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Cardiology
At Asian Heart Institute we offer the full
range of cardiology services, from early disease
detection to complex interventions. Our diagnostic
services include, ECG, stress testing, 2-dimensional
echocardiography, stress echocardiography, holter
testing, and angiography. |
| The Cardiac
Catheterization Laboratory, where angiographies,
angioplasties etc. are performed, is a state-of-the-art,
first fully digital panel Cathlab in Mumbai.
The flat panel technology replaces the image
intensifier technology, which has been in
use for many years. |
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| The flat panel technology
incorporates Solid-state Digital Detector
to reliably provide consistently high imaging
performance through the full range of cardiac
procedures. This is a fully integrated imaging
system that meets all clinical needs for
interventional and diagnostic cardiac angiography
with advanced image quality, innovative
dose management and ease of positioning.
The flat panel technology promises the highest
level of clarity of the angiogram without
any loss of detail. This will be helpful
in complex angioplasty procedures where
minor details and better image quality are
critical for achieving results. |
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| Click
here to view the Cath lab |
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 Heart Rhythm Management:
Overview
Heart Rhythm Disorder
Causes of Tachycardia and Bradycardia
Symptoms
Diagnostic Tests
Treatments
Specialized Pacing Pherapy
Cardiac Electrophysiologist
Overview:
Heart rhythm disorder comprises of fast heart rhythm known as tachycardia and slow heart rhythm known as bradycardia. In USA, more than 300,000 sudden cardiac deaths occur every year. In India with a billion populations, the incidence of cardiac disease especially coronary artery disease is very high. The sudden cardiac death in India is estimated to be much higher due to increased prevalence of coronary artery disease. Apart from the heart rhythm problem associated with coronary artery disease, many patients also suffer from fast heart rate or slow heart rate not associated with any structural heart disease. This also may be life threatening in certain cases. Therefore there is an urgent need for specialty clinics to identify and treat these patients.
Asian heart institute is fully equipped to treat the cardiac rhythm disorder, which is the predominant cause for sudden cardiac deaths. Various diagnostic and management options for cardiac rhythm management are widely available in this center.
Heart Rhythm Disorder:
Heart rate varies from 60 to 100 per minute at rest. If it becomes too fast it results in tachycardia and when it is too slow, it results in bradycardia. During both the occasions, the cardiac output becomes low and patient may develop various symptoms which may be mild to sudden cardiac death in extreme situations. Patient needs to immediately report to the doctor if such symptoms develop at any time and undergo a full cardiac checkup by the experts.
Causes:
Causes of fast heart rate (Tachycardia):
• Supraventricular Tachycardia
- Atrioventricular nodal reentrant tachycardia
- Atrioventricular reentrant tachycardia including WPW syndrome
- Others
• Ectopic atrial tachycardia
• Atrial flutter
• Atrial fibrillation
• Ventricular tachycardia
• Ventricular fibrillation
Atrial Flutter: May need Electrophysiology study and Radiofrequency ablation
Causes of slow heart rate (Bradycardia):
• Sick sinus syndrome
• Various degree of heart block
Sick Sinus Syndrome: May need Pacemaker implantation
Symptoms:
Symptoms may vary from mild to severe in any individual case with cardiac rhythm disorder: These are as listed below but not limited to:
• Giddiness (Light headed ness)
• Palpitation (Feeling of heart beating fast)
• Presyncope (Blackout)
• Syncope (Transient loss of consciousness associated with a fall)
• Extreme fatigue
• Excessive tiredness
• Sudden cardiac death
Diagnostic tests:
Electrocardiogram (ECG):
This test shows the electrical activity of heart at rest. A persistent slow or fast cardiac rhythm problem can be detected by ECG and a proper diagnosis can be made in most of the patients.
Ambulatory ECG (24 hour Holter):
This is an extended recording of ECG over 24 hour period. ECG may not pick up a transient cardiac arrhythmia. The 24 hour ECG rhythm is recorded in a cassette or disc which is analyzed and reported. Ambulatory ECG picks up transient arrhythmias if it occurs during that 24 hour hook in period.
Electrophysiology study (EPS):
This test is done in the catheterization laboratory for which patient needs to be admitted. Procedure is performed usually under local anesthesia. Multiple catheters are put via the major veins into the cardiac chambers and positioned at different regions and the natural electrical conduction pattern in the heart is studied. If required, various stimulation study is performed to determine the exact nature of heart rhythm abnormality.
Click here to view Electrophysiology study in the Catheterization laboratory
A tracing during EP study
Treatments:
Tachycardia:
Drugs:
Various kinds of drugs are available to treat tachycardia. Depending on the clinical situation, the physician selects the appropriate drug. Often the drug has to be taken for a prolonged period of time. The drugs may have side effects needing withdrawal in some.
Radiofrequency ablation:
Radiofrequency (RF) ablation is a part of electrophysiology study and is often done at the same time. Once the nature of tachycardia is determined, a RF catheter is put in side the heart and RF is performed at an appropriate site. It destroys the underlying culprit tissue by means of the RF current which is an electromagnetic wave of around 500 KHz. It generally is a painless therapy. It often leads to permanent cure from tachycardia.
Implantable cardioverter and defibrillator (ICD):
Very fast rhythm like ventricular tachycardia carries a high risk of sudden cardiac death. This kind of tachycardia needs immediate detection and deployment of appropriate therapy. Very often ICD device is used in such patients. ICD looks like a pacemaker device and consists of a long lasting battery, a capacitor and an electronic circuit encased in a can. This device is implanted below the left collar bone under the subcutaneous tissue. A high voltage lead is inserted to the cardiac chamber and the ICD is connected to it at its proximal end. Via the lead, the ICD detects if there is any tachycardia and immediately determines the nature of the tachycardia and delivers appropriate therapy. Different kinds of therapy are programmed by the implanting physician depending on the nature of the underlying tachycardia which varies from antitachycardia pacing to shock therapy. ICD is often lifesaving.
ICD: Delivers shock between can and the RV lead
Bradycardia:
Correction of offending cause:
If the bradycardia is due to a systemic disease like hypothyroidism or due to any drugs like beta blocker, calcium channel blocker which is administered for another aliment, then correction of these can lead to recovery from bradycardia.
Pacemaker therapy:
If excessive bradycardia leads to symptoms in a patient, then a pacemaker may be necessary. Pacemaker is a device consisting of a long lasting battery; an electronic circuit encased in a can and is placed below the collarbone underneath the subcutaneous tissue. Lead/Leads are inserted to the cardiac chambers and the proximal end is connected to the pacemaker. Pacemaker does beat to beat monitoring and delivers pacing therapy when needed.
Dual chamber pacemaker: Leads placed at right upper chamber and right lower chamber. It senses the electrical activity in both the chambers and if required delivers pacing therapy
Specialized Pacing therapy:
Cardiac resynchronization therapy (CRT):
In some cases of heart failure drugs alone may be insufficient. Part of the heart failure due to severe depression of pumping function can be caused by the underlying dyssynchronus contraction of the heart muscles. This dyssynchrony can be corrected by simultaneous pacing of right ventricle (right lower chamber) and Left ventricle (Left lower chamber). This is a specialized pacing therapy and requires positioning of leads at right ventricle and left ventricle.
Fluroscopy picture of CRT: One lead is placed at LV, another lead at RV and the third lead is placed at RA
| Cardiac Electrophysiologist:
Dr. Santosh Kumar Dora MD, DM (Click here)
Electrophysiology fellow at Cedar Sinai Medical Center, UCLA, Los Angeles, USA
Email: santosh.dora@ahirc.com
Tel. : +91-22-66986666
Cell : 9920069719
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 Laboratory Medicine:
The department of Laboratory
Medicine is a round the clock facility with
state of the art equipment.
Biochemistry section has a fully automated,
discrete, computerized Hitachi 902, random acres
analyzer with a throughput of 200 Tests / hour.
The laboratory has the facility to perform
Arterial Blood Gas estimation with electrolyte
estimation on stat basis with the IL 1610 and
IL 1650 and ILYTE, ABG and electrolyte analyzer.
The Blood Bank provides whole blood and various
components like: Packed Cells, Saline Washed
Packed Cells, Fresh Frozen Plasma, Platelet
Concentrate, Cryoprecipitate, Cryo-poor Plasma.
Platelet pharesis with donor screening is also
carried out on the MCS+.
The Blood Bank has a Component Preparation
Laboratory with equipment like the Cryofuge
5500i from Heraeus. There is a deep freezer
from Heraeus and platelet agitator and incubator
from Terumo Penpol for storage of components.
The department caters to out patients as well
as in patients. Well-trained staff provide round
the clock service.
The instruments are interfaced with the Hospital
Information Management System. |
| Click
here to view the Department of Laboratory Medicine |
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| Physiotherapy |
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is an allied health service that involves rehabilitating and maximizing the functional potential of an individual who has a disease/dysfunction or injury |
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is the prevention of injury and health promotion |
The Physiotherapy Department at
ASIAN Heart Institute provides a fully comprehensive
service to the Institute and community with state
of the art equipment and a well qualified
skilled staff.
Physiotherapy at ASIAN Heart comprises of:
Inpatient Rehabilitation Program:
The physiotherapists work closely with members of the medical team to reduce period of hospitalization and optimize patient's physical functions.
The services are provided for patient admitted to the hospital mainly in the areas of cardio-pulmonary care.
These services are rendered in the intensive care units (ICU) as well as patient rooms (wards).
Some of these services are:
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Respiratory Physiotherapy |
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Therapeutic Exercises for cardiac and non cardiac cases |
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Electrotherapy for pain management |
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Patient and Family Education and counseling |
Pulmonary Rehabilitation Program:
This program aims to reduce symptoms and improve physical fitness of patients suffering from respiratory diseases like bronchial asthma, COPD (Chronic Obstructive Pulmonary Disorders).
Physiotherapists work closely with the physician, intensivist and the nurse to:
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Prevent acute episodes |
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Reduce hospital stay |
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Improve patient's level of fitness and endurance and gain their optimal functional independence |
This program is provided for inpatients & outpatients. Some of these services are:
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Aerosol Therapy: (nebulization) |
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Chest Therapy: which includes Postural Drainage on specially designed postural drainage couch, Ventilatory Muscle Training, Endurance and Strength Training, Pacing Techniques, Relaxation Techniques |
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Self Care Training: Help to cope up with daily living activities |
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Patient and Family Education: Patient information and counseling |
Out Patient Rehabilitation:
Caters to the following types of cases:
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Sports Injury and Rehabiliation:
This program includes sports performance enhancement, gait analysis, biomechanical assessment. Also includes common problems like a sprained ankle, tennis elbow, rotator cuff injuries, knee ligament injuries, postural and biomechanical disorders (scoliosis) etc.
The physiotherapist evaluates and provides appropriate treatment which includes:
- Electrotherapy to promote healing process and pain relief
- Hands on joint mobilization by manual therapy, soft tissue mobilization, , stretching, strapping
- Therapeutic exercise to maintain & improve joint flexibility, muscular strength, endurance, balance and coordination, postural awareness / correction and gait training
Exercises are taught so that they can be safely performed at home. Electrotherapy equipments are of Chattanooga USA. The electrotherapy services are:
- Moist Hot Packs
- Cold Packs
- Infra red
- Ultrasound Therapy
- Interferential Current Therapy (IFT)
- Transcutaneous Nerve Stimulation
- Muscle Stimulation |
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Geriatric Care Program: This program caters to the elderly populations who have problems like multi-joint pain, frequent falls, osteoporosis, general physical fitness, etc.
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Paediatric Rehabilitation Program: This caters to children with orthopaedic problems [congenital deformities or injuries], neurological problems [cerebral palsy, erbs palsy, etc], respiratory problems [asthma, bronchiolitis, etc]. The child care program promotes physical fitness in school children.
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Neurological Conditions: This caters to people with neurological problems like stroke, Parkinsons, multiple sclerosis, etc.
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Corporate Wellness: (click here to know more about Corporate Wellness)
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General Fitness Promotion: This caters to people who are interested in improving their physical fitness and preventing injuries. the aim is to promote healthy lifestyles, weight reduction and includes health promotion talks. |
Testimonials from patients: (click here)
For further enquiries / appointments, contact us at:
| Address: |
Dept. of Physiotherapy
Asian Heart Institute
Bandra Kurla Complex
Bandra (E)
Mumbai 400 051 |
Asian Heart City Centre
Qi Life Care
1st floor, Eros building
Churgate
Mumbai 400 020 |
| Tel. nos.: |
022 66986559, 022 66986538 |
022 66390011, 9819900123 |
| E-mail: |
physiotherapy@ahirc.com |
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PHYSIOTHERAPY: SCIENCE OF HEALING, ART OF CARING
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