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Angiography Tips

Know How Angioplasty Can Help Combating Heart Disease!

Dr.Siddhartha Mani 92% (46ratings)
MBBS, MD - General Medicine, DM - Cardiology
Cardiologist, Kolkata
Know How Angioplasty Can Help Combating Heart Disease!

When a person suffers from the typical symptoms of heart weakness that includes breathlessness, weakness, sudden sweating, discomfort while doing minor exertions, chest pain, pain radiating along the arms, back, neck and shoulders and other symptoms, the doctor will ask for investigations to study the heart.

The Heart is a muscular organ in the chest and like any other muscle in the body, it has its own unique blood vessel network that does the function of supplying nutrition to the heart muscles. Like any network, the Cardiac blood supply also begins with major vessels that branch off into minor and then very small blood vessels. It is these very small blood vessels that actually reach the muscle fiber to give nutrition.

When this is a problem with the free-flowing blood to reach the muscle cells, the strength of the heart muscles reduces and the overall heart functioning is in trouble. Until now, it was commonly believed that cholesterol deposits make blockages in the blood vessels that cut off nutrition supply causing the heart to go into disease stage. Today, extensive research has proved that there are many reasons for hampered blood supply to heart muscles, and plaque formation (blockages caused by cholesterol deposits) need not be the reason for heart attacks entirely. Blood vessel disease called Atherosclerosis is the root cause.

In modern times, if the patient consults a cardiologist, the first line of investigation prescribed is the Angiography. This procedure requires the patient to be admitted to the hospital. Under anesthesia, the Doctor will make a cut/incision in a major blood vessel of the thigh joint or the arm. He will then insert a tube called catheter into the blood vessel and guide it through the major arteries till it reaches the important position from where the blood vessels that supply nutritious blood to the heart muscles is reached. At this position, a dye is pushed into the blood flow and a series of specialized X-rays are taken that will show the blood vessels.

In these images, it is the Doctor’s expertise that will identify positions where the blood flow is reduced, or disturbed. The dye has a short life span and is able to show flow dynamics only up to the secondary blood vessel network. The Doctor will determine which part of the heart blood vessels are affected based on these images, the length of the plaque, position and kind of blockage and derive the damage to heart, based on these anatomical visuals. The catheter is then removed; the blood vessel opening stemmed and the patient has to remain immobile in the hospital till the blood vessel improves. The Doctor will prescribe a list of medication that includes beta-blockers, aspirins, statin and antibiotics.

Very often, if the Doctor decides, he will suggest the next procedure of Angioplasty immediately. This procedure involves pushing a mini wireframe tube called ‘stent’ or an inflatable balloon through the same catheter to the area of blockage. This balloon or stent is guided to the area of the blockage and mechanically expanded to push aside the plaque to help the blood flow resume. There are different kinds of balloon and stent procedures.

None of these procedures “removes” the blockage plaque. The procedure helps to resume blood flow in the major arteries only. 

No invasive therapy is safe and there is a lot of reports backed by Research Data from very reputed global authoritative organizations that highlight the unnecessary number of angio procedures being done as well as the side effects of these procedures within few months. (Many Stent Procedures Unnecessary” Heart Drugs Just as Good at Preventing Heart Attacks, Death in Some People, Study Shows By Charlene Laino: March 26, 2007 (New Orleans).

Can blockage affect a person after having angiography?

It is important for the patient and patient’s family to understand that the blockage formation process in the body does not reverse with angioplasty or even a Bypass procedure. The patient suffers from the same kind of symptoms as earlier when new blockages form in different sections of the coronary network or very often when a deposit/scar forms within the stent itself leading to hampered blood flow. This ‘reformation of blockages’ is referred to as restenosis. This is the greatest problem registered in current studies of patients after angio and bypass and this is seen within a few weeks to after 10 to 14 months of the procedure.

The reformation of blockages or further formation of new sites with blockages depends on the individual patient's health condition. Patients who are Diabetic, High BP, on certain kind of long term medication, obese, with bad lifestyle; all have the additional threat of secondary attacks.

Restenosis cannot be prevented with another stent or bypass procedure. The procedure only once again’ mechanically opens the blockage or in CABG, creates a bypass around the blocked blood vessel.

How can restenosis be prevented?

The only and best way to avoid restenosis is to make major changes in diet, exercise, weight management, stress management. It is also very important to be under the right kind of medication that will support the natural process done by the Liver and blood to reduce and wash out inflammation (that causes maximum problems in natural blood flow), repair blood vessels, reduce and remove existing blockages and scar tissue within blood vessels, add strength to the heart muscles.

These new studies and treatment options should be searched out by the patient and his/her family to understand the reason of blockages, the possible need and safety of invasive procedures, the option to medicine based treatments before undertaking any invasive procedure. Remember, it is scientific research that has clearly proclaimed that less than 30 -20% of all the angio’s performed are necessary or have a lasting effect on their own.

877 people found this helpful

CT Angiography Of Brain - Know Merits Of It!

Dr.Nitin Jagdhane (Jain) 91% (33ratings)
MCh Neurosurgery, Fellowship in Spine surgery, MS - General Surgery
Neurosurgeon, Mumbai
CT Angiography Of Brain - Know Merits Of It!

A brain computed tomography angiography (CTA) is a specialized neurologic CT scan, and it involves fast CT imaging while simultaneously injecting IV contrast into a vein in the arm. This procedure allows visualization of the specific vascular anatomy of the organs in the body. It can also be used to evaluate vessels or plan a surgery. Mostly it is used to identify a small aneurysm or arteriovenous malformation (abnormal communications between blood vessels) inside the brain.

  • A patient can expect the following things during the brain CTA examination:
  • The patient is asked to lie on the examination table.
  • If contrast is used, an automatic injection pump connected intravenously will release the contrast material at a controlled rate.
  • Although the movement of the table occurs slowly at first, it gains rapid momentum when the actual CTA is performed.
  • The patient may be asked to hold his/her breath during the scanning.
  • Any motion in the form of breathing or body movements can lead to artifacts on the images.

The entire CTA exam may be completed within a few seconds. However, the patient’s actual time in the room may be long. This delay can occur as the technologist takes his/her time to position the patient on the table, check or place an IV line, do preliminary imaging to verify the beginning and end points of the exam, and set up the scan and contrast injection settings based on the part of the body being imaged.

Benefits of brain CTA include the following:

  • The need for surgery may be eliminated by angiography; however if surgery remains necessary, it can be performed with much accuracy because of brain CTA findings. As the CTA is able to detect the obstruction of blood vessels, it allows for potentially corrective therapy.
  • The CTA may give precise anatomic detail than a magnetic resonance imaging (MRI), particularly in cases of small blood vessels.
  • The CTA is faster, noninvasive, and has lesser complications than catheter angiography, which involves placing a catheter (plastic tube), (usually at the groin) into the patients’ major blood vessels and injecting a contrast material along with probable sedation or general anesthesia.
  • The CTA examination costs lesser than catheter angiography.No radiation remains in a patient's body after a CTA examination.

Risk factors for brain CTA

A small chance of cancer from excessive exposure to radiation History of allergy to X-ray contrast material Risk for kidney failure, as the contrast material could potentially further damage the kidney function in patients with pre-existing kidney disease

2537 people found this helpful

Age Related Macular Degeneration - How To Diagnose It?

Dr.Vrij Bhushan 86% (26ratings)
MD - Ophthalmology, MBBS
Ophthalmologist, Dehradun
Age Related Macular Degeneration - How To Diagnose It?

Age-related macular degeneration, also known in brief as AMD or ARMD is one of the most common age-related causes for vision loss. It causes “blind spots” in vision, causing difficulty in activities requiring central vision like reading, sewing, driving, watching TV, computer usage, etc.

How it happens?

The centre portion of the eye is known as retina which has a screen in the posterior portion. For proper vision, light falls on this screen and is then processed to enable ‘vision.’ When this screen is not clear, blurred vision results. It may not cause total blindness but impairs vision including double vision and loss of central vision.

Types: There are two types of AMD, wet and dry.

  1. Dry: There are yellow deposits known as drusen which form in the macula, and as they grow in size, they impair vision, specifically the central vision. This is the common variant and can lead to the wet form.
  2. Wet: There are abnormal blood vessels which are formed in the retina. There is leaking of blood and fluid which makes it ‘wet.’ There could be scarring of these leaked substances, which again leads to loss of central vision. Further studies have shown that retina produces a protein knows as vascular endothelial growth factor (VEGF) which promotes the generation of new blood vessels, normally required for the production of new blood vessels. However, increased VEGF causes excessive proliferation of blood vessels, leading to macular degeneration.

Risk factors: Though age related, there are definitely some factors which put one at a higher risk for AMD

  1. Genetics: AMD is hereditary and runs in families
  2. Gender: Females are more prone to develop AMD than males
  3. Ageing: People above 60 are at greater risk
  4. Smoking: Direct and passive smoking contributes to AMD.
  5. Obesity: Accelerates the pace of AMD and the severity of complications.
  6. Hypertension: Increases the chances of developing AMD
  7. Ethnicity: Caucasians are more prone to develop AMD as their lighter skin and eye color is more prone to sun damage
  8. Sun exposure: Increased sun exposure accelerates the onset of AMD

Symptoms:

  1. No symptoms in the initial stages
  2. Gradually, there is impaired central vision, affecting activities like reading, driving, and computer usage
  3. Color perception is impaired

Diagnosis:

  1. A routine eye exam will reveal the yellow deposits which actually cause the condition.
  2. An angiography may be done after injecting a dye to detect blood vessel growth.

Treatment:

There is no cure, but progress can be delayed

  1. Anti-angiotensin agents reduce pressure in the eyes and stop the development of newer blood vessels
  2. Vitamins help slow down loss of vision
  3. Vision aids to correct vision
2568 people found this helpful

Radial Angioplasty - All You Should Know!

Dr.Tejas V Patel 92% (17ratings)
DM - Cardiology, MD - Medicine, MBBS, Observership
Cardiologist, Ahmedabad
Radial Angioplasty - All You Should Know!

What is Radial Angioplasty?

Angioplasty is a medical procedure done when you have coronary artery disease. A sticky deposit due to high cholesterol blocks the arteries so the blood flow is compromised. Angioplasty restores the blood flow in your heart.

How is it done?

• A long, thin tube called a catheter is inserted into the vein or artery in the wrist and into the heart
• You will be given anaesthesia around the punctured site so you would not feel a thing
• A balloon is attached at the end of the catheter to open the blocked arteries
• Sometimes, a small metal mesh-like device called stent is put inside to support the blood vessels
• Direct pressure is applied to the incision to stop the blood flow
• The wound is bandaged

When do you need it?

Angina - Chest pain due to reduced blood flow to the heart
Myocardial infarction or heart attack - Chest pain due to blocked blood flow to the heart
Atherosclerosis - Increased accumulation of fat and cholesterol in arterial walls
High cholesterol - Increased low-density lipoprotein cause high cholesterol in the blood

Who can have it?

Patients with the good blood supply in both their hands through radial and ulnar arteries are eligible for radial angioplasty.

After the procedure, the radial artery may become blocked. If the ulnar artery has good blood flow, there will not be any problem.

Some tips after your angioplasty:

• The patients can start walking right away after the sedatives wear off
• Be careful about the punctured area
• Rest your forearm on a pillow
• Do not bend your wrist for 8 hours after the procedure
• Refrain from using your wrist for a day
• Do not lift heavy weights for at least 2 days
• Remove the bandage on the second day to fasten the healing process
• If you feel the punctured site beating or it starts to bleed, call your doctor immediately
• Do not forget to follow up after 1 month

Radial angioplasty helps the patients to recover faster than those who do femoral angioplasty (the catheter is put through the groin area). Thus, doctors usually recommend the former if the necessary conditions are met.

2305 people found this helpful

एंजियोग्राफी क्या होता है - Angiography in Hindi

Dr.Sanjeev Kumar Singh 92% (193ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurvedic Doctor, Lakhimpur Kheri
एंजियोग्राफी क्या होता है - Angiography in Hindi

एंजियोग्राफी, जिसे एंजियोग्राम के रूप में भी जाना जाता है, एक एक्स-रे परीक्षण है जो एक नस या धमनी के अंदर रक्त परिसंचरण की स्पष्ट तस्वीरें लेने के लिए एक कैमरे के साथ-साथ डाई का उपयोग करता है। यह प्रक्रिया छाती, पीठ, हाथ, सिर, पेट और पैरों की नसों या धमनियों के लिए की जा सकती है।

एंजियोग्राम में सबसे सामान्य पल्मोनरी एंजियोग्राम (छाती का), कोरोनरी एंजियोग्राम (दिल का), सेरेब्रल एंजियोग्राम (मस्तिष्क का), कैरोटिड एंजियोग्राम (गर्दन और सिर का), परिफेरल एंजियोग्राम (हाथ और पैरों का) और महाधमनी (महाधमनी) शामिल हैं।

एंजियोग्राम का उपयोग एन्यूरिज्म (रक्त वाहिकाओं के अदंर उभार) का पता लगाने के लिए किया जाता है। रक्त वाहिकाओं के किसी भी रुकावट या संकुचन जो उचित रक्त प्रवाह को प्रभावित करते हैं, इस प्रक्रिया से भी पता लगाया जा सकता है। इस तकनीक द्वारा कोरोनरी धमनी विकार होने की संभावना और इसकी स्थिति को निर्धारित किया जा सकता है।

कैसे होती है एंजियोग्राफी? - How Angiography Performed?

एंजियोग्राफ में रेडियोधर्मी तत्व या डाई का इस्तेमाल किया जाता है. इसके माध्यम से शरीर के रक्त वाहिनी नालिकाओं को एक्स रे द्वारा स्पष्ट रूप से देखा जा सकता है. डिजिटल सबस्ट्रेक्शन एंजियोग्राफी एक नयी तकनीक है जो धमनियों की पृष्ठभूमि को गायब कर देता है जिससे इमेज ज्यादा स्पष्ट दिखने लगते हैं.

इस तकनीक का इस्तेमाल रक्त वाहिकाओं में ब्लॉकेज की स्थिति में प्रयोग किया जाता है. इससे हृदय की धमनी में ब्लॉकेज या संकुचन की स्थिति की पता लगाया जा सकता है. इस स्थिति के पता लगने के बाद डॉक्टर द्वारा बीमारी से ग्रसित धमनियों को एंजियोप्लास्टी द्वारा खोल देता है. इस उपचार के बाद रोगी के हृदय की धमनियों में रक्त का प्रवाह बढ़ जाता है और उसे फ़ौरन राहत मिल जाता है. इसके अतिरिक्त, हृदयाघात की जोखिम भी कम हो जाती है.

एंजियोग्राफी के प्रकार - Types of Angiography in Hindi

एंजियोग्राफी के कई प्रकार होते है. इसके कुछ प्रकार निम्नलिखित हैं:

  1. सेरेब्रेल एंजियोग्राफीइसमें मस्तिष्क सम्बन्धी समस्याओं के बारे में पता लगाया जाता है.
  2. फ्लोरोसीन एंजियोग्राफीइसका प्रयोग आँखों के रेटिना से सम्बन्धित समस्याओं का उपचार करने के लिये किया जाता है.
  3. फेमोरल एंजियोग्राफीयह एंजियोग्राफी जाँघ में समस्या का पता लगाने के लिए किया जाता है
  4. इसके अलावा किडनी और कोरोनरी आदि की भी एंजियोग्राफी की जाती है.

एंजियोग्राफी की प्रक्रिया - Procedure of Angiography in Hindi

लोकल एनेस्थीसिया के माध्यम से बाँह या जाँघ को सुन्न किया जाता है, इसके बाद बांह या जाँघ के अंदर कैथेटर और तार डालकर उसकी धमनियों में आये अवरोधों को पता लगाया जाता है. इससे अवरोध की स्थिति का पता लगता है अवरोध कितना बड़ा और कहाँ स्थिति हैं. इस अवरोध को स्पष्ट रूप से देखने के लिए एक्सरे फिल्म बनाया जाता है और बेहतर इमेज के लिए डाई इस्तेमाल किया जाता है. एंजियोग्राफी के साथ ही सीधे मॉनीटर पर देखते हुए अवरोध को बैलून डालकर खोल भी दिया जाता है

इस प्रक्रिया में लगभग 6 से 12 लगते है और आपको टेस्ट करवाने से पहले डॉक्टर द्वारा दिए गए दिशा निर्देशों को पालण करना पड़ता है. एक दूसरे प्रकार की एंजियोग्राफी भी होती है जिसे रेडियल एंजियोग्राफी कहते हैं. इसमें धमनी की एंजियोग्राफी बाँह के पास से की जाती है. इस तकनीक से न तो खून के रिसाव का डर रहता है और न ही रोगी को लम्बे समय के लिये लेटना ही पड़ता है. इस एंजियोग्राफी के बाद रोगी जल्द ही अपने घर जा सकता है और अपने पैरों पर चल भी सकता है. सामान्यत: इसे करने से पहले रोगी को सलाह दी जाती है कि वह सात-आठ घण्टे पूर्व कुछ न खाने के बाद ही एंजियोग्राफी करवाने के लिये हॉस्पिटल आये. एक्सरे किरणों के प्रभाव से बचाने के लिये गर्भवती महिलाओं को यह परीक्षण न कराने की हिदायत दी जाती है.

6 people found this helpful

Cardiologist in Gurgaon

Dr.Sanjeev Kumar Singh 92% (193ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurvedic Doctor, Lakhimpur Kheri
Cardiologist in Gurgaon

Heart problems can be very dangerous and can even lead to death in some cases. Best cardiologist in Gurgaon are someone who specialises in diagnosing, preventing and treating any kind of heart problems or disorders. Cardiologist are specialised in subspecialties and can be classified as clinical cardiologists or cardiac surgeons. Clinical cardiologists can perform minimally invasive surgeries like pacemaker implantation and few others for effective management of heart problems. Few of the best cardiologists in Gurgaon are mentioned below:

1. Dr. Naresh Trehan

Diplomate, Diplomate, M.B.B.S.

Consultation fees: ₹1000

Dr. Trehan is a world-renowned cardiovascular and cardiothoracic surgeon. He has been awarded Padma Bhushan and the Padma Shri the most prestigious awards by Government of India for his contribution in the field of cardiology. In 50 years of his practice he has to his record over 48,000 successful open heart surgeries. He is pioneer of many advanced technologies in India and is currently the Chairman and Managing Director of Medanta – The Medicity, Gurgaon. His areas of specialization are Cardiothoracic Surgery, Cardiovascular Surgery, Minimally Invasive Cardiac Surgery and Heart Transplant.

2. Dr. Umesh Gupta

MBBS, MD - General Medicine, DM - Cardiology

Consultation fees: ₹1000- 1500

Dr. Umesh Gupta is a reputed cardiologist with 48 years of experience, recipient of Bharat Gaurav award and founder of Umkal Hospital, Gurgaon. He is pioneer of cardiac surgeries and had introduced techniques like the Tilt Table Test and Late Potential Analysis. He in years of practice has treated several cases of chronic heart problems and is known for his ethical practice.

3. Dr. Balbir Singh

D.M. (Cardiology), M.B.B.S., M.D. (General Medicine)

Consultation fees: ₹1000

Dr. Balbir Singh is one of the best Cardiologists with 35 years of experience. He has many feathers to his hat like Medical Excellence Award, B D Kumar Oration, Recognition in the Limca Book of Records, Sujoy B Roy. Interventional Cardiology is his area of expertise and all the awards are for the same. He is known for the treatment like  Angiography Procedure, Pacemaker, Stent Surgery, Bypass Surgery, Mitral Valve Replacement Surgery and Coronary Bypass Surgery. He is also a professional membership of Cardiological Society of India (CSI) and currently practices at Medanta Hospital.

4. Dr. Anil Dhall

MBBS, MD - Medicine, DM - Cardiology

Consultation fees: ₹1000

Dr. Anil Dhall is  a senior cardiologist with more than 36 years of experience. He has keen interest in Complex Coronary Interventions, Peripheral Interventions, Carotid Angioplasty  and  Cardiac Resynchronisation Therapy. He has been pioneer of preventive cardiology techniques and developing improved processes for STEMI care. He is also an academic contributor, a postdoctoral teacher and examiner in Cardiology and has formulated guidelines on research activities.

5. Dr. Neeraj Kumar

DM (CARDIOLOGY), MD (MEDICINE), MBBS

Consultation fees: ₹1200

Dr. Neeraj has more than 15 years of experience in cardiology & interventional cardiology and currently practices at W Pratiksha Hospital, Gurgaon. He has performed more than 11,000 angiographies and 4000 angioplasties. He has done several fellowships in cardiology and is engaged in the academic training, CMEs and as principal clinical investigator with various national and international organisations.

6. Dr. Madhukar Shahi

DM (Cardiology), DNB (Cardiology), MBBS, MD ( Medicine)

Consultation fees: ₹1000

Dr. Madhukar Shahi is amongst reputed cardiologist , who has 29 years of experience and currently practices at Medanta - Gurgaon. He has a professional membership of CSI,  ESI and CISI. He is known for angiography procedure and valve replacement surgery. He has also performed various vascular surgeries and coronary bypass surgeries.

7. Dr. Manvinder Singh Sachdev

MBBS, Diploma in Paediatrics, MD - Pediatrics, National Board (Paediatric Cardiology)

Consultation fees: ₹800

Dr. Manvinder Singh Sachdev is a renowned pediatric cardiologist and interventionist with 18 years of experience. He has been associated with some of the best hospitals before joining Medanta. His area of specialisation are fetal Cardiology and is currently working in the field of device closure of Perimembranous Ventricular Septal Defect.

8. Dr. Bharat B. Kukreti

MBBS, MD - Medicine, DM - Cardiology

Consultation fees: ₹800-1000

Dr. Bharat B. Kukreti is an experienced cardiologist with 15 years of practice. He handles all kind of cardiac related  problems like heart blockage or increased levels of LDL cholesterol. In  his tenure he has performed over 20000 coronary angiographies, over 5000 angioplasties including peripheral and renal angioplasties, 250 valvuloplasties and 500 pacemakers and ICD implantations. He currently practices at Paras Hospital, Gurgaon.

14 people found this helpful

Top 10 Cardiologist in Delhi!

Dr.Sanjeev Kumar Singh 92% (193ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurvedic Doctor, Lakhimpur Kheri

Cardiac problems are very scary and what is more scary is choosing the top cardiologist in Delhi. There are so many cardiologists in Delhi and there are so many type of cardiologist depending on their area of specialization. Clinical cardiologists, adult cardiologist, paediatric cardiologist.

There are few cardiologist who specializes in procedures like electrophysiology, echocardiography, and interventional procedures such as stent placement and balloon angioplasty. Cardiologist are specialized in diagnosing any kind of disorder or dysfunctioning of heart and can perform minimally invasive surgeries like pacemaker implantation.

Here is the list of top 10 cardiologist in Delhi, who are specialized and experts at treating all kind of heart problems:

1. Dr. Anupam Goel

MBBS, MD (Gen. Medicine), DM (Cardiology)

Consultation fees: ₹1000

Dr. Anupam Goel is a senior Interventional Cardiologist. She is currently associated with Max Super Speciality Hospital, Saket. She has an experience of 25 years in this field. She has done several fellowships in cardiology and is engaged in the academic training, CMEs and as principal clinical investigator at various national and international levels. Her areas of expertise are: Percutaneous Coronary Angioplasty and Stent Implantation, Primary Angioplasty in Acute Myocardial Infarction, Acute Coronary Care, Clinical Cardiology and Coronary Angiography and Angioplasty via Radial Artery Route.

2. Dr. Nitin Kumar

CCT - Cardiology (UK), MRCP (UK), FHEA (UK), MBBS

Consultation fees: ₹800

Dr Nitin Kumar is a consultant cardiologist with 16 years of national and international experience. He is currently affiliated with Express clinic, Delhi and CREDENCE Super specialty Clinic in Gurgaon. His area of specialization are transradial interventions (angiography and angioplasty through the wrist), treating acute heart attacks by Primary Angioplasty, management of acute coronary syndromes, complex angioplasty including bifurcation lesions, Intravascular imaging including IVUS and OCT, Fractional Flow Reserve assessment (FFR study) and Rotablation.

3. Dr. Rajiv Agarwal

MBBS, MD - Medicine, DM - Cardiology, Fellowship in Interventional Cardiology

Consultation fees: ₹500

Dr Rajiv Agarwal is a Senior Interventional Cardiologist and currently works at Max Smart Super Speciality hospital as Senior Director and Unit Head, Department of Cardiology. He has 33 years of experience. His areas of interest are Coronary Interventions & Valvuloplasty, Electrophysiology Study, Device Implantation (including Combo device), Device closures and Peripheral Interventions and also including Bronchial and Renal Artery Embolization. He has been awarded several national and international awards for his contribution in the field of cardiology.

4. Dr. R. R. Mantri

DNB (Cardiology), DM - Cardiology, MD - General Medicine, MBBS

Consultation fees: ₹1000- 1500

Dr. RR Mantri is a very reputed name in his fraternity. He is currently working as Director Cath Lab & Cardiac Arrhythmia Services, Department of Cardiology, Sir Ganga Ram Hospital, New Delhi. He has experience of more than 35 years as Interventional Cardiologist, Diabetologist and Electrophysiologist. His areas of clinical interest are treating patients suffering from congenital heart diseases, cardiovascular diseases, cardiac valve diseases, hypertension, artery blockages, heart failure, high cholesterol, diabetes due to obesity. He is a pioneer in Transradial Angiography in India.

5. Dr. Anil Saxena

DNB Cardiology, MD - Internal Medicine, MBBS

Consultation fees: ₹1000 

Dr. Anil is currently practicing as Director, Cardiac Pacing & Electrophysiology at Fortis Hospital, Okhla. His areas of clinical interest are Electrophysiologic Study, Catheter RF Ablation of complex arrhythmias, 3D Mapping of Cardiac Arrhythmias with CARTO and Ensite, Implantation of Permanent Pacemakers, Implantation of ICD, Implantation of Biventricular pacemakers (CRT). Implantation of CRT-D (Combo Device), Lead Extraction and Coronary Angiography. He is not only member of some reputed national and international organisations, but also recipetents of many awards. 

6. Dr. Viveka Kumar

DM - Cardiology, MD - General Medicine, MBBS

Consultation fees: ₹1000 

Dr. Viveka Kumar has 29 years of practice in the field of Cardiac interventions and Electrophysiology. In years of his practice he has done more than 7500 angioplasties and 2500 balloon valvotomy. He has also handled some complex cases of angioplasties. He is considered to be a pioneer of using advanced technologies like bifurcation and left main angioplasties with Rota Ablation. He has special interest in clinical research and has been associated with principal investigator or a sub-investigator in more than 14 national and international trials.

7. Dr. Ripen Gupta

MBBS, MD - Medicine, DM - Cardiology

Consultation fees: ₹1000 -1200

Dr. Gupta has 26 years of experience and is considered to be one of the most reputed cardiologists of Delhi. He was the first cardiologist to be awarded the Postdoctoral Fellowship of National Board in Interventional Cardiology instituted by National Board of Examinations. His areas of specializations are treatment of arrhythmia, coronary artery disease and dyslipidemia. He currently practices at Max super speciality, Saket and Dr Ripen Gupta's Clinic, Vasant Kunj, Delhi.

8. Dr. Rajneesh Jain

DM - Cardiology, MD - Internal Medicine, MBBS

Consultation fees: ₹1500 -2000

Dr. Rajneesh Jain is amongst the most experienced and best cardiologist in Delhi. In 35 years of practice he has handled and treated some very complicated cases of adult cardiac catheterization, angiography, and acute coronary emergencies. Some of other specializations are peripheral angiograms and angioplasty, percutaneous balloon valvuloplasty of all valves, permanent pacemaker implantation. He is currently associated with Sir Ganga Ram Hospital, Delhi.

9. Dr. Nishith Chandra

DM Cardiology

Consultation fees: ₹1000 -1500

Dr. Chandra, is currently working as a director interventional cardiology, at Fortis Escorts Heart Institute & Research Centre, New Delhi. In his 21 years of practice he is a famous and reputed name in the field. His areas of core interest and specialization are complex coronary interventions including Rotablation, Carotid Interventions, Balloon Valvotomies and Peripheral Vascular Interventions. One of his greatest accomplishment is setting up the Air Ambulance Unit of Escorts Heart Institute that has helped in treating more than 300 critically cases.

10. Dr. Rajiv Bajaj

MBBS, MD - Internal Medicine, DM - Cardiology

Consultation fees: ₹500

Dr. Rajiv Bajaj is currently associated with Batra Hospital, Delhi. He has experience of 38 years and is amongst the eminent doctors in the field of cardiology. He has performed numerous coronary angioplasties, more than 200 electrophysiology studies and 100 ablations including VT and flutter ablations in adults and pediatric population. His areas of interest are Coronary angioplasty, cardiac catheterization in permanent pacemaker implantations, electrophysiology, echocardiography.

9 people found this helpful

Renal Biopsy - When Should You Go For It?

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Renal Biopsy - When Should You Go For It?

Kidneys play an important metabolic role and are essential for balancing salt, minerals and water in the body. They also play a significant role in removing waste products from the body. They make urine, which contains all the waste materials that are eliminated from the body. They also play an important role in blood pressure regulation and in maintaining the balance of various minerals in the body. Any suspected kidney damage should be confirmed by a kidney biopsy, which will reveal the exact disease, thereby directing towards the appropriate treatment. 

Why and when is it done? 

A renal or kidney biopsy is done in the following situations: 

  1. When there is abnormal protein in the blood or urine, which is indicative of a kidney disease, and the exact cause needs to be found out
  2. When kidney failure is suggested by blood tests but cause is not clear 
  3. To find the cause of bleeding in the urine (haematuria) 
  4. To identify and/or confirm diagnosis after a CT scan or ultrasound 
  5. To check how well a transplanted kidney has been received 

Know about the procedure 

A renal biopsy is mostly done as an outpatient procedure and is a type of biopsy known as percutaneous biopsy (biopsy where a needle is inserted through the skin into the renal tissue). Very rarely, it may be combined with the CT scan or ultrasound and be done in the radiology department. This may be done on inpatients. The patient is made to lie on his/her back and a local anesthetic is used on the area of the injection. A thin, long needle is directed towards the area of the kidney from where some kidney tissue is removed for sampling.

In some cases, the direction of the needle may be decided by a CT scan or ultrasound. While this is a closed biopsy procedure, in some cases, as a part of the surgery, open biopsies may also be obtained, where a sample of tissue is extracted for analysis. 

Recovering from a biopsy 
The person would need some time to recover from the procedure, as there would be some discomfort at the site of a needle insertion. Vital signs would be monitored for the next couple of hours during which the person would also be monitored for internal bleeding. A pain reliever can be used if required. Haematuria or blood-tinged urine can be seen disappearing within the next 12 hours. Very rarely the bleeding can be severe and require angiography and further procedures. The person should also avoid strenuous activities for the next few days. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

2942 people found this helpful

Coronary Angiography And Angioplasty - An Insight On It!

Dr.Tejas V Patel 92% (17ratings)
DM - Cardiology, MD - Medicine, MBBS, Observership
Cardiologist, Ahmedabad
Coronary Angiography And Angioplasty - An Insight On It!

Sedentary lifestyle and unhealthy food habits result in many lifestyle diseases, coronary heart diseases being one among them. One of the top 10 leading causes of death, heart attack might scare you, and it is necessary to know the facts to avoid risk factors and seek the best treatment.

The coronary arteries supply blood to your heart muscle. But at times, they can become blocked owing to the buildup of cholesterol and other substances known as plaque. It can reduce the flow of blood to the heart. When the blood flow is entirely restricted, it may result in a heart attack.

Doctors typically recommend angiography during or after a heart attack or in the case of angina to find out about the condition of the heart and proceed accordingly. If any blockages are observed, angioplasty would be advised to improve the blood flow to the heart by widening the narrowed arteries. Read on to know further details regarding this.

What is coronary angiogram?
A coronary angiogram is a special X-ray test which helps in detecting if any of the coronary arteries are narrowed or blocked, hindering the optimal flow of blood. It can help your cardiologist understand whether you need any treatment such as stent or angioplasty or simple medical therapy. 

During the process of angiography, your doctor would numb a spot in the arm or groin for inserting a thin catheter into the artery. You will get the feeling of a pinprick, and x-rays would be taken as the fluid goes through the coronary artery. After the process is completed, your doctor would discuss the results of the test with you and determine whether you need to undergo angioplasty.


What is coronary angioplasty?
A coronary angioplasty is a process which is used for widening blocked or narrowed blood vessels that supply blood to the heart. The term angioplasty entails using a balloon for stretching open the blocked artery. But the modern approaches to angioplasty procedures involve insertion of a short-wire mesh tube known as a stent. This stent is permanently left alone in the deployed state to allow free flow of blood to the heart. 

Coronary angioplasty is often referred to as percutaneous transluminal coronary angioplasty or PTCA. The combination of angioplasty together with stenting is known as a percutaneous coronary intervention. Even though angina can be easily treated with the help of medicine and some lifestyle changes, a coronary angioplasty may be required for restoring the flow of blood to the heart. Doctors recommend undergoing coronary angioplasty as an emergency treatment after a heart attack. 

What are the benefits of coronary angioplasty?
The flow of blood through the coronary arteries is massively improved after the coronary angioplasty. Many people find that the symptoms and discomfort are improved after undergoing this treatment. For individuals who have suffered a heart attack, angioplasty can significantly improve the chances of survival.

So, with this awareness, follow the doctor’s advice for a complete recovery from a heart attack. In case you have a concern or query you can always consult an expert & get answers to your questions!

2148 people found this helpful

Options to Angioplasty - A Scientific Understanding!

Dr.Sujata Vaidya 90% (844ratings)
PhD, Human Energy Fields, Diploma in PIP, EFI, Aura scanning for Health evaluation; Energy field assessment, Fellowship Cardiac Rehabilitation, Cardiac Rehabilitation, MD (Ayur - Mind Body Med), Mind Body Medicine
Non-Invasive Conservative Cardiac Care Specialist, Pune
Options to Angioplasty - A Scientific Understanding!

When a person suffers from the typical symptoms of heart weakness that includes breathlessness, weakness, sudden sweating, discomfort while doing minor exertions, chest pain, pain radiating along the arms, back, neck and shoulders and other symptoms, the Doctor will ask for investigations to study the heart.

The Heart is a muscular organ in the chest and like any other muscle in the body, it has its own unique blood vessel network that does the function of supplying nutrition to the heart muscles. Like any network, the Cardiac blood supply also begins with major vessels that branch off into minor and then very small blood vessels. It is these very small blood vessels that actually reach the muscle fiber to give nutrition.

When this is a problem with the free flowing blood to reach the muscle cells, the strength of the heart muscles reduces and the overall heart functioning is in trouble. Until now, it was commonly believed that cholesterol deposits make blockages in the blood vessels that cut off nutrition supply causing the heart to go into disease stage. Today, extensive research has proved that there are many reasons for hampered blood supply to heart muscles, and plaque formation (blockages caused by cholesterol deposits) need not be the reason for heart attacks entirely. Blood vessel disease called Atherosclerosis is the root cause.

In modern times, if the patient consults a cardiologist, the first line of investigation prescribed is the Angiography. This procedure requires the patient to be admitted to the hospital. Under anesthesia, the Doctor will make a cut/incision in a major blood vessel of the thigh joint or the arm. He will then insert a tube called catheter into the blood vessel and guide it through the major arteries till it reaches the important position from where the blood vessels that supply nutritious blood to the heart muscles is reached. At this position, a dye is pushed into the blood flow and a series of specialized X-rays are taken that will show the blood vessels.

In these images, it is the Doctor’s expertise that will identify positions where the blood flow is reduced, or disturbed. The dye has a short life span and is able to show flow dynamics only up to the secondary blood vessel network. The Doctor will determine which part of the heart blood vessels are affected based on these images, the length of the plaque, position and kind of blockage and derive the damage to heart, based on these anatomical visuals. The catheter is then removed; the blood vessel opening stemmed and the patient has to remain immobile in the hospital till the blood vessel improves. The Doctor will prescribe a list of medication that includes beta blockers, aspirins, statin and antibiotics.

Very often, if the Doctor decides, he will suggest the next procedure of Angioplasty immediately. This procedure involves pushing a mini wireframe tube called ‘stent’ or an inflatable balloon through the same catheter to the area of blockage. This balloon or stent is guided to the area of the blockage and mechanically expanded to push aside the plaque to help the blood flow resume. There are different kinds of balloon and stent procedures.

None of these procedures “removes” the blockage plaque. The procedure helps to resume blood flow in the major arteries only. 

No invasive therapy is safe and there is a lot of reports backed by Research Data from very reputed global authoritative organizations that highlight the unnecessary number of angio procedures being done as well as the side effects of these procedures within few months. (Many Stent Procedures Unnecessary” Heart Drugs Just as Good at Preventing Heart Attacks, Death in Some People, Study Shows By Charlene Laino: March 26, 2007 (New Orleans).

Can blockage affect a person after having angiography?

It is important for the patient and patient’s family to understand that the blockage formation process in the body does not reverse with an angioplasty or even a Bypass procedure. The patient suffers from the same kind of symptoms as earlier when new blockages form in different sections of the coronary network or very often, when a deposit / scar forms within the stent itself leading to hampered blood flow. This ‘reformation of blockages’ is referred to as restenosis. This is the greatest problem registered in current studies of patients after angio and bypass and this is seen within few weeks to after 10 to 14 months of the procedure.

The reformation of blockages or further formation of new sites with blockages depends on the individual patients health condition. Patients who are Diabetic, High BP, on certain kind of long term medication, obese, with bad lifestyle; all have the additional threat of secondary attacks.

Restenosis cannot be prevented with another stent or bypass procedure. The procedure only once again’ mechanically opens the blockage or in CABG, creates a bypass around the blocked blood vessel.

How can restenosis be prevented?

The only and best way to avoid restenosis is to make major changes in diet, exercise, weight management, stress management. It is also very important to be under the right kind of medication that will support the natural process done by the Liver and blood to reduce and wash out inflammation (that causes maximum problems in natural blood flow), repair blood vessels, reduce and remove existing blockages and scar tissue within blood vessels, add strength to the heart muscles.

Ayurveda has many proved medication combinations that include Arjuna (improves Heart muscle condition) Draksha (powerful anti-oxidant and liver repair) Dadimba (Pomegranate is known to participate in repair of blood vessels and rebuild damaged vessels called Angiogenesis), Ashwagandha (Cardio-protective) and Colostrum (powerful immunity modulator, participate in muscular and nerve repair, Angiogenesis Growth Factor, Endothelial growth Factor, Nerve growth factor, PDGF, natural Vitamins and Minerals).

These treatments are now available in select Ayurvedic treatment centres and are also being proved with clinical pre and post investigations to support their success.

These new studies and treatments options should be searched out by the patient and his/her family to understand the reason of blockages, the possible need and safety of invasive procedures, the option to medicine based treatments before undertaking any invasive procedure. Remember, it is scientific research that has clearly proclaimed that less than 30 -20% of all the angio’s performed are necessary or have lasting effect on their own.

3316 people found this helpful
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