The vocation of the Diagnostic & Interventional Cardiology Department is the detection and management of coronary and valvular heart disease.

 

 

Coronary angiography:

 

Coronary heart disease can cause pain in the chest (angina pectoris), myocardial infarction and heart failure (manifesting as shortness of breath). Since deterioration can be slowed down by appropriate treatment regimen, early, reliable diagnosis is key.

 

Coronary angiography defines the underlying coronary artery problem (stenosis or blockage) but sometimes echocardiography is necessary to obtain a higher-resolution image. If revascularisation is necessary, either a percutaneous (coronary angioplasty) or a surgical (aorto-coronary bypass surgery) approach may be used.

 

Coronary angioplasty:

 

Coronary angioplasty is a way of achieving myocardial revascularisation. The heart is a muscle fed by arteries, namely the coronary arteries. If one or more of these is blocked, it has to be unblocked. Coronary angioplasty involves introducing a small balloon at the site of the blockage by pushing it through the artery on a metal wire. The balloon is then inflated to dilate the artery, then it is deflated and removed. In some cases, a tubular prosthesis (a stent, a mesh tube which lines the artery wall) is left in place at the site. Other instruments like a drill (Rotablator) may also be used.

 

Trans-thoracic echocardiogram:

 

Based on a probe that emits waves of ultrasound, trans-thoracic echocardiography provides information about heart contractile function and the permeability of the heart valves.

 

With the patient lying down, the chest is coated with a water-soluble, conducting gel. The probe is placed over the heart at a series of different spots. When coupled with Doppler imaging, this can provide information about how the blood is circulating in the heart cavities.

 

Transesophageal echocardiogram:

 

Transesophageal Doppler echocardiogram involves introducing a probe into the oesophagus to image the heart. This technique yields very high-quality images.

 

It is a painless examination performed with local anaesthesia which provides the cardiologist with valuable information about the heart.

 

It should only ever be performed if a preliminary trans-thoracic echocardiographic examination has failed to furnish the required information, or if greater resolution is needed.

 

The patient who should have been fasting for six hours and treated with a local anaesthetic, lies on his or her left and the probe is gently inserted via the mouth. Then the aorta is located and, 4 centimetres lower down, the left atrium and the other structures of the heart.

 

Exercise test

 

This type of test is carried out to investigate coronary artery function to evaluate the severity of coronary heart disease with a view to treatment, and to investigate suspected exertion-induced arrhythmia or conduction problems.

 

It is often performed on athletes or after heart surgery and physical therapy, to evaluate the capacity for effort in children or adults.

 

It is performed using a cycloergometre (a kind of bicycle). The examination is not without risk and surveillance by a nurse and an experienced cardiologist is essential. The heart’s rate, rhythm and electrical activity (electrocardiography) are measured continuously throughout the test.