Preventive Health Care Checks

Intensive Care Units

ICCU

We have an 8-bedded Intensive coronary care unit located on ground floor next to the emergency department. The unit is fully equipped with all facilities to address a range of needs of critically ill cardiac patients. Our nursing staff has many years of experience of working in the cardiac ICUs and provide close supervision with the help of central monitoring system with 1:1 nursing ratio for ventilated and critically ill patients while 1:2 ratio for other patients.
We have reliable, sophisticated high-tech equipment such as multichannel monitors, defibrillator, ventilators, IABP system pumps etc. capable of providing care to all complex patient needs dealing with cases such as heart attack, heart failure, acute coronary syndrome and all kinds of emergency cardiac situations

RECOVERY ROOM

The recovery room is a specialized intensive cardiac care unit wherein patients from who undergo cardiac surgery (CABG, open heart surgery, Valvular heart surgery like mitral value repair and replacement, AVR, DVR etc.) and those who’ve undergone interventional cardiac procedures from cathlab (ASD, VSD device closure) are managed post operatively and continuously monitored, until they are stable enough to be shifted out to wards. Patients regain consciousness under the supervision of nurses working closely with anesthetists in a safe environment. The length of time spent inside the ICU depends upon the type of surgery performed and condition of individual patient.
The ICU has strict infection control protocols and visitors are not allowed inside the ICU for patient safety reasons. However, attendants are counseled after surgery, kept informed about current state of the patient, and their loved one is shown to them through glass windows without allowing any of the visitors inside.
We are committed to giving quality care to our patients in an environment marked by deep empathy.

Cardiac Diagnostics

ECG (Electrocardiogram)

ECG is a test that measures the electrical activity of the heart. With each beat, an electrical impulse (or wave) travels through the heart. This wave causes the muscle to squeeze and pump blood from the heart. In order to perform an ECG, electrodes are positioned on the chest, wrists and ankles and a recording is made. An ECG reflects what is happening in different areas of the heart and may pick up an abnormality or previous damage.

Stress test

Stress test measures the heart's ability to respond to external stress in a controlled clinical environment. The stress response is induced either by exercise (treadmill test) or by intravenous drug stimulation (Dobutamine). As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart (coronary arteries).

• TMT (Treadmill test) – This is the exercise stress test that usually involves walking on a treadmill while your heart rhythm, blood pressure and breathing are monitored through ECG. Throughout the test, the speed and incline of the treadmill increase. The results show how well your heart responds to the stress of different levels of exercise.
• DSE (Dobutamine Stress Echo) - A stress echo is a combination of an ultrasound and exercise test. Dobutamine is a medication administered to place your heart under a similar amount of strain as would be achieved with exercise and then ECHO is done. This information helps cardiologist in assessing the state of your heart muscle and the arteries feeding that muscle.

Holter

Holter - A Holter monitor is a small, wearable, portable device that continuously records heart's electrical activity (ECG) continuously for 24 to 48 hours or longer. It can detect abnormalities in heart rhythm that an electrocardiogram cannot detect.

Ambulatory Blood Pressure Monitor

Ambulatory blood pressure monitor is a portable blood pressure recording device. It is used to record blood pressure at specified times during a 24-hour period. A one-time blood pressure measurement is often not enough to confirm whether your blood pressure is too high or too low. If your doctor suspects that you have hypertension or other blood pressure problems, they may refer you for ambulatory blood pressure monitoring.

ECHO and Color Doppler

An ECHO (echocardiogram), also known as a transthoracic echocardiogram (TTE), is an imaging technology that uses ultrasound waves to create images of your heart. It is a diagnostic test used to examine the heart and its blood supply, determine how large the heart is, how well it contracts, and how its valves function. In this, an ultrasound probe is placed on the patient’s chest (thorax) and high frequency sound waves are used to create images of the heart. Doppler technology is used to analyze the speed and direction of blood flow

Trans-esophageal Echo

In this test, sound waves are used to create pictures of heart muscle, chambers, valves as well as blood vessels. This test gives more details than a standard echocardiogram can give. In this test, the echo transducer is attached to a thin tube which is passed through mouth, down the throat and into esophagus.

Peripheral Vascular Imaging

Imaging of peripheral blood vessels using ECHO and color Doppler is done to diagnose Peripheral vascular disease (PVD), or atherosclerosis of peripheral blood vessels.

Cardiac Catheterization Lab

Cardiac catheterization lab, simply known as Cath lab, is where cardiologists perform diagnostic procedures (such as angiography and electrophysiology studies) and therapeutic interventions to treat many types of heart conditions.

Coronary Angiography,

Coronary Angiography is the Gold Standard test to diagnose Coronary Artery Disease. It is safe, effective, less time consuming and highly reliable. The procedure involves using a special dye (contrast) and x-rays to see how blood flows through the arteries in your heart.
The procedure most often lasts 30 to 60 minutes. The same procedure is used to determine blockages in other vessels like renal artery (Kidney).

Electrophysiology Studies (EPS) Angioplasty (including PAMI)

Electrophysiology Studies (EPS) studies use cardiac catheterization techniques to study patients who have irregular heartbeats (called arrhythmias). EPS shows how the heart reacts to controlled electrical signals. These signals can help cardiologists find out where in the heart the arrhythmia starts and what medicines will work to stop it. EPS can also help doctors know what other catheter techniques could be used to stop the arrhythmia.

Angioplasty (including PAMI)

An angioplasty is a technique used to dilate a narrowed coronary artery with a balloon catheter. A small tube (catheter) is inserted in the groin which is then maneuvered into the heart and coronary arteries. A balloon is then inserted through the catheter. The balloon is inflated inside a blood vessel to flatten any plaque that blocks it and cause it to become narrowed, decreasing the blood flow.
After the obstruction is relieved by the balloon dilation, most patients then immediately receive a stent. Stents are small, metal mesh cylinders that are delivered to the site of obstruction and expanded in the artery. Stents act as scaffolds to hold the artery open so it can heal with a normal diameter to allow blood to flow freely. Elective angioplasty is performed on patients who are not experiencing a heart attack, but have blockages significant enough to require an interventional procedure. Primary (or emergency) angioplasty (PAMI) is performed on a patient who is in the throes of an acute myocardial infarction (heart attack).

Rotablation

Sometimes, when the plaque (buildup of fat, cholesterol in artery's inner lining) is particularly hard, or so narrow that the balloon can’t pass through it during angioplasty, rotablation may be used. A special catheter (a thin tube) is inserted along the wire with a tiny drill at its tip. This drill is used to grind away the plaque to gradually widen the narrowing in the artery. Once this is done, a balloon can be inserted and the angioplasty proceeds as usual.

FFR Guided PCI

FFR (Fractional Flow Reserve) is a guide wire-based procedure that can accurately measure blood pressure and blood flow through a part of coronary artery. FFR is done through a standard diagnostic catheter at the time of coronary angiography. The measurement of Fractional Flow Reserve is useful in assessing whether or not to perform angioplasty on certain blockages.

CRT/ CRT-D (Cardiac Resynchronization Therapy)

There are two types of CRT devices. One is a special kind of pacemaker. It’s called a cardiac resynchronization therapy pacemaker (CRT-P) or “biventricular pacemaker.” The other is the same device, but it also includes a built-in implantable cardioverter defibrillator (ICD). This type is called a cardiac resynchronization therapy defibrillator (CRT-D).
While functioning like a normal pacemaker to treat slow rhythms, CRT-P device also delivers small electrical impulses to the left and right ventricles to help them contract at the same time so you heart pumps more efficiently.
A CRT-D is a special device for heart failure patients who are at high risk for sudden cardiac death. A CRT-D device can treat dangerously fast heart rhythms (arrhythmias) that can lead to sudden cardiac arrest. If the device senses heartbeats that are dangerously fast, it delivers a shock to the heart. This shock (defibrillation) stops the abnormal rhythm. Without this life-saving therapy, the dangerously rapid rhythm could lead to death in minutes.
CRT devices are fitted with a battery which will run out over time. Since the battery is permanently placed inside device, it can’t be replaced when it’s down. So if the battery runs out, entire device needs to be replaced. The battery life depends on the settings your doctor programs and how much therapy you receive.

ICD & Pacemaker Implantation

ICD

Arrhythmias, which are abnormal heart rates or rhythms, are caused by issues with the electrical system of the heart. ICD (Implantable cardioverter-defibrillator) is a device that can correct these life-threatening arrhythmias. It can perform cardioversion, defibrillation, and pacing of the heart. It is implanted under the skin on the chest.

Pacemaker

It can monitor and record the rate and rhythm of the heart. The main purpose of a pacemaker is to make sure the heart rate does not get too slow. It is implanted under the skin on the chest.

Balloon Valvotomy

In this procedure, a thin catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed heart valve, a balloon located on the tip of the catheter is inflated, causing widening of the valve.

PDA, ASD, VSD Closures

PDA (Patent Ductus Arteriosus), ASD (Atrial Septal Defect) and VSD (Ventricular Septal Defect) are the congenital birth defects of the heart. All these defects allow blood to pass from the left side of the heart to the right side, which is abnormal and increase load on the heart. Majority of these defects can be corrected in cath lab without needing open heart surgery.

Electrophysiology Studies

Electrophysiology studies are minimally invasive procedure used for diagnostic study which tests the electrical conduction system of the heart. It is recommended in people with heart rhythm problems (arrhythmias).

Cardiac Operation Theatre

NMWIC is a pioneer in cardiac operation theatre set up which was established in 1990. Our cardiac set up includes two dedicated operating rooms with modern equipment which includes Laminar flow with HEPA filter, Drager – Fabius plus anesthesia machine, Philips MP 70 anesthesia invasive monitor along with two indigenous Heart-lung machines, two latest Datascope intra-aortic balloon pumps etc.
NMWIC has performed all types of cardiac surgeries including pediatric cardiac surgeries.
Types of surgeries done at NMWIC

CABG (Bypass)

Coronary artery bypass surgery, also known as heart bypass or bypass surgery is a surgical procedure to restore normal blood flow to an obstructed coronary artery. The procedure involves taking a healthy blood vessel from thigh, arm or chest and connecting it beyond the blocked arteries in heart, thereby creating a bypass for improved blood flow. It is a major open heart surgery indicated in patients with more than one diseased coronary artery.

Valve Repair & Replacement

Diseased and narrowed heart valve which cannot be repaired/ replaced in cath lab can be repaired in an open-heart surgery. In this surgery, a large incision is made in the chest and the heart stopped for a time so that the surgeon can repair or replace the valve(s).

Vascular surgery

These are the surgeries performed on diseased blood vessels of the peripheries. Examples - Peripheral bypass, embolectomies, carotid endarteriotomies for prevention of strokes etc.