GENERAL CARDIOLOGY SERVICES
Physicians in the heart and vascular program at SGRH offer care for all heart patients, from the sickest patients who need heart transplants to those at risk for developing heart disease. Our physicians and other health care professionals work closely with patients and their families to coordinate additional services, including arrangements for outpatient and home-based care when necessary.
General cardiology services are available through consultant cardiologists and associates in Cardiology.
General cardiology services include preoperative evaluation and treatment and assessment of:
Adult congenital heart disease
Valvular heart disease
Rheumatic heart disease
Hypertension and related problems
Disease of the pericarduim
Infiltrative disease of the heart
Noninvasive evaluation of heart disease patients
Congestive heart failure
Inflammatory disease of the heart with endocarditis
Disease of the aorta, including Marfan's syndrome and aortic aneurysm
Other services include care for pregnant women with heart disease
Management of patients on anticoagulants
The hospital is geared up to take care of all cardiac emergencies. Ambulance services are available to transport very sick patients. We have facilities to transport the sick patients including those requiring ventilatory support, pacing and intra-aortic balloon pump to our centre in association with Dharamvira Heart Centre at Sir Ganga Ram Hospital .
COMMON CARDIAC CONDITIONS
What Happens During a Heart Attack?
A heart attack (myocardial infarction or MI) occurs when a heart muscle has reduced blood flow. Sometimes plaque inside heart arteries breaks open or ruptures; a clot then can form that blocks blood flow through the artery.
Plaque is made up of cholesterol, white blood cells, calcium, and other components and is surrounded by a thin layer of cells. Different things-one of which may be high blood pressure-can cause the capillary to tear or rupture. Cholesterol then leaks out the tear and mixes with blood in the artery and a clot is formed. This blood clot in an artery can sometimes obstruct blood flow to the heart muscle, which causes the heart attack.
Some heart attack symptoms may include:
Chest pain that is crushing, squeezing, or feels like a heavy weight on the chest.
Chest pain with sweating, shortness of breath, nausea or vomiting.
Chest pain that spreads to the neck, jaw, shoulder(s) or arm(s).
Dizziness or lightheadedness.
Fast or irregular heartbeat.
Sometimes symptoms are only arm or back pain (not only chest pain).
Often pain with MI will wax or wan and may improve with rest or may happen at rest. It is important to seek emergency care to prevent death. Our cardiologists may perform an urgent angioplasty with stent placement to open the artery and return blood flow to the heart.
See the various diagnostic tests that assess your cardiac damage. Depending on these test results, doctors may begin treatment to reduce heart muscle damage caused by a heart attack.
Sudden (Cardiac) Death
This describes a condition in which an individual collapses abruptly and unexpectedly and - unlike syncope - does not recover spontaneously. In the US , approximately 400,000 people die each year due to sudden cardiac death - more deaths than those combined from lung and breast cancer and AIDS.
There are many conditions that can cause sudden death such as bleeding from a tear in the aorta (the largest artery in the body) or in the brain. However, 90% of sudden (cardiac) death episodes are due to an abnormal heart rhythm called ventricular fibrillation (VF). In VF the heart rate in the lower chambers (ventricles) abruptly increases to > 250 beats per minute. Indeed the heart rhythm is extremely chaotic, the heart pump function thus ceases, the blood pressure drops and the patient collapses.
Unless prompt resuscitation with cardiac defibrillation (a shock) is delivered, death occurs within minutes. Many victims of sudden cardiac death have known heart disease (i.e., prior heart attack or myocardial infarction, or congestive heart failure) or are at high risk for heart disease.
Sudden cardiac death is not the same as a heart attack. In a heart attack, one of the coronary arteries blocks up and interrupts the blood flow to a specific region of the heart. In sudden cardiac death, the heart rhythm abruptly becomes chaotic with ventricular fibrillation.
Patients with known severe heart disease are at increased risk for sudden cardiac death and should be evaluated for possible therapy with an implantable cardioverter defibrillator (ICD).
This is a heart rhythm disorder that is so common in our population that it deserves a special mention. This is a disorder that principally affects people over the age of 60. The upper chambers of the heart (atria) develop an electrically chaotic rhythm such that these chambers can no longer mechanically pump blood. These chaotic electrical signals cross (conduct) to the lower chambers (ventricles) in a random, irregular fashion, giving the sensation of irregular palpitations. In addition to feeling irregular, the pulse will usually be quite fast, about 100 to 150 beats/minute. Episodes of atrial fibrillation may start and stop of themselves after a few hours. However, over time, the episodes usually last longer until eventually they do not stop by themselves.
The treatment of atrial fibrillation is targeted towards controlling the fast pulse and trying to restore a normal (sinus) rhythm. Usually medications are sufficient to control the fast pulse or to try to prevent the heart from going into atrial fibrillation in the first place.
To restore a normal rhythm, the cardiologist may want to do a cardioversion, where the patient is deeply sedated and then a shock is delivered to the heart to reset the normal rhythm.
Sometimes catheter ablation can be helpful-either to help control the heart rate in atrial fibrillation in conjunction with a pacemaker, or in selected younger individuals to treat abnormal electrical connections that can trigger atrial fibrillation.
However, the most important thing of all is to prevent a stroke. Since in atrial fibrillation the upper chambers cannot pump any blood, blood can stagnate in these chambers and form clots. If a clot goes to the brain, there can be a stroke. Therefore, many patients are advised to be on blood thinner called warfarin, (also called coumadin).
This is the medical term for "passing out" or "fainting." During syncope, a temporary loss of consciousness together with loss of muscle tone (slumping over or falling) occurs, however the patient recovers quickly and spontaneously. Syncope is due to a transient decrease in blood flow to the brain.
There are many conditions that can cause syncope-some of which may be related to heart disease such as certain heart valve disorders or arrhythmia. The most common condition-the "common faint"-is due to a transient blood pressure and/or heart rate decrease and is typically seen in healthy individuals (for example during blood draws or painful events).
All patients with syncope should be thoroughly evaluated especially if they have known heart disease, as some causes for syncope can potentially be dangerous
This is the medical term for "abnormal heart rate and/or rhythm." The heart rhythm may be too slow (bradycardia) or too fast (tachycardia).
The abnormal heart rhythm may originate from the:
upper chambers (supraventricular tachycardia, atrial fibrillation, atrial flutter) or
Lower chambers (ventricular tachycardia, ventricular fibrillation).
The episodes of arrhythmia may be very brief (non-sustained) or long lasting (sustained). Factors that can cause arrhythmias are stress, caffeine, alcohol, and many forms of heart disease