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How do I get an appointment?
A: To schedule an appointment or follow-up, please call Dr. Menon’s Cardiologie Clinic (022 23676954/55) |
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Heart
Disease |
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Heart
Procedures |
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The
Normal Heart |
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Heart
Tests |
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Heart
Health / Heart Disease Prevention |
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| Heart
Procedures |
Q:
What is Interventional Cardiology?
A: Interventional cardiology procedures are
part of a non-surgical, invasive field. The
technology was developed to help physicians
battle coronary artery disease and has been
increasingly successful over the past several
years. Interventional cardiology began in 1977
with the introduction of the PTCA procedure,
followed by the first coronary stent in 1993,
and now in 2003 the availability of the drug
eluting stent .
Q: What is the role of
interventional cardiology and the treatment
of Coronary Artery Disease?
A: When the coronary angiogram procedure shows
that there are significant narrowings or obstructions
in the coronary arteries, the risk of heart
attack with subsequent heart muscle damage is
high, if left untreated.
Interventional cardiology procedures are available
to help in the treatment of obstructions within
the coronary arteries with no or minimal surgical
intervention.
Medications are available to help prevent heart
attack, by lowering blood cholesterol or blood
pressure. However, currently, there are no medications
available to eliminate the narrowings or obstructions
within the coronary arteries.
Q: What is a drug eluting
stent? 
A: Approved for use by the FDA in April 2003,
the drug eluting stent is a revolutionary new
method for physicians to help in the treatment
of coronary artery disease, by slowly releasing
a drug to limit the over-growth of normal tissue
as the healing process occurs following coronary
stent implantation.
Approximately 70% to 80% procedures in interventional
cardiology currently use a wire mesh-like stent
that have been a successful in preventing coronary
artery disease, however, still issues remain
with in-stent restenosis and thrombosis.
The introduction of drug coated stents (drug
eluting stents) has shown promising results
in slowing down the growth of unwanted cells
(restenosis), thus preventing the patient from
undergoing bypass surgery and allowing the proper
healing of the vessels.
Q: The use of aspirin
and heart disease:
The use of aspirin can reduce risks of myocardial
infarction. In addition to administration of
aspirin upon an MI occurrence, long-term therapy
has also been proven to reduce the prevalence
of a heart attack. Please, consult with your
physician to determine your treatment and dosage
or eligibility.
Aspirin should not be an alternative to other
methods to reduce heart disease such as exercise,
diet, and stress management. |
| AFTER
AN INTERVENTIONAL PROCEDURE |
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Q:
How long is the hospital stay?
A: Your hospital stay depends on several factors
including any difficulties that you may have
experienced during the interventional procedure,
and how well the puncture site is healing. The
amount of time depends on your physicians' orders.
Q: Can I participate in
regular activities?
Once you have returned to your hospital room,
you may eat and drink, and your family may visit
depending on your physicians' orders. Your doctor
will advise you when you can leave the bed,
rest, and walk. You may also be referred to
cardiac rehabilitation program.
Q: What are the signs
and symptoms I should be aware of after my procedure?
Call your doctor immediately if you feel that
you cannot tolerate your medications or develop
any side effects such as bleeding, upset stomach,
rash, or have any questions. |
| WHAT
TO EXPECT FROM: |
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Q:
What to expect from your coronary angiogram
(or heart cath)?
A: To perform a heart catheterization or coronary
angiogram, a thin flexible tube called a catheter
is threaded through a blood vessel in the arm
or leg and advanced to the heart. Through the
catheter, the doctor can measure blood pressure
and blood flow; take blood samples, and injects
a liquid dye (contrast material) into the heart
and its arteries.
Q: What to expect from
your intravascular ultrasound procedure?
A: In intravascular ultrasound, a tiny device
(transducer) that sends and receives sound waves
is mounted on the tip of a thin flexible tube
(catheter). The catheter is threaded through
a blood vessel up into the coronary artery.
The transducer rotates within the artery to
create an image of the artery and provide information
about the thickness and amount of plaque buildup
in the artery wall.
Q: What to expect from
your angioplasty procedure?
During the angioplasty procedure, a thin flexible
tube (catheter) is inserted through an artery
in the leg or arm and carefully guided into
the narrowed coronary artery. Once the tube
reaches the narrowed artery, one of the following
methods is used to help restore normal blood
flow:
- Balloon angioplasty:
a small balloon located at the end of the
tube that is inflated. The pressure from
the inflated balloon presses the plaque
against the wall of the artery, will create
more room for blood to flow.
- Stent: a
small, expandable wire tube, which is permanently
inserted into the artery. The balloon is
placed inside the stent and inflated. This
will open the stent and push it into place
against the artery wall. The stent meshlike
composition will allow the cell lining of
the blood vessel to grow through and around
the stent, which will secure it. This procedure
will help to: Open the artery and press
the plaque against the artery's walls, thereby
improving blood flow, keep the artery open
after the balloon is deflated and removed,
seal any tears in the artery wall, prevent
the artery wall from collapsing or closing
off again (restenosis), which might cause
a heart attack.
Q: What
to expect from your Rotoblator Procedure?
A: The cardiologist will guide a thin catheter
to the blocked artery area. This thin catheter
will help clear the blockage from the arteries
by pulverizing the calcified plaque. |
| THE
ELECTRICAL SYSTEM OF THE HEART |
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Q:
What is the Electrical System of the Heart?
A: The chambers of the heart contract and pump
blood with the directions conducted by the electrical
system of the heart. The electrical system starts
usually at the sino-atrial node (SA node), a
cluster of specialized cells. The SA node works
as a pacemaker and produces electrical impulses
at regular intervals, setting the pace for the
heartbeat. Each electrical impulse spreads throughout
the atria (upper chamber of the heart) causing
the heart to contract and pump blood into the
ventricles (lower chambers of the heart). Beginning
at the atria, the electrical impulse reaches
the atrio-ventricular node (AV node). The AV
node then slows each electrical impulse prior
to going to the ventricles. This slower impulse
reaches the ventricles through a conduction
pathway (made of specialized muscle fibers).
This pathway divides into a network of smaller
fibers, distributing the impulse throughout
both the lower entricles allowing them to contract
and pump blood.
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| LIVING
WITH A PACEMAKER |
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Q:
What are some of the common suggestions when living
with a pacemaker?
A: |
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Carry the implant
card with you at all times
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Do not have a Magnetic
Resonance Imaging (MRI) test.
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If unsure of limitations,
please read your implant booklet or
consult with your physician.
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Q: Can I participate in
regular activities?
A: After pacemaker implantation, gradually increase
activities as you are able to tolerate and per
your physician instructions. Follow physician
instructions regarding raising the arm above
your head (on the side where the pacemaker is)
and on any other recommendations.
· How do I know if my pacemaker is functioning
properly?
Complete checking of pacemaker will be done
in the physician's office; otherwise, you will
not be able to know if your pacemaker is functioning
properly. Should you feel lightheaded, dizzy
or experience fainting (syncope), call you physician
immediately. Follow your physician's instructions
for the next pacemaker evaluation.
Q: How often do I need
to adjust my pacemaker?
A: Pacemaker reprogramming may be needed from
time to time. Your cardiologist will evaluate
data from the pacemaker and make adjustments
if necessary.
Q: How often do I need
to replace my pacemaker?
A: A pacemaker generator (battery) must be replaced
every five to seven years. The battery energy
is evaluated during every check done in the
physician's office.
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| WHAT
TO EXPECT FROM: |
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Q:
What to expect from your frequency your Radiofrequency
Ablation procedure?
A: A catheter with an electrode tip is inserted
into an area of the heart muscle. The catheter
is guided with a moving x-ray (fluoroscopy)
which is then shown in a video screen to the
physician. The physician guides the catheter
to the location in the heart where electrical
signals stimulate an abnormal heart rhythm.
The purpose of the radiofrequency arrhythmia
ablation is to end these particular muscle cells
of the heart to continue to cause the additional
impulses, which cause the rapid heartbeats.
Q: What to expect from
your Electrophysiology Study?
The goal of an Electrophysiology Study (or EPS)
is to diagnose whether an abnormal rhythm is
present, and to determine the appropriate treatment.
Wire electrodes are placed inside the heart
for recording of the electrical signals. They
are threaded via the vein in the groin or neck
area. You will receive sedation, but may not
necessarily be asleep. During the procedure
your blood pressure, breathing and oxygenation
are closely monitored. The procedure may take
two to four hours.
Once the procedure is completed, the catheters
are removed and pressure is applied for 10-20
minutes to reduce the risk of bleeding. The
patient will be moved to a recovery area or
sent to a hospital room for further monitoring.
Q: What to expect from
your Permanent Pacemaker procedure?
The pacemaker is directly implanted in the body,
where it supplies the electrical signal needed
by the heart to maintain its normal heartbeat.
There are three basic parts to a pacemaker:
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The
pulse generator: is a small metallic
unit containing a battery and electrical
circuit. It will generate timed electrical
pulses or signals.
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The
lead wire: is an insulated wire.
Electrical signals travel along the lead
wire to the electrode.
- The electrode:
is a minuscule metal tip at the end of the
lead wire. It delivers electrical signals
directly to the heart muscle.
In most cases, the lead wire
is placed in a vein in the upper chest, then
treated along the vein to one of the chambers
of the heart. The electrode is left touching
the inner wall of the heart chamber. The pulse
generator is implanted under the skin in the
upper chest are with lead wires attached.
Prior to the procedure, you should not eat or
drink anything after midnight. You should report
any symptoms of flu, cold or infection to your
physician.
The pacemaker implantation usually takes about
two hours
Q: What to expect from
your ICD implant procedure?
A: During the one to two hour procedure, an
intravenous line will be inserted into the your
arm. A sedative may be provided to help with
relaxation. The ICD is usually implanted in
the upper chest area, next to the left shoulder.
A local anesthetic is injected to numb the area
where the implant will occur. The physician
will make a small incision in the area as well,
and place the small ICD device. The lead wire
is then inserted through that same incision
into a vein, guided (with the help of a x-ray
camera) through, and placed inside the heart.
The connection between the lead and the pulse
generator is made and tested. The device is
also programmed for your heart.
Q: What to expect from
your Tilt Table test?
A: You are positioned in a supine position and
brought to a predetermined angle or angles from
the horizontal position. Such positioning will
help the cardiologist determine the cause of
any decrease of oxygen to the brain. Certain
types of drugs may also be used during the procedure.
You will be directed to rest on a special table
(called a tilt table). An intravenous line is
inserted in one arm and a blood pressure cuff
is used on the other arm. ECG electrodes are
placed on the chest to allow the doctor to monitor
your heart rhythm. At the beginning of the test,
you will lie flat on the tilt table, then it
will be tilted until your head is upright (at
about 60 to 80 degrees). The doctor will be
monitoring your heart rhythm for about 45 minutes. |
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