CARDIOLOGY

CARDIOLOGY

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WORLD CLASS CARDIOLOGY MANAGEMENT IN INDIA - SUCCESS FACTORS FOR EXCELLENT OUTCOMES

The most experienced cardiologists in the world

Highly skilled team of cardiologist with huge experience and trained around the world who have the capability of managing the most complex of cardiac disorders and deliver clinical outcomes at par with global standards.

NABH and JCI accredited world class hospitals having state of the art facilities.

Angiography

Angiography in one of the most advanced cath-labs in  the world at the hands of the most experienced of interventional cardiologists.

Electrophysiology Lab

Facilities to perform electrophysiology study in the most advanced labs to detect and treat electrical distortions in the activity of the heart.

256 slice CT and PET-CT

The latest 256 Slice CT scan and PET-CT scan machines for patients who prefer non-invasive alternatives for Cath-lab angiographies and other vital investigations

SPECT Thallium

Myocardial perfusion SPECT to evaluate damage that might have been caused by a myocardial infarction (heart attack) and to assess the presence and extent of myocardial ischemia (reduced blood flow due to obstruction in the vessels).

Cardiology (Medical Management)

Cardiology (Medical Management)

Cardiology is all about the human heart. A cardiologist specializes in surgeries related to the heart. There are various categories and sub-categories of heart problems. Based on these categories, the surgeons specialize in one or two categories and perform the required procedures and surgeries. On this page we’ll talk about cardiac diseases and disorders that can be medically managed. Our centers are known as the best cardiac centers in India, with the most experienced team of cardiologists. Some of the most common diseases/disorders that can be medically managed are:-

Hypertension (High Blood Pressure)

Hypotension, genetic or heart failures

Palpitations

Heart Failure management

Cardiology involves managing patients cardiac disorders/diseases through drugs and various lifestyle changes. Maximum people after the age of 50 develop some kind of cardiac disorder including hypertension or a weak heart. These can be avoided through a regular annual check-up of the heart. We strongly encourage everyone to go through these.

 

Angioplasty

COMPREHENSIVE RANGE OF ADVANCED SERVICES OFFERED BY HEALTH & HOLIDAYS

Our staff is sensitive to the needs of the patients and stand with you every step of the way.  They are capable to deliver assistance 24*7 in case of emergencies.

  • Pre-arrival, no-obligation free quote for your medical condition along with consultations and selection of best doctor/hospital

  • At H&H, all our assistance services are complimentary and you are not charged extra at the hospital if you go through us or go directly. Rather we have the capability of getting you the best prices.

  • Dedicated case manager as one-point contact for all your needs while you are here with us,also responsible to help you get the best price for your procedure

  • Complimentary Airport Pick-up/Drop, Translation,Interpretation services and assistance in choosing the best accommodation.

  • Complete assistance in making the right decisions when choosing the best procedure and full support during your stay at the hospital

  • When you’re back in your home country, we are always a click/call away for your regular follow-up, your visit was just the beginning of our relationship

Pre – Treatment

Cardiac disorders require extensive check-up of the heart which may include Blood investigations, ECG, 2D-Echo, TMT, Dopplers and Angiography among others. Most of these checks are offered in a package to offer patient convenience and affordability. They can be completed over 1-2 days and once the reports are collated, your cardiologist devises a treatment plan. The treatment plan may include drugs, interventional procedures, surgery or a combination of each.

Post – Treatment

Most cardiac disorders require regular follow-ups with your cardiologist in order to adjust your drug dose and monitor the progress or stability of the disease. These may be required once in 3 months or 6 depending on the disorder/disease. We can very much arrange these follow-ups via internet if the required investigations can be done in your home country.

TMR (Transmyocardial Revascularization)

TMR (Transmyocardial Revascularization):-
TMR stands for Transmyocardial Revascularization .TMR is a type of surgical procedure performed in the treatment of stable angina that cannot be treated with medication. TMR is used as a treatment only if typical treatments like angioplasty or bypass surgery cannot be worked. Laser is used during the procedure to make channels in the left ventricle of the heart.

How is TMR Performed?

  • An antibacterial solution is applied on the left side of the chest.
  • A sedative is given through an intravenous line.
  • Electrocardiogram isused to monitor the heart rate and blood pressure.
  • Once the anesthesia is managed, an incision is made on the left side of the chest.
  • Channels of about one millimeter in size are assembled in the left ventricle with the help of a special laser.
  • Bleeding of the channels is brought  to an end by pressing on them gently.

How to Prepare for TMR?

  • The patient’s medical condition is discussed by the doctor.
  • Cardiac catheterization is usedto view the coronary arteries and blockages if any.
  • Echocardiogram isused.
  • Positron Emission Tomography (PET) is used to evaluate the function of the heart.
  • Other tests like Dobutamine Echocardiography and Cardiac MRI are also us

Duration of procedure/surgery :1 to 2 hours

Days admitted :4 to 7 days

Anesthesia :General Anesthesia

Recovery :– A complete recovery may take about three months.
– Some patient may experience immediate relief after TMR.
– The patient may still be required to take medications after TMR to improve blood flow.

Risks :– Chest pain
– Heat valve damage
– Heart failure
– Heart rhythm problems
– Blood vessel damage
– Heart attack
– Low blood pressure

After care :– The patient should abstain from strenuous activities.
– Specific activity guidelines are given to the patient.
– The patient may need to undergo a cardiac rehabilitation program to help in recovery.
– The patient needs to meet the cardiologist frequently for follow up visits to monitor the progress after the TMR.

 

Electrophysiology (EP) study

What is an Electrophysiology (EP) study?

This is a type of test which is used to record the electrical pathways and activity of the heart. An electrophysiology study is executed by an electro physiologist who is a medical doctor who specializes in the treatment, diagnosis, and management of abnormal heart rhythms.
Why do I need an EP study?

  • To decide which is the best treatment for an abnormal heart rhythm
  • To determine the best device before ICD (implantable cardioverter/defibrillator) placement
  • To identify the causeof  abnormal heart rhythms
  • To locate the origin of an abnormal heart rhythm
  • To monitor the success of the treatment.

How should I prepare for the EP study?

  • If you are taking any medications ,do so with only a small sip of water. You should not drink or eat anything the evening before the electrophysiology study. If you will be discharged on the same day you will need someone to drive you home.
  • Discuss with your doctor what medications you are taking so that you can be advised on what to avoid or take. If you have some health conditions such as diabetes, your doctor willadjust your medications.

How is the procedure performed?

  • You will lie on a bed an intravenous line (IV) will getstarted in your arm. This is to enable you to receive fluids and drugs (to make you feel relaxed ) during the procedure.
  • You will be connected to several monitors. A nurse will shave your groin and cleanse it with an antiseptic solution. Sterile drapes will be used to cover you from your neck to your feet. A soft strap will be tied across your arms and waist to prevent your hands from touching the sterile field.
  • The electrophysiologist will numb the skin in your groin with medication. He/she will then insert several catheters into the vein beneath the skin. The catheters are threaded to your heart guided by a fluoroscopy machine. Electrical impulses will be delivered to your heart by a pacemaker. The catheters evaluate the conduction system of your heart by sensing electrical activity in your heart.
  • Your doctor will reproduce your abnormal heart rhythm. He/she may then give you various medications to see which one controls the abnormal heart rhythm best. This can also be done to determine the best device or procedure to use in treating your abnormal heart rhythm.
  • During the procedure, you may feel your heart beating stronger or faster. You should let the doctor or nurses know if this or another symptoms occur. Depending on the results of the EP study the doctor may decide to continue with a different procedure such as catheter ablation procedure or device implant such as a pacemaker.

How long does the EP study last?

  • The test usually takes about two to four hours to perform.
  • However, this may takelonger depending on if additional procedures or treatments are performed at the same time such as catheter ablation.

After the EP study?

  • You will need to rest in bed for about one to two hours.
  • If there are no complications, you can go home the same day.
  • After the EP study, the catheters will be removed from your groin.
  • To prevent bleeding, pressure will be applied to the entry site.

Risks :-Arrhythmias -Infection –

Bleeding

-Blood clots that lead to embolism

-Injury to the vein

-Low blood pressure

-Heart attack

-Stroke

 

Congenital Heart Disease

Congenital Heart Disease:-

Congenital heart disease is also called a congenital heart defect. It is an abnormality of the heart that exists at birth. The defect generally influences heart organs such as the blood vessels, valves or the heart walls. The disease ranges from minor defects to censorious conditions that can result in the death of the affected individual.

Types of congenital heart disease

The congenital diseases can be classified into three main groups:

  • Valve congenital diseases– these defects may affect the flow of blood in the heart. The valves may open and close irregularly.
  • Blood vessels congenital defects– This condition may develop into a chronic disease if not rectified quickly. Includespoor functioning of weak blood veins and arteries carrying blood in and out of the heart.
  • Heart wall congenital diseases-these defects create the walls of the heart chambers grow in a defective manner hence causing pumping of blood in the chambers very hard. This defect makes the heart try to pump the blood in a high pressure which may result in hypertension.

Other types

Cyanotic and Acyanotic Congenital Heart Disease

In both of these defects, the blood from the heart is not pumped in the accurate manner. The main difference between acyanotic and cyanotic defects is that cyanotic defects cause low oxygen levels in the blood while acyanotic conditions blood is pumped in low levels. The heart fails to pump enough blood to be supplied to the body due to defects of the heart. Babies born with these defects will have developed the blue-baby disease or breathing problems. The condition may develop later in life resulting in high blood pressure.

Symptoms of congenital Heart Disease

Mostly congenital defects are discovered during an ultrasound scan. Treatment may start instantly or when approved by the doctor. Babies with congenital defects may show symptoms such as:

  • Breathing complications
  • Blue skin and toes
  • Low weight at birth
  • Suckling difficulties
  • Chest complications
  • Stunted growth

 

In cases where the conditions develop in later years, the symptoms may include:

  • Breathing problems
  • Swellings on the skin
  • Seizures
  • Frequent dizziness
  • Irregular heartbeats
  • tiredness after minor tasks

Causes congenital heart disease

  • Conditions such as diabetes during pregnancy
  • Pregnant mothers who have viral diseases may end up giving birth to babies with heart conditions
  • The heart defect may be a hereditary case
  • Intake of certain prescription drugs
  • Consuming alcoholic beverages and other illegal substances

Treatment of congenital heart diseases

The type of the disease controls the type of treatment given to the patient. Some of the diseases can cure on their own when the kid is still young while others require intense treatment. The following are some of the advanced treatment options available:

  • Catheter Procedures: Catheter procedures includes repair of definite congenital heart disease without performing surgery on the chest or heart. The procedure includes insertion of a thin tube through a vein in the leg up to the heart. The doctor will then use this tube to pass small tools through it and correct the condition.
  • Prescribed Medications: These medications are used to prevent conditions such as blood clot in heart blood vessels and irregular heartbeat.
  • Implantable Heart Devices: These devices involve heart pacemaker and implantable cardioverter defibrillators. The heart pacemaker restores the normal heart beat rate while the implantable cardioverter defibrillator corrects the adverse irregular heart beat syndrome.
  • Open-Heart Surgery:The surgery corrects defects such as holes in the heart, constricted blood vessels and dysfunctional heart valves.In cases of extreme conditions, surgery is necessitated.
  • Heart Transplant: This option is the last in case of maximal defects. A totally shuttered heart will need replacement from a donor.

How to prevent congenital heart diseases

If you are pregnant, there are various precautionary measures you can undertake to prevent your unborn kid from developing a congenital heart defect:

  • Ensure that any medications you take are prescribed by a qualified physician
  • Undergo genetic screening if your family has a history of congenital heart disease.
  • Avoid consumption of alcoholic beverages or prohibited drugs.
  • For those with diabetes, ensure that you control your levels of blood glucose before becoming pregnant.
  • Get rubella and measles vaccination and avoid contracting the diseases

 

Coronary Heart Disease

What is Coronary Heart Disease?

Coronary heart disease (CHD) is a disease which develops when plaque (a waxy substance) grows inside the coronary arteries.

What are the symptoms of CHD?

  • Shortness of breath:When the heart cannot pump enough blood to the body it results in extreme tiredness or shortness of breath.
  • Chest pain:  It is also called angina. It is identified by tightness or pressure inthe chest. It is generally triggered by emotional or physical stress.
  • Heart attack:This may occur when a coronary artery becomes totally blocked.
  • Other symptoms involves, neck pain, sweating, jaw pain, and tiredness.

Treatment

Although the disease cannot be healed,treatment options are available which help control the symptoms and reduce the risk of complications. These involve lifestyle changes, surgery and medications.

 

Lifestyle changes

Treatment involves stopping smoking. This can reduce the risk of having a heart attack. Making dietary changes ensure that meals are well-balanced and Being healthy is also very important. In addition, you should ensure that you exercise regularly.

Medication

Medicines aim at either widening the arteries or reducing blood pressure. Some medicine may have side effects so it may take some time in finding the one that works right for you. Medication should not be stopped suddenly as this may worsen the symptoms. Medications used to treat coronary heart disease involve:

  • Antiplatelets:This helps reduce the risk of heart attack by thinning your blood to prevent clotting.
  • Statins:These are cholesterol lowering medications that your doctor may prescribe. They block the formation of cholesterol and increase the number of LDL receptors in the liver which help remove cholesterol from your blood.
  • Beta-blockers:They are used to treat high blood pressure and prevent angina. They slow down the heart beat and improve blood flow.
  • Nitrates:These relax your blood vessels allowing more blood to flow through. They lower blood pressure and widen the blood vessels.
  • ACE (angiotensin-converting enzyme) inhibitors:They improve blood flow by blocking the activity of a hormone called angiotensin II which causes blood vessels to become
  • Angiotensin II receptor antagonists:This one lowers blood pressure by blocking angiotensin II.
  • Calcium channel blockers:They relax the heart’s wall muscles and lower the blood pressure.
  • Diuretics:They are used to flush excess water and salt from the blood through urine.

Side effects of medications

  • Dry cough
  • Headaches
  • Facial flushing

Surgery

If the symptoms cannot be controlled by lifestyle changes or medications your doctor may recommend surgery. Surgical procedures involve:

  • Coronary angioplasty:It is also mention to as percutaneous transluminal coronary angioplasty (PTCA), percutaneous coronary intervention (PCI), or balloon angioplasty. It involves inserting a small balloon which pushes the fatty tissue in the narrow arteries outwards. This allows for increased blood flow. A metal stent is then placed in the artery to hold it open.
  • Coronary artery bypass graft (CABG):It is also referred to as heart bypass, bypass surgery or coronary artery bypass surgery. It involves inserting a blood vessel between the aorta and a part of the coronary artery beyond the blocked or narrow area. This allows blood to bypass the affected arteries.
  • Heart transplant:This is done when the heart is too damaged and all other options are ineffective. It involves replacing the heart (that is damaged or not working properly) with a healthy heart donated.

 

Echocardiology

What is Echocardiology?

Echocardiology is type of a branch of medicine that studies how to get and interpret ultrasonic images of the heart. Echo-cardiologists work together with cardiologists to diagnose and treat problems associated with peripheral blood vessels and the heart. It uses ultrasounds to measure the heart’s performance and to create images of the heart.
What is an Echocardiogram?

It is a type of test that uses sound waves sent through a transducer. It is also called as an echo. This test is non-invasive and does not have any known side effects. The echoes displayed on a video screen as moving pictures of your heart.
Who performs an Echocardiography?

An echocardiology test is performed by an echocardiology technician, also referred  as a cardiovascular sonographer.
Why is an echocardiogram performed?

  • To control  the overall function of your heart
  • To identify the presence of any type of heart diseases such as valve disease, congenital heart disease, cardiac masses, pericardial disease, infective endocarditis, and myocardial disease.

To follow up on the progress of valve disease

  • To determine the effectiveness of your present surgical or medical treatments.
  • To evaluate wall motion and systolic function
  • To evaluate diastolic function
  • To evaluate pericardial disease and effusion
  • To assess pulmonary pressure
  • To check the thickness of the heart wall
  • To evaluate how well an artificial heart valve is functioning
  • To measure the shape and size of the heart’s chambers
  • To evaluate cardiac performance
  • To locate tumors and blood clots inside the heart.

Types of echocardiograms

  • Transthoracic echocardiogram (TTE):During this test, the transducer is moved to the several locations on the abdominal wall and chest.
  • Stress echocardiogram:This test is done while at rest and then again after your heart is stressed. The heart can be stressed through exercise or injecting a drug t make it beat faster and harder.
  • Doppler echocardiogram:This test is used to observe the flow of blood through the heart chambers, valves, and the blood vessels.
  • Transesophageal echocardiogram (TEE):During this test a probe is passed through the esophagus to show clearer images. An anesthetic and sedative are applied to the throat.

How is the test performed?

  • Three electrodes which are attached to an electrocardiograph will be placed on your chest by the sonographer. The electrocardiograph (EKG) monitor is used to chart your heart’s activity during the test.
  • You will lie on the examination table on your left side. A gel which helps produce clear images will be poured on the chest area. The sonographer will place a transducer on various areas of your chest. You may also be asked to hold your breath for a while. The sonographer may ask you to change positions during the test.
  • The test generally takes less than an hour and you may resume regular activities immediately after the test. You may experience coolness from the gel and some pressure from the transducer but no major discomfort..

How to prepare for the test

  • You can eat and drink as normal on the day of the test.
  • If you are under any medications, you should continue taking them as prescribed.
  • A medical gown will be provided for you to wear during the test.
  • Your doctor will discuss with you the procedure and possible side effects or complicationsetc.

 

Enhanced external counterpulsation

What is EECP?
Enhanced external counterpulsation (EECP) is a type of procedure for the treatment of angina, cardiomyopathy or heart failure. It reduces symptoms of ischemia, and supplements the functional ability and quality of life of the patient.
EECP is a type of noninvasive procedure that uses inflatable cuffs to compress the blood vessels of the lower limbs. These cuffs are set around the calves, thighs and buttocks of the patient. In this method, the blood flow in the coronary arteries grow.
EECP is increased by computer technology, blood pressure monitors and electrocardiography. These facilitate right timing of the inflation and deflation of the pressure cuffs with the heart beat and blood pressure of the patient.

How is EECP Performed?

  • The patient is required to lie down on a bed.
  • The patient’s calves, thighs and buttocks are wrapped around with blood pressure cuffs.
  • The patient’s systole and diastole of the heart is measured by placing three ECG stickers on the patient’s chest.
  • When the heart relaxes at the precise time of diastole, the cuffs start inflating from the calves, moving upwards to the buttocks. This leads to a counter pulsation of the blood.
  • When the heart contracts, the cuffs quickly deflate and relax. The sensation may feel like a firm massage.

What is the Treatment Regimen of EECP? EECP consists of 35 hours of treatment. The patient may take one hour session per day. The patient may also take two hours of treatment in a day, with a gap in between the first and second hour. In some cases, patients may need additional treatments if they do not respond to the treatment by the 30th session.
After the treatment course is complete, the patient can still carry on with a preservation dose of EECP for one to two days a week.

How to Prepare for EECP?

  • The patient’s blood pressure, pulse, breathing rate and weight are examined.
  • The patient’s legs are checked for symptoms of possible vascular problems.
  • The patient is required to wear tight fitting clothing such as athletic tights to avoid chafing.
  • The patient is informed about the benefits and risks of EECP by the health care team.
  • The patient needs to sign a consent form before the procedure.
  • The patient is asked to stop smoking and using tobacco products.

 

Duration of procedure/surgery :One to two hours per session.

Days admitted :EECP is performed as an outpatient procedure.

Anesthesia :None.

Recovery :

– EECP is called to benefit patients with results similar to angioplasty and bypass surgery. Significant improvements are observed after EECP among 80% of the patients.
– As EECP does not completely prevent recurrent coronary artery disease, the patient needs to make lifestyle changes and take the prescribed medications.

Risks :EECP is a safe treatment. A side effect that may result is chafing and leg pain due to the compression caused by the cuffs.

After care :– The patient should quit smoking as smoking damages blood vessels and causes high blood pressure.
– The patient should maintain a healthy weight by following a thoughtful diet and exercising.
– A cardiac rehabilitation exercise program that is supervised by professional is beneficial for the patient.
– The patient’s diet should consist of fruits, vegetables, whole grains, and non-fat dairy products.
– Some prescribed medications need to be taken on a life-long basis.
– The patient should follow up with the doctor regularly.

 

Nuclear Cardiology

What is Nuclear Cardiology?

Nuclear cardiology is a type of branch of medical imaging to assess disorders of the heart. The study uses techniques that are non-invasive and minimal amounts of radioactive tracer material.
Why the test is performed?

  • To visualize the size of a heart attack
  • To evaluate how the heart is pumping
  • To control if you are at risk for heart disease
  • If you experience aggravate angina or new pain in the chest
  • To diagnose coronary heart disease
  • To evaluate how well a treatment such as medication, angioplasty or heart surgery is working
  • To determine the best treatments for diagnosed disorders
  • To determine the size of your heart
  • To determine the extent of coronary heart disease

Types of nuclear cardiology techniques

  • Myocardial perfusion imaging: This test can be done in a hospital or outpatient center. Exercise on a stationary bicycle or treadmill or an extra special drug is used to stress the heart. This technique is executed by injecting a small amount of radioactive material into the patient. A gamma camera is used to measure the uptake of the imaging material by the heart during stress and at rest. The doctor then waysthe blood flow through the heart observing for any blockages specified by decreased blood flow. Myocardial perfusion imaging is also used by doctors to evaluate the heart’s pumping function and the extent of damaged heart muscle. It enables the doctor to identify which patients require invasive procedures such as heart surgery, angioplasty, and coronary angiography.
  • PET rubidium study: This non-invasive technique is used to observe the heart’s metabolic activity and provide the doctor with information about the blood supply to the heart muscle. The PET rubidium study gives clear resolution than standard technology as it is more sensitive. This test  generallytakes less than an hour.
  • It is also able to manifest which heart muscles can recover if an angioplasty or bypass surgery is performed thus determine which patients are candidates for the procedures. This technique is able to show scarred heart muscle from previous heart attacks. It is also able to evaluate the heart’s nervous system.
  • MUGA (Multigated Acquisition) scans: This technique is used to control if the heart is properly pumping blood by designing images of the ventricles. It is able to show the size of the ventricles, blood flow through the heart and any abnormalities that are present. This technique is also called as radionuclide ventriculography.

How the test is performed?

  • You will then put your heart under stress by exercise such as walking on a riding or treadmill a stationary bicycle. This can also be done by using medication that the doctor will give you to make your heart beat harder and faster. The radioactive material will be injected in again. You will wait for 15 to 45 minutes for the gamma camera to scan your heart and take images of the blood flow.
  • Throughout the test, your heart rhythm and blood pressure will be monitored. The doctor uses the two sets of images to identifyyou or detect if any existing conditions have worsened or improved.
  • You will have an intravenous line (IV) begun and a radioactive substance will be injected in. You will lie down and wait for about 15 to 45 minutes. A gamma camera will scan your heart and create images showing how the substance has traveled through your blood vessels and into the heart.
  • This test can be done in a hospital or at an outpatient center.

 

Risks :

-Muscle cramps

-Headache

-Nausea

-Palpitations

-Chest pain

-Shortness of breath

-Tiredness

 

Pediatric Cardiology

Pediatric Cardiology

What is pediatric cardiology?

This is a subspecialty of cardiology which focuses on diseases and conditions of the heart and circulatory system which influence infants, children, and adolescents. Medical doctors who specialize in this specialty are called as pediatric cardiologists.
What conditions are treated?

 

  • Congenital Mitral Stenosis
  • Partial Anomalous Pulmonary Venous Connection
  • Coronary Artery Fistula
  • Double Orifice Mitral Valve
  • Valvar Pulmonary Stenosis
  • Congenital heart defects
  • Valvular heart disease
  • Heart failure
  • Coronary Sinus Atrial Septal Defects
  • Aortopulmonary Septal Defect
  • Electrophysiology
  • Coronary artery disease
  • Acquired Mitral Stenosis
  • Myocardial Infarction in Childhood
  • Patent Ductus Arteriosus (PDA)
  • Endocardial Fibroelastosis
  • Heterotaxy Syndrome and Primary Ciliary Dyskinesia
  • High Altitude Pulmonary Hypertension
  • Infundibular Pulmonary Stenosis
  • Williams Syndrome
  • Junctional Ectopic Tachycardia
  • Muscular Ventricular Septal Defect
  • Ostium Primum Atrial Septal Defects
  • Pediatric Atrial Ectopic Tachycardia
  • Pediatric Atrial Flutter
  • Truncus Arteriosus
  • Ventricular Inversion
  • Pediatric Aortic Valve Insufficiency
  • Ventricular Septal Defects
  • Ostium Secundum Atrial Septal Defects
  • Atrioventricular Node Reentry Supraventricular Tachycardia
  • Commotio Cordis
  • Bicuspid Aortic Valve
  • Anomalous Left Coronary Artery From the Pulmonary Artery
  • Coarctation of the Aorta
  • Interrupted Aortic Arch
  • Double-Chambered Right Ventricle
  • Double Outlet Right Ventricle With Normally Related Great Arteries
  • Velocardiofacial Syndrome
  • Double Aortic Arch
  • Coronary Artery Anomalies
  • Double Outlet Right Ventricle With Transposition

Devices used in pediatric cardiology

  • Stethoscope:This is an acoustic device which the pediatric cardiologist uses to listen to the internal sounds such as heart sounds. It can also be used to listen for bowel sounds, lung sounds and bruits (renal and carotid).
  • EKG calipers:This is a device used to measure intervals and also compare intervals on EKGs.
  • Pacemaker:This is an electrical device which is inserted to replace the natural pacemaker of the heart.
  • Defibrillator:It is used to top fibrillation of the heart. This is an electrical device which alters the heart’s rhythm using electrical energy.

 

Diagnostic tests and procedures

  • Echocardiogram:– a sound wave picture to check the structure and function of the heart.
  • Ambulatory ECG:This is a test, which is done during activity to look for any abnormal heart rhythms.
  • Exercise test:This is a test to measure if the heart is functioning well.
  • Cardiac Catheterization:This test involves placing a small tube (catheter) in or near the heart for closer observation. It can also be used to relieve the blockage.
  • Blood tests:This includes testing the levels of cholesterol, Creatine kinase, and Troponin .
  • Echocardiography (echo):This test inspects the heart’s chambers and blood flow.
  • Transthoracic echocardiogram (TTE):This is an echocardiogram of the heart via the thorax. It is a noninvasive procedure and takes a short time.
  • Transesophageal echocardiogram (TEE):This is an echocardiogram of the heart through the esophagus. It can require general anesthesia or sedation.
  • Cardiovascular magnetic resonance imaging (CMR): An MRI of the heart utilizes the ECG to observe specific mechanical functions of the heart.
  • Auscultation:This test involves listening to sounds such as heart sounds using a stethoscope.
  • Electrocardiography (ECG or EKG):This test measures the electrical task of the heart using electrodes which are placed on the skin.

Why do i see a pediatric cardiologist?

Pediatric cardiologists are specially instructed and have the expertise needed to treat children. In addition, their offices are decorated with cartoon characters and toys and games to make the children relaxed. They know how to talk to the children making them feel relaxed.

 

Pericarditis

What is Pericarditis?

This is a type of medical condition that causes swelling and irritation of the pericardium, which is a thin fluid-filled sac-like membrane surrounding your heart. When the pericardium layers rub against each other they cause an irritation that leads to chest pain and swelling. Most pericarditis cases are not acute and do not need medical attention. However, severe cases may need medication or surgery.

Types of pericarditis

  • Acute pericarditis:Symptoms present like flu and last for less than three months. Symptoms solve within a week if medication is used.
  • Recurring pericarditis:This is when acute pericarditis occurs repeatedly.
  • Chronic pericarditis:This is when symptoms last for more than three months

What are the symptoms of pericarditis?

  • The main and most usual symptom is chest pain.
  • It may present as a sudden sharp pain behind your breastbone although sometimes it may be more of a dull ache.
  • The pain is worsened by lying down or inhaling and sitting up normally relieves it.

Causes of pericarditis

This condition normally influences men between the ages of 20 to 50. It often results after viral infections such as influenza, echovirus or Coxsackie virus. It may also be due to bacterial or fungal infections although this is not usual. It also happen in people with diseases and state such as:

  • Tuberculosis
  • Rheumatic fever
  • Heart attack
  • Cancer
  • HIV infection and AIDS
  • Kidney failure
  • Swelling or inflammation of the heart muscle
  • Certain medicines, such as hydralazine, procainamide, isoniazid, and phenytoin
  • Underactive thyroid gland
  • Heart surgery or trauma to the chest, esophagus, or heart
  • Drugs used to suppress the immune system or treat cancer
  • Radiation therapy to the chest

Treatment

  • Acute pericarditis:This is usually treated with medication such as nonsteroidal anti-inflammatory drugs (NSAIDS), which aim at reducing the swelling and decreasing the pain. Antibiotics and antifungal medications may be given if there is presence of a bacterial or fungal infection respectively. Other medications include corticosteroids and diuretics.
  • Recurring pericarditis:This is usually treated with a medication called colchicines, which aims at preventing the return of symptoms.
  • Chronic pericarditis: Treatment for chronic pericarditis aims at treating the underlying cause. While some cases respond well to medication, surgery may have to be performed on others.

Risks :

Complications of pericarditis: Fluid buildup in the pericardium If fluid construct up in the pericardium the heart may function poorly. Treatment for this includes:

-Pericardiocentesis: This is a procedure which may be done using an echocardiography-guided needle to drain the fluid from the sac

. -Subxiphoid pericardiotomy: This procedure cuts a small hole in the pericardium. This drains the fluid into the abdominal cavity. This procedure is normally done if the pericarditis is chronic, recurring r causes tightening and scarring of the tissue around the pericardium.

-Cardiac tamponade: is a rare complication that can be triggered by pericarditis. It causes an excess buildup in the pericardium. This results in the heart’s inability to beat properly because of the pressure caused by the extra fluid. This complication causes symptoms that include: –Nausea

–Palpitations

–Blurred vision

–Lightheadedness

–Myocarditis (inflammation of the heart muscle)

–Chest pain resembling that of a heart attack This complication is life-threatening and you should seek immediate medical attention if you develop any of the symptoms above.

 

Rheumatic Heart Disease

What is rheumatic heart disease?

This is a devastating disease that stiffens and damages the heart’s valves due to swelling. It deranges the normal blood flow of the heart. The disease generally affects the left-sided heart valves. However, due to malfunction of the left-sided heart valves the right side valves are harmed indirectly.

Causes of rheumatic heart disease

  • Rheumatic heart disease generally occurs after repeated heart valve damage due to repeated episodes of acute rheumatic fever which may sometimes be asymptomatic. In the early stages, it manifests in a leakiness of a left-sided valve which leaks blood from the lower ventricle to the upper atrium. The mitral valve can also narrow or constrict resulting in obstructed blood flow. The back pressure from this can cause leakiness of the right-sided valves and the right chambers may enlarge.
  • It is effected by a bacterial infection caused by the bacterium Group A Streptococcus (GAS).When the body is exposed to the bacterium it generates antibodies to destroy the bacteria. However, the bacterial cell wall and heart tissue are alike in structure and the antibodies may attack the heart tissue as well as the bacteria.

Risk factors

  • Inadequate hygiene
  • Lack of awareness
  • Overcrowding
  • Poor access to healthcare

Symptoms of rheumatic heart disease

  • Palpitations
  • Stroke
  • Dizziness
  • Chest pain
  • Shortness of breath
  • Tiredness
  • Ankle swelling
  • Formation of blood clots

Diagnosis

  • Echocardiography includes scanning of the heart using ultrasound. It assists to diagnose and identify the affected valves which are thick and distorted.
  • If you experience the symptoms of rheumatic heart disease you should see your doctor.
  • The doctor suspects that you have rheumatic heart disease he will need to identify abnormal heart murmurs. This is produced from the diseased heart valves and may be inaccurate in the early stages.
  • Some of the procedures that can be shifted out to diagnose rheumatic heart disease involve balloon dilatation of the narrowed valve, open-heart valve surgery, and echocardiography.

Prevention and treatment of rheumatic heart disease

  • Primordial prevention:This focuses on better living conditions, access to medical care and proper hygiene.
  • Primary prevention:This focuses on treating all GAS sore throat by penicillin to prevent he initial attack. Oral antibiotic may be administered for 10 days or single intramuscular injection.
  • Secondary prevention:This focuses on managing penicillin after beginning of  acute rheumatic fever attack to avoid re-infection which in turn stops subsequent episodes.
  • Surgery:This is required to replace or repair damaged heart valves.

Risks:

 

-Heart failure: This leads to extensive damage to the heart to the point that it cannot pump enough blood around the body. Treatment includes surgery to expand damaged valve with a balloon or to

-Issue of rheumatic fever: Mild rheumatic heart disease can generally be treated with medication, such as ACE inhibitors, which relax your arteries, making it easier for your heart to pump blood around your body.

 

-Atrial fibrillation: This is a heart condition that causes an abnormally fast and irregular heart rate. Treatment includes medication to control the heart rhythm and medication to prevent stroke.

-Endocarditis prophylaxis: This is an infection of the heart valves. Antibiotics are specified during surgery to prevent infection.

 

 

Cost Estimate

Cost Estimate -$100 to $1000

Cardiology checks and investigations may range between the above mentioned amounts. Further cost and treatment plan depends on the results of the investigations. The above mentioned cost is for Investigations done on an outpatients basis.

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