Cardiology Services

Echocardiography

This is a method of studying the heart’s structure and function by analysing sound waves bounced off the heart and recorded by an electronic sensor placed on the chest. It uses ultrasound to process the information to produce a 1, 2 or 3 dimensional moving picture that shows how the heart and heart valves function. The procedure is completely painless and does not require any preparation. The doctor or technician carrying out the investigation will ask you to lie on a couch partly on your left hand side and will use a probe which is placed on the left side of your chest to make the recordings. The procedure normally takes about 20 to 30 minutes.

Exercise Testing

An exercise test, helps us to know how the heart copes with exertion. The test can show if the blood supply is reduced to the heart. You will walk slowly in place on a treadmill. The speed is then increased for a faster pace and the treadmill is tilted to produce the effect of walking up a hill. You can stop the test at any time if needed after which you will sit or lie down to have your heart and blood pressure checked.
The heart rate and blood pressure and electrocardiogram are monitored during the test. We may recommend you have a stress test to investigate how well your heart functions under strenuous work loads, and to predict the risk of a dangerous heart attack occurring in the future.

Coronary Angiography (via the radial artery approach) for improved safety and patient experience
Calcium Scoring is a technique where the extent of calcification in the coronary arteries is measured and scored from x-ray images produced by a multi-slice CT scanner. There is a direct correlation between the extent of calcium in the coronary arteries and the risk of a future cardiac event.

The CT scan accurately measures the level of calcified plaque in the walls of the coronary arteries. This will enable us to assess your relative risk.

CT Coronary Angiography is an alternative out-patient procedure to conventional angiography for evaluation of the coronary arteries. It is a non-interventional procedure which will not require a stay in hospital. It is particularly suitable for patients who have cardiac type symptoms but who are otherwise at low risk of coronary artery disease.

CT Coronary Angiography can be used to evaluate:

  • the coronary arteries
  • cardiac function
  • the pulmonary veins
  • the thoracic aorta
  • the pericardium

Patients requiring this procedure undergo a strict screening process by a cardiologist to ensure their suitability for this test.

Coronary catheterization

Coronary catheterization uses pressure monitoring and blood sampling through a catheter inserted into the heart through blood vessels in the arm to determine the functioning of the heart, and, following injections of radiocontrast dye, uses X-ray fluoroscopy, typically at 30 frames per second, to visualize the position and size of blood within the heart chambers and arteries. Coronary angiography is used to determine the patency and configuration of the coronary artery lumens. This determines the degree of narrowing within the coronary arteries and gives us an overall impression of the current pattern of arterial narrowings and how best to treat them.

Percutaneous coronary intervention (PCI) – Angioplasty

Commonly known as coronary angioplasty or simply angioplasty, is one therapeutic procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. These stenotic segments are due to the build up of cholesterol-laden plaques that form due to atherosclerosis. PCI is performed by me as a very effective curative therapy for significant artery disease and is performed from the wrist, and is usually done as a daycase.

Fractional flow reserve/Pressure wire

(FFR) is a technique used in coronary catheterization to measure pressure differences across a coronary artery stenosis (narrowing, usually due to atherosclerosis) to determine the likelihood that the stenosis impedes oxygen delivery to the heart muscle (myocardial ischemia).
The decision to perform a PCI (angioplasty) is usually based on angiographic results alone. Angiography can be used for the visual evaluation of the inner diameter of a vessel. In ischemic heart disease, deciding which narrowing is the culprit lesion is not always clear-cut. Fractional flow reserve provides a functional evaluation, by measuring the pressure decline caused by a vessel narrowing and is a useful adjunct to deciding optimal therapy.

Intravascular ultrasound

Intravascular ultrasound, also known as a percutaneous echocardiogram is an imaging methodology using specially designed, long, thin, complex manufactured catheters attached to computerized ultrasound equipment to visualize the lumen and the interior wall of blood vessels. This is a technical procedure that can give us very useful extra information at the time of a coronary angiogram or angioplasty. It allows me to imagine the exact size and nature of the narrowings present within the coronary arteries and more accurately treat them in the long term.