The Cardiology Department diagnoses and treats mainly cardiovascular disease since our inception has developed into a cutting edge Centre for treating cardiovascular diseases.

Our experts use state-of-the-art examination and treatment methods, .the department offers 24/7 services for the treatment of patients with acute myocardial infarction. Some of the newest cardiac procedures have been performed at our Centre.

Our team is very focused on international best practice and developments in procedures and technologies which make our work safer, more efficient and improve recovery time for patients. The cardiology team comprises of national and international trained and well reputed cardiologists, providing the best cardiac care at par with international standards.

Patients also find the outpatient services offered very valuable. We have a number of screening and diagnostic facilities, which, in conjunction with Emergency Department, mean that patients with cardiac concerns can receive urgent diagnosis, treatment and care.

Treatment is provided for the following conditions

· Diseases of the coronary vessels, the cardiac muscle and the cardiac valves

· Pacemaker implantation

· Heart failure (acute and chronic cardiac insufficiency)

· Cardiac arrhythmia

· Vascular diseases of the peripheral arteries and veins

Cardiac Catheterizsation Laboratory
Cardiac Catheterization Laboratory provides diagnostic and therapeutic services to patients suffering from a wide range of diseases of the blood supply to the heart, the cardiac muscle or the cardiac valves.

These include

· coronary angiography, i.e. imaging of the coronary arteries that makes it possible to easily identify constrictions or blockages;

· coronary interventions to reopen such constrictions or blockages;

· medical care for patients who suffered an acute myocardial infarction.

Overview of Services Offered In The Cardiac Catheterization Laboratory
Peshawar Institute of cardiology has 3 fully functional cardiac catheterization lab and further 3 will be operational soon. These labs are equipped with latest technology and provides state of the art cardiac care.

Coronary Angiography
A diagnostic cardiac catheter is inserted into the femoral artery (in the upper leg) or the radial artery (in the wrist) to inject a contrast agent into the right and left coronary artery. This makes it possible to easily identify constrictions or blockages. In addition, a technique called fractional flow reserve (FFR) can be used to measure the blood pressure directly in the coronary artery. This is done mainly to plan further procedures.

Coronary Interventions with/without Drug-eluting Stents (Drug-Coated Stents)
If coronary arteries are found to be constricted or blocked, they can be widened using a balloon catheter (balloon angioplasty, PTCA). A small metal tube (stent) is usually implanted during this procedure in order to hold the vessel open. Patients need to take blood-thinning aspirin and clopidogrel for several weeks or months after the surgery to prevent clots from forming within the stent.

In some patients, excessive wound healing in the area of the stent may cause the vessel to narrow again (restenosis). Modern stents are therefore coated with specific drugs that slow the healing process

slightly in order to prevent this narrowing. However, patients with such stents need to take aspirin and clopidogrel for a longer period of time.

Today, state-of-the-art materials have also made it possible to reopen blockages in the coronary arteries by inserting a special microcatheter into the blockage. This catheter is then used to pass a special guide wire through the blockage. A very small balloon can then be positioned at the affected site to open up the blockage, almost always finishing with the placement of a stent.

Procedures
Coronary angioplasty involves the treatment of narrowings or blockages in the coronary arteries with fine wires and balloons introduced in a “key-hole” procedure from the top of the leg or wrist. In nearly all cases this involves leaving a metal tube made from a fine wire mesh called a stent in the vessel to serve as scaffolding to hold the artery open whilst it heals.

Angioplasty is performed in a variety of situations ranging from planned routine procedures for patients with troublesome angina to emergency procedures for patients suffering from an acute heart attack (primary angioplasty). Many patients who previously would have had to have a coronary bypass operation can now be successfully treated by angioplasty.

We utilize state-of-the-art technologies in our modern catheter laboratories, which have digital X-ray imaging facilities. We are nationally noted for our use of intra-coronary imaging, using tiny ultrasound or light-emitting probes to provide detailed pictures of heart arteries, and improve outcomes during stent procedures.

We routinely use pressure measurements inside the heart arteries to guide our treatments, and are even able to open arteries that have

been blocked for many years. We are able to provide alternatives to surgery in patients who are unable to have full open-heart operations, and work closely with our surgeon and anaesthetic colleagues to provide the best care available for the very sickest and most vulnerable cardiac patients.

Right Heart Catheterization To Investigate Valvular Defects or Shunts
Determining the blood oxygen levels in the various cavities additionally allows an assessment of the heart’s pumping capacity. Less common heart conditions (e.g. malformation of the cardiac septum) can also be diagnosed this way. Right heart catheterization is also commonly performed prior to surgical procedures on the cardiac valves in cases such as narrowing of the aortic valve (aortic valve stenosis) or leakage of the mitral valve (mitral valve regurgitation).

Pericardial Puncture
An accumulation of fluid in the pericardium (e.g. due to inflammation) can considerably affect the heart’s function. In some cases, it may be necessary to remove this fluid by employing a special puncture needle as well as a drainage catheter. This is also done in the Cardiac Catheterization Laboratory with the help of fluoroscopy, allowing for the puncture to be performed safely and quickly.

Electrophysiological Examinations

On-call Emergency Service for Acute Myocardial Infarctions.
The Cardiac Catheterization Laboratory has been offering around-the-clock medical care. This is the only way to guarantee that a clogged coronary artery can be swiftly reopened in the event of an acute myocardial infarction. An ECG is obtained and transmitted to the hospital by radio while the patient is still in the ambulance. Based on the ECG results, the team of the Cardiac Catheterization Laboratory can be alerted even before the patient arrives at the hospital. By the time the patient reaches the hospital, the emergency team is already on site to immediately initiate treatment.

Cooperation With Cardiosurgery
Not all patients can be helped with balloon catheter dilatation and stent implantation. In some cases, venous or arterial bypass surgery is the better option. This is why we work closely with the cardiac surgery department. This close co-operation provides significant improvement in the care of patients suffering from coronary heart disease as well as valvular heart diseases.

Pacemaker Implantation
In patients suffering from an abnormally slow heart rate and related health problems such as dizziness or fainting, a pacemaker can be used to restore a normal heartbeat and often also improves symptoms. Modern pacemakers are capable of supporting or mimicking the heart’s natural rhythm. Depending on the type of arrhythmia, one or several electrodes are inserted into the ventricles. The procedure itself is performed under local anesthesia under sterile conditions. The patient is under close medical supervision throughout the entire procedure. The pacemaker is subsequently programd to meet the patient’s specific pacing needs.