the surgery is done.

However if the patient has come in an emergency with an ongoing heart attack or acute coronary syndrome an emergency angiography followed by emergency Angioplasty / emergency CABG would be done.

 

 

Coronary angioplasty (Called Percutaneous Transluminal Coronary Angioplasty (PTCA))

Percutaneous transluminal coronary angioplasty (PTCA) is performed to open blocked coronary arteries caused by coronary artery disease (CAD) and to restore arterial blood flow to the heart tissue without open-heart surgery. A special catheter (long hollow tube) is inserted into the coronary artery to be treated.  This catheter has a tiny balloon at its tip. The balloon is inflated once the catheter has been placed into the narrowed area of the coronary artery. The use of fluoroscopy (a special type of x-ray) assists the physician in the location of blockages in the coronary arteries as the contrast dye moves through the arteries. The inflation of the balloon compresses the fatty tissue in the artery and makes a larger opening inside the artery for improved blood flow.  A stent which is a tiny, expandable metal coil is inserted into the newly-opened area of the artery to help keep the artery from narrowing or closing again.

Newer stents (drug-eluting stents, or DES) are coated with medication to prevent the formation of scar tissue inside the stent. These drug-eluting stents release medication within the blood vessel itself. This medication inhibits the overgrowth of tissue that can occur within the stent. The effect of this medication is to deter the narrowing of the newly stented blood vessel.

It is necessary to take a medication, such as aspirin or clopidogrel which decreases the "stickiness" of platelets (a type of blood cells that clump together to form clots to stop bleeding), in order to prevent blood clots from forming inside the stent.

 

 

Atherectomy

The physician may determine that another type of procedure is necessary during / before PTCA. This may include the use of atherectomy (removal of plaque) at the site of the narrowing of the artery. In atherectomy, there may be tiny blades on a balloon or a rotating tip at the end of the catheter.

When the catheter reaches the narrowed spot in the artery, the plaque is broken up or cut away to open the artery. Atherectomy is used when the plaque is calcified, hardened, or if the vessel is completely closed.

 

 

Electrophysiological study and Ablation

An EP study may be performed for the following reasons: 

·         To evaluate symptoms such as dizziness, fainting, weakness, palpitation, or others for a rhythm problem when other noninvasive tests have been inconclusive

·         To locate the source of a rhythm problem

·         To assess the effectiveness of medication(s) given to treat a rhythm problem

·         To treat a heart rhythm problem

An electrophysiological study (EP study) is an invasive procedure that evaluates abnormal heart rhythm disturbances.

During an EP study, small, thin wire electrodes are inserted through a vein in the groin (or neck, in some cases). The wire electrodes are threaded into the heart, using a special type of X-ray, called fluoroscopy. Once in the heart, electrical signals are measured. Electrical signals are sent through the catheter to stimulate the heart tissue to try to initiate the abnormal heart rhythm disturbances for evaluation.

There are several ways EP studies may assist in diagnosing heart rhythm abnormalities. An abnormal rhythm may be deliberately stimulated by a doctor during the EP study so that the underlying problem can be identified. The abnormal heart rhythm may also be stimulated to evaluate the effectiveness of a drug.

During the EP study, doctors may also map the spread of electrical impulses during each beat. This may be done to locate the source of an arrhythmia or abnormal heart beat. If a location is found, an ablation (elimination of the area of heart tissue causing the abnormality) may be done.

The results of the study may also help the doctor determine further therapeutic measures, such as inserting a pacemaker or implantable defibrillator, adding or changing medications, performing additional ablation procedures, or providing other treatments.

Other related procedures that may be used to assess the heart include  Holter monitor,  computed tomography (CT scan) of the chest, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, and cardiac CT scans. 

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