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 NABH Patient Safety & Quality of Care
 gknm hospital materinity

Cardiac Catheterisation :

This test is done to know the extent of the disease or narrowing of blood vessels (artery) that supply blood to the heart. This is routinely done under local anaesthesia through an artery in the hand or in the thigh. Average time for the procedure is approximately 15- 30 minutes. Patient is conscious throughout the procedure. Patients are kept under observation for a minimum period of 6-8 hours and can be discharged on the same day if the procedure is done through the hand (the radial route)

Temporary & Permanent Pacemaker Implantation :

Temporary pacemakers are usually implanted in cases of emergency. A small tube is inserted through a leg vein or a neck vein and is taken into the right side of the heart. This tube is connected to the battery operated instrument which will stimulate the heart and initiate heart beat. Permanent pacemaker, a small equipment weighing 25-30 gms is placed below the skin just under the collar bone. It is done under local anaesthesia. The equipment permanently lies inside the patient’s body. Patient needs to stay in the hospital for 2-4 days.

Colour Doppler Echocardiogram :

An echo cardiogram is an ultrasound examination of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional and three dimensional slices of the heart. Electrocardiography is used to diagnose most of the cardiovascular diseases.

The department works between 8am-5pm from Monday to Saturday. Echo cardiograms are done by prior appointments for outpatients and inpatients.

Transthoracic echocardiogram, transesophageal echocardiogram, 3 Dimensional echocardiogram, Pharmacological stress echocardiogram and tissue doppler are done routinely.

Transthoracic echocardiogram :

The internal structure of the heart and blood vessels is imaged using ultrasonic waves sent from a small equipment placed on the patient's chest. It is a noninvasive examination with least discomfort to the patient. Time taken for this test is about 15 – 30 minutes.

Transoesophageal echocardiogram :

Transoesophageal echocardiogram is a semi invasive procedure. It is like endoscopy. Patient needs to come on an empty stomach. Patient is asked to swallow a small tube which helps to scan the heart once it is in the food path (Oesophagus). Local anaesthetic agents and a spray are administered so that the procedure is done without any pain. The time taken for this test is about 15-30 minutes.

Stress Echocardiogram :

Pharmacological stress echocardiogram is similar to the usual transthoracic echocardiogram. The only difference being the echo is done while administering a drug to the patient. The echos are recorded at regular intervals at different doses of the drug. This is an alternative to treadmill test. It will be done as per the Cardiologist’s discretion. Normally this test takes about one hour.

3 Dimensional echocardiogram :

Provides 3 dimensional imaging of the heart from the chest. Offers more clear picture of structural abnormalities, pumping efficiency, wall motion abnormalities etc., The department also has  facilities for nuclear cardiology like Myocardial perfusion imaging (Stress thallium) viability study. Details for which can be found in the nuclear medicine department.

Tissue Doppler Imaging :

Tissue doppler imaging is the latest advance in echo technique which utilises effective ultrasound waves for cardiac tissue. This is the latest technique which can detect cardiac muscle dysfunction very early in the course of the disease.

Treadmill Test :

TMT test involves dynamic electro cardiographic monitoring. In layman’s words in this test ECG is being continuously recorded when the patient is walking on a belt. The speed and the height of the belt gradually increases at predetermined levels. Total duration of the test will be approximately 30-40 minutes including preparation. Patient is advised to come relatively on empty stomach. In case of male patients they need to shave their chest.

Holter Monitoring :

A Holter monitor (also called an ambulatory electrocardiography device),is a portable device for continuously monitoring the electrical activity of the heart for 24 hours or more. Its extended recording period is sometime useful for observing occasional cardiac arrhythmias that would be difficult to identify in a shorter period of time. A small machine will be tied on to the patient's chest and the patient is advised to do normal activities. The ECG tracings are continuously recorded and later fed to a computer for analysis.

Ambulatory Blood pressure monitoring :

This  non invasive 24 hours periodical recording of blood pressure, gives immense information in diagnosing adequacy of treatment and prognosis of hypertension

Advanced Heart Failure Clinic :

Heart failure clinic is a dedicated clinic for patients with advanced heart failure. Patients who are under regular and optimal medication for heart failure and who have undergone corrective surgeries like Coronary Artery Bypass Surgery, Valve replacement, congenital heart disease correction but continue to have refractory heart failure are evaluated in this clinic. Advance options for heart failure which include device therapy like implantable cardiac defibrillator, Cardiac resynchronization therapy and Radio frequency ablation are considered. Patients are evaluated for operative techniques like ventricular assisted device, total artificial heart and Cardiac transplantation.