Cardiovascular emergencies are life-threatening disorders that must be diagnosed quickly to avoid delay in treatment and to minimize morbidity and mortality. Patients may present with severe hypertension, chest pain, dysrhythmia or cardiopulmonary arrest. Ramkrishna CARE Hospiatls has a state-of-the-art coronary care unit, supervised by specially trained intensive care unit (ICU) doctors and caregivers. Our cardiologists offer the following services round-the-clock:
- Primary coronary angioplasty (angioplasty performed during a heart attack)
- Stent implantation
- Peripheral angiography and angioplasty
The interventional cardiologists at Ramkrishna CARE Hospiatls are well experienced in treating complex coronary and structural heart diseases. The Cardiac Catheterization Laboratory is one of the top in the country and our doctors are leaders in this technology. The state-of-the-art procedures and services offered include high-risk unprotected left main coronary artery stenting, transcatheter aortic valve replacement, paravalvular leak closure and hybrid procedures.
Our interdisciplinary team of interventional cardiologists, along with renowned echocardiographers and dedicated heart failure specialists, work closely to assess the optimal treatment options for patients with complex heart disease.
The common procedures performed are:
- CT coronary angiography
- Peripheral angiogram & angioplasty (carotid, subclavian, lilac femoral, renal, etc.)
- Radial angiography & angioplasty
- Directional coronary artery stenting
- Bradycardia pacing
- Coronary artery stenting
- Intra-vascular ultrasound
- Balloon valvuloplasty
- Non-surgical closure of holes in the heart such as atrial septal defect (ASD), ventricular septal defects (VSD) and patent ductus arteriosus (PDA)
- Pacemaker implantation/ICD/CRT implant (cardiac resynchronization therapy)
Cardiothoracic & Vascular Surgery
Ramkrishna CARE Hospitals has one of the largest, most experienced cardiac surgery teams in the country. Cardiothoracic surgery refers to the treatment of diseases affecting the organs inside the chest (thorax), including conditions of the heart and lungs. The Center for Cardiothoracic Surgery is a Center of Excellence, which performs virtually every type of heart surgery and attracts thousands of patients from India and across the world. The Institute of Cardiac Sciences specializes in closed and open heart surgery, beating heart surgery and valve replacement. With a transplant theater and well-equipped ICUs, Ramkrishna CARE Hospiatls has been consistently ensuring excellent outcomes.
Ramkrishna CARE Hospiatls also has advanced facilities for heart transplantation for patients with damaged hearts, who have stopped responding to medicines.
Coronary Artery Bypass Graft (CABG)
Coronary bypass surgery is one of the options to treat heart disease. The coronary artery bypass graft is a procedure that restores the blood flow to the heart muscle, by diverting the flow of blood around a section of a blocked artery in the heart. In coronary bypass surgery, a healthy blood vessel is taken from the leg, arm, chest or abdomen and connected to the other arteries in the heart so that the blood is bypassed around the diseased or blocked area. After a coronary bypass surgery, blood flow to the heart improves.
Coronary bypass surgery improves symptoms such as chest pain and shortness of breath, due to poor blood flow to the heart. In some situations, coronary bypass surgery may improve the heart function and reduce the risk of death due to heart disease.
Beating Heart Surgery
In a beating heart surgery, a procedure is performed without stopping the heart. Surgeons use a special device to stabilize that part of the heart on which they are operating. The heart continues to beat and circulate blood to the heart muscle during the operation. Surgery on a beating heart offers reduced risk of complications, normally associated with stopping the heart temporarily during surgery.
Minimally Invasive Heart Surgery
A minimally invasive heart surgery is performed through small incisions in the right side of the chest, as an alternative to open heart surgery. Our surgeons operate between the ribs and don't split the breastbone, which offers reduced pain and quicker recovery for most people. In minimally invasive surgery, the heart surgeon has a better view of some parts of the heart than in open heart surgery. As in open surgery, minimally invasive heart surgery requires stopping the heart temporarily and diverting blood flow from the heart using a heart-lung machine.
Our thoracic surgeons perform extensive and challenging thoracic procedures (lung, esophagus, etc.) with excellent outcomes. These include operations for removal of malignancies from the lung and the esophagus. The procedures performed include minimally invasive procedures on the lung and esophagus, as well as Video-Assisted Thoracoscopic Surgery (VATS).
The Institute of Cardiac Sciences has a complete transplant team with:
- Transplant surgeons
- Transplant cardiologists
- Intensivists & critical care specialists
- Infectious disease consultants
- Transplant coordinators
- Trained staff nurses
Heart Valve Surgery
Heart valve surgery is done to replace or repair heart valves that are not working correctly. Most valve replacements involve the aortic and mitral valves. The aortic valve separates the left ventricle (the heart’s main pumping chamber) and the aorta (the major artery that carries blood to the body). The mitral valve separates the left atrium from the left ventricle.
The Nuclear Cardiology Division at Ramkrishna CARE Hospiatls uses non-invasive techniques to assess myocardial blood flow, evaluate the pumping function of the heart and visualize the size and location of the heart attack.
Myocardial Perfusion Imaging
Myocardial perfusion images are combined with exercise to assess the blood flow to the heart muscle. The exercise mode for this is usually walking on the treadmill. A "chemical" of "pharmacological" stress test using the drug dipyridamole, adenosine or dobutamine is performed in patients who are not able to exercise maximally, providing similar information about the heart's blood flow.
A small amount of an imaging agent or thallium is injected into the blood stream during rest and during exercise or chemical stress. A scanning device (gamma camera) is used to measure the uptake of the imaging material by the heart during stress and at rest. If there is significant blockage of a coronary artery, the heart muscle may not get enough blood supply, while performing the exercise or during chemical stress. This decrease in blood flow will be detected by the images.
Myocardial perfusion helps in identifying areas of the heart muscle that have inadequate blood supply, as well as those areas that are scarred due to a heart attack. In addition to the localization of the coronary artery with atherosclerosis, myocardial perfusion quantifies the extent of the heart muscle that has limited blood flow and also provides information about the pumping function of the heart.
The Division of Pediatric Cardiology has achieved extraordinary success in diagnosing and treating the most difficult and complex cardiac conditions in fetuses, children and young adults. The division is globally recognized for its pioneering approach to the science and clinical care of patients with cardiovascular diseases. The division also cares for newborns with congenital heart disorders, providing support and education to their parents.
The division represents one of the best and largest pediatric cardiology programs in India, providing all non-invasive diagnostic and pediatric cardiac interventional services. The diagnostic modalities include foetal echocardiography, transthoracic and transesophageal echocardiography, 24-hour Holter, CT and MR angiography and diagnostic cardiac catheterisation. The interventional or non-surgical procedures performed include hybrid pediatric cardiac interventions, balloon atrial septostomy, device closure of atrial septal defect (ASD), ventricular septal defects (VSD), patent ductus arteriosus (PDA), balloon valvuloplasty of critical pulmonary, aortic stenosis and coarctation of aorta, MAPCA coiling, etc.
The Division of Pediatric Cardiology offers both neonatal and pediatric cardiac intensive care. Ramkrishna CARE Hospiatls is renowned for its dedicated Pediatric Cardiac Catheterization Suite and laboratory for performing hybrid procedures.
Pediatric Cardiology Services
- Echocardiogram: Transthoracic echocardiogram & transesophageal echocardiography (TTE & TEE)
- Fetal echocardiogram
- ECG services
- CT/MRI angiography
- Interventional pediatric cardiology
- Pediatric cardiac angiography
- Device closures: Patent ductus arteriosus (PDA), atrial septal defect (ASD), ventricular septal defect (VSD)
- Balloon septostomy
- Balloon valvuloplasty
- Stenting of coarctation and branch PAs
- Coil closures of collaterals & PDA
- Surgical services
- Closing holes in the heart
- Shunt surgery
- Tetralogy of Fallot repair
- TAPVC (total anomalous pulmonary venous connection) repair
- Arterial switch operation
- Valve repair and replacement
- Conduit surgery
- Truncus arteriosus correction
- Senning operation
Preventive Heart Care
Ramkrishna CARE Hospiatls offers multiple preventive health check-up packages to detect and prevent heart disease at an early stage.
(More information on health packages available in each hospital’s section)
Electrophysiology is a field of cardiology which deals with the electrical systems of the heart and its abnormalities, such as variations in heart rate and rhythm. It covers patients with palpitations, fast or slow heart beating pulses and episodes of blackout — which place patients at a high risk of sudden cardiac arrest. Treatment is planned on the basis of an electrophysiological (EP) study and radio frequency (RF) ablation pacemaker and ICD (defibrillator implantation).
An electrophysiology study is a specialized procedure conducted by a trained cardiac specialist, called an electrophysiologist. In the procedure, one or more thin, flexible wires, called catheters are inserted into a blood vessel (usually the groin) and guided into the heart. Each catheter has two or more electrodes to measure the heart’s electrical signals as they travel from one chamber to another.
EP studies are done to diagnose cardiac rhythm abnormality to help determine the best treatment and to pinpoint the site where therapy may be useful.
The CARE Hospitals’ Division of Electrophysiology, with its highly skilled team and advanced technology, is a one-stop centre for the treatment of arrhythmias. The team has enormous experience in all types of electrophysiology studies, radio frequency ablations, pacemaker implantation, other devices implantations and resynchronization therapy.
CARE Hospitals’ Cardiac Imaging Centre is a state-of-the-art facility where cardiac imaging specialists from radiology and cardiology work together to provide patients the most accurate and appropriate diagnostic medical imaging services. The Cardiac Imaging Center offers thorough and advanced imaging services. Ramkrishna CARE Hospiatls was the first hospital in the country to perform a cardiac MRI.
The Cardiac Rehabilitation Department at Ramkrishna CARE Hospiatls offers a professionally supervised program to help patients recover from heart attacks, heart surgery and percutaneous coronary intervention (PCI) procedures, such as stenting and angioplasty. The Cardiac Rehabilitation Department provides education and counseling services to help heart patients increase physical fitness, reduce cardiac symptoms, improve general health and reduce the risk of future heart problems, including a heart attack.
Cardiac rehabilitation is beneficial for anyone who has a history of:
- Heart attack
- Coronary artery disease
- Heart failure
- Peripheral arterial disease
- Chest pain (angina)
- Certain congenital heart diseases
- Coronary artery bypass surgery
- Angioplasty and stents
- Heart transplant
- Heart valve replacements
People of all ages with heart conditions can benefit from cardiac rehabilitation.
The Catheterization Laboratory at Ramkrishna CARE Hospiatls facilitates in diagnosing and treating heart patient while conducting angiographies, medicated and non- medicated stent and ballooning, if required, within the shortest period of time. The Cath Lab has a high capacity to transform X-ray beams into perfect visual images, which enable physicians and surgeons to diagnose diseases accurately and treat patients efficiently.
The state-of-the-art intravascular ultrasound (IUVS) is a test that uses sound waves to see inside the blood vessels. An IVUS is usually done to make sure that a stent is placed correctly during angioplasty. It may also be used to view the aorta and structure of the artery walls (which can show plaque build-up) and identify which specific blood vessel is involved in aortic dissection.
Echocardiography shows the size and shape of the heart and how well the heart chambers and valves are working. An echo can pinpoint areas of the heart muscle that aren't contracting well, because of poor blood flow or injury from a previous heart attack. An echo also can detect possible blood clots inside the heart, fluid build-up in the pericardium (the sac around the heart) and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from the heart to the body.
Transesophageal echocardiography (TEE)
This is a type of echocardiography that uses sound waves to create high-quality moving pictures of the heart and its blood vessels.
The 3-dimensional echocardiography is one of the most widely used diagnostic tests in cardiology. It provides a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity and the location and extent of any tissue damage.
64-slice CT Angiography
This state-of-the-art imaging system provides high-quality, precise imaging from head to toe, making it possible to detect abnormalities in any part of the body. Its high speed scanning reduces time, thus reducing patient discomfort during the imaging procedure.
Dual Source CT Scanner
The Dual Source CT Scanner can image the entire heart in a single rotation, providing volumetric temporal resolution that is superior to the multi-slice temporal resolution, resulting in a clearer image quality. It not only shows the whole organ’s anatomy, but also the changes in the entire organ over time, resulting in a better, faster and more complete diagnosis. Moreover, it can perform a comprehensive neurological examination, providing arterial, venous and whole brain perfusion in a single study with both less contrast and radiation dose. It is especially helpful in identifying the level of heart disease in people with high cholesterol levels and high blood pressure, but with few overt signs and symptoms.
Magnetic resonance imaging (MRI) is a diagnostic procedure that uses a combination of a large magnet, radio frequencies and a computer to produce detailed images of the organs and structures within the body.