Cardiology is a branch of medicine that deals with the complication of our heart as well as some parts of our circulatory system. The doctor who deals with these problems is known as a cardiologist. It is considered as a branch of internal medicine. The thing to note here is that a cardiologist should not be confused with a cardiac surgeon as both of them are different. A cardiologist specializes in diagnosing and treating the diseases of our cardiovascular system whereas a cardiac surgeon will cut open our heart to perform a surgery.
A cardiologist specializes according to the age of the patient. It is specialized into two classifications –
1. Pediatric cardiology – a pediatric cardiologist is a pediatrician who specializes in diagnosing and treating children’s cardiac problems. The extensive training that has been received by a pediatric cardiologist is solely for treating children.
2. Adult cardiology – the diagnosis and treatment of adults is different than children. Their training differs from pediatricians.
Cardiology involves various different tests and treatments. Before the tests are given, a patient’s height, weight, blood pressure, blood sugar level tests are done. If there is an interventional cardiologist involved, then he/she may carry out procedures such as angioplasty, stenting, valvuloplasty, -congenital heart defect corrections, thrombectomies etc. There are several tests that are carried out –
1. Electrocardiogram – Also known as ECG, this test is done to record the electrical activity of our heart over a period of time with the help of electrodes that are placed on the skin.
2. Ambulatory ECG – heart rhythms are recorded when a person is doing physical activity. This is carried out by electrodes that are connected by wires to a holter monitor which records the reading.
3. Echocardiogram – the structure of the heart chamber and the surrounding areas is shown with the help of echocardiogram which provides an ultrasound picture. If there is any inflammation around the heart, then also it can be detected with the help of echocardiogram.
4. Cardiac catheterization – this test is done to relieve a blockage in the heart. It is a small tube in or near the heart that collects the data. With the help of cardiac catheterization, functioning of the heart and the electrical system is also checked. In this process, the diagnosis is done by inserting catheter into the heart and then treated accordingly. A needle puncture is made through the skin and a catheter will be guided into the vessel. The positioning of the catheter will be monitored by the video screen. Instruments are placed at the tip to measure the pressure of the blood in each heart chamber. One of the methods to diagnose heart problem is coronary angiography. When a catheter is used to inject a dye which is seen on X-rays is known as angiography.
5. Nuclear cardiology – it uses radioactive materials with the help of nuclear imaging techniques to study cardiovascular system in a noninvasive way.
There are different surgical procedures that are given by us –
1. Coronary artery bypass graft – this surgery is provided for patients who have significant narrowing in their heart and blockages of the heart arteries. With the help of this surgery, new routes are formed around narrowed and blocked arteries. This allows blood to flow which delivers oxygen and nutrients to the heart muscle.
2. Beating heart surgery – it is a form of coronary artery bypass graft surgery but in this, no heart-lung machine is used. In simpler terms, heart will not be stopped while performing this surgery. In this surgery, one section of the healthy vein is removed and attached to the heart above the blockage in the artery. Once this vein is attached, normal blood flow is restored.
3. Heart valve surgery – heart valve repair is a surgical technique to fix defects in our heart valves. Some of the abnormalities that are treated are mitral regurgitation or aortic stenosis. There is leakage of blood through the mitral valve in mitral regurgitation and in aortic stenosis, our aortic valve becomes narrower hampering the normal flow of blood.
Some of the disorders of the heart which are dealt in cardiology are as follows –
1. Hypertension – Hypertension or high blood pressure has become common but long term blood pressure may cause coronary artery disease, stroke, heart failure, etc.
2. Arrhythmias – it is a condition in which there is irregular heartbeat. It can be too fast or too slow.
3. Cardiac arrest – cardiac arrest is a condition in which there is no smooth blood flow. This is because the heart does not contract effectively.
1. Cardiac surgery
Cardiac surgery is that form of surgery in which our heart and blood vessels are operated to repair the damage caused by diseases of the cardiovascular system. This surgery is used to treat diseases such as ischemic heart disease, congenital heart disease, valvular heart disease, rheumatic heart disease etc. Some of the common types of cardiac surgeries are.
a. Open heart surgery – In an open heart surgery, the patient’s heart is stopped and surgery is performed on its internal structures. In this type of surgery, the heart is temporarily stopped and the patient is put on cardiopulmonary bypass. It is the technique in which there is a heart-lung machine which takes over the function of the heart and lungs to maintain the circulation of blood and the oxygen content of the patient’s body.
b. Heart transplantation – It is a surgical transplantation procedure for patients who are suffering with end stage heart failure or severe coronary heart disease. This procedure is imparted when every other surgical treatment has failed. In this procedure, the patient’s own heart is either removed and replaced with the donor’s heart or the recipient’s diseased heart is left in place to support the donor heart.
c. Coronary artery bypass grafting – It is a surgical procedure for an obstructed coronary artery to restore normal blood flow. It is also known as revascularization. The main aim of this surgery is to create an alternate path to deliver blood supply to the heart and body to prevent formation of clot.
d. Minimally invasive surgery – These surgeries are an alternate to complex surgeries where small incisions in the chest wall are made. An endoscopic procedure is carried out in which a small camera and special tools are inserted. One example of a minimally invasive heart surgery is robot-assisted heart surgery.
2. Interventional cardiology
Interventional cardiology is a branch of cardiology which deals with non surgical means. It specifically uses catheter based treatment of structural heart diseases. Catheter is a small, flexible tube which is used to repair damaged or weakened vessels, narrowed arteries or other affected parts of the heart’s structure. Coronary heart diseases, heart valve diseases, peripheral vascular diseases are some of the common conditions that are treated with the help of interventional cardiology. Some of the procedures are as follows –
a. Angioplasty – It is a minimally invasive endovascular procedure to dilate either arteries or veins. In this procedure, deflated balloon attached to a catheter is passed into the narrowed vessel and then inflated to a fixed size. The inflation forces expansion of the blood vessel allowing an improved blood flow. Stents are inserted after clearing of the blockages. In this procedure, a catheter is used to clear a narrowed or blocked artery.
b. Valvuloplasty – Valvuloplasty is a procedure that is done to open a stiff heart valve with the help of a catheter that is inserted into the blood vessel in the groin and progresses it through the aorta into the heart.
c. Congenital heart defect correction – With the help of congenital heart defect correction, defects like atrial septal and ventricular septal are corrected.
The average time is 1-2 hours for a heart catheterization and 2-4 hours for procedures that involve irregular heartbeat.
The need of anesthesiologist depends on the individual needs. The physician will make sure you have what you need.
Complications may occur but with improvements in technology, the risk of complications is being reduced.
Most children are born with heart disease but there are some problems which may develop later.