Cardiology
Heart disease is one of the most common causes of death worldwide. For this reason, various educational programmes are often provided to patients, as it is of great importance to raise their awareness. Cardiology department physicians in our hospital apply various diagnostic methods to reach a diagnosis after listening to patient complaints.
Cardiology specialists create various treatment options for patients diagnosed with methods such as ECG, Echocardiography, Stress Test, Thallium Test and Coronary Angiography. Which of these methods should be followed and in what order is determined by the “Treatment Algorithm” rules.
The physician prescribes effective medication. He/she makes recommendations on controlled exercises and nutrition to improve the quality of life. In patients with too many problems for these to be sufficient, an angiographic examination is performed to determine the final state of the coronary vessels.
What is a Cardiologist?
Cardiology is the department where all kinds of diseases of the heart and cardiovascular system are both diagnosed and treated. Cardiology, which was previously a sub-branch of the internal diseases department, now serves as a separate branch of science. Specialised doctors working in this department take the title of cardiologist.
Cardiologists often have to deal with emergency cardiovascular diseases. Sudden heart attack or rapidly developing heart failure, high blood pressure, palpitations and chest pain etc. These problems can be given as examples. In these cases, cardiology specialists, who take action to make the diagnosis under hospital conditions, may occasionally have to consult with cardiovascular surgeons and make the necessary referrals for the operation of their patients.
Which Diseases Do Cardiology Specialists Treat?
The most important task of the heart, which is the vital organ of our body, is to pump enough blood to the body. If it cannot pump the blood the body needs, heart failure develops in patients. Heart failure shows symptoms such as frequent urination at night, sudden fainting, heart palpitations, rapid fatigue.
Cardiology department also diagnoses and treats patients with the following diseases of the heart and circulatory system.
- Hypertension
- Ischaemic heart disease,
- Atherosclerosis
- Acute coronary syndrome,
- Mitral valve stenosis and insufficiency,
- Aortic stenosis and insufficiency,
- Myocardial infarction,
- Triscuspid valve stenosis,
- Pulmonary insufficiency and stenosis,
- Endocardial diseases,
- Pericardial effusion
- Cardiac arrhythmia and sudden cardiac arrest,
- Peripheral arterial disorders,
- Atrial fibrillation,
- Cardiac and primary tumours,
- Atrial myxoma,
- Wolf Parkinson White Syndrome.
- Pericardial tamponade,
- Cardiomyopathy
Diagnostic Methods in Heart Diseases
In order to make sense of the symptoms that occur in cardiological patients, Cardiology specialists refer to the following examinations. Electrocardiography, Echocardiography, Heart stress test, determination of cardiac enzyme levels in the blood; If the results obtained from methods such as myocardial perfusion scintigraphy are not sufficient, Cardiology specialists can see the vessels in full detail by performing coronary angiography.
In the meantime, they save the patient’s life by inserting stents, which are like tiny tubes, into the coronary vessels they deem appropriate in order to facilitate blood flow. If there are too narrow and too many coronary arteries to be stented, these can only be opened by surgery. In this case, patients are referred to cardiovascular surgeons
AREAS OF INTEREST OF CARDIOLOGY DEPARTMENT
Hypertension
One of the most important weapons of cardiologists in the fight against high blood pressure, which is also of interest to branches such as nephrology and endocrinology, is the “Blood Pressure Holter”. It is a smart electronic device that is attached to the patient’s arm and measures and memorises the blood pressure within 24 hours at certain intervals. The patient with the Holter goes home and the next day the physician removes the device from the arm and analyses the records in the memory and obtains detailed information about hypertension. Thus, in the light of the data obtained, more accurate treatment recommendations will be made.
Coronary Artery Disease
Coronary arteries are the arteries that carry oxygen and nutrients to the heart muscle. Age and certain risk factors cause these soft and flexible arteries to gradually harden. These stiffnesses (atheroma plaques) grow into the arteries and slow down the blood flow in the coronary arteries over time. Sometimes they also cause clot formation. As a result, it can completely block the blood flow and cause sudden blockage of the vessel.
Symptoms: When the coronary arteries narrow, the blood supply to the heart muscle decreases. Symptoms include tightness in the chest, a burning sensation of pressure and pain, usually radiating into the left arm and jaw. Conditions that increase the heart’s need for blood, such as exercise and stress, can initiate these complaints and they usually pass when rested. This condition is called “Angina Pectoris”. If the coronary artery is suddenly blocked, the heart muscle is permanently damaged. When this is accompanied by prolonged chest pain, it is called “myocardial infarction” (heart attack).
Plaques that cause narrowing of the coronary arteries are usually found in a limited area of the artery. Beyond the narrowed area, the vessel diameter is normal. If the problem is limited to one or two vessels, the existing stenosis can be opened by a kind of dilatation procedure without the need for surgery. This procedure is called “Balloon Angioplasty” (PTCA). This procedure is performed by cardiologists using angiographic x-ray devices. In cases where the balloon is not sufficient, medicated or non-medicated stents are placed to optimise the blood flow.
If coronary artery disease involves several vessels and is complicated, coronary artery bypass surgery is required. In this operation, new vessels from the leg or another suitable location are added to the narrowed or non-functioning vessels. The heart muscles, which are starved for fresh blood and oxygen, can then breathe a sigh of relief. By-pass operations are performed by cardiovascular surgeons.
Heart Rhythm Disorders (Arrhythmias)
During a heartbeat, the atria at the top of the heart contract and fill the relaxed ventricles (ventricles) with blood. Half a second later, the ventricles contract and release the blood into the body circulation. For effective blood circulation, a regular heart rate (RHYTHM) of between 60 and 100 beats per minute must be maintained when the body is at rest. The rhythm is regulated by the electrical system of the heart. Each heartbeat normally originates from a group of specialised cells called sinus nodes. This sinus node is located in the upper right atrium of the heart. The heartbeat is maintained by electrical impulses emanating from this node. This is why the normal heart rhythm is called “sinus rhythm”. When the heart does not work in its natural rhythm, it is called “arrhythmia”.
Arrhythmias originate from either ventricles (ventricular) or atria (atrial). Tachycardia (more than 100 beats per minute) is a fast heartbeat, bradycardia (less than 60 beats per minute) is a slow heartbeat. Not every tachycardia or bradycardia means there is a disease.
WHAT IS ATRIAL FIBRILLATION?
“Atrial Fibrillation” is the rapid and irregular beating of the atria and is the most common arrhythmia. Atrial fibrillation (AF) completely disrupts the electrical function of the atria. It is a very risky situation when the atria start to beat so fast that they reach 300 to 400 beats per minute. This condition is called “Fibrillation”.
Structural heart diseases such as rheumatic heart disease, hypertension, heart failure are important risk factors leading to atrial fibrillation. This condition leads to disorders in the heart muscle or thrombosis (embolism).
There are 3 different treatment options to correct fibrillation and restore sinus rhythm.
- Drug therapy; Some drugs can restore sinus rhythm in patients with new atrial fibrillation.
- Angiographic method; During angiography, “Catheter Ablation”, which means burning some conduction pathways to restart sinus rhythm in the heart, is performed. This method may be useful in early AF cases, especially if there is no other accompanying heart disease.
- Operation; In the case of severe rhythm disturbance, a meticulous cardiac surgery is performed to neutralise the impaired heart conduction system and thus restore normal sinus rhythm.
Congenital Heart Diseases
Many children are born with congenital heart disease. This can sometimes lead to life-threatening problems. There are various types, ranging from heart valve diseases to holes between the ventricles or atria. Some of them are mild enough to be monitored, while others require immediate surgery. The initial diagnosis and follow-up is the work of paediatric cardiologists, and if surgery is chosen as the treatment decision, the experienced cardiac surgeons of our hospital come into play.
High Cholesterol and Triglycerides
One of the things imposed by modern life is malnutrition and the other is sedentary life. When you add a genetic predisposition to this, it is only a matter of time before you live with high blood fats. Blood cholesterol and triglyceride levels, markers of metabolic syndrome, and the cardiologist who draws the route will provide the most appropriate treatment recommendations to the patient.