Diagnostic, Therapeutic and Surgical Intervention

The heart is a muscular organ found in all vertebrates that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions. The term cardiac (as in cardiology) means “related to the heart” and comes from the Greek word, kardia, for “heart.”

From the moment it begins beating until the moment it stops, the human heart works tirelessly. In an average lifetime, the heart beats more than two and a half billion times, without ever pausing to rest. Like a pumping machine, the heart provides the power needed for life.

There are many types of heart diseases. Common among them is the Coronary heart disease. Coronary artery disease is a disease of the artery caused by the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium. Angina pectoris (chest pain) and myocardial infarction (heart attack) are symptoms of and conditions caused by coronary heart disease.

Causes of Heart Failure

Causes of heart failure are difficult to analyze due to challenges in diagnosis, differences in populations & age.

Common causes ranked as per their risk factor:

• Ischaemic Heart Disease 62%
• Cigarette Smoking 16%
• Hypertension (high blood pressure)10%
• Obesity 8%
• Diabetes 3%
• Valvular heart disease 2%
  (much higher in older populations)

Rarer causes of heart failure:

• Viral Myocarditis (an infection of the heart muscle)
• Infiltrations of the muscle such as amyloidosis
• HIV cardiomyopathy (caused by Human Immunodeficiency Virus)
• Connective Tissue Diseases such as Systemic lupus erythematosus
• Abuse of drugs such as alcohol
• Pharmaceutical drugs such as chemotherapeutic agents
• Arrhythmias

Obstructive Sleep Apnea, a condition of sleep disordered breathing, overlaps with obesity, hypertension and diabetes and is regarded as an independent cause of heart failure.

Signs and Symptoms

Classical symptoms of acute myocardial infarction include:

• Sudden chest pain (typically radiating to the left arm or left side of the neck)
• Shortness of breath
• Nausea
• Vomiting
• Palpitations
• Sweating
• Anxiety (often described as a sense of impending doom)

Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue. Approximately one quarter of all myocardial infarctions are silent, without chest pain or other symptoms.

Conditions/diseases that can be treated at CNS – Cardiac Sciences

• Angina / Unstable Angina
• Acute Heart Attack (MI)
• Acute shortness of breath / Heart failure Valvular Disease
• Congenital Heart Diseases Patients requiring pacemaker
• Patients with abnormal heart rate (Arrythmia)
• Syncope or faint attacks

Facilities Available

Diagnostic (Non-Invasive)

• ECG (12-lead, computerised)
• TMT
• Holter monitor
• Stress echo
• Tilt-table test
• Ambulatory blood pressure monitoring
• Echo-cardiography (Colour Doppler, trans-esophageal and 3D )
• Preventive cardiology (lifestyle modification, control of risk factors)

Diagnostic (Invasive)

• Coronary Angiography
• Femoral
• Radial (Day care procedure)
• Carotid/cerebral
• Peripheral/renal
• Electrophysiology (arrhythmia study)
• Intravascular ultrasound
• FFR study
• Cardiac catheterisation & haemodynamic study
• Catheterisation & evaluation of congenital heart disease

Therapeutic Intervention

Diagnostic (Non-Invasive)

• Elective Coronary Angioplasty and stent implant
• Primary or emergency Coronary Angioplasty (during early hours of MI)
• Renal Angioplasty
• Carotid Angioplasty
• Limb artery Angioplasty
• Aorta intervention
• PTSMA
• Pericardial fluid aspiration
• Balloon Valvuloplasty (Mitral, Aortic, Pulmonary, Tricuspid valve ballooning)
• Device (ASD, VSD, PDA) closure of holes in the heart
• Acute intervention after birth (TGA, PDA opening)
• Closure of abnormal arterial channels in children

Pacing Modalities Group

• Pacemaker implantation (single/dual chamber, bi-ventricular)
• Multi-site pacing
• Ablation therapy for SBT, VT, AF, WPW
• Stent valve implantation

Surgical Intervention

CABG

• Off-Pump
• Multi-Vessel Total Arterial Bypass(LIMA-RIMA Y) Valve surgery

Valve Surgery

• Aortic Valve Replacement / Repair
• Mitral Valve Replacement/Repair
• Double Valve Replacement
• Tricuspid Valve repair
• Stent-less Aortic Valve
• Replacement
• Aortic Root Surgery (Bentalls Operation, ROSS Procedure)

Congenital Heart Surgery

• ASD Closure
• VSD Closure
• PDA Ligation
• BT Shun
• BD Glenn Shunt
• Fontan’s Procedure
• TAPVC Repair
• Total Correction of TOF
• Rastelli’s Procedure
• Senning’s Operation
• Arterial Switch for DTGA
• Double Switch for CCTGA
• Norwood Procedure
• Minimally Invasive Cardiac Surgery
• Hybrid Surgery

Department of Paediatric Cardiology

Worldwide statistics show that nearly one in every hundred children born suffer from congenital heart disease along with the new additions every year, the burden is huge. Considering the present birth rate in India, every year we have almost two lakh new born babies who suffer from such a defect. Approximately half of them need treatment in first year of life. If we consider the existing children already suffering from congenital heart diseases, along with the new additions every year, the burden is huge. Unfortunately only two percent of these children get proper treatment and it tells us about the sorry state of our performance in this field.

Special Clinics

• Heart Failure Clinic
• Pain Clinic
• Syncope Clinic
• Special care for elderly patients
• Special Packages (below economy packages)

CNS Makes a Difference in Patient Care

• Early Diagnosis & Wellness
• Environment Friendly
• Access and choice
• Convenience
• Privacy
• Quality
• Cost Effective
• Healthy & Vibrant Ambience
• High Tech

Patient Friendly

• Large patient rooms to provide separate zones for patient, care provider and staff.
• Sized and equipped to handle all critical and intensive care.
• Minimizes patient transfers which reduces errors and injuries.

Timely Intervention Can Help Baby Hearts

Worldwide statistics show that nearly one in every hundred children born suffer from congenital heart disease along with the new additions every  year, the burden is huge. Considering the present birth rate in India, every year we have almost two lakh new born babies who suffer from such a defect. Approximately half of them need treatment in first year of life. If we consider the existing children already suffering from congenital heart diseases, along with the new additions every year, the burden is huge. Unfortunately only two percent of these children get proper treatment and it tells us about the sorry state of our performance in this field.

For proper treatment, we need to diagnose the problem in time and start the treatment early under the supervision of a dedicated team of doctors specialised in treatment of patients with congenital and structural problems.

When do you suspect heart problem in your child?

• Not feeding well, getting tired early
• Breathing difficulty when running or playing
• Turns blue
• Repeated Respiratory tract Infections, specially if requires hospital admission
• Poor growth
• Doctor suspects without any apparent problem

If there is any doubt, immediately get in touch with a Paediatric Cardiologist and get proper evaluation for your kid. Just presence of heart disease in a baby does not mean that he will need surgery. Many heart diseases don’t need immediate treatment, some need regular follow-up to check for spontaneous improvement or any deterioration, some of them can be managed with medications and some babies will need early surgery or intervention. But it is very important to get early evaluation and regular follow-up to decide about the management plan and only a Paediatric Cardiologist can guide you properly.

Time is precious. Delay in diagnosis and treatment can often hamper the normal life of your kid, treatment may not have optimal result and sometimes delay can make his heart problem unsuitable for ideal treatment. The main growth of body and brain occurs in first two years of life…so any neglect at that vital period may leave a permanent scar in him.

Thankfully, most of these children can lead a normal and healthy life with timely intervention. So, we need to diagnose these problems early and treat them timely to help the little hearts beat healthy. Medica Superspecialty Hospital, a multispeciality tertiary care centre, is delighted to offer comprehensive Paediatric Cardiology Services under one roof. The Paediatric Cardiac Care Team comprising Paediatric Cardiologist, Paediatric Intensivist, Cardiac Surgeons, Anaesthetists and well trained paramedical staff is capable of handling any cardiac emergency. Availability of all major paediatric superspecialties, neonatal and paediatric intensive care support enable us to deliver world-class patient care.

Comprehensive Paediatric Cardiac Care

Treating structural heart problems without surgery is a fascinating field of technological advances. Paediatric Cardiac intervention is a well established area and many of the heart problems can now be resolved without opening the chest. Many of us know about angioplasty and, if possible, we prefer it over Bypass surgery.

But how many of us know that many holes in the heart can be closed by placing a plug like device in it! Many blocks in the heart valves can be opened by balloon dilation! All these are done without any scar on chest, without any
blood transfusion and with a very short stay in hospital.

Facilities Available

Comprehensive Paediatric Cardiac Care

• Paediatric Cardiology consultation
• Paediatric Echocardiography
• Paediatric Stress Test / Tilt Table Test
• Management of Cardiac Emergencies
• Paediatric Cardiac Catherisation
• Paediatric Cardiac Surgery
• Paediatric Electrophysiology Study & RFA
• Foetal Echocardiography for pregnant ladies
• Paediatric ECG/24 hour Holter Monitoring
• Paediatric Cardiac Intervention (Keyhole surgery)

Paediatric Cardiology Procedures

• Diagnostic Catheterisation
• Balloon Valvuloplasty
• PDA Device Closure
• ASD Device Closure
• VSD Device Closure
• Stenting of coarctation of Aorta
• Neonatal intervention
• Balloon atrial septostomy
• Transcatheter intervention (keyhole surgery)
• Balloon dilatation of severe aortic and pulmonary block

Paediatric Cardiac Surgery Procedures

• PDA Ligation
• Coarctation Repair
• BT Shunt
• Glenn Shunt
• ASD Closure
• VSD Closure
• TOF Repair
• Fontan’s Operation
• Rastelli Procedure
• Arterial Switch Operation

CNS Makes a Difference in Patient Care

• Early Diagnosis & Wellness
• Environment Friendly
• Access and choice
• Convenience
• Privacy
• Quality
• Cost Effective
• Healthy & Vibrant Ambience
• High Tech