Cardiac Sciences

Cardiac sciences is a broad area of medicine dealing with the diagnosis, treatment, and management of heart and vascular conditions. It encompasses many specialist areas as a single entity for overall cardiovascular care. For instance, cardiology manages heart diseases through non-surgical means, including coronary artery disease, heart failure, or arrhythmias.

Cardiac surgical practices include procedures like coronary artery bypass grafting, valve repairs, and transplants, in respect to severely diseased hearts. Interventional cardiology focuses more on less invasive treatments for diseased arteries through techniques such as angioplasty and stenting. Electrophysiology focuses on the diagnosis and cure of heart rhythm disorders through strategies like catheter ablation and the use of implantable devices. In addition, Vascular medicine deals with diseases involving blood vessels, such as aneurysms and peripheral artery disease, and so provides comprehensive care of all aspects of cardiovascular health.

What Types of Heart Conditions Are Addressed in Cardiac Sciences?

The cardiac team at Marengo Asia Hospitals is dedicated to treating extensive conditions regarding the heart. Their services include the following treatment of conditions:

• Coronary artery disease
• Heart attack known as myocardial infarction
• Heart failure
• Arrhythmias or irregular heartbeats
• Hypertension or high blood pressure
• Valvular heart disease
• Congenital heart defects
• Peripheral artery diseases
• Cardiomyopathy
• Aneurysms

Risk Factors of Cardiovascular Diseases

Cardiovascular diseases have been rated to be the number one cause of death globally. Knowing the risk factors is a good move toward prevention and better management of cardiovascular diseases early on. The risk factors can be categorised into broad headings, namely modifiable and non-modifiable.

1. Non-Modifiable Risk Factors:

• Age: The risk of developing cardiovascular diseases increases in old age. Blood vessels get less elastic with every passing year, and thus, it is more likely to get heart-related problems.
• Gender: Heart disease is more likely to occur and earlier among men than women. However, after menopause, the risk becomes higher in women.
• Family History (Genetics): If anyone in your immediate family, especially younger relatives, had heart disease, the risk seems to be increased. You may be predisposed to heart disease through inheritance.

2. Modifiable Risk Factors:

• High Blood Pressure (Hypertension): Uncontrolled high blood pressure is one of the primary contributors to heart disease. It puts too much strain on the heart and blood vessels, thereby increasing the risks of heart attacks and strokes.
• High Cholesterol Levels: Elevated levels of LDL or bad cholesterol lead to the deposition of fatty deposits in the arteries, which then narrows these and increases the chances of having cardiovascular events. Levels of HDL or good cholesterol are usually very low.
• Smoking: Inhaling tobacco significantly increases the chances of developing cardiovascular diseases, and this is so because smoking damages blood vessels, diminishes the carrying capacities of oxygen within the blood, and increases the opportunities for the clotting of blood.
• Obesity: Obesity, especially central obesity, raises the prevalence of more risk factors with increased blood pressure, high cholesterol levels, and type 2 diabetes, all of which are the major determinants of cardiovascular disease.

3. Other Contributing Risk Factors:

• Stress: Chronic stress may contribute to heart disease as it causes elevated blood pressure and promotes unhealthy coping behaviours, such as overeating, smoking, or alcohol abuse.
• Sleep Apnea: A sleep disorder that causes interrupted breathing while at rest. It can lead to hypertension and heart stress over time.

What Are The Various Tests Performed To Diagnose Cardiovascular Diseases?

The heart condition diagnosis is supposed to use several tests and procedures in scrutinising the heart structure, thus diagnosing its functionality. Common tests that are conducted include:

• Electrocardiogram (ECG or EKG): An electrocardiogram measures electrical activity within the heart. This is useful in identifying arrhythmias, and heart attacks, among other heart conditions.
• Echocardiogram: Gives out images of the heart structure and functionality with the use of ultrasound waves. It thus helps the physician look at heart valves and chambers.
• Stress Test: Evaluates how the heart performs under physical stress, often induced through exercise or medication to mimic exertion on the heart.
• Chest X-ray: This will display images of the heart and lungs to determine enlargement of the heart and fluid buildup in the lungs.
• Cardiac MRI and CT Scans: They give advanced views of the heart and blood vessels to diagnose many complex conditions and evaluate possible treatments.
• Holter Monitor: A portable ECG device worn for 24-48 hours to monitor heart rhythm over an extended period.
• Blood Tests: This measures the level of cardiac biomarkers. It may reflect damage to the heart or increase the risk factors.

Cardiac Treatment at Marengo Asia Hospitals

Interventional Procedures

Interventional cardiology involves some minimally invasive interventions used for the management of certain heart conditions without the involvement of major surgery. They are:

1. Angioplasty: Also known as percutaneous coronary intervention (PCI), the procedure restores blood flow to the heart by opening blocked or narrowed arteries called coronary arteries. A small balloon, via a catheter, is inflated at the site of the blockage compressing the plaque against the artery wall and restoring blood flow. In many cases, this is followed by the placement of a stent to keep the artery open.

2. Stent Placement: A stent is implanted almost invariably after an angioplasty. It is a small, expandable, tubular mesh made of metal, implanted in the artery to ensure it does not narrow again. A stent supports walls between which blood flows, providing better flow to the heart muscle. Types of stents include bare-metal stents and drug-eluting stents. The latter has a drug coating to prevent the narrowing of the arteries again (restenosis).

3. Balloon Valvuloplasty: This intervention is mainly used for stenosis of the heart valve by inflating a balloon on the end of the catheter that is taken through the blood vessels to the stiff or narrowed heart valve. The balloon will then dilate the valve and improve its function. Blood flow now becomes uncomplicated throughout the heart.

Cardiac Surgery

Sometimes, if the medication and the minor interventions are considered less apt, the patient may be in a position requiring surgical intervention. These surgical alternatives are especially used for major or complicated heart conditions:

1. Coronary Artery Bypass Grafting (CABG): This is an operation that creates a bypass route past obstructed coronary arteries in order to restore blood flow to the heart muscle. Grafting is accomplished through the surgical removal of an unrestricted blood vessel from another area, such as the leg (saphenous vein) or chest (internal mammary artery), which is then grafted past the obstructed segment of the artery. CABG is often the procedure of choice for the treatment of patients with severe coronary artery disease. This is because it improves heart function and quality of life.

2. Valve Repair or Replacement: When heart valves are damaged or do not open and close properly, surgery becomes obligatory. Surgeons attempt to repair the valve initially, where they reconstruct the existing valve to regain its normal functioning. If the valve has been damaged beyond usability, it can be substituted with an artificial valve (mechanical or biological). The surgery helps pump blood efficiently through the heart and alleviates symptoms of heart failure or other complications associated with valve disease.

3. Heart Transplant: The heart transplant is reserved for patients who have end-stage heart failure. It becomes the final option in case other treatments fail. In this treatment process, the diseased heart is removed, and a healthy donor heart is implanted. The nature of transplants is very complex and calls for an evaluation for appropriateness. A patient is, after the surgery, expected to be given immunosuppressive drugs that prevent rejection of the new heart. They are kept under close observation for complications.

4. Cardiothoracic Surgery: Cardiothoracic surgery encompasses all those surgical procedures primarily focused on the heart and thoracic cavity. These include the cardiac surgeries enumerated above but also those concerning the lungs and major blood vessels, addressing a range of conditions from congenital flaws to complex cardiovascular problems.

Electrophysiological Procedures

They are specific therapies for arrhythmia conditions. The treatments include:

1. Ablation Therapy: This treatment is intended to remove abnormal extra electrical pathways of the heart that are causing arrhythmias. A catheter is placed inside a blood vessel and then directed toward the heart, where the problematic area or tissue is destroyed by radiofrequency energy or cryotherapy. In this way, ablation can be employed for the restoration of normal heart rhythm and to reduce the recurrence or severity of arrhythmias. This therapy is particularly effective for conditions like atrial fibrillation and atrial flutter.

2. Pacemaker Implantation: This involves the insertion of a very small device under a part of the chest through a small incision to help coordinate slow or irregular heartbeats. It sends electrical impulses to stimulate the heart to beat in a normal fashion. The process is very minimally invasive and usually carried out under local anaesthesia. Pacemakers can sometimes have an extremely positive effect on the lifestyle of patients with bradycardia, slow heart rate, or other types of heart rhythm disorders.

3. Implantable Cardioverter Defibrillator (ICD): ICD is a device implanted inside the chest. This continuously monitors the rhythm of the heart. If a life-threatening arrhythmia is caught, the ICD delivers an electric shock to restore a normal heartbeat. It is uniquely important for those patients who would be at an increased risk of sudden cardiac death due to conditions such as ventricular tachycardia or ventricular fibrillation. In this way, it would be lifesaving to patients and will provide peace of mind to their family members.

4. Cardiac Resynchronization Therapy (CRT): This is a high-tech treatment of heart failure where a pacemaker helps to synchronise the contractions of the ventricles of the heart. CRT has shown efficacy in patients for the improvement in the mechanical functions of the heart, and those individuals with a slow or dye synchronised rhythm who have had a diagnosis of heart failure. It has been demonstrated to increase exercise tolerance, quality of life enhancements, and diminish hospitalisation due to heart failure.

Management of Cardiovascular Diseases

Once a diagnosis of cardiovascular disease is made, physicians start recommending appropriate treatments according to the patient's specific medical condition. Some standard practices that are often followed in managing cardiovascular diseases are as follows:

Lifestyle Changes

The most common prescription for managing cardiovascular diseases is in terms of a heart-healthy lifestyle. Physicians usually advise patients to:

• Follow a Low-Fat Diet: Taking a diet that is high in fruits, vegetables, whole grains, and lean meats but low in saturated fats, trans fats, and cholesterol, reduces blood pressure and cholesterol.
• Exercise Regularly: Exercise makes the heart stiff and enhances circulation. According to most experts, doing at least 150 minutes of moderate aerobic exercise per week is good.
• Quit Smoking and Limit Alcohol: Quitting smoking is of paramount importance since it reduces the risk of heart disease by as much as three-quarters. Cutting down on alcohol can similarly help in the improvement of your heart health.

Medications

For instances where lifestyle modification is not sufficient, certain medicines will be used based on the type of heart condition. Common categories of heart medications include:

• Antihypertensives: Use them to regulate blood pressure.
• Statins: They reduce cholesterol levels and also lower the risk of a heart attack.
• Anticoagulants: These drugs prevent patients from getting blood clots whenever they are suffering from heart-related conditions.
• Beta-blockers and ACE inhibitors: The treatments control heart failure and the former helps in increasing the functioning of the heart.

Pacemakers or ICD

For patients suffering arrhythmias, the doctor may prescribe an implantable cardiac pacemaker or even an Implantable Cardioverter Defibrillator. These devices are implanted in the chest or abdomen through minor surgery; they control irregular heartbeats.

• Pacemakers send impulses to stimulate the heart when it beats too slowly to ensure a normal heart rate.
• ICD devices monitor the heart rhythm constantly and shock when necessary, especially when it has been detected that life-threatening arrhythmias have been experienced and could lead to instant cardiac arrest.

Surgery

When drugs and any other lifestyle change cannot bring about a cure, surgery may be required. The kinds of common heart surgeries conducted in cardiac hospitals include:

• Coronary Artery Bypass Grafting (CABG)
• Heart Valve Replacement or Repair
• Percutaneous Coronary Intervention (PCI)
• Heart Transplant

Why Choose Marengo Asia Hospitals For Cardiac Care?

Marengo Asia Hospitals is unique for cardiac care because:

• Specialized Cardiac Services: We use the latest technology, including advanced imaging systems and surgical tools with facilities for robotics systems and cardiac monitoring devices.
• State-of-the-Art Facilities: Equipped with the latest technology, including advanced imaging systems, robotic-assisted surgery tools, and cardiac monitoring devices.
• Expertise and Experience: Our cardiologists and cardiac surgeons are highly qualified and experienced in not only delivering personalised care but also delivering effective care to complex cardiovascular issues.
• Comprehensive Support Services: We have adequate support services to encompass patient education, rehabilitation programs, nutritional counselling, and psychological support.