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Department of Cardiology

Heart, the vital muscular organ in the human body is what defines our overall wellbeing. If you are heart healthy, it means your body’s physiology is functioning at its optimal level

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Department Overview

Heart, the vital muscular organ in the human body is what defines our overall wellbeing. If you are heart healthy, it means your body’s physiology is functioning at its optimal level, aiding other organs, and is in fact striking a perfect balance between the physical and mental wellbeing too.

Heart is not just an organ that pumps oxygen rich blood through the body but is also undeniably an epicentre of your emotions, which often defines your mood, temperament and bears the brunt of stress. Unfortunately, many young lives are succumbing to heart-related ailments owing to various factors and it means that this crucial organ needs that extra special care and attention, in these fast-paced lives.

Cardiology, a major branch in the study of medicine deals with the diagnosis and prevention of various cardiac conditions. Precise diagnosis backed by the expert doctors; state-of-the-art facilities play an imperative role in saving a life – as each second counts. The Department of Cardiology at Dr. Rela Institute & Medical Care functions as a Centre of Excellence in Cardiac Sciences is one such incredible health facility backed by internationally acclaimed cardiologists, super trained support staff offering best practices in non-invasive and interventional procedures, along with round-the-clock comprehensive emergency services.

We believe that the medical needs of every patient are different and would require tailor-made treatment plans for a complete recovery. The ‘Heart Team Approach’ followed by our experts ensures collective decision by the team for an overall care.

The Department of Cardiology at Dr. Rela Institute & Medical Care offers a wide range of invasive and non-invasive both for diagnostics and intervention purposes. Read on to know more about our services.

Achievements

  • Successfully completed over 800 Cath procedures since inception of the hospital, that includes 700 coronary angiograms, over 100 PTCA (angioplasty) procedures.
  • Successfully performed Rotablation assisted PTCA procedure in chronic liver disease patient listed for transplant.
  • Successfully performed over 40 primary PTCA procedures with average door to balloon

 

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Infrastructure & Technology

Besides high-end surgical techniques, the department also offers a wide range of diagnostic procedures in order to decide upon the further course of treatment.

Electrocardiography (ECG)

An electrocardiography or ECG helps in measuring the electric activity of the heartbeat. The ECG will analyse the timing of top and lower chambers. An abnormal ECG is usually an indication of impending cardiac problem and would help the cardiologist to decide upon the further course of treatment.

Treadmill Test

Treadmill test or a stress test assess how your heart is functioning during intense activity like exercise, work. The test reveals if the blood supply is getting reduced while the patient is running on the treadmill and if the heart is pumping more blood. It measures heart rate, blood pressure, ECG and the doctor will also consider how tired the patient is after the test.

3D Echocardiography

The 3D Echocardiography or 3Dimensional Echocardiography gives complete evaluation of both left ventricle and right ventricle, ejection fraction with imaging reference. Since it provide the total picture of the functioning of heart, it helps the cardiologist in reaching an accurate diagnosis.

Advanced Echocardiography

An advanced echocardiography provides advanced imaging to diagnose the conditions like atrial and ventricular septal defects, blocked heart valves and various other abnormalities related to heart functioning. With the help of clear imaging, the cardiologist will understand the condition of the patient and decide upon the further treatment.

Transoesophageal ECHO Cardiography

Transesophageal Echo Cardiography or TEE is a test that provides with complete imaging of the heart functioning aided by ultrasound. Under this procedure, a thin tube is passed through the mouth and then esophagus. Since the esophagus is closely located to heart if facilitates better pictures with utmost clarity to understand the structure of the heart and valves.

128 Slice Cardiac CT

128 Slice Cardiac Computing Tomography provides overall information about the heart and its functioning by providing the cardiologists all necessary information to rule out or diagnose life threatening conditions like pulmonary embolism, aortic dissection, acute coronary syndrome. The test provides computerized imaging procured through narrow beam of x-rays even in the cross-sectional or slices as they are often referred to.

Holter Monitoring

Holter monitoring is done to evaluate the heart’s activity for a period of 24 hours to 48 hours. A battery operated portable device, it is attached to the skin with electrodes. Doctors would recommend holter monitoring if the patient complains of fast or slow heartrate, feeling dizzy and also to assess the functioning of pacemaker.

Myocardial Perfusion Scintigraphy

Myocardial Perfusion Scintigraphy is a nuclear medicine imaging test in which radioactive tracer gets injected in small amounts to assess the blood supply to the heart. It gives a clear understanding of the difference in blood supply during rest and stress and also helps the doctor to diagnose the damage to the heart after suffering a heart attack.

PET-Scan

Positron Emission Tomography or PET scan is a nuclear medicine imaging test in which radioactive tracer gets injected in small amounts to take pictures of the heart. It is recommended in the case of diagnosing coronary artery disease and also to assess the damage of heart following a heart attack. In certain cases, it is also done to assess if an angioplasty, stenting, coronary artery bypass surgery would help the patient in complete recovery.

Treatments and Procedures

Primary Angioplasty

Primary Angioplasty also known Percutaneous Coronary Intervention is a life-saving procedure which is usually done in the cases of acute myocardial infarction or heart attack in layman’s terms. It treats blocked coronary arteries, and restores immediate blood flow to the heart. Under local anaesthesia, a catheter gets inserted into the main artery through the thigh or arm. The balloon passed over the wire through the catheter then gets inflated opening the artery after which a medicated metal stent gets placed facilitating blood flow. The stent thus becomes the permanent part in the body and reduces the risk for further cardiac events.

Since, every second counts in saving the life during a heart attack, this facility is available 24×7 and we ensure performing it within 30 to 60 minutes, soon after suffering from it.

Elective Coronary Angiography and Angioplasty

An elective Coronary Angiography and Angioplasty is done to diagnose and to treat the conditions related to heart and blood vessels. It is recommended if the patient complains about chest pain, discomfort or pain in jaw, neck and arms, sudden episodes of chest pain, abnormal results in heart stress tests, a heart valve problem, congenital heart disease. The elective angiography and angioplasty serve as preventive measures to save the heart from an impending heart attack or a stroke.

The Coronary Angiogram procedure is aided by an x-ray machine and a dye gets inserted into the blood vessels. The x-ray machine then takes the imaging of blood vessels and the expert would be able to view clogged arteries, if any. These images are called angiograms.

If the expert diagnoses clogged arteries, then an angioplasty would follow the angiogram. Angioplasty or Percutaneous Coronary Intervention is done under the local anaesthesia, in which a catheter gets inserted into the main artery through the thigh or arm. The balloon passed over the wire through the catheter then gets inflated opening the artery after which a medicated metal stent gets placed facilitating blood flow. The stent thus becomes the permanent part in the body and reduces the risk for further cardiac events.

Complex Coronary Angioplasty with Advanced Imaging Technology (IVUS & OCT)

The cardiac procedures have undergone major technological advancements in the recent years helping the medical fraternity in much faster and accurate diagnosis. Complex Coronary Angioplasty with Imaging Technology is one such invention that is greatly aiding the medical experts.

IVUS: Known as Intravascular Ultrasound, IVUS is usually recommended to determine the amount of plaque build-up in epicardial coronary artery. A specially designed catheter with a tiny ultrasound probe attached to computerized ultrasound equipment gets inserted into the coronary arteries. The IVUS not only provides a complete understanding of the regression and progression of artherosclerotic lesions but also helps the expert take stock of hidden plaque or atheroma. This procedure comes in diagnosing patients with restenosis.

Intravascular OCT:

Intravascular Optical Coherence Tomography helps in examining coronary arteries and this procedure offers high resolution of the blocked tubes. It can in fact help the expert doctor in differentiating between fibrous, lipid-rich or calcified plaque. It also provides other detailed information during angioplasty helping the cardiologist to decide upon the type of stent implantation especially in the patients suffering from restenosis.

Chronic Total Occlusion PCI

A Chronic Total Occlusion Percutaneous Coronary Intervention is done to clear blockages that have been present for more than 3 months, often a result of atherosclerosis. It is done in the case of completely blocked arteries and the duration of the procedure varies from patient to patient. This requires a greater expertise as the doctor uses both antegrade and retrograde approaches to reach to the blockage. After identifying the blockage, the expert cardiologist would insert catheter into the collateral vessels for entering the blocked artery. An inflated balloon then gets placed and blown up at the tip of the catheter facilitating a wide opening of the arteries for restoring blood flow and also place a stent.

FFR GUIDED PCI

Fractional Flow Reserve Percutaneous Coronary Intervention helps in ascertaining the pressure differences in case of coronary artery stenosis. It gives a fair idea to the cardiologist if the stenosis is blocking oxygen delivery to the heart muscle, a condition known as myocardial ischemia. During the procedure, a catheter gets inserted through the groin and an FFR – a small sensor at the tip of the catheter measures the pressure, temperature and severity of the lesion. This procedure helps the expert doctor to determine the amount of pressure decline caused due to vessel narrowing.

DIAGNOSTIC CARDIAC CATHETERISATION

Cardiac Catheterisation is a diagnostic procedure to treat various cardiovascular conditions. Under this procedure a long, thin catheter gets inserted into the body via groin, arm or neck to locate narrowed or blocked arteries, measure oxygen and pressure, to check the functioning of right and left ventricles, to extract a tissue from the heart, diagnosing congenital heart ailments and also to study defects in heart valves.

It is also often used as a part of angiogram and angioplasty for interventional purposes.

PERCUTANEOUS VALVULOPLASTY

A Percutaneous Valvuloplasty is a technique where a single or multiple balloon are inserted beneath the skin and then get inflated to open a stenotic valve. It is recommended for patients suffering from mitral, aortic and pulmonic stenosis. It serves as an amazing option for those patients at the high risk of surgical complications and it provides an immediate and a great degree of relief from symptom

TRANSCUTANEOUS AORTIC VALVE IMPLANTATION (TAVR)

Transcutaneous Aortic Valve Implantation or TAVR is done when the aortic valve fails to open and is a great option for the patients at the high risk of surgical complications following an open-heart surgery. Patients with kidney damage and lung related ailments too get benefited through this procedure. It will decrease major symptoms like recurrent chest pain, fainting, swelling in the legs and prevents sudden cardiac failure and death.

During the procedure the surgeon will insert a catheter to access the heart and valve. Soon after positioning the new valve, the balloon gets inflated and replaces the valve in the appropriate place. The catheter is removed after securely placing the valve.

IMPLANTATION OF PACEMAKERS

Pacemaker is a small electronic device that is placed in the chest for regulating slow electric problems in the heartbeat. Comprised of three parts – a pulse generator, one or more leads and an electrode on each lode, pacemaker sends signals to the heart to beat when it going dangerously low or going irregular. It is needed for the patients who suffer from the lack of electric stimulation of the heart to heart muscle and the response from heart’s chambers.

Pacemaker implantation is done under local anaesthesia. A small incision will be under the collarbone and the pacer will be slowly placed with the help of lead wire into the blood vessel and then to the heart. After it reaches inside the heart, the functioning will be tested aided by fluoroscopy and ECG. The pacemaker generator will be then placed on the non-dominant side of body (if you are right-handed person it is placed on to your left and vice-versa). The patient would be able to resume normal duties within few days.

IMPLANTATION OF AUTOMATIC CARDIAC DEFIBRILLATORS

Automatic Cardiac Defibrillators are a boon to patients with a known ventricular tachycarida or fibrillation. The Cardiac Defibrillator plays a crucial role in preventing sudden cardiac arrest in high risk patients. An ICD in few cases even serves as a pacemaker. It is in fact a battery powered device that gets implanted under the skin which monitors heart rate. The moment it recognises an abnormal rhythm it sends electric shock and restores normal heart rate.

It is implanted under the collarbone just below the skin. The leads are attached to the pulse generator and it prevents the need of open-heart surgery.

IMPLANTATION OF IVC FILTERS

Inferior Vena Cava Filter of IVC filter is a medical device, implanted into the inferior vena cava a large vein that carries deoxygenated blood to prevent pulmonary emboli. It is implanted a thin catheter is inserted in the inferior vena cava aided by an X-ray or an ultrasound. The filter at the tip of the catheter is then placed and will be securely attached. The catheter is then removed. The filter placed in vena cava traps and stops the blood clots in the lower body, preventing them from travelling to the lungs, thus saving the patient from a life-threatening condition.

ASD/VSD/PDA/COLLATERAL DEVICE CLOSURES

Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDS) are congenital birth defects diagnosed in children but can be found in grownups at a later stage. Under these conditions, the blood flows from left side of the heart to the right, mounting a lot of workload on the heart.

Advanced closure methods with the help of catheters also known as device closures come in handy in treating these life-threatening ailments without going for an open-heart surgery. In this technique, a catheter gets inserted via groin and then guided to the heart. After reaching the defect, an umbrella like device gets placed on the defect. The device not only corrects the blood flow but closes the defect over a period of time.

COIL CLOSURE OF PDA/MAPCAS

Patent Ductus Arteriosus or PDA is a medical condition in which ductus arteriosus or ductus botalli, a blood vessel connecting pulmonary artery to the proximal descending aorta in the developing foetus fails to close after birth. As a result, a portion of oxygenated blood from the left heart flows back to the lungs causing pulmonary hypertension, right-sided heart failure, loss of weight gain, heavy breathing etc in the child.

Major Aortopulmonary Collateral Occlusion is an ailment under which the bronchial arteries that supply blood to the lungs are underdeveloped. These arteries can eventually become stenotic and narrowed and if not attended immediately, can lead to congestive heart failure.

Coil closure of PDA/MAPCAs is done to close the opening between the aorta and pulmonary artery in a child. During the procedure a catheter will be inserted through the groin, neck or arm under the general anaesthesia. The expert paediatric cardiac surgeon then would use 1 or more coils to close the Patent Ductus Arteriosus or (PDA). The catheter gets removed after completing the procedure.

In case of MAPCAs, the similar procedure is followed but it is aimed at grouping the collateral arteries and converting the supply of deoxygenated blood from right side of the heart.

BALLOON PULMONARY/ AORTIC VALVULOPLASTY

Balloon Pulmonary or Aortic Valvuloplasty is a technique to cure congenital pulmonary stenosis in which the pulmonary valve fails to open completely. As a result, the child’s heart would suffer from overworked heart and severe symptoms like chest pain, shortness of breath, fatigue and fainting.

Balloon Pulmonary Valvuloplasty is a procedure under the expert inserts a catheter through the groin, to access the pulmonary valve, after which a balloon at the tip of the wire or catheter gets inflated stretching the valve and helping it to open. It facilitates the blood flow to the pulmonary artery without any obstruction.

LPA/PDA/COARCTATION OF AORTA: BALLOON DILATION AND STENTING

Patent Ductus Arteriosus or PDA is a medical condition in which ductus arteriosus or ductus botalli, a blood vessel connecting pulmonary artery to the proximal descending aorta in the developing foetus fails to close after birth.

Coarctation of Aorta is narrowing of the aorta and these both conditions are present at the birth.

The treatment usually involves balloon angioplasty often coupled with stenting for treating the narrowing down of aorta. The doctor during the procedure would insert a thin, catheter through the groin of the child and the balloon at the tip opens the narrowed aorta. Once inflated, the aorta gets widened, facilitating the normal blood flow.

In some cases, the doctors may use a metal mesh or a stent into aorta to prevent it from blocking again. The same procedure is followed in the case of Patent Ductus Arteriosus too but the opening will be closed with the help of catheter.

Diseases and Conditions

Coronary Artery Disease (CAD)

Heart Arrhythmias

Heart Failure

SUCCESS STORIES

Resilient Heart | Rela Hospital

Resilient Heart | Rela Hospital

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MEDIA

Rela Heart Beats

Rela Heart Beats

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Events

Launch Ceremony Rela Institute Pioneering Cardiac Support Group

Launch Ceremony Rela Institute Pioneering Cardiac ...

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EXPERT TALKS

Tavr Procedure Offers Hope For High Risk Patient | Dr. V. Narendra Kuma

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