City Heart Centre offers a wide range of cardiovascular and pulmonary services, from prevention to surgery and rehabilitation. City Heart Centre provides a large verity of Facilities to its Patients with the latest technology & equipment available in the market in a clean and hygienic environment
In conventional x-rays, a beam of energy is aimed at the part of the body being studied. A plate behind the body part captures the variations of the energy beam after it passes through skin, bone, muscle, and other tissue. While much information can be obtained from a regular x-ray, specific detail about internal organs and other structures is not available.
During a computed tomography scan (CT scan), the x-ray beam moves in a circle around the body. This allows for many different views of the same organ or structure, and provides much greater detail. The x-ray information is sent to a computer which interprets the x-ray data and displays it in 2-dimensional form on a monitor. While many images are taken during a CT scan, less radiation is received by the patient than during a single standard x-ray, in many cases.
CT scans may be done with or without contrast. "Contrast" refers to a substance taken by mouth or injected into an intravenous line that causes the particular organ or tissue being studied to be seen more clearly. If your physician schedules you for a CT scan of the heart or chest, you may need to be NPO (fasting, or nothing by mouth) for four hours prior to the procedure if contrast dye will be used. Your physician will provide specific instructions.
You will need to let your physician know if you have ever had a reaction to any contrast dye, or if you are allergic to iodine or seafood. If you are pregnant or think you may be pregnant, you should notify your physician. If you are claustrophobic or tend to become anxious easily, tell your physician ahead of time, as he/she may prescribe a mild sedative for you before the procedure to make you more comfortable. It will be necessary for you to remain still and quiet during the procedure, which may last 30 to 60 minutes.
Chest x-rays may be ordered as part of a physical examination, before hospitalization and/or surgery, or to assess signs or symptoms of conditions such as those related to the heart or lungs. Some signs or symptoms that may indicate the need for a chest x-ray include, but are not limited to, the following:
Chest x-rays are also used to check the position of implanted pacemaker wires and other internal devices such as pulmonary artery catheters or central venous catheters. Pulmonary artery catheters and central venous catheters are usually inserted through a vein in the neck (the jugular vein) or under the collarbone (the subclavian vein). A pulmonary artery catheter is advanced through the two chambers on the right side of the heart into the pulmonary artery in order to measure pressures in the heart to assess its function. A central venous catheter is advanced to the upper right chamber of the heart in order to assess fluid status and to infuse certain medications that cannot be given through a smaller vein in the arm or hand.
If your loved one needs medical assistance, City Heart & Medical Centre is open 24 hour a day-everyday to take care of your big and small emergencies. The emergency department is always ready for you and staffed by an emergency physician and an experienced staffed. We provide immediate response for heart attack patient.
The emergency department offers level III emergency care consisting of
Every time the heart beats, tiny electrical impulses are discharged. Using a process called electrocardiography, those electrical discharges can be recorded and used to measure the heart's condition. Several thin wires are attached to the body. The wires conduct the electrical charges into a machine that measures them and produces readout. Since most electrocardiograms show a healthy heart for patients at rest, doctors take the readout while the patient is under the stress of strenuous activity. Stress electrocardiography reveals a different picture of the heart's health. Usually, the patient walks on a treadmill machine while the heart readings are taken.
An exercise echocardiogram, also known as a stress echocardiogram, is a test that combines an ultrasound study of the heart with an exercise test. The test allows doctors to learn how the heart functions when it is made to work harder.
The exercise test is generally safe. A small amount of risk does exist since exercise stresses the heart. Extremely rare complications include abnormal heart rhythms and a heart attack. Experienced personnel are available to handle any emergency.
An echocardiogram works very much like sonar. Ultrasound waves are transmitted into the chest and the reflection of these waves off the various parts of the heart is analyzed by sophisticated equipment.
A transducer, which is a small microphone-like device, is held against the chest. The transducer sends and receives the ultrasound waves. By moving the transducer to various positions on the chest, different structures of the heart may be analyzed.
A computer assembles the reflected ultrasound waves to create an image of the heart. These images appear on a television screen. The images may be recorded on videotape or printed on paper for review by the cardiologist.
To provide a baseline of information, an echocardiogram is first done while the patient is at rest. Then, a second echocardiogram is obtained during or immediately after an exercise test using a treadmill.
The images of the heart at rest and during exercise (under stress) are compared. Normally, all areas of the heart muscle pump more vigorously during exercise. If an area of the heart muscle does not pump, as it should during exercise, this often indicates that it is not receiving a sufficient flow of oxygen-rich blood because of a blocked or narrowed coronary artery.
Although an exercise echocardiogram indicates regions of the heart that may be affected by reduced blood flow through the coronary arteries, it does not provide images of the actual coronary arteries. If blocked or narrowed coronary arteries are suspected, your doctor may recommend additional tests.
The branch of medicine concerned with the prompt diagnosis and treatment of injuries or trauma or sudden illnessemergency medicine includes techniques for effective handling of medical emergencies and resuscitation of patients.Responding to medical emergencies
The proper way to handle a medical emergency is to activate emergency medical services and call for help using your local emergency telephone number Be ready to give your name and location, and to tell what is wrong with the person you are calling about. Answer the questions you are asked truthfully.
If you are trained to perform first aid. Emergency care given before regular medical aid can be obtained first aid, do what you can to care for the victim. If you are not, remain calm and stay with the person. Do not allow others to crowd around unless their presence is needed. Evacuate the victim yourself unless you are either completely confident of your ability to do so or have no other alternative. Self-transport should be to the nearest emergency room. A room in a hospital or clinic staffed and equipped to provide emergency care to persons requiring immediate medical treatment emergency room.Artificial Respiration
An emergency procedure whereby breathing is maintained artificially artificial respiration may be immediately required to save their life.
An emergency procedure whereby breathing is maintained artificially Artificial respiration is part of: CPR
An emergency procedure consisting of external cardiac massage and artificial respiration, the first treatment for a person who has collapsed and has no pulse and has stopped breathing; attempts to restore circulation of the blood and prevent death or brain CPR training.
A person trained to assist medical professionals and to give emergency medical treatment paramedic can use airway. A duct that provides ventilation (as in mines) airway management techniques to help a person who is not breathing, which is one reason to call for help. If a person is not breathing and their heart is not beating (i.e., no pulse), cardiopulmonary resuscitation.Cardiopulmonary Resuscitation
An emergency procedure consisting of external cardiac massage and artificial respiration; the first treatment for a person who has collapsed and has no pulse and has stopped breathing; attempts to restore circulation of the blood and prevent death or braicardiopulmonary resuscitation (CPR) is necessary to sustain life until help arrives.
Holter monitoring is a continuous, twenty-four hour electrocardiographic (EKG) recording of the heart's rhythm.
Electrodes are placed on the chest area with the leads attached to a small recorder.
The patient will keep a 24-hour diary to record daily activities and any symptoms experienced.
It will take 15 minutes to have the monitor put on.
The patient will return the next day to have the monitor removed.
This test must be ordered by a doctor.
This test will help the doctor evaluate the type and amount of irregular heart beats during regular activities, exercise and sleep.What Can be Expected After the Monitor is Put on?
Once the monitor is in place, do not touch or adjust the electrodes or the monitor.
Do not get the electrodes or the monitor wet.
Do not have X-rays taken while wearing the holter monitor.
Avoid using an electric blanket, heating pad or water bed while wearing the monitor.
The patient must record daily activities and any symptoms he experiences in the daily diary provided. This will help the doctor make a more accurate evaluation.
Do not apply creams, oils, or powder to your chest before the test.
Wear loose, comfortable clothing.
Pre-register 1-3 days prior to the day the test is scheduled. This will save considerable time on the day of the test.
Please call (0135) 2651919, 2656439 Mobile: 9897049966 to pre-register.
Plan to arrive 15 minutes before the scheduled time of the test.
Enter the hospital through the main lobby.
If pre-registered go directly to the Cardiology Department.
Fully equipped to treat all type of medical emergency twenty four hours fully equipped modern pathology lab with air conditioner ICU. A modern out patient department which is staffed by highly qualified doctors.
For more 20 years, noninvasive blood pressure (NIBP) monitors have been widely used in operating rooms and critical care units to closely monitor blood pressure in patients of all ages. Despite the widespread use of automated blood pressure monitors, clinicians continue to deliberate over the accuracy and reliability of automated NIBP devices compared to other methods of blood pressure determination. The following answers to commonly asked questions about the use of NIBP monitoring are based on clinical research.How do blood pressure measurements obtained with automatic noninvasive blood pressure (NIBP) devices compare to direct arterial measurement of blood pressure?
Clinical research studies have demonstrated that when blood pressures (systolic, diastolic, and mean arterial) determined by NIBP monitors from various manufacturers are compared to direct arterial pressures, the two values are, on average, within 5 mm Hg of each other. (1-9) Factors such as the anatomical location of measurement contribute to the differences that exist between direct and indirect methods. For example, in comparing brachial arterial pressure obtained by the NIBP monitor to radial arterial pressure obtained by direct arterial cannulation, radial arterial pressure is normally higher because the radial artery is a smaller vessel and creates greater resistance to flow, which in turn leads to a higher blood pressure reading than that determined via the brachial artery.
These studies also indicate that occasionally, an individual NIBP blood pressure determination value will vary by as much as 37 mm Hg from the direct arterial value. (1-9) this large discrepancy indicates that treatment should never be made based on a single NIBP determination without comparison to an auscultatory blood pressure determination or several consecutive measurements performed by an NIBP monitor.Is it important to use the correct cuff size when using automatic NIBP devices?
Yes. Using a cuff that is 1oo small will lead to falsely high readings, and using a cuff that is too large will lead to falsely low readings. The cuff width selected should equal 40% of the arm circumference (see Figure). The American Heart Association recommendations for appropriate cuff sizes based on upper-arm circumference should also be followed when using NIBP monitors (see Table). (10)Are there any patient-related complications associated with using NIBP devices?
Skin and tissue compression from NIBP monitors, which can lead to skin irritation and bruising, are probably the most commonly occurring complications. Prolonged use and frequent blood pressure determinations can lead to venous pooling and congestion. Excessive venous pressures can lead to tissue ischemia and nerve damage. (11, 12)What factors can interfere with obtaining accurate NIBP measurements?
Several circumstances can prevent accurate determination of blood pressure with NIBP devices. Highly irregular or rapid cardiac rhythms make it difficult to accurately determine blood pressure using NIBP devices because of the great beat to beat variability. Most NIBP devices employ oscillometric technology that is dependent on fairly regular cardiac rhythms to determine blood pressure. Excessive patient movement such as shivering, restlessness or external movement such as that from a helicopter, ambulance transport, or a rapid-cycling ventilator can interfere with detection of cardiac oscillations by the NIBP monitor. This can lead to erroneous blood pressure measurements. (1, 13) Table
American Heart Association recommended sizes for blood pressure cuffs based on arm circumference (10)
Extremity circumference * (cm) Cuff name
5 - 7.5 Newborn
7.5 - 13 Infant
13 - 20 Child
17 - 25 Small adult
24 - 32 Adult
32 - 42 Wide/large adult
42 - 50 Thigh
Noninvasive ventilation is the delivery of ventilatory support without the need for an invasive artificial airway. Such ventilation has a role in the management of acute or chronic respiratory failure in many patients and may have a role for some patients with heart failure. Noninvasive ventilation can often eliminate the need for intubation or tracheostomy and preserve normal swallowing, speech, and cough mechanisms. The use of noninvasive positive-pressure ventilation (NPPV) in acute hospital settings and at home has been steadily increasing.Advantages of NIMV
A pacemaker is a small electronic device that regulates the heart beat by sending electrical signals to the heart.
The pacemaker device consists of two parts:
The battery unit: a small metal case that contains the power source and regulates how often signals are sent to the heart
The wire: carries electrical messages back and forth between the heart and the pacemaker
The device is much smaller than a deck of cards and weighs a bit more than an ounce.
When a problem develops in the heart's electrical tissue, this can cause the heart to beat too slow or too fast.
When the heart is not beating fast enough to pump an adequate amount of blood to the body, symptoms such as dizziness, fainting spells, blurred vision or shortness of breath can occur.
A permanent pacemaker is needed when these conditions cannot be controlled by medications.
A permanent pacemaker is inserted in the operating room.
The patient is sedated during the procedure.
The pacemaker battery unit is usually placed just under the skin in the upper chest. The pacemaker wire is threaded through a vein into the heart muscle.
A small dressing will be placed over the incision site and sutures.
The patient is admitted to a special cardiac care unit for about 24 hours so he can be closely monitored.
The patient's pulse, blood pressure, and incision site will be checked frequently.
Purpose of Pulmonary Function Testing
Pulmonary Function Testing has been a major step forward in assessing the functional status of the lungs as it relates to:
Screening for the presence of obstructive and restrictive diseases Evaluating the patient prior to surgery - this is especially true of patients who :
TMT is the most widely used test in the diagnosis of ischemic heart disease. It involves recording the 12-lead ECG before, during, and after exercise on a treadmill.
The test consists of a standardized gradual incremental increase in external workload while the patient's ECG, symptoms, and arm blood pressure are continuously being monitored. The test is discontinued upon evidence of chest discomfort, severe shortness of breath, dizziness, fatigue, ST-segment depression of greater than 0.2 mV (2 mm), a fall in systolic blood pressure exceeding 10 mmHg, or the development of a ventricular tachyarrhythmia.
This test helps to discover any relation between exercise and chest discomfort and the typical ECG signs of myocardial ischemia.
ECG signals from two approximately orthogonal leads are combined in a rectangular-to-polar coordinate converter to obtain signals representing the magnitude and angle of the vector. The vector angle existing at the instant the magnitude of the QRS vector reaches its peak is first identified, and a voltage corresponding to the vector angle is sampled and stored for later use. Secondly, the vector angle existing at the instant the magnitude of the T-wave vector reaches its peak later in the cardiac cycle, is identified, and a voltage corresponding to this second vector angle is sampled and stored. The voltages representing the QRS and the T-wave vector angles are then applied to a differential amplifier to obtain a difference voltage representing the angular difference existing between the two maximal vectors. This angular difference possesses certain characteristics which are diagnostically significant. A classifying circuit determines which one of a number of angular ranges the angular difference falls into. A counter is provided for each angular range to accumulate over successive heartbeats the number of differences which have fallen into each of the angular ranges, and the cumulative counts are displayed.
Nebulisers in General Practice : A nebuliser is a device that converts liquid into aerosol droplets suitable for inhalation. Nebulisers use oxygen, compressed air or ultrasonic power to break up medication solutions and deliver a therapeutic dose of aerosol particles directly to the lungs. The use of nebulisers in the community is declining. However they may still be useful in certain clinical situations, and are preferred by some patients.
Ultrasonic nebulisers use a rapidly vibrating piezoelectric crystal to produce aerosol particles. Ultrasonic nebuliser machines are often smaller and quieter.
Other than cardiology City Heart Centre also provide all the below mentioned services and the consultants are available round the clock.