Dr. Rajiv Rastogi
Senior Consultant – Clinical Cardiology
MBBS. MD Medicine, DM-Cardiology
Dr Swapnil Pathak
Senior Consultant - Clinical Cardiology
MBBS. MD Medicine, DNB Cardiology, AFSEC
Introduction to Cardiology
A branch of medicine that specializes in diagnosing and treating diseases of the heart, blood vessels, and circulatory system. These diseases include coronary artery disease, heart rhythm problems, and heart failure.
What Is Coronary Artery Disease (CAD)?
The heart is a beating muscle that continually pumps blood to the rest of the body. The coronary arteries supply the heart itself with the necessary oxygen and nutrients it needs to function effectively. Over time, fatty deposits called plaque can build up inside the arteries, clogging the passages and reducing the flow of blood. If the coronary arteries develop plaque, blood flow to the heart can be compromised.
Eventually, blood flow to your heart muscle gets reduced, and because blood carries much-needed oxygen, your heart muscle is not able to receive the amount of oxygen it needs. Reduced or cut-off blood flow and oxygen supply to your heart muscle may lead to problems like:
Chest pain or discomfort occurs when your heart does not get enough blood.
Myocardial Infarction (MI)
MI happens when a blood clot at the site of a narrowing in a coronary artery suddenly cuts off most or all the blood supply to the part of the heart muscle. Cells in the heart muscle begin to die if they do not receive enough oxygen-rich blood. This can cause permanent damage to the heart muscle and may even result in death.
Over time if untreated, CAD can weaken the heart muscle and contribute to Heart failure.
In heart failure, the heart can’t pump blood effectively to the rest of the body. Heart failure does not mean that the heart has stopped or is about to stop. Instead, it means that the heart is failing to pump enough blood the way that it should.
Arrhythmias are abnormalities in the normal beating (rhythm) of the heart. Some of them can be quite serious/life-threatening.
Symptoms Of CAD
The following are the symptoms a person with significant narrowing in coronary arteries may experience:
- A squeezing/suffocating pain arises in the center of your chest and sometimes migrates to your arm, neck, back, throat, or jaw.
- Shortness of breath
- Loss of sensation / abnormal sensation in your arms, shoulders, or wrists
How Is CAD Diagnosed?
After taking your detailed medical history, your doctor will conduct a thorough physical check-up and may advise you on the following tests.
- ECG (Electrocardiogram): Your heart’s electrical activity (while you rest) will be recorded as a graph on an ECG sheet. It will record any abnormality of heart rhythm.
- Echocardiography: It uses ultrasound waves to produce an image of your heart to see the functioning of various chambers and valves of the heart.
- Exercise ECG / Treadmill Test (TMT): During this test, your ECG and BP are recorded while you walk on a treadmill. If abnormal, this test suggests a reduction of blood supply to your heart when you exert yourself.
- Exercise Thallium Test: An advanced test, which is similar to TMT, in which a radioactive substance is injected into your bloodstream at the peak of exertion. This enables your doctor to see the blood flow to various regions of your heart.
- Coronary Angiography: During this test, your doctor will inject a dye through a catheter into your coronary arteries (arteries supplying blood to heart muscles). He will then take serial X-ray images to see the blood flow through your coronary arteries.
- This test will enable your doctor to choose the right treatment for you, depending on the number and extent of blockages.
Your doctor may prescribe one or a combination of medicines. Some medicines decrease the workload on the heart while others decrease the chances of having a heart attack.
Special Care Units/ Diagnostic Equipment’s/ Facilities
- Treadmill Test (TMT)
- Echocardiography (Colour Doppler)
- Stress Echocardiography
- 24 Hour Holter Monitoring
- Ambulatory BP Monitoring
- Stress Thallium Test
- 128 slice CT angiography
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