Clinical & Critical Cardiology

Clinical and Critical Cardiology: Understanding the Importance of Heart Health

Heart disease is the leading cause of death worldwide. According to the World Health Organization (WHO), an estimated 17.9 million people died from cardiovascular diseases (CVDs) in 2019, accounting for 32% of all global deaths. In the United States alone, heart disease is responsible for one in four deaths, making it the leading cause of death for both men and women.

Clinical and critical cardiology are two essential fields of medicine that deal with the prevention, diagnosis, and treatment of heart diseases. These two areas of cardiology are crucial in ensuring the optimal care of patients with heart conditions.

What is Clinical Cardiology?

Clinical cardiology is the branch of medicine that deals with the diagnosis and treatment of heart diseases. Clinical cardiologists specialize in the management of patients with various heart conditions, such as coronary artery disease, heart failure, valvular heart disease, and arrhythmias.

A clinical cardiologist typically evaluates patients who have symptoms of heart disease, such as chest pain, shortness of breath, palpitations, or fatigue. The cardiologist conducts a comprehensive evaluation, including a physical examination, medical history, and diagnostic tests, such as electrocardiogram (ECG), echocardiogram, stress test, or cardiac catheterization.

Based on the evaluation, the cardiologist provides a diagnosis and recommends an appropriate treatment plan, which may include medications, lifestyle modifications, or procedures such as angioplasty or heart surgery. The cardiologist also provides ongoing management and follow-up care to ensure that the patient’s heart condition is well-controlled and any potential complications are addressed promptly.

What is Critical Cardiology?

Critical cardiology is a specialized field of medicine that deals with the management of patients with acute or life-threatening heart conditions, such as acute myocardial infarction (heart attack), cardiogenic shock, or severe heart failure. Critical cardiologists work in intensive care units (ICUs) and provide round-the-clock care to patients who require close monitoring and advanced interventions.

Critical cardiologists are trained in advanced cardiac life support (ACLS) and are skilled in using various life-saving treatments and devices, such as mechanical ventilation, intra-aortic balloon pump, or extracorporeal membrane oxygenation (ECMO). These treatments help support the patient’s heart function and vital organs until the underlying condition is treated.

In addition to providing advanced interventions, critical cardiologists work closely with other healthcare professionals, such as cardiac surgeons, nurses, respiratory therapists, and pharmacists, to ensure the optimal care of critically ill patients. The goal is to stabilize the patient’s condition, minimize complications, and improve the chances of a full recovery.

Why is Heart Health Important?

Heart health is essential for overall health and well-being. The heart is a vital organ that pumps blood and oxygen to all parts of the body, providing the necessary nutrients and energy for cells to function properly. When the heart is not functioning correctly, it can lead to various complications, such as heart attack, stroke, kidney failure, or even death.

Maintaining a healthy heart involves adopting healthy lifestyle habits, such as regular exercise, a balanced diet, avoiding tobacco and excessive alcohol consumption, and managing stress. In addition, it is crucial to managing any underlying medical conditions that may affect heart health, such as hypertension, high cholesterol, or diabetes.

Early detection and treatment of heart disease are critical in preventing complications and improving outcomes. Regular check-ups with a cardiologist can help identify any potential risk factors or early signs of heart disease, allowing for prompt intervention and treatment.

Conclusion

Clinical and critical cardiology are two critical areas of medicine that play a crucial role in ensuring the optimal care of patients with heart diseases.

Paediatric Cardiology, Pediatrics, Cardiology, Heart Diseases, Congenital Heart Defects, Pediatric Cardiac Surgery, Pediatric Heart Conditions, Pediatric Cardiac Care.

Paediatric Cardiology: Understanding the Complexities of Children’s Heart Health

The heart is a crucial organ that pumps blood throughout the body, supplying vital oxygen and nutrients to all organs and tissues. Paediatric cardiology is a specialized field of medicine that focuses on the diagnosis, treatment, and management of heart disease in children from infancy to adolescence.

Children’s heart health is a complex subject that requires a deep understanding of both the anatomy and physiology of the heart, as well as the unique challenges that children face when it comes to heart health. In this blog post, we will explore some of the key aspects of paediatric cardiology, including common heart conditions in children, diagnostic procedures, and treatment options.

Common Heart Conditions in Children

Congenital Heart Defects

Congenital heart defects (CHD) are structural abnormalities that occur during the development of the heart and blood vessels in the womb. CHDs can range in severity from minor defects that may not require treatment, to life-threatening conditions that require immediate intervention.

Some of the most common types of CHDs include:

  • Atrial septal defects (ASD): A hole in the wall between the two upper chambers of the heart.
  • Ventricular septal defects (VSD): A hole in the wall between the two lower chambers of the heart.
  • Tetralogy of Fallot (ToF): A combination of four heart defects that affect blood flow through the heart and lungs.
  • Patent ductus arteriosus (PDA): Failure of a blood vessel that connects the aorta and pulmonary artery to close after birth.
  • Coarctation of the aorta: Narrowing of the aorta that restricts blood flow to the lower body.

Arrhythmias

Arrhythmias are irregular heart rhythms that can affect the heart’s ability to pump blood effectively. In children, arrhythmias can occur as a result of congenital heart defects, electrolyte imbalances, or underlying medical conditions.

Some common types of arrhythmias in children include:

  • Supraventricular tachycardia (SVT): A rapid heart rate that originates in the upper chambers of the heart.
  • Ventricular tachycardia (VT): A rapid heart rate that originates in the lower chambers of the heart.
  • Wolff-Parkinson-White syndrome (WPW): A rare condition where an extra electrical pathway in the heart can cause rapid heart rates.

Cardiomyopathy

Cardiomyopathy is a condition where the heart muscle becomes weak or stiff, making it difficult for the heart to pump blood effectively. In children, cardiomyopathy can be caused by genetic factors, viral infections, or other underlying medical conditions.

Some of the most common types of cardiomyopathy in children include:

  • Dilated cardiomyopathy: The heart becomes enlarged and weakened, reducing its ability to pump blood effectively.
  • Hypertrophic cardiomyopathy: The walls of the heart become thickened, making it harder for the heart to pump blood effectively.
  • Restrictive cardiomyopathy: The heart becomes stiff and unable to fill with blood properly.

Diagnostic Procedures in Paediatric Cardiology

Diagnosing heart conditions in children requires a thorough evaluation of the child’s medical history, physical examination, and a variety of diagnostic tests.

Some common diagnostic procedures in paediatric cardiology include:

  • Electrocardiogram (ECG): A test that records the electrical activity of the heart and can help identify abnormal heart rhythms or other electrical abnormalities.
  • Echocardiogram: A test that uses sound waves to create images of the heart and can help identify structural abnormalities or problems with the heart’s function.

Angioplasty is a minimally invasive procedure that is commonly performed in cardiology to treat coronary artery disease (CAD). The procedure involves using a balloon catheter to dilate narrowed or blocked coronary arteries, thereby restoring blood flow to the heart muscle. Angioplasty is often performed as part of a larger treatment plan for CAD, which may also include lifestyle changes, medication, or coronary artery bypass surgery. In this article, we will explore the different types of angioplasty, the indications for the procedure, and its associated risks and benefits.

Types of Angioplasty: There are several different types of angioplasty, each of which is used to treat different types of coronary artery disease. The most common types of angioplasty include:

  1. Balloon angioplasty: Balloon angioplasty is the most common type of angioplasty. During this procedure, a small balloon is inserted into the blocked or narrowed coronary artery and inflated to widen the artery and restore blood flow.
  2. Drug-eluting stent: A drug-eluting stent is a small mesh tube that is inserted into the blocked or narrowed coronary artery. The stent is coated with a medication that is slowly released over time to prevent the artery from narrowing again.
  3. Coronary atherectomy: Coronary atherectomy is a procedure that involves using a small device to remove plaque from the walls of the coronary arteries. This procedure is often used in cases where the plaque is too hard or calcified to be treated with balloon angioplasty.

Indications for Angioplasty: Angioplasty is typically recommended for patients with significant blockages or narrowing of the coronary arteries. The procedure may be indicated in cases where the patient is experiencing symptoms such as chest pain, shortness of breath, or fatigue, which are often caused by reduced blood flow to the heart muscle.

Angioplasty may also be recommended for patients who have had a heart attack, as restoring blood flow to the affected area of the heart can help to prevent further damage and improve long-term outcomes. In some cases, angioplasty may also be recommended as a preventive measure for patients who are at high risk of developing CAD, such as those with a family history of the condition or those with multiple risk factors, such as high blood pressure, high cholesterol, or diabetes.

Risks and Benefits of Angioplasty: Like any medical procedure, angioplasty carries some risks, including bleeding, infection, and damage to the blood vessels or surrounding tissues. In rare cases, patients may experience more serious complications, such as heart attack, stroke, or kidney damage.

However, for most patients, the benefits of angioplasty far outweigh the risks. By restoring blood flow to the heart muscle, angioplasty can help to relieve symptoms, improve quality of life, and reduce the risk of heart attack and other complications. For many patients, angioplasty is an effective and relatively low-risk treatment option for coronary artery disease.

Conclusion: In conclusion, angioplasty is a common and effective treatment option for patients with coronary artery disease. The procedure is minimally invasive and can be performed on an outpatient basis, with most patients able to return to normal activities within a few days. While angioplasty carries some risks, for most patients, the benefits of the procedure far outweigh the potential complications. If you are experiencing symptoms of CAD or have been diagnosed with the condition, talk to your doctor about whether angioplasty may be a good treatment option for you.

Interventional Cardiology, Coronary Angioplasty, Stenting, Atherectomy, Laser Angioplasty, Rotational Atherectomy, Balloon Valvuloplasty, Transcatheter Aortic Valve Replacement, TAVR, Patent Foramen Ovale Closure, PFO Closure

Cardiovascular disease is one of the leading causes of death worldwide, and its management has been a major focus in modern medicine. Interventional cardiology is a subspecialty of cardiology that focuses on the treatment of heart disease using minimally invasive procedures. These procedures are designed to treat blockages in the coronary arteries that cause chest pain (angina) or a heart attack. In this blog, we will discuss interventional procedures in cardiology in detail.

Coronary Angioplasty:
Coronary angioplasty is a procedure that involves inserting a catheter (a long, thin tube) into the blocked artery and inflating a small balloon at the tip of the catheter to open up the blocked area. This is a minimally invasive procedure that is performed under local anaesthesia. The balloon is then deflated and the catheter is removed. In some cases, a stent (a small, mesh-like device) may be placed to keep the artery open. This procedure is commonly used to treat angina, heart attack, and other types of coronary artery disease.

Stenting:
Stenting is a procedure that involves inserting a stent into the blocked artery to keep it open. A stent is a small, mesh-like device that is placed inside the artery to prevent it from closing again. Stents can be made of different materials such as metal or plastic. This procedure is commonly used in conjunction with angioplasty.

Atherectomy:
Atherectomy is a procedure that involves removing plaque buildup from the walls of the arteries using a catheter. This procedure is usually performed in conjunction with angioplasty or stenting.

Laser Angioplasty:
Laser angioplasty is a procedure that uses a laser to remove plaque buildup from the walls of the arteries. This procedure is rarely used today due to the advent of other, more effective interventional procedures.

Rotational Atherectomy:
Rotational atherectomy is a procedure that involves removing plaque buildup from the walls of the arteries using a rotating catheter with a diamond tip. This procedure is usually performed in conjunction with angioplasty or stenting.

Balloon Valvuloplasty:
Balloon valvuloplasty is a procedure that involves inserting a catheter with a balloon at the tip into a narrowed heart valve. The balloon is then inflated to widen the valve opening. This procedure is commonly used to treat aortic stenosis, a condition in which the aortic valve narrows and restricts blood flow from the heart to the rest of the body.

Transcatheter Aortic Valve Replacement (TAVR):
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that involves replacing a diseased aortic valve with a new valve. The new valve is delivered to the heart through a catheter that is inserted into a blood vessel in the groin or chest. TAVR is typically performed in patients who are not good candidates for traditional open-heart surgery.

Patent Foramen Ovale (PFO) Closure:
Patent foramen ovale (PFO) closure is a procedure that involves closing a small hole in the heart that is present at birth. The hole, called the foramen ovale, is supposed to close shortly after birth but remains open in some people. This can cause blood clots to travel from the veins to the arteries, which can lead to a stroke. PFO closure involves inserting a catheter with a small device at the tip into the hole and deploying the device to close it.

In conclusion, interventional cardiology has revolutionized the treatment of heart disease by offering minimally invasive procedures that are safe and effective.

A heart attack is a serious medical condition that occurs when there is a blockage in the flow of blood to the heart. It is a life-threatening event that requires immediate medical attention. Heart attacks can happen to anyone, but certain risk factors like smoking, high blood pressure, and high cholesterol can increase the risk. Knowing the signs of a heart attack can help save a life. In this blog, we will discuss the signs of a heart attack in detail.

  1. Chest Pain or Discomfort  – The most common symptom of a heart attack is chest pain or discomfort. It usually feels like a tightness, pressure, or squeezing in the chest that lasts for more than a few minutes. The pain may also spread to the arms, shoulders, neck, jaw, or back.
  2. Shortness of Breath – Shortness of breath is another common symptom of a heart attack. It may occur before or at the same time as chest pain. You may feel like you can’t catch your breath or like you’re suffocating. This symptom can be particularly concerning if it occurs during rest or with minimal exertion.
  3. Nausea and/or Vomiting – Nausea and vomiting can be a sign of a heart attack, particularly in women. These symptoms can occur with or without chest pain.
  4. Sweating – Sweating, particularly cold sweats, can be a sign of a heart attack. This symptom may occur along with other symptoms, such as chest pain or shortness of breath.
  5. Fatigue – Fatigue or extreme tiredness can be a sign of a heart attack, particularly in women. This symptom may occur days or weeks before the actual heart attack.
  6. Dizziness or Lightheadedness – Dizziness or lightheadedness can be a sign of a heart attack, particularly in women. This symptom may occur before or at the same time as chest pain.
  7. Indigestion or Heartburn – Indigestion or heartburn can be a sign of a heart attack, particularly in women. These symptoms may occur with or without chest pain.
  8. Pain in the Upper Back, Shoulder, or Neck  – Pain in the upper back, shoulder, or neck can be a sign of a heart attack, particularly in women. This symptom may occur before or at the same time as chest pain.
  9. Jaw Pain – Jaw pain can be a sign of a heart attack, particularly in women. This symptom may occur before or at the same time as chest pain.
  10. Anxiety – Anxiety or a feeling of impending doom can be a sign of a heart attack. This symptom may occur before or at the same time as chest pain.

If you experience any of the above symptoms, it is important to seek medical attention immediately. Delaying treatment can lead to serious and sometimes fatal complications.

In addition to knowing the signs of a heart attack, it is also important to know the risk factors. These include:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Obesity
  • Diabetes
  • Family history of heart disease
  • Age (men over 45 and women over 55)

If you have any of these risk factors, it is important to take steps to reduce your risk of a heart attack. This may include quitting smoking, exercising regularly, eating a healthy diet, and managing any existing health conditions.

In conclusion, a heart attack is a serious medical condition that requires immediate attention. Knowing the signs of a heart attack can help save a life. If you experience any of the symptoms discussed in this blog, seek medical attention right away. Remember, the earlier treatment is received, the better the chances of a full recovery.

One of Delhi’s best cardiologists explains… 

Heart disease is the primary cause of death in the world and what is most alarming is the rise in the number of young people succumbing to this. After a certain age or after some warning signs due to other reasons, getting regular heart checkups is very important. So if you’re looking for heart checkups in Dwarka, you can visit our hospital for heart disease (in Dwarka)

During a heart checkup, a doctor will  look out for any signs of heart disease and assess the risk of developing heart disease in the future. . Some risk factors are high blood pressure and cholesterol, high blood sugar, being overweight and obese and  certain lifestyle choices like tobacco and alcohol consumption. 

Some heart health foundations recommended that screening tests should begin as early as age 20, given the growing number of young people succumbing to heart disease. We all know the coronavirus pandemic is still very much a reality we cannot ignore, but a heart condition is something you definitely can’t ignore. Schedule your appointments well in advance and consult a doctor who can help you learn which screenings are relevant for you and how many times you should get them. 

Get a doctor’s help immediatel if any of these symptoms occur

          A feeling of discomfort or pain in the chest

          Fluttering in the chest

          Slowing or racing heartbeat

          Shortness of breath

          Feeling dizzy

          Extreme fatigue

          Swelling in the feet or abdomen

These are more or less the major symptoms of a heart condition which needs immediate attention. Regular heart health screening is a very important part of preventive healthcare for adults. From around the age of 20, even earlier in some cases,, your doctor will most likely recommend you get many screening tests regularly. In case the results of the screening tests show signs of heart disease or high risk of developing heart disease in the future, your doctor may mandate some additional tests.

Family history is also taken into account to determine when the testing should start and with what frequency.

Routine tests

Even if there is no history of heart disease, these tests are recommended generally

          Blood pressure and cholesterol tests, beginning by the by age20 for most people

          Blood glucose tests, starting by  40 to 45 for most

          Body mass index (BMI) measurement

 

Some may recommend high-sensitivity C-reactive protein (hs-CRP) testing which measures C-reactive protein (CRP), a marker of inflammation or infection that’s associated with higher risk of heart attack. 

Other heart tests

If a doctor believes you may have heart disease, they may order some of the following tests to better assess the condition of your heart:

          Electrocardiography (ECG, EKG). Tiny sticky electrodes are put on to your chest and attached to  machine known an an ECG machine which will record a heart’s electrical activity and give information about your heart rate and rhythm.

          Exercise cardiac stress test. Electrodes are stuck on to your chest and attached to an ECG machine. Then you’ll have to walk or run on a treadmill, or pedal on a stationary cycle, while healthcare professionals assess your heart’s response to the physical stress. 

          Echocardiography. An ultrasound machine will create moving images of your heart to determine whether you have problems with the pumping of your heart, and to assess the valves. 

          Nuclear stress test. A minuscule amount of radioactive dye will be  injected into your bloodstream from where it will travel to the heart., and using an imaging machine a healthcare professional will learn how blood is flowing through your heart.

          Cardiac CT scan for calcium scoring. You’ll be placed under a CT scanner with electrodes attached on the chest to record the heart’s electrical activity. A healthcare professional will uses a CT scanner to re-create images of your heart and check for any plaque that may have built up in the coronary arteries.

          Coronary CT angiography (CTA). Similar to cardiac CT scans, you’ll be made to  lie under a CT scanner with electrodes attached to the chest in order for a healthcare professional to record the heart’s activity and render pictures of it based on the CT scan images. A contrast dye will be injected into the  bloodstream to make it easier for doctors to check for plaque buildup in the coronary arteries.

          Coronary catheter angiography. A tiny tube, or catheter, is inserted into the groin or arm and careered through an artery to the heart. Contrast dye is injected via the catheter and a healthcare professional will  take  X-ray images of your heart, allowing them to check whether the  coronary arteries are narrowed or blocked.

If diagnosed with a heart disease, you may have to go in for a combination of changes in lifestyle, medication, or any other treatment to manage it.

A heart checkup test isn’t all that complicated 

A regular heart health checkup doesn’t usually  involve any complicated tests. To monitor your heart’s health, your doctor will measure your weight and assess BMI, measure blood pressure, order a few blood tests to check for cholesterol and blood sugar, enquire about your diet, activity, ask about personal and family medical history and ask whether you’ve noticed changes in your overall health recently. 

Monitoring the parameters of your heart is as important as any other aspect of your overall health. Don’t skip out on regular heart check ups because of coronavirus, hospitals like ours follow all international protocols and safety measures, with isolated consultation and testing areas. Heart conditions are serious, and should not be left by the wayside. 

If you’re looking for heart treatment in Dwarka, this article from one the best cardiologists in Dwarka can be of help, especially if you’re a woman. Here are a few facts on cardiac health in women to them to help them better cope with one of the biggest health issues of our day: heart disease.

Heart diseases are the leading cause of death in men and women the world over and this is true for Indians as well. The risk of heart diseases for both sexes is high, but heart disease affects men and women differently. Of the deaths that are reported in India, cardiovascular diseases cause 20.3% deaths in men and 16.9 % deaths in women.

In fact more women die of heart disease than men each year, yet heart disease and related risk factors are often overlooked in women, and this is cause for concern. The symptoms of coronary artery disease and heart attack, for instance, are quite different in women than men.

 

Women looking for heart surgery in Dwarka should keep these facts in mind before going in for surgery.

 

The risk factors for women:

Although several common risk factors for coronary artery disease like high cholesterol, high blood pressure and obesity do affect women and men, some other factors may play a greater role in the development of heart disease in women. For example, risk factors for women include:

  • Women who have diabetes are at greater risk of developing heart disease than men with diabetes.
  • Mental stress and depression. Women’s cardiovascular health is affected by stress and depression more than men.
  • For women, smoking is a far greater risk factor for heart problems than it is for men.
  • Absence or lack of physical activity is a major risk factor for heart disease, and some research has found women to be more inactive compared to men.
  • Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels.
  • Certain chemotherapy drugs and radiation therapy for cancer, such as those used to treat breast cancer can increase the risk of cardiovascular disease.
  • Pregnancy complications. High blood pressure or diabetes during pregnancy can increase a woman’s long-term risk of high blood pressure and diabetes and increases the risk of developing heart disease in mothers.

 

Coronary Artery Disease is the most common type of heart disease and develops when your coronary arteries become damaged or diseased.

 

When the coronary arteries become narrowed or blocked, it means there is less blood flowing into the heart; in some cases, atherosclerotic plaque can rupture and blood flow is abruptly and completely blocked. CAD can cause:

  • Chest pain (angina)
  • Heart Attack or Myocardial infraction
  • Breathlessness on exertion/ heart failure
  • Heart Rhythm problems manifesting as palpitations

Women usually tend to have different and more subtle symptoms and are treated less aggressively compared to men.

 

Reducing the risk of heart disease 

 

Women can make lifestyle changes to reduce the risk of heart disease like-

  • Quit smoking, or don’t begin
  • Exercise regularly
  • Keep a healthy weight.
  • Follow a balanced diet that includes whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans fat, added sugars, and high amounts of salt.

We must remember that a woman’s risk of dying from heart disease is eight times greater than that of breast cancer!

Most women are busy taking care of everyone else, and their own wellbeing and health tends to fall last, and that shouldn’t be the case. Women need to make their cardiovascular health a priority and encourage others to do the same.