Wide Range of Cardiology Diagnostics

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ECHOCARDIOGRAPHY
An echocardiogram, often referred to in the medical community as a cardiac ECHO or simply an ECHO, is a sonogram of the heart (it is not abbreviated as ECG, which in medicine usually refers to an electrocardiogram). Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. Our latest ultrasound system employs 3D real-time imaging.

In addition to creating two-dimensional pictures of the cardiovascular system, an echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue at any arbitrary point using pulsed or continuous wave Doppler ultrasound. This allows assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and calculation of the cardiac output as well as the ejection fraction. Other parameters measured include cardiac dimensions (luminal diameters and septal thicknesses) and E/A ratio.

NEMIO-30 Toshiba Japan equipment provides superlative details Echocardiography. All valves of the heart can be visualised and correct diagnosis of many valvular, pericardical and myocardial diseases is possible. Tests can be repeated for comparative study without any discomfort to the patient. We also offer portable echo services in emergencies

COLOUR DOPPLER STUDY
Ultrasonic Doppler imaging provides a non-invasive assessment of the arterial and venous circulation in the lower / upper limb or heart and is accepted as a valuable diagnostic technique. Grey-scale images identify plaque and thrombus, duplex assessment provides a measurement of blood velocity through a vessel. Colour Doppler imaging enables the rapid localization of arterial stenoses and occlusions and the identification of incompetent veins. It not only indicates the shape and size of the heart, but also investigates its functional capacity. The amount of blood flowing through the various cardiac valves and velocity of blood can be measured and it is exquisitely seen on the monitor. It is one of the most important investigations for all types of limbs / heart diseases





MULTIPLANE TRANSESOPHAGEAL ECHO (TEE)

The advantage of TEE over Trans-Thoracic Echocardiography (TTE) is usually clearer images, especially of structures that are difficult to view trans-thoracicly (through the chest wall). The explanation for this is that the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. This reduces the attenuation (weakening) of the ultrasound signal, generating a stronger return signal, ultimately enhancing image and Doppler quality. Comparatively, trans-thoracic ultrasound must first traverse skin, fat, ribs and lungs before reflecting off the heart and back to the probe before an image can be created. All these structures, along with the increased distance the beam must travel, weaken the ultrasound signal thus degrading the image and Doppler quality.

In adults, several structures can be evaluated and imaged better with the TEE, including the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries. TEE has a very high sensitivity for locating a blood clot inside the left atrium.

TEE is essential in all cardiac Valvular Heart diseases. Any patient having emphysema / obesity and poor Echo window should undergo TEE for excellent Echocardiographic Examination. It is a must before any Valvular Cardiac Surgery

DOBUTAMINE STRESS ECHO
In order to diagnose certain heart conditions, some heart studies require that the heart be subjected to "stress" or exercise. This allows the cardiologist to evaluate the heart while it is working its hardest.

The dobutamine stress echo was developed for people who are unable to exercise on a treadmill or stationary cycle as required using a more traditional stress echo. In this test, you will be given dobutamine, a special medication that will stimulate your heart and make it think that it is actually exercising.

The dobutamine stress echo is a valuable diagnostic tool that allows the cardiologist to assess a number of different things including:

  • The overall function of your heart's valves and chambers
  • The clinical manifestations of many types of heart disease such as valvular problems, myocardial disease, pericardial disease, coronary artery disease and congenital heart disease
  • Monitoring, evaluation and follow-up of medical treatments (drugs) or surgical procedures


COMPUTERIZED E.C.G.
Electrocardiography (ECG or EKG [from the German Elektrokardiogramm]) is a transthoracic (across the thorax or chest) interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the outer surface of the skin and recorded by a device external to the body.[1] The recording produced by this noninvasive procedure is termed an electrocardiogram (also ECG or EKG). Our Schiller (Switzerland) & Cardiofax V machines give superior printing with instant computerized ECG reporting. The doctor can also see the heart activity on the screen provided with the machine. Portable ECG is available.

COMPUTERIZED STRESS TEST (T.M.T)
It is common to find heart patients who have normal ECG. One must remember that the ECGs are taken at rest when the heart is beating at its lowest rate. Even with 90% blocks the patients can have a normal ECG. In such cases the patient would also agree that at rest there is no pain in the chest, the angina symptoms would only come when they increase the heart rate, while doing some physical exertion like walking.
This is the condition where we need a TMT test. The patients are to gradually increase their heart rate, thus increasing the blood requirement of the heart muscles. Simultaneously ECG records are taken. If there is a blockage of approximately more than 70% ECG shows changes, suggestive of Angina.
Patients have to physically exert for this test which uses a computerised machine. The level of the exercise is gradually increased according to a standard protocol called the Bruce's Protocol. The continuous ECG monitoring during the exercise would reflect any blood and oxygen deficit in the muscles of the heart during exercise. The patient is asked to stop exercising as soon as ECG changes appear or any symptoms of chest pain or discomfort or breathlessness are felt. Our NASAN TMT machine does perfect calculations and generates accurate reports.

DIGITAL HOLTER MONITORING
A Holter monitor (often simply "Holter" or occasionally ambulatory electrocardiography device) is a portable device for continuously monitoring various electricalactivity of the central nervous system for at least 24 hours (often for two weeks at a time). The Holter's most common use is for monitoring heart activity (electrocardiography or ECG). Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias or epileptic events which would be difficult to identify in a shorter period of time. For patients having more transient symptoms, a cardiac event monitor which can be worn for a month or more can be used. The heart is under continuous supervision for 24/48 hours, while the patient is working, eating or sleeping. This is a highly sophisticated test for investigating missing beats, cardiac ischaemia and extremes of variation of heart rate. It is a must for pacemaker installation.


LUNG FUNCTION TEST
Spirometry, using a spirometer, is the most common of the pulmonary function tests, measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled.Lung capacity can be measured by our Schiller AT-10 (Switzerland) machine. It is strongly advisable for smokers, industrial workers and obese people to have this test at regular intervals. This test is a very good guide for selection of medicines for patients with breathing difficulty.

AMBULATORY B.P. MONITORING
Ambulatory blood pressure monitoring (ABPM) measures blood pressure at regular intervals. It is believed to be able to reduce the white coat hypertension effect in which a patient's blood pressure is elevated during the examination process due to nervousness and anxiety caused by being in a clinical setting. Out-of-office measurements are highly recommended as an adjunct to office measurements by almost all hypertension organizations. Diurnal variation of blood pressure can be studied , while the patient is working or sleeping .a very important investigation for adjusting the dose of medicine in hypertension . Fluctuations of Blood Pressure over 24 hrs. can be properly recorded and managed accordingly.

CARDIAC MONITORING
A service which can be provided at the patient's home . it is imperative for the detection of any arrhythmia or block developing in the heart. An expert technician takes care of the monitoring equipment.

H-R VARIABILITY & LATE POTENTIAL STUDY
Heart rate variability (HRV) is a physiological phenomenon where the time interval between heart beats varies. It is measured by the variation in the beat-to-beat interval.
Other terms used include: "cycle length variability", "RR variability" (where R is a point corresponding to the peak of the QRS complex of theECG wave; and RR is the interval between successive Rs), and "heart period variability".
See also Heart rate turbulence.
Methods used to detect beats include: ECG, blood pressure, and the pulse wave signal derived from a photoplethysmograph (PPG). ECG is considered superior because it provides a clear waveform, which makes it easier to exclude heartbeats not originating in the sinoatrial node. The term "NN" is used in place of RR to emphasize the fact that the processed beats are "normal" beats.


A resting electrocardiogram (ECG) is recorded in the supine position using an ECG machine equipped with SAECG software; this can be done by a physician, nurse, or medical technician. Unlike standard basal ECG recording, which requires only a few seconds, SAECG recording requires a few minutes (usually about 7-10 minutes), as the machine must record multiple subsequent QRS potentials to remove interference due to skeletal muscle and to obtain a statistically significant average trace. For this reason, it is important for the patient to lie as still as possible during the recording.
A unique way of predicting serious arrhythmia in all patients with ischaemic heart disease and myocardial infarction. Proper steps can be taken to prevent death and disability.

CARDIO-CALL (ANYTIME ECG)
It is an instant ECG. Arhythm strip is recorded at the time of symptoms like palpitation, blackout etc.

COPUTERIZED PATHOLOGY
All pathological investigations like blood, Urine, Stool, Sputum etc. are accurately done on our advanced equipment.

HEPATITIS PROFILE
Complete Hepatitis profile investigation can be done on patients having jaundice and other related diseases to know which type of virus is responsible for the disease. The degree of complication of the concerned disease can also be predicted with great accuracy.

TROPONIN-T, APOLIPOPROTIEN - A & B
Troponin-T is an essential investigation to give exact diagnosis in heart attack or in any typical chest disease. Apo- A & B are specific lipo-proteins which can correctly screen high-risk individuals for ischaemic heart diseases.

ENDOSCOPY
This is indispensable for disorders like gas formation, difficulty in swallowing, peptic ulcer, chronic colitis etc. On the basis of endoscopy, final diagnosis can be made and appropriate medicine can be administered.
  

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Calcutta Heart Research Centre
Unit of: Aloka Medicare Private Limited
114B, Sarat Bose Road
Kolkata - 700029
Tel: + 91 33 2454 6083 / 84
Fax: + 91 33 2474 4848.
Email: mail@chrc.co.in
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