This is the medical subspecialty which deals with the evaluation and management of conditions related to the heart and circulatory system. The field of cardiology has further evolved so that there are now three distinct areas of interest or further sub-specialization. The Non-invasive cardiologist deals mainly with clinical evaluation of the heart, and usually has special expertise in assessing the heart with Echocardiography, stress testing etc.; The Invasive Cardiologist- focuses on treatment of coronary artery disease with angiography, angioplasty and stenting blocked coronary arteries . The Cardiac Electrophysiologist focuses on the electrical system of the heart-evaluation and treatment of arrhythmias (Supraventricular tachycardia (SVT), Ventricular Tachycardia (VT), Atrial fibrillation, heart block etc), insertion and management of cardiac pacemakers, intracardiac defibrillators (ICDs) and so on.
At Eureka Medical Clinic cardiology specialty services are offered by Dr. Heskith Vanterpool, who after 20 years of doing general internal medicine and gastroenterology in the British Virgin Islands, returned to the UK (2005-7) to study cardiology (MSc Cardiology, Imperial College London/Royal Brompton Hospital and the Echo Department, Northwick Park Hospital) and to obtain accreditation in echocardiography (British Society of Echocardiography).
Noninvasive cardiac services offered at Eureka Medical Clinic include:
- Resting Electrocardiogram (ECG, EKG)
This is a recording of the pattern of electrical activity of the heart. Some conditions may alter the pattern on the tracing, thus allowing us to make a diagnosis or assess the severity of the condition. These changes may indicate evidence of conditions, such as myocardial infarction or ischemia, ventricular hypertrophy, or electrical problems with the heart rhythm (e.g., SVT, AF) or electrical conduction, etc.
- Exercise Stress ECG (Stress Test)
Under the stress of exercise or certain drugs, a particular pattern of ECG changes may be observed when there is significant narrowing ( blockage) of the coronary arteries. This may indicate the need for further cardiac intervention.
- 24 Hr. Holter ECG monitoring
Certain arrhythmias ( abnormal heart beats) occur only intermittently. This test records the ECG of every heatbeat over a 24 hr. period. The recording is then analyzed to determine what type of arrhythmia , if any, occurred during that time and allows the cardiologist to determine the appropriate management.
- Echocardiography (resting)
An Echocardiogram is a special ultrasound examination of the heart. With the application of the ultrasound probe directly to the chest wall, two dimensional (2D) Images of the heart structure: heart muscle, cardiac chambers and valves are obtained. Color flow Doppler and spectral Doppler analysis allows the detection of leakages( regurgitation or incompetence) or narrowing (Stenosis) of the valves, and the calculation of velocity of blood flow and pressures within the heart.
- Stress Echocardiography (Exercise or DSE)
Echocardiography may be performed during exercise or drug induced stress. This allows the monitoring of heart muscle behavior during rapid heart rates . Stress Echocardiography is a more sensitive and specific method of assessing coronary artery disease than Treadmill exercise stress testing alone. Stress Echo has been shown to be equivalent to Nuclear Stress Testing (Thallium or MIBI Stress Testing) for the purpose of assessing significant coronary disease.
- Trans-Esophageal Echo (TEE/TOE)
In this test the echo probe is inserted into the esophagus (gullet) and the heart examined from behind at very close range. This allows clearer images and greater detail of the inside of the heart to be obtained. This test is usually done under intravenous sedation plus anesthetic spray to the back of the throat.
- Cardiac Pacemaker Management
- Pacemaker Insertion
- Pacemaker Monitoring