Adult Cardiology

The heart has a complex, multi-dimensional shape. A proper assessment of the function of its parts requires a multi-dimensional depiction of its structural and functional intricacies. This complex physical relationship can be studied using reflections from high frequency sound waves, called ultrasound, which can give information on blood and heart muscle motion.
Services offered included in echocardiography:

• Transthoracic Echocardiography.
• Transesophageal Echocardiography.
• Tissue Doppler Imaging (Tissue velocity and strain imaging).
• 3D Echocardiography.
• Contrast Echocardiography.
• Pharmacological Stress Echocardiography.
• Intraoperative Echocardiography.

Four echo labs are located in the out-patient department. Echo machines are also used in the Cath lab, Surgical theatres and ICUs.
Available machines include high end – Vivid 7 Dimensions 9GE), Philips IE 33 with 3 D with transesophageal probe.

For the imaging of cerebrovascular, cardiac, visceral and peripheral vasculatures, CT coronary angiography using a Siemens Somatom 64 slice CT scanner enables accurate, noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome and negative biomarkers. It is also useful for screening patients with intermediate risk for developing coronary artery disease. It is now the choice of diagnostic test for evaluating blood clots on arteries supplying lungs (pulmonary embolism).
Diagnosis and treatment planning with nonoperative techniques for aortic aneurysms (thinning and bulging) as well as the dissection of the aorta needs good quality picture generated by MDCT. Occlusion of blood supply to legs, hands and other organs can also be accurately quantified by this technique.

This imaging is very useful in assessing the damage of heart muscles caused by heart attack, as well as:

• Evaluation of heart failure.
• Detection and quantification of heart defects present at birth.
• Tumors of the heart.
• Pericarditis (inflammation of the sac covering heart).
• Evaluation of arrhythmogenic RV dysplasia, sarcoidonic and other causes of ventricular arrhythmia and heart failure.

Using radioisotopes as a diagnostic tool, it is possible to assess the function of the heart and its blood supply. Our sophisticated facility has a Siemens gamma camera to perform the following procedures:

• Thallium and MIBI perfusion studies.
• Viability testing.
• MUGA (Ventriculogram).
• Ventilation perfusion lung scans.
• Renal perfusion scans.
• Tc labelled RBC venogram for DVT.

Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging. It is used to identify the patients with damaged heart muscles likely to get benefit from angioplasty and bypass surgery. It is also effective in determining the blood flow to heart as well as infections and cancers.

Holter monitoring and head up tilt tests with pharmacological challenges are utilized for the evaluation of patients with syncope. Detailed expert clinical assessments and implantation of Loop recorder as well as EP study in selected patients is conducted when necessary.

The cardiac catheterization lab is equipped with a twin suite Siemens HICOR digital imaging system which is fully networked. The Cath Lab is one of the larger volume centers in India and with the outstanding results achieved so far, the AIMS Cath Lab has played a role in elevating the hospital to national prominence.

Remediation offers services including:

• Diagnostic Angiogram.
• Intravascular Ultrasound.
• Fractional Flow Reserve (FFR).
• Angioplasty and Stenting.
• Rotabalation.
• Day care radial route angiogram and angioplasty.
• Primary angioplasty program offers 24×7 acute myocardial infarction treatments. In order to facilitate the rapid establishment of blood flow in occluded artery, we bypass the emergency room delay by transporting patients directly to Cath Lab.

• Angioplasty and stenting of blood vessel supplying brain (carotid artery) to prevent catastrophic. stroke in symptomatic patients with blocks.
• Renal angioplasty in patients critically reduced blood flow to kidneys.
• Limb saving recanalization of occluded peripheral vessels.
• Aortic angioplasty and stenting for congenital/acquired evaluation/aortoarteritis.

• Device closure of heart defects – congenital atrial septal defect and ventricular septal defect.
• Post myocardial infarction septal rupture device closure.
• Keyhole treatment of valvular heart disease-Mitral, Aortic , Pulmonary and Tricuspid balloon valvotomy.
• Alcohol ablation of septal myocardium in Obstructive Hypertrophic Cardiomyopathy.

• Aortic aneurysm treatment with stent grafts.
• Peripheral artery aneurysm- stent grafting.

• AIMS is one of the few centres in India offering comprehensive cardiac arrhythmia services and has taken the lead in providing the most modern cardiac arrhythmia care by installing a state-of-the-art, 3D mapping system. This system helps in navigating EP catheters in real time as well as for mapping any arrhythmias. The system generates and displays 3D graphical images of cardiac structures. This 3D system helps in offering long lasting cures for complex arrhythmias like post MI scar ventricular tachycardia, Atrial Fibrillation and Focal tachycardia. It also helps improve procedural success and at the same time reduces procedural time and X ray exposures (fluoroscopy) times. The EP team provides:

  • Diagnostic electrophysiological study.
  • Radiofrequency ablation of different arrhythmias in adults and children.
  • Pacemaker implantation for patients with Brady (slow) arrhythmias.
  • Cardiac resynchronization (biventricular pacing) in patients with heart failure with expertise in optimization of therapy based on expert ECHO guidance.
  • Automatic Internal Cardiac Defibrillator (AICD) for patients with potentially lethal heart rhythm abnormalities.
  • Syncope evaluation including autonomic evaluation, Head-Up Tilt Testing.
  • Pacemaker – AICD follow up clinic.
  • Implantation of loop recorders for evaluation of syncope of unknown etiology.