INTERVENTIONAL CARDIOLOGY
Interventional Cardiologist in Chennai — Dr. Gem Raghav Prashanth
What interventional cardiology is, when it is indicated, and which procedures Dr. Gem performs.
IN PLAIN TERMS
What interventional cardiology means
Interventional cardiology treats heart disease through catheters rather than open surgery. A thin tube is passed into an artery — usually at the wrist or the groin — and guided to the heart under X-ray. Through it, the coronary arteries can be imaged and narrowings can be opened and held open with a stent.
It sits between medical therapy and cardiac surgery. Many patients with coronary artery disease need neither; some need medication alone; some need bypass surgery. Deciding which category a patient falls into is the substance of the consultation, and it is decided on clinical grounds before any procedure is scheduled.
PROCEDURES PERFORMED
What Dr. Gem performs
Procedures such as coronary angiography, PTCA (percutaneous transluminal coronary angioplasty), temporary pacemaker insertion, cardiac catheterization, etc., are performed at appropriate centres and not at the clinic.
Where a patient would be better served by bypass surgery or by a procedure Dr. Gem does not perform, he says so and refers appropriately. A cardiologist who only offers what he can do himself is not giving you a full picture.
WHEN IT IS CONSIDERED
Conditions that may lead to intervention
Stable angina not controlled on medication
Chest pain on exertion that persists despite appropriate medical therapy, or that limits daily activity, may warrant angiography to define the anatomy.
Acute coronary syndrome
Heart attack and unstable angina are emergencies. They are managed acutely in hospital, not through outpatient booking — go directly to an emergency department.
Strongly abnormal non-invasive tests
A markedly positive stress test or a high-risk finding on cardiac imaging may prompt invasive assessment.
Coronary disease in diabetes
Coronary disease in diabetic patients is often more diffuse and less symptomatic — a particular research and clinical interest of Dr. Gem's, and the subject of the CADRIDS risk score he developed.
Emergency — do not wait
A suspected heart attack is not an appointment. Severe chest pain, chest pain with sweating, vomiting or breathlessness, or collapse require immediate emergency care. Time to treatment determines how much heart muscle is saved.
Discuss whether intervention is appropriate
Most consultations do not end in a procedure. The assessment comes first.