The document provides information about cardiology and innovations in the field. It discusses: 1) Cardiology is concerned with diseases of the cardiovascular system. CVDs are the leading cause of death globally. In India, over 54.5 million people have CVDs. 2) The history of cardiology in India and globally, including important figures and firsts like the first open-heart surgery, pacemaker, and heart transplant. 3) Components of cardiac catheterization laboratories, their purpose, equipment, and staff requirements. Administrative issues regarding utilization, performance evaluation, and quality assurance are also covered. 4) Current innovations in cardiology like wearable technology, virtual/augmented reality, 3D

1. DEPARTMENT OF CARDIOLOGY
SHILPA SINGH
SHIVANGI DAS
SHIVANI SHAKTI RAO
SHIVANI VISHWAKARMA
SHREEPARNA DAS
SHREOSEE MUKHERJEE
1
By
GROUP H
SHRUTI AGGARWAL
SHWETA BISHT
SHWETA SHASTRI
SONAL JAIN
SONALI TAGGAR

2. INTRODUCTION
• Cardiology is the medical subspecialty concerned
with the prevention, diagnosis, management, and
rehabilitation of patients with diseases of the
cardiovascular system.
• A Cardiologist is a specialist who is an expert in
the diagnosis and management of all aspects of
cardiovascular disease.
• CVDs are the number one cause of death globally,
taking an estimated 17.9 million lives each year. Of
these deaths, 85% are due to heart attack and
stroke.
• In 2016, the estimated prevalence of
CVDs in India was estimated to be 54.5
million. One in 4 deaths in India are now because
of CVDs with ischemic heart disease and stroke
responsible for >80% of this burden.

3. HISTORY
TRADITIONAL INDIAN HISTORY
• PRE-VEDIC ERA explained heart & circulation
• RIG & ATHARVA VEDA covered concept of health
• Role of YOGA & TRANSCENDENTAL MEDICINE - cure of
heart problems
• ‘HATHAYOGA’- prevention of cardiovascular diseases
• The 4th Chakra HEART CHAKRA- controlled the operation of the heart and
the circulation of blood.
GLOBAL HISTORY
• WILLIAM HARVEY- Circulation of Blood in Body in 1628
• STEPHEN HALES- Measurement of Blood pressure in 1733
• RENE T.H LAENNEC- Invented the Stethoscope in 1816
• First Electrocardiograph was invented in 1905
• First open-heart surgery was done in 1952
• First whole heart transplant in 1967 by Christian Bernard
• First artificial heart was implanted in 1982

4. INDIA'S FIRST
• Dr. Bidhan Chandra Roy led formation of the Cardiological Society
of India (CSI) on 4th April 1948
• In 1994, Indian Academy of Echocardiogarphy was founded
• Dr. KS Shadaksharappa founded Indian College of Cardiology at
Bengaluru
• First cardiac catheterisation laboratory for clinical studies in
AIIMS,Delhi
• First cardiothoracic surgery department at Vellore in 1949
• First ECG machine in K.E.M. Hospital, Mumbai, late 40's
• First Coronary Artery Bypass Graft (CABG) surgery done by Dr.
K.M. Cherian in 1975 at Chennai.
• First heterologous cardiac transplant with pig's heart was done at
K.E.M. Hospital, Mumbai by Dr. PK Sen
• First heart and lung transplant in 1999 by Dr. KM Cherian
• First electrophysiology lab established in 5th March 1975 at G.B. Pant
Hospital by by Dr. M Khaliluallah
• First temporary pacemaker manufactured in India was the
Khalilullah-Mendez pacemaker in 1970
• First Indian doctor in Paediatric Cardiology was Dr. S Padmawati.

5. CARDIAC HOSPITAL PLANNING AND DESIGNING

6. COVID-19 CLINICAL GUIDELINES FOR THE CARDIOVASCULAR TEAM
• COVID-19 Implications For Patients With Underlying
Cardiovascular Conditions
• Quickly identify and isolate cardiovascular patients with
COVID19 symptoms
• All cardiovascular patients should be made aware about the
risk and precautions
• Patients with CVD to remain current with vaccinations like
the pneumococcal vaccine ,vaccination against influenza
• Use telephonic or telehealth visits for in-person routine visits
for stable CVD patients to avoid possible nosocomial COVID-
19 infection
• Protocols for the diagnosis, triage, isolation, and management
of COVID-19 patients with cardiovascular complications
should be developed in detail and rehearsed; the cardiovascular
team has to be trained properly in personal protective
equipment (PPE) donning, usage, and doffing
Case fatality rates for comorbid
patients are materially higher than the average population:
Cancer: 5.6%
Hypertension: 6.0%
Chronic respiratory disease: 6.3%
Diabetes: 7.3%
Cardiovascular disease: 10.5%Source- American Collge of Cardiology

7. PATIENT MANAGEMENT
• The use of telemedicine in heart
failure patients is
one of the most advanced approache
s in telecardiology regarding feasibil
ity and clinical evidence
• Telemonitoring with cardiovascular
implantable electronic devices (CIE
D) provides diagnostic information
about early markers regarding the on
set of pulmonary congestion
• Remote patient management (RPM)
describes a holistic digital concept i
n the outpatient care of HF patients

8. 8
RPM PROVIDED BY A TMC
Within the last 15 years, many RCTs have been
conducted to demonstrate the efficacy of RPM
to reduce cardiovascular morbidity
and mortality
It can be concluded that RPM patients
recently hospitalized for HF had fewer
unplanned hospitalization and days in
hospital, a lower all-cause/cardiovascular
mortality and improved quality of
life compared to patients with
usual care only
The TMC represents a department of a
third level hospital (e.g., a university clinic)
with departments to treat the
most common comorbidities of HF (e.g.,
stroke, depression, kidney
dysfunction, diabetes) and to carry
out consultations.

9. 9
8 Ways to Improve the Hospital's Heart Program and overall performance
Combine government-
recommended quality
measures with measures
that serve your
specific community
Choose a payment
model that incents
physicians to
perform better.
Organize your teams
by specialty
Build a structured
process for
deciding which
technologies to
invest in.
Review every single
patient death.
Eliminate unnecessary
transitions between
providers.
Promote good
relationships
with community
providers and
other hospitals.
Promote collaboration
between
nurses, physicians and
administration.

10. 10
CORONARY CARE UNIT
An article, Evolved role of the cardiovascular intensive care
unit mentioned the main feature of CCU as:
Continuous monitoring
of the cardiac rhythm
Cooperation between
cardiologists and
intensive care specialists
Targeted temperature
management
Another article, 'The Changing Role
of the Coronary Care Unit
Cardiologist' stated the changing face
of CCU & roles of cardiologists for
managing the acutely unwell cardiac
patients :
• Ventilator
• blood purification device
• auxiliary circulation
devices, such as IABP & PCPS
To cope with CVD patients with
various complications, such as
respiratory failure, renal failure,
and sepsis.
to improve long-term neurological
outcome
Mandatory additional training & close
collaboration between cardiologists and
intensivists.

11. PROGRESSIVE CARDIAC CARE UNIT
• Patients admitted
to specialized progressive
care units typically have
a cardiac (heart-related) diagnosis
• Patients who needs PCCU -
i. Post-stent placement
ii. Post-cardiac catheterization
iii. Heart attack
iv. Congestive heart failure (CHF)
v. Heart rhythm abnormalities
vi. Pacemaker
vii. Internal heart defibrillator.
DIFFERENCE BETWEEN PROGRESSIVE & INTENSIVE CARE UNIT
Progressive Care Unit Intensive Care Unit
Intermediary step between an ICU and a
medical/surgery floor
A special facility in a hospital or other healthcare facility to serve the
extremely ill
Patients are more stable than the patients
who require Critical Care
For the patient who requires the highest level of care that stabilizes the
condition. ICU patients are unstable and might be relying on a range of
equipment such as artificial ventilators.
PCU personnel must work in close-knit
environments with more support staff that
those in general care units.
ICUs usually have a large care team that might not provide care at the same
time, but each of them provides service that complements the care beach
professional to save the life of the patient and enable healing
Surgical Progressive Care
Unit
Medical Progressive Care
Unit

12. New Pacemaker Technologies
MRI- Safe Pacemakers
One of the biggest trends in pacemaker technology in the last few years
has been the introduction of U.S. Food and Drug Administration (FDA)-
cleared MRI-conditional models.
Ø Pacemakers without MRI-conditional use technology usually
prevented patients from being able to get an MRI.
Ø Biotronik is the first company in the United States to offer both single- and
dual-chamber pacemakers approved for use in an MRI environment.
The Leadless Pacemaker
Ø leadless pacing systems that are small enough to be placed inside the
heart and avoid the need for a subcutaneous pocket and transvenous leads
Ø Current leadless pacemakers are designed to be compatible with
magnetic resonance imaging.
Ø Battery life is approximately 5-15 years, comparable to that of
a transvenous pacemaker.
Ø The primary advantage of a leadless pacemaker is the elimination of several
complications associated with transvenous pacemakers and leads.

13. MARKETING FOR 150 BEDDED CARDIAC HOSPITAL
Strategic
Place
Infrastructure
Facilities
Interventional
Cardiology
Service
Profile
Choose your
Personal
Cardiologist
Non-Invasive
Cardiology
Services
Pediatric
Cardiac Care
Heart Failure
&
Transplant
Program

14. PROMOTIONALACTIVITIES
Cardiac Rehabilitation
Center of the Hospital
Cardiac Health
Check Up Camps
Corporate
Promotion
Golden Hour Moment
&
Emergency Services
Media Promotion
Branding
Internal
Marketing
Medical Value
​Accreditation
Tie Ups​
Collaboration
Patient Assistance
Department
Special Cause
Related Marketing

15. CATHETERIZATION LABORATORIES
• Cardiac catheterization is an invasive procedure used to
identify cardiac anatomy, measure intracardiac pressure
shunt and oxygen saturation and calculate systemic and
pulmonary resistance.
• This procedure is performed in an area of the hospitals
called the 'catheterization laboratory' or 'cath labs'
• Catheterization lab is an examination room used
to visualize the arteries and treat any stenosis
or abnormality found
• India is a country of about 1.3 Billion people, with 35
million people suffering from Cardiovascular disease.
• There are just 1300-1400 Cath labs available
in about 140 cities. About 225 Cath Labs get added
to the market every year

16. CATHETERIZATION LABORATORIES (contd...)
Equipements of cath lab:
1. C- arm
2. X-ray source tube
3. Detector
4. Catheterization table
5. X-ray generator
6. Monitors
7. Control handle
8. Pedals
9. Control room with diagnostic application
Staff requirements:
• Chief cardiologist
• Assistant angiographer
• Laboratory director
• Cardiovascular trainee
• Nursing personnel- scrub nurse & float circulating
nurse
• Technical staff- radiation technologist,
radiation physicist, lab technologist, dark room
technician, computer technician, monitoring
technician
• Non-technical staff- medical transcriber, Clerks

17. Components of Cath Lab and area required by each component
17
Use Suggested min. Size
(in sq. Ft.)
Procedure room 500-600
Control room 150-200
Equipment room 100-120
Dark room 70
Holding room >120
Patient preparation
room
120
Recovery room 120
Stock room 100
Patient dressing room 70
Staff dressing room 70
Toilets (staff & patient) 60
Reception area 70
Blood gas analysis 20
Conference room 120

18. ADMINISTRATIVE ISSUES
2. Lab
performance
evaluation
1. Utilization
levels
3. Quality assurance
Laboratory safety and
efficiency is measured
by:
1. Complication rates
(through records)
2. No, of studies that
must be repeated
because of inadequate
data or image quality
1. Laboratory
For optimum lab
performance & cost
effectiveness
2. Physician-
Operator
For adequate
performance and
preventing excessive
radiation exposure.
The quality assurance
program in cardiac cath
labs has 3 components:
1. Clinical proficiency
2. Equipment
maintenance and
management
3. Quality improvement
program development
Administrative issues

19. INNOVATIONS IN CARDIOLOGY
• WEARABLE TECHNOLOGY FOR PATIENT
MONITORING
Smart software and AI is being incorporated into the
wearable and app algorithms to detect abnormally
high heart rates, arrhythmias, and other factors to
alert patients to contact their doctors.
• VIRTUALAND AUGMENTED REALITY
The latest technology is being used in
medical devices to make visualization effortless
and precise.
• EASE OF PLANNING AND PROCEDURE
Three-dimensional-printed cardiac prototypes aid
surgical decision-making and preoperative planning
of complicated cases

20. INNOVATIONS IN CARDIOLOGY (contd...)
3D PRINTING
Scientists all around the world are at the
brink of a breakthrough in 3D printing
of a heart, it will revolutionize
the transplant industry.
ARTIFICIAL HEART
It is a prosthetic device implanted in the
body to replace the cardiac functions.
LAB GROWN HEART TISSUE
Lab grown heart tissue was transplanted
for the first time in 2020. If successful, it
could ultimately eliminate some of the
transplant procedures.

21. THANK YOU