Cardiology science and technology


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Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease. The biggest advantage to echocardiography is that it is not invasive does not involve breaking the skin or entering body cavities and has no known risks or side effects.

Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. A large number of procedures can be performed on the heart by catheterization.

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This most commonly involves the insertion of a sheath into the femoral artery but, in practice, any large peripheral artery or vein and cannulating the heart under X-ray visualization most commonly Fluoroscopy. The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery.

Additionally, interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute Myocardial infarction. This procedure can also be done proactively, when areas of the vascular system become occluded from Atherosclerosis. The Cardiologist will thread this sheath through the vascular system to access the heart.

This sheath has a balloon and a tiny wire mesh tube wrapped around it, and if the cardiologist finds a blockage or Stenosis , they can inflate the balloon at the occlusion site in the vascular system to flatten or compress the plaque against the vascular wall. Once that is complete a Stent is placed as a type of scaffold to hold the vasculature open permanently. In recent times, the focus is gradually shifting to Preventive cardiology due to increased Cardiovascular Disease burden at an early age.

Preventive cardiology also deals with routine preventive checkup though non invasive tests specifically Electrocardiography , Stress Tests, Lipid Profile and General Physical examination to detect any cardiovascular diseases at an early age while cardiac rehabilitation is the upcoming branch of cardiology which helps a person regain his overall strength and live a normal life after a cardiovascular event.

Helen B. Taussig is known as the founder of pediatric cardiology. She became famous through her work with Tetralogy of Fallot , a congenital heart defect in which oxygenated and deoxygenated blood enters the circulatory system resulting from a ventricular septal defect VSD right beneath the aorta. This condition causes newborns to have a bluish-tint, cyanosis , and have a deficiency of oxygen to their tissues, hypoxemia. She worked with Alfred Blalock and Vivien Thomas at the Johns Hopkins Hospital where they experimented with dogs to look at how they would attempt to surgically cure these "blue babies.

Tetralogy of Fallot, pulmonary atresia, double outlet right ventricle, transposition of the great arteries, persistent truncus arteriosus, and Ebsteins anomaly are various congenital cyanotic heart diseases. Congenital cyanotic heart diseases is where something is wrong with the heart of a newborn and it is not oxygenating the blood efficiently. Tetralogy of Fallot is the most common congenital heart disease arising in 1—3 cases per 1, births.

The cause of this defect is a ventricular septal defect VSD and an overriding aorta. These two defects combined causes deoxygenated blood to bypass the lungs and going right back into the circulatory system.


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The modified Blalock-Taussig shunt is usually used to fix the circulation. This procedure is done by placing a graft between the subclavian artery and the ipsilateral pulmonary artery to restore the correct blood flow. Pulmonary Atresia happens in 7—8 per , births and is characterized by the aorta branching out of the right ventricle. This causes the deoxygenated blood to bypass the lungs and enter the circulatory system. Surgeries can fix this by redirecting the aorta and fixing the right ventricle and pulmonary artery connection. There are two types of pulmonary atresia, classified by whether or not the baby also has a ventricular septal defect.

Double outlet right ventricle is when both great arteries, the pulmonary artery and the aorta, are connected to the right ventricle. The surgeries that can be done to fix this defect can vary due to the different physiology and blood flow in the defected heart. One way it can be cured is by a VSD closure and placing conduits to restart the blood flow between the left ventricle and the aorta and between the right ventricle and the pulmonary artery. Another way is systemic-to-pulmonary artery shunt in cases associated with pulmonary stenosis.

There are two different types of transposition of the great arteries , Dextro-transposition of the great arteries and Levo-transposition of the great arteries , depending on where the chambers and vessels connect. Dextro-transposition happens in about 1 in 4, newborns and is when the right ventricle pumps blood into the aorta and deoxygenated blood enters the blood stream.

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The temporary procedure is to create an atrial septal defect ASD. A permanent fix is more complicated and involves redirecting the pulmonary return to the right atrium and the systemic return to the left atrium, which is known as the Senning procedure.

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The Rastelli procedure can also be done by rerouting the left ventricular outflow, dividing the pulmonary trunk, and placing a conduit in between the right ventricle and pulmonary trunk. Levo-transposition happens in about 1 in 13, newborns and is characterized by the left ventricle pumping blood into the lungs and the right ventricle pumping the blood into the aorta.

This may not produce problems at the beginning, but will eventually due to the different pressures each ventricle uses to pump blood. Switching the left ventricle to be the systemic ventricle and the right ventricle to pump blood into the pulmonary artery can repair levo-transposition. Persistent truncus arteriosus is when the truncus arteriosus fails to split into the aorta and pulmonary trunk.

This occurs in about 1 in 11, live births and allows both oxygenated and deoxygenated blood into the body. The repair consists of a VSD closure and the Rastelli procedure. Ebstein's anomaly is characterized by a right atrium that is significantly enlarged and a heart that is shaped like a box. The surgical repair varies depending on the severity of the disease. Pediatric cardiology is a sub-specialty of pediatrics. To become a pediatric cardiologist in the United States , one must complete a three-year residency in pediatrics, followed by a three-year fellowship in pediatric cardiology.

As the center focus of cardiology, the heart has numerous anatomical features e. Disorders of the heart lead to heart disease and cardiovascular disease and can lead to a significant number of deaths: cardiovascular disease is the leading cause of death in the United States and caused The primary responsibility of the heart is to pump blood throughout the body.

It pumps blood from the body — called the systemic circulation — through the lungs — called the pulmonary circulation — and then back out to the body. This means that the heart is connected to and affects the entirety of the body. Simplified, the heart is a circuit of the Circulation.

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While plenty is known about the healthy heart, the bulk of study in cardiology is in disorders of the heart and restoration, and where possible, of function. The heart is a muscle that squeezes blood and functions like a pump. Each part of the heart is susceptible to failure or dysfunction and the heart can be divided into the mechanical and the electrical parts. The electrical part of the heart is centered on the periodic contraction squeezing of the muscle cells that is caused by the cardiac pacemaker located in the sinoatrial node. The action potentials generated in the pacemaker propagate throughout the heart in a specific pattern.


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The system that carries this potential is called the electrical conduction system. Dysfunction of the electrical system manifests in many ways and may include Wolff—Parkinson—White syndrome , ventricular fibrillation , and heart block. The mechanical part of the heart is centered on the fluidic movement of blood and the functionality of the heart as a pump.

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The mechanical part is ultimately the purpose of the heart and many of the disorders of the heart disrupt the ability to move blood. Failure to move sufficient blood can result in failure in other organs and may result in death if severe. Heart failure is one condition in which the mechanical properties of the heart have failed or are failing, which means insufficient blood is being circulated. Coronary circulation is the circulation of blood in the blood vessels of the heart muscle myocardium. The vessels that deliver oxygen-rich blood to the myocardium are known as coronary arteries.

The vessels that remove the deoxygenated blood from the heart muscle are known as cardiac veins. These include the great cardiac vein , the middle cardiac vein , the small cardiac vein and the anterior cardiac veins. As the left and right coronary arteries run on the surface of the heart, they can be called epicardial coronary arteries. These arteries, when healthy, are capable of autoregulation to maintain coronary blood flow at levels appropriate to the needs of the heart muscle. These relatively narrow vessels are commonly affected by atherosclerosis and can become blocked, causing angina or a heart attack.

See also: circulatory system. The coronary arteries that run deep within the myocardium are referred to as subendocardial. The coronary arteries are classified as "end circulation", since they represent the only source of blood supply to the myocardium; there is very little redundant blood supply, which is why blockage of these vessels can be so critical.

The cardiac examination also called the "precordial exam" , is performed as part of a physical examination , or when a patient presents with chest pain suggestive of a cardiovascular pathology. It would typically be modified depending on the indication and integrated with other examinations especially the respiratory examination. Like all medical examinations, the cardiac examination follows the standard structure of inspection, palpation and auscultation.

Cardiology is concerned with the normal functionality of the heart and the deviation from a healthy heart.

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Many disorders involve the heart itself but some are outside of the heart and in the vascular system. Collectively, the two together are termed the cardiovascular system and diseases of one part tend to affect the other. Hypertension , also known as "high blood pressure"", is a long term medical condition in which the blood pressure in the arteries is persistently elevated.

Lifestyle factors can increase the risk of hypertension. These include excess salt in the diet, excess body weight , smoking , and alcohol. Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively.

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