Description

 Cardiology

Heart diseases and especially coronary artery disease are among leading cause of death in Turkey and around the world. Organs need nutrients and oxygen in order to sustain viability and fulfill functional requirements. The required oxygen and nutrients are carried to organs through arteries. Heart pumps blood to arteries.

Our heart requires nutrients to function. Coronary artery is the vessel that supplies blood to the heart. Our heart cannot receive oxygen and nutrients sufficiently and cannot function properly, when stenosis or occlusion develops in coronary arteries secondary to therosclerosis. Since the function of pumping blood to the body impairs, amount of oxygen and nutrients carried into our organs decrease over time and various organs show symptoms of failure.

Why should Coronary Angiography be performed?

Early diagnosis and treatment of atherosclerosis is crucial for people with risk factor(s) for heart disease. Here, the aim is to protect the patient against devastating effects of myocardial infarction. For patients with suspicion of coronary artery disease in cardiologic tests such as ECG, echocardiography and cardiac stress ECG (treadmill), a certain diagnostic procedure, called coronary angiography, may be required to verify the diagnosis.

Coronary angiography is a diagnostic method rather than a type of surgery. Coronary angiography images cardiac vessels (coronary arteries) using a special imaging system, after a contrast agent is instilled. Coronary angiography is done at advanced laboratories equipped with an angiography device by well-trained and experienced cardiologists and healthcare personnel. Patient doesn’t need to be anesthetized for this procedure. The patient stays alert and can talk throughout the procedure. Right femoral artery is usually punctured to access
coronary arteries in coronary angiography. Inguinal area is anesthetized before the right femoral artery is punctured and a plastic sheath is inserted into the artery. Patient may feel a mild ache in this process. Patient feels nothing in the rest of the procedure. Next, a thin and flexible tube (catheter) is advanced through a plastic sheath into the greatest artery (aorta) from which vessels originate; and it is deployed to origins of coronary arteries in aorta and a contrast agent is instilled into the coronary artery. This allows coronary arteries to be visualized at different projections and location and grade of stenosis can be determined. Administration of contrast agent doesn’t cause pain. However, transient hot flash, redness and nausea can be felt for 20 to 30 seconds, while the contrast agent is administered.​

What is arrhythmia (cardiac rhythm disorder )? How is it diagnosed and treated?

A healthy heart beats 60 to 80 times per minute at rest. The time between each beat is equal or rhythmic, in other words. Heart beats per minute increases when a person is engaged in physical activities such as walking, sports, strenuous work or stress. However, the time between beats is still equal and rhythmic. In the heart, a certain point regulates the rhythm; this point, which generates electric stimulation, may itself produce beats in an abnormal rhythm, or the healthy rhythm stimulations generated by this point are abnormally conducted to myocardium by cardiac fibers. Both scenarios can cause heart beats with abnormal rhythm. Patients may, occasionally, visit their doctors by feeling such abnormal beats, but heart beats with abnormal rhythm can be accidentally detected by the doctor in a routine ECG that is ordered for a reason whatsoever.

Arrhythmic heart beats disrupt blood pumping function of the heart, depending on severity of the problem, and causes formation of blood clots which occlude vessels of heart, lungs, brain and other organs, resulting in acute and fatal problems. Therefore, arrhythmia must be regarded as a crucial cardiac problem which must be treated.

Electrophysiology laboratories are established that are specially developed for patients with
rhythm disorder due to a reason whatsoever. Heart beats are examined in detail in these laboratories and diagnosis of arrhythmia is established. Next, efforts are made to clarify whether the rhythm disorder originates from the stimulatory point or conduction pathways. After this procedure, called mapping, is completed, the precise location to intervene at conduction pathways in the heart is determined. Radiofrequency energy is delivered to these abnormal conduction points using catheter technique in coronary angiography laboratory and the foci that generate abnormal rhythm are destructed, and thus, normal cardiac rhythm is restored.

Our cardiology Departments are the departments where cardiological clinic and laboratory activities are conducted and diagnosis and treatment methods are applied. Within the adult cardiology section, the departments are comprised of coroner intense care units, cardiology policlinics and a cardiologie laboratory where non-interventional examinations (EKG, effort test, echocardiography, Holter, ambulatory blood pressure control] are carried out.

Echocardiography

Echocardiography is a completely safe and non-interventional examination assessing heart
anatomically and functionally. After echocardiography, information is acquired in terms of the state of pumping function of heart, nature of cardiac valves and their functional sate and structural abnormalities of heart. It is important in detecting the presence and severity of leakages and tightening in cardiac valves in diagnosis of congenital heart disorders and myocardium diseases. In emergency cases, the examinations with the mentioned devices are
possible for the patients by the side of their beds in the Cardiology Departments of Medical Park.

Holter

It is the record of heart beats by a device carried for 24-48 hours and then the conversion of these to EKG traces by a computer program. Therefore, abnormal rhythms, extra beats as well as changes indicative of ischemia in EKG can be detected. Besides it could be used in order to trace the impact of the treatment.

Ambulatory Blood Pressure Follow-up

It requires the portable sphygmomanometer which records tension measures once every 15 or
30 minutes to remain upon the patient for a period of 24 hours. It is plugged for patients diagnosed with hypotensive and hypertensive and seldom for assessing the response to the treatment.

Effort Tests Treadmill

In Cardiology Departments of Medical Park Hospital, tread mill tests are practiced as effort
tests. Tread mill, publicly known as running mill, is based on walking of a patient in accordance with certain protocols while he/she is plugged to a 12-derivative EKG device, and running as the mill speed is regularly increased. In case of a positive result, the diagnosis of cardiovascular disease is ensured along with a further examination such as cardiac catheterization.

What You Need to Know about Treadmill (Effort Test)

Treadmill test is an examination carried out by measurement of your blood pressure and generation of your EKG reports immediately while you walk in a certain pace on the mill. It enables the detection of the abnormal evidence that cannot be detected in your EKG after the given effort.

When you come to your appointment of Treadmill Test

Do not eat anything 3 hours before the test. Bring your previous EKG values. The male patients have to shave their chests. If you use one of the medicines below, stop taking them at least 48 hours before. (Dideral, prent, tensinor, visken, lopresor, trasicor, beloc, betadol, nortan, artex, concor, diltizem, dilatrent, carvexal, isoptin, digoxin) Please do not stop the medicine you take because of high blood pressure.

Hypertension

It happens when your blood pressure measured by the sphygmomanometer on your arm is equal to or more than 140/90 mmHg. Blood pressure is the power that the blood in your
veins, due to the energy that your heart generated, against the vein periphery. The situation that is called hypertension is that these values measured by the physician are above 140/90 mmHg at least in two separate days. Approximately one fifth of every adult is hypertensive. The frequency of hypertension increases along with the age. There is hypertension in 60% of those over 60 years, 66% of those over 70 years. The frequency even increases in those who
are overweight. Hypertension is essential a hereditary disease. Therefore it is more frequent in families having a hypertensive member. There is no complaint in the initial phase of hypertension. That is why hypertension is called “silent murderer.” However, if your blood pressure level is too high you will have the complaints of headaches, over-sweating, exhaustion, confusion, visual impairment and restlessness. If not treated, hypertension disrupts brain, heart and kidney veins in a slow pace and leads to functional disorders in these organs, are above 140/90 mmHg at least in two separate days. 

Heart Diseases Symptoms and Complaints

Chest Pain

Pain chest in relation with coroner heart disease emerges due to increasing work Load of heart after usually effort, stress or after meals and it continues for minutes and slow downs or goes away by resting or by taking hypoglottis or oral sprays that are called hypoglottis nitrate and it is a pain that emerges upon chest bone or left chest and that could expand towards left arm, chin or back.

Difficulty in Breathing

It generally starts with the physical activities and is in a progressive character, in the next phases it may cause to increase the number of pillow or failure to sleep straight.

Edema

It is the accumulation of water and salt in the body do the congestive heart failure.

Widdling at Night

It is to urinate two or more times at night due to the disposal of the over accumulated water and salt in the daytime by urine.

Fainting

Fainting in relation with a heart disorder usually lasts shortly (a few minutes) and it is sudden and leads to complete loss of consciousness. There are no responses to verbal or aching stimuli. It is generally repetitive and progressive.

Tachycardia

It is the abnormal feeling of heart beats in the chest area or sometimes in the stomach. Especially tachycardias accompanied by faster, irregular sweating or fainting are indicative of a heart disorder.

Cyanosis

It is the bluish discoloration in generally hand and foot fingers and lips caused by the insufficient transportation of oxygen to the tissues. Congenital heart disorders, severe heart failures, cardiac valve disorders as well as severe lung disease may cause cyanosis.

Fatigability

Despite its many causes, it can be an early indication of a heart failure. It is especially important in old people and in those who have diagnosed coroner heart disorder or cardiac valve disorders.​