Cardiovascular Services

Cardiovascular Services

Your heart health is our priority

Conditions and Treatments

The emphasis is on the prevention of, early diagnosis, and most current treatment of various forms of cardiovascular disease. This includes adult congenital cardiac disease, diseases involving the cardiac muscle (cardiomyopathies), ischemic coronary artery disease, valvular heart disease, and disease involving the electrical system of the heart.

Treatments/Service Provided

Our cardiologists offer clinical care of patients with a wide extend of cardiovascular conditions. We offer a complete range of symptomatic testing for the discovery and evaluation of different shapes of heart conditions (stress testing including echo imaging), electrophysiological and devices follow up, and progressed cardiac CT imaging. We offer a full run of therapeutic interventions including coronary angioplasty and stenting, ablation of abnormal rhythms, and Devices Implantations.

Cardiovascular Services:

  • Non-invasive cardiology (diagnostic monitoring, diagnostic tests, device follow-up).
  • Imaging (ultrasound).
  • Cardiac rhythm management.
  • Cardiac rhythm management.
  • Rapid access chest pain clinic.
  • Vascular services.
  • Cardiac Rehabilitation.

1. Non-invasive cardiology (diagnostic monitoring,  diagnostic tests, device follow-up Imaging (ultrasound).

The Non- invasive cardiovascular department is committed to performing high quality, fetched successful symptomatic assessments for outpatients. Our board- certified cardiologist and technologist within the department are driving specialists within the determination and treatment of heart conditions.

Non-invasive demonstrative cardiology procedures are ordinarily secure and effortless, and permit you to return to your standard exercise nearly immediately.

Diagnostic monitoring

We use portable devices, which monitor heart’s rhythm and blood pressure during your normal daily routine, to help diagnose potential heart conditions.

The type of device we choose to use will depend on the symptoms and the reason for the monitoring.

01. Heart monitors

A heart monitor may be used to assess the heart rate and rhythm for 24 hours or longer. It can be used to identify abnormal heart rates or rhythms, which may or may not be associated with particular symptoms.

02. Blood pressure monitors

A blood pressure monitor is used to measure and record blood pressure over a 24-hour period during your normal daily routine. It can be used to diagnose conditions such as high blood pressure (hypertension).

03. Cardiac event recorders

A cardiac event recorder is a small hand-held device which is used to record the heart rate and rhythm when we activate it. The recordings are then sent through to the department using the event recorder and a landline telephone. This can help the doctor to see if any symptoms patient might be experiencing are associated with changes in the heart rate and rhythm.

Diagnostic tests

We can use a variety of tests to assess how your heart responds in different situations. These tests may be used to diagnose new conditions or assess existing ones. 

01. Electrocardiogram (ECG)

An electrocardiogram records the electrical signals in your heart. It’s a common test used to detect heart problems and monitor the heart’s status in many situations. Electrocardiograms — also called ECGs or EKGs — are often done in a doctor’s office, a clinic or a hospital room. And they’ve become standard equipment in operating rooms and ambulances.

An ECG is a noninvasive, painless test with quick results. During an ECG, sensors (electrodes) that can detect the electrical activity of your heart are attached to your chest and sometimes your limbs, these sensors are usually left on for just a few minutes.

Your doctor may discuss your results with you the same day as your electrocardiogram or at your next appointment.

02. Exercise stress test

A stress test, sometimes called a treadmill test or exercise test, helps a doctor find out how well the heart handles work. As the body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart. It also helps doctors know the kind and level of exercise appropriate for a patient.

03. Cardio pulmonary exercise test

Provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction.

Imaging (ultrasound)

Our team of specialist sonographers will use the latest 2D and 3D echocardiography technology to produce images for the heart.

01. Echocardiogram

An echocardiogram or ‘echo’ is a scan that uses sound waves (ultrasound) to produce pictures of the heart. It’s a completely painless test that doesn’t have any side effects and doesn’t use radioactivity. An echocardiogram tells us how well the heart is pumping and whether the heart valves are working properly, but it doesn’t indicate whether or not to have angina.

02. Stress echocardiogram

Some arrhythmias are triggered or worsened by exercise. During a stress test, patient will be asked to exercise on a treadmill or stationary bicycle while the heart activity is monitored. If doctors are evaluating patient to determine if coronary artery disease may be causing the arrhythmia, and they have difficulty exercising, then the doctor may use a drug to stimulate the heart in a way that’s similar to exercise.

2. Cardiac rhythm management

We’re a world-renowned unit helping patients with heart rhythm disorders. We study and treat the electrical conduction and disturbances of the heart, also known as cardiac electrophysiology.

We see patients with a wide range of heart complaints, from people with palpitations and dizzy spells, to patients who have survived an episode of sudden cardiac death.

As a center of excellence for diagnosing and treating heart rhythm disorders, patients from surrounding areas are referred to our specialists. We have particular experience in atrial fibrillation ablation, ablation and device therapies in congenital heart disease, and cardiac resynchronization therapy for heart failure patients.

3. Rapid access chest pain clinic

Our rapid access chest pain clinic assesses people with suspected angina. Angina is a chest pain that occurs with exercise and resolves with rest and may indicate a partial blockage of a coronary artery.

4. Vascular services

Invasive cardiology

01. Cardiac Catheterization

Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization.

Cardiac catheterization is done to see if there is a heart problem, or as a part of a procedure to correct a heart problem that the doctor already knows about.

  • Locate narrowing or blockages in your blood vessels that could cause chest pain (angiogram)
  • Measure pressure and oxygen levels in different parts of your heart (hemodynamic assessment)
  • Check the pumping function of your heart (right or left ventriculogram)
  • Diagnose heart defects present from birth (congenital heart defects)
  • Look for problems with your heart valves

Cardiac catheterization is also used as part of some procedures to treat heart disease. These procedures include:

Angioplasty with or without stent placement.

Angioplasty involves temporarily   inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery.

Angioplasty is usually combined with implantation of a small metal coil called a stent in the clogged artery to help prop it open and decrease the chance of it narrowing again (restenosis).

  • Electrophysiology Procedure & devices implantation

Heart arrhythmia Diagnosis and Treatment

To diagnose a heart arrhythmia, the doctor will review symptoms and medical history and conduct a physical examination, he may ask about — or test for — conditions that may trigger your arrhythmia, such as heart disease or a problem with your thyroid gland. He may also perform heart-monitoring tests specific to arrhythmias. These may include:

Electrocardiogram (ECG). During an ECG, sensors (electrodes) that can detect the electrical activity of your heart are attached to your chest and sometimes to your limbs. An ECG measures the timing and duration of each electrical phase in your heartbeat.

Holter monitor. This portable ECG device can be worn for a day or more to record your heart’s activity as you go about your routine.

Event monitor. For sporadic arrhythmias, you keep this portable ECG device available, attaching it to your body and pressing a button when you have symptoms. This lets your doctor check your heart rhythm at the time of your symptoms.

Implantable loop recorder. This device detects abnormal heart rhythms and is implanted under the skin in the chest area.

If your doctor doesn’t find an arrhythmia during those tests, he or she may try to trigger your arrhythmia with other tests, which may include:

Stress test. Some arrhythmias are triggered or worsened by exercise. During a stress test, patient will be asked to exercise on a treadmill or stationary bicycle while the heart activity is monitored. If doctors are evaluating patient to determine if coronary artery disease may be causing the arrhythmia, and they have difficulty exercising, then the doctor may use a drug to stimulate the heart in a way that’s similar to exercise

Electrophysiological testing and mapping. In this test, doctors thread thin, flexible tubes (catheters) tipped with electrodes through your blood vessels to a variety of spots within your heart. Once in place, the electrodes can map the spread of electrical impulses through your heart.

In addition, the cardiologist can use the electrodes to stimulate your heart to beat at rates that may trigger — or halt — an arrhythmia. This allows for doctor to see the location of the arrhythmia and what may be causing it.

02. Cardiac Device Implantation

Sometimes lifestyle change and medication aren’t enough to combat heart disease. When other treatments are no longer effective, physician may recommend an implantable cardiac device (pacemaker) to help monitor and/or regulate the rhythm of the heart. There are different types of implantable devices, and it depends on the diagnosis as to which type the doctor will choose for. Cardiac resynchronization therapy (CRT) pacemakers help a very slow heart beat more regularly. Implantable cardioverter defibrillators (ICDs) shock the heart when it is beating too fast to prevent cardiac arrest. Additionally, some devices have been developed that can do both.

01. Pacemaker Implantation

A pacemaker literally sets the pace of the heart. This tiny device is implanted under skin and attached to the heart by tiny wires or leads. The signals, or pacing pulses, are carried along this electrical lead, to the heart and stimulate the heart muscle to beat. It monitors and adjusts the heartbeat based on customized limits. If the heart rate is slower than the set low limit, an electrode sends an electrical current to the heart causing it to beat. If the heart rate is faster than the set high limit, no current is sent.

02. Cardioverter Defibrillator (ICD) Implantation

ICDs are small devices that are surgically implanted just below the collarbone. It connects to the heart using tiny wires, or leads, and continuously monitors the heart’s rhythm. When the heart beats to quickly, the ICD delivers a life-saving electrical current to restore the hearts normal rhythm and prevent sudden cardiac death. ICDs can also act as a pacemaker, when a slow heart rate is detected. ICDs monitor and adjust the heartbeat based on customized, high and low limits, and are similar to a pacemaker.

03. Cardiac Resynchronization Therapy (CRT) for Heart Failure (Bi-Vent Pacing) or (Bi-Vent ICD)

CRT is innovative new therapy for patients with heart failure by improving the coordination of the heart’s contraction. CRT builds on the technology used in pacemakers and ICDs. It also can protect the patient from slow or fast heart rhythms. The CRT device has three electrical leads that are placed in the right and left chambers of the heart – different from a pacemaker or ICD which only have electrical leads placed in the right side of the heart. This allows the CRT device to simultaneously stimulate the left and right sides of the heart and restore the heart’s coordinated pumping function. This is referred to as Bi-ventricular pacing.

Cardiac Rehabilitation

There are four phases of cardiac rehabilitation. The first phase occurs in the hospital after your cardiac event, and the other three phases occur in a cardiac rehab center or at home, once you’ve left the hospital. Keep in mind that the recovery after a cardiac event is variable; some people sail through each stage, while others may have a tough time getting back to normal. Work closely with your doctor to understand your progress and prognosis after a cardiac event.

  1. Phase One Cardiac Rehab: The Acute Phase
  2. Phase Two Cardiac Rehab: The Sub acute Phase
  3. Phase Three: Intensive Outpatient Therapy
  4. Phase Four: Independent Ongoing Conditioning

Phase One Cardiac Rehab: The Acute Phase

The initial phase of cardiac rehabilitation occurs soon after your cardiac event. An acute care physical therapist will work closely with your doctors, nurses, and other rehabilitation professionals to help you start to regain your mobility.

If you’ve had a severe cardiac injury or surgery, such as open heart surgery, your physical therapist may start working with you in the intensive care unit (ICU). Once you no longer require the intensive monitoring and care of the ICU, you may be moved to a cardiac stepdown unit.

The initial goals of phase one cardiac rehabilitation include:

  • Assess your mobility and the effects that basic functional mobility has on your cardiovascular system
  • Work with doctors, nurses and other therapists to ensure that appropriate discharge planning occurs
  • Prescribe safe exercises to help you improve your mobility, and to improve cardiac fitness.
  • Help you maintain your sternal precautions is you have had open heart surgery.
  • Address any risk factors that may lead to cardiac events
  • Prescribe an appropriate assistive device, like a cane or a walker, to ensure that you are able to move around safely

Work with you and your family to provide education about your condition and the expected benefits and risks associated with a cardiac rehabilitation program

Phase Two Cardiac Rehab: The Subacute Phase

Once you leave the hospital, your cardiac rehabilitation program will continue at an outpatient facility. Phase two of cardiac rehabilitation usually lasts from three to six weeks and involves continued monitoring of your cardiac responses to exercise and activity.

Another important aspect of phase two cardiac rehabilitation is education about proper exercise procedures, and about how to self-monitor heart rate and exertion levels during exercise. This phase centers around your safe return to functional mobility while monitoring your heart rate.

Towards the end of phase two, you should be ready to begin more independent exercise and activity.

Phase Three: Intensive Outpatient Therapy

Phase three of cardiac rehabilitation involves more independent and group exercise. You should be able to monitor your own heart rate, your symptomatic response to exercise, and your rating of perceived exertion (RPE). Your physical therapist will be present during this phase to help you increase your exercise tolerance, and to monitor any negative changes that may occur during this phase of cardiac rehab.

As you become more and more independent during phase three of cardiac rehabilitation, your physical therapist can help tailor a program of exercises, including flexibility, strengthening, and aerobic exercise.

Phase Four: Independent Ongoing Conditioning

The final phase of cardiac rehabilitation is your own independent and ongoing conditioning. If you have participated fully in the previous three phases, then you should have excellent knowledge about your specific condition, risk factors, and strategies to maintain optimal health.

Independent exercise and conditioning is essential to maintaining optimal health and preventing possible future cardiac problems. While phase four is an independent maintenance phase, your physical therapist is available to help make changes to your current exercise routine to help you achieve physical fitness and wellness.