Appointment
blog
A recipe to allay fears of cardiac patients keeping away from hospitals for fear of COVID

A recipe to allay fears of cardiac patients keeping away from hospitals for fear of COVID

In the current COVID times, even at the risk of deterioration of their cardiac condition and of developing complications; patients are keeping away from hospitals because of fear of contracting COVID.

Of the many competing minimally invasive therapies; some are better than others because technologies which require shorter stay in-hospital are associated with lesser staff –patient interaction, thus reducing risk of COVID cross- infection.

It is important for people to be aware of various available options for heart treatment, so that they can choose the best option for themselves; rather than avoid taking treatment altogether, for fear of getting COVID. 

Heart treatment commonly involves angiography (a test to detect blockages) or angioplasty of heart arteries (opening of blocked arteries with balloon and stent).

Robotic angioplasty has been done in a town in Gujarat many miles away, by an operator  sitting at robotic controls in Ahmedabad.

But this is not a feasible practice because it is investigationaland has limitations.

Robotic heart bypass, prostatic surgery or angioplasty with the operator sitting at the robot`s controls in the adjoining room are more feasible and have been done too. Ofcourse , trained personnel are still required in the operating room to attend to the patient and to fulfil other procedural requirements.

Again, use of Robotics for angiography or angioplasty is still experimental and increases cost several fold.  Moreover, is it worth going Robotic for all cases, to minimize contact with staff, to reduce risk of cross-infection in COVID times? Maybe it is; but it isn’t realistic or dependable or established.

So what alternative feasible options do we have?

There are 2 ways toreach the heart for performing angiography (a test to detect blockages) or to treat the blockages of heart arteries with angioplasty(opening of blocked arteries with balloon and stent). The first is Via  hand: called `Radial` while the second method is to reach the heart through the groin or `femoral`.

Coronary angiography and angioplasty performed via the wrist or back of hand, is popular worldwide, not only because patient comfort is more;since patients can sit-up, have food and can bemobilized immediately after procedure, but also, more importantly, because risk of bleeding complications and risk of death is less, especially in patients with heart- attacks. 

In COVID times, with a shorter hospital stay and reduced contact time with staff before during and after procedures, the risk of cross-infection is lower with angiography and angioplasty performed through hand (radial) compared to that performed via groin(femoral)!

Further, following a `radial` angiography or angioplasty, a wrist or hand bandage is applied to stop bleeding from the puncture site that is used to reach the heart. Hence theroutine stable patients can be sent away to a lounge or an open airy space in the hospital, with recliners and sofas, maintaining social distancing.  This lounge can be supervised by nurses where patients can be watched and monitored before discharge after 3 hours of an angiogram. After angioplasty, stable patients can be sent home after 12 h in hospital.  Even patients with heart attack who ae stable can be discharged by 48 h. Hence,contact between staff and patient is minimized.  On the contrary manual compression is used to stop bleeding after angiography or angioplasty via groin thus increasing mutual contact between staff and patients.  Such patients necessarily go to a ward/ intensive care unit (ICU)because the patients have to lie supine for at least 6 h after angiogram and 12 h after angioplasty via the groin !  And wards/ICUs are often congested.

Further,with procedure viathe groin (Femoral), even if all goes well, about 12 h stay are required after angiogram and 48 h after angioplasty.  God forbid, if life-threatening bleeding complications occur, which is not uncommon, and is 3% even in best hands,    prolongation of in-hospital stay increases cost, as well as staff-patient interaction, and therebyfear of cross-infection in COVID times. 

Hence radial access is a better option for patients and staff in COVID times.

What are the groin complications that may require prolonged in hospital stay?

Bleeding complications requiring blood transfusion or surgery; and prolonged compression of groin to seal off `pseudo-aneurysms`, which are outpouchings in the groin artery due to a tear in the artery.

Can these happen with radial?

These happen only with use of groin for heart procedures and are extremely rare with radial.

 Femoral access for angiography and angioplasty should be avoided whenever possible because not only is it associated with higher risk of bleeding complications and death; it also requires manual compression for hemostasis.  Further, with higher risk of complications they have the potential to increase cost as well as in-hospital stay.  The latter is also associatedwith increased contact with other healthcare personnel, and patients and hence greater fear of cross-infection.

 Not so with radial procedures by hand.

Radial is thus more economical than femoraland impacts outcomes favorably

Yet, because of lack of training, skills and experience , currently in India, only 30-40% of routine angioplasty and only 2% of angioplasty in heart attacks, in the country are being performed through wrist or hand.   Angioplasty via wrist or hand is still a small percentage of total angioplasties even in National capital region (NCR) of Delhi, which includes Gurgaon, Noida, Ghaziabad and 4zones of Delhi; though it is much higher in Southern India.   The reasons are resistance by some established cardiologists, because of its learning curve for operators.  In addition, lack of demand by patients due to their lack of awareness.

But COVID TIMES dictate greater usage of this life saving technique!

In conclusion, we aren’t quite ready with the robot yet!

And, in COVID TIMES, while it is imperative to minimize contact and hence exposure between staff and patients, Radial angiography and angioplasty have relevant advantages over femoral  .  Avoidance of femoral  will help minimize risk of cross- infection and also keep patients safe with reduced bleeding complications, and lower risk of death.  It will also save money.    Early ambulation, and discharge are additional bonuses for patients undergoing angiography and angioplasty via hand rather than groin.  

Radial is an economical technique which benefits the masses and is especially advantageous for patients, in COVID times.

By,

Dr. Sanjay Chugh

Senior Consultant Interventional Cardiologist

RLKC hospital and Metro Heart Institute (Naraina, Delhi)



<< Back

@ Metro Group of Hospitals | All Rights Reserved
Developed By   mediBrandox 
Developed By   mediBrandox 
X
Speciality
Hospitals
Doctors
Appointment
Select Specialities provided by Metro Group Hospitals
  • Anaesthesiology
  • Bariatric & Metabolic Surgery
  • Blood Bank
  • Cardiology & CTVS
  • Dentistry
  • Dermatology
  • Endocrinology And Diabetes
  • ENT & Cochlear Implant
  • Gastroenterology & Gastro Surgery
  • Haemotology
  • Holistic Medicine
  • Homeopathy
  • Internal Medicine
  • Interventional Radiology
  • IVF
  • Laboratory
  • Laparoscopic & General Surgery
  • Nephrology & Renal Transplant
  • Neurosciences
  • Nutrition & Health
  • Obstetrics and Gynaecology
  • Oncology & Onco Surgery
  • Ophthalmology, Metro Eye Centre
  • Orthopaedics, Joint Replacement & Spine Surgery
  • Paediatrics & Neonatology
  • Physiotherapy
  • Plastic, Cosmetic & Reconstructive Surgery
  • Psychiatry
  • Psychology
  • Pulmonology & Sleep Medicine
  • Radiology
  • Rheumatology
  • Stem Cell Therapy
  • Urology

Anaesthesiology

Best Anaesthesiology

We’ve got the best Anaesthetics and Critical Care experts coupled with latest anesthesia machines ensuring adequate gas mixture delivery to the patient, Anesthetic gas monitors who ensure extreme economy and negligible theatre pollution. The department has long experience of giving successful anaesthesia in various thoracic, vascular and congenital heart disease cases.

Bariatric & Metabolic Surgery

Best Bariatric & Metabolic Surgery

Metro Centre for Bariatric & Metabolic (diabetic) Surgeries is an advanced set-up having complete diagnostic and surgical facilities. We provide a relaxing and satisfying experience to every patient and help them achieve their weight-loss goals.

Blood Bank

Best Blood Bank

Our Blood Bank is committed to provide high quality services by assuring the supply of safe and quality blood and its products to the patients. The blood bank adopts most modern technology and equipment. We’ve fully automatic ELISA processor, blood grouping and cross matching and blood component equipments. All the records and standard operative procedures (SOPs) are maintained and followed as per National and International standards.

Cardiology & CTVS

Best Cardiology & CTVS

Department of Cardiology is headed by Padma Vibhushan & Dr. B C Roy National Awardee Dr. Purshotam Lal, a pioneer in Interventional Cardiology consisting of a team of highly qualified and skilled interventional Cardiologists. Under his leadership, the centre has grown into the most specialized centre for angiography and angioplasty.

Dentistry

Best Dentistry

Metro Dental And Implant Centre has delivered millions of smiles over the years. The centre offers state-of-the-art dental services both through general out-patient and private OPD.

Dermatology

Best Dermatology

The centre provides a holistic, scientific and a technologically advanced approach for all dermatological and cosmetic conditions. Consultations with our experienced dermatologists ensure that the patients get the best advice, be it for skin diseases or cosmetic interventions. Our specialized services include- Pimples / Acne – Pigmentation Treatment, Cosmetic Peels, Non-surgical removal of warts, Laser treatment, as more.

Endocrinology And Diabetes

Best Endocrinology And Diabetes

Department of Endocrinology and Diabetes is a full-fledged facility involved in evaluating and treating patients for diabetes, Obesity, Sexual disorders, Hirsutism, PCOD, Osteoporosis, Adrenal disorders, other endocrine disorders. We offer a wide range of treatment options for endocrine and metabolic diseases. Our specialists are the most experienced one having a long track record of successful treatment of the patients.

ENT & Cochlear Implant

Best ENT & Cochlear Implant

We provide the complete diagnostic and treatment of disease and conditions associated with the ear, nose and throat. We are well experienced in treating everything from a basic disease to doing a complicated surgery involving Otolaryngologists, Audiologists, Speech-language pathologists and other medical professionals. Services include Endoscopic Sinus Surgery, Micro-Surgery of Ear, Cochlear Implant, Rhinoplasty, Head & Neck Surgeries, and more.

Gastroenterology & Gastro Surgery

Best Gastroenterology & Gastro Surgery

Metro Centre for Liver & Digestive Diseases (Gastroenterology & GI Surgery) has combined medical and surgical department. The team of doctors has received super speciality training in their respective field which ensures high quality of care. The combined setup of Gastroenterology and GI Surgery allows quick assessment and treatment of the patient. Our surgical services include the performance of specialized and complex GI surgical procedures for the management of diseases of various parts of the GI tract.

Haemotology

Best Haemotology

Clinical Haematology unit headed by very senior clinical haematologist . To support this, Metro Path Labs are well equipped and advanced labs to handle relevant investigations related to blood, lymphnode and spleen disorders like Leukemia, Thalassemia, multiple myeloma, etc. Routine procedures done here are Bone Marrow Aspiration, Bone Marrow Biopsy, Peripheral Smear Study, Reticulocyte count.

Holistic Medicine

Best Holistic Medicine

The department aims at healing the person completely - body, mind, spirit, and emotions aimed at optimal health and wellness. This is achieved with the help of specialists and by gaining proper balance in life. Our specialists use all forms of healthcare ranging from conventional medication to alternative therapies, to treat a patient. Our doctors use the combinations of drugs and lifestyle modifications to address any condition.

Homeopathy

Best Homeopathy

We bring you the convenience of getting quality homeopathic treatment for all your chronic and long standing illnesses. We are committed to provide you the best of the information and constitutional homeopathic treatment. Diseases Treated by Homoeopathy are Infectious Diseases, Viral Diseases, Diseases of Infancy and Childhood & Allergic Disorder.

Internal Medicine

Best Internal Medicine

The Department of Internal Medicine is a full-fledged facility offering comprehensive care for general and preventive medicine for all ages. The Department has the support and back-up of all super-specialities in the hospital providing end to end services varying from diagnosis, prevention, treatment, wellness, preventive health checks, rehabilitation services and management of various medical conditions.

Interventional Radiology

Best Interventional Radiology

A sub-speciality of Radiology is a subspecialty of radiology, providing minimally invasive treatments performed under guidance of x-ray fluoroscopy, ultrasound or computed tomography (CT Scan). In simple terms interventional radiologists “Not Just Diagnose But Treat too” with minimal invasive techniques. The advanced technology in Radiology provides a strong platform for efficient Interventional Radiological Procedures.

IVF

Best IVF

Metro Centre for IVF is at the forefront of delivering quality services in the field of Assisted Reproductive Techniques like IVF-IUI, ICSI, Surrogacy, etc.

Laboratory

Best Laboratory

A highly skilled team of medical professionals including physicians, medical technologists, medical technicians, lab assistants, biologists, chemist, microbiologists, geneticists, and other specialists work collaboratively to provide advanced diagnosis and laboratory services. Fully automated Robotic Arm, State-of-the-art BacT / Alert 3D Microbial Detection System etc. are among our top of the line technologies available.

Laparoscopic & General Surgery

Best Laparoscopic & General Surgery

Metro Hospitals and Heart Institute is well equipped with latest technological advancements in general and laparoscopic surgery and the centre is boasted to an advanced centre for general and laparoscopic surgeries.

Nephrology & Renal Transplant

Best Nephrology & Renal Transplant

Our department of nephrology and renal transplant is a well equipped unit with a dedicated team of skilled consultants and paramedical staff which offers patient the advantages of a multidisciplinary approach. Our center deals in treating children and adolescents with congenital and acquired kidney diseases. We accept patients at any stage of kidney disease. The services include Medical Management of Kidney Diseases, Dialysis and Renal Transplant.

Neurosciences

Best Neurosciences

The Department of Neurosciences has extremely talented and very well trained doctors who collaboratively work towards creating new paradigms for knowing the human brain condition and caring for it. Facilities include NCV, EMG, EEG, Video EEG, Botox Therapy for migraine and movement disorders (dystonia), Dedicated Stroke ICU, Neuro Rehabilitation Advanced facilities for Surgical Neurology.

Nutrition & Health

Best Nutrition & Health

A balanced diet provides complete balanced nutrition which is essential for a healthy life, enhancing the immunity of the person. The department consisting of expert dieticians provides Diet counseling according to the diagnosis of the patients, Diet counseling for different types of diseases like Diabetes, Liver diseases, Renal diseases, Diet related to pregnancy and lactation, Cardiac diseases, Weight management and many more.

Obstetrics and Gynaecology

Best Obstetrics and Gynaecology

Metro Centre For Obstetrics And Gynaecology is determined to unite their exceptional medical competence, advanced technology and novelty to offer the best treatments to the patients. Our broad spectrum of services include painless deliveries, management of high risk pregnancies/late pregnancies, gynae laparoscopic procedures, gynae onco services, pre and post natal care, amongst others.

Oncology & Onco Surgery

Best Oncology & Onco Surgery

We strive to create the best in class infrastructure, comprehensive facilities and render care and support by handholding every cancer patient in their journey. The management plan for each cancer is chalked out once the cancer is identified and staged. Treatment plan may include surgery, radiation and/or cancer medicine therapy. The team of Oncology Comprises of expert Medical Oncologists, Surgeons and Radiation Oncologists.

Ophthalmology, Metro Eye Centre

Best Ophthalmology, Metro Eye Centre

The team of highly experienced Ophthalmologists in a modern set-up perform various services like Phacoemulsification (Sutureless Cataract Surgery), YAG laser (for after cataract and glaucoma), Green laser (for diabetic and retinal eye diseases), Automated Perimetry, (For Glaucoma and Neurological visual Field), Applanation Tonometry for Glaucoma, Glaucoma surgery, Squint Surgery, etc. The results of all procedures match the international standards.

Orthopaedics, Joint Replacement & Spine Surgery

Best Orthopaedics, Joint Replacement & Spine Surgery

Metro Centre for Orthopaedics and Joint Replacements offers a wide range of treatment and comprehensive care for all kinds of musculo-skeletal conditions such as joint pain, spine pain, trauma, sports and other injuries. The Centre is well recognized for joint replacement surgeries of hip, knee and shoulder. The department is led by highly trained Orthopaedicians along with wide array of advanced technology. The Centre is specialized in providing services such as minimally invasive surgery, joint replacements, Orthopaedic Rehabilitation.

Paediatrics & Neonatology

Best Paediatrics & Neonatology

Metro Centre for Paediatrics & Neonatology is a top-notch centre for childcare which provides comprehensive paediatric, surgical, and immunization services to children up. We follow a holistic approach to treatment with our Neonatal Intensive Care Unit, Paediatric Intensive Care Unit, Paediatric and Neonatal Emergency, etc.

Physiotherapy

Best Physiotherapy

The services in Physiotherapy & Rehabilitation include Consultation, Diagnostic: examination, S D curve, muscle testing, ADL testing, Manual therapy: active/assisted/passive/resisted/graded resisted exercise etc., physiotherapeutic interventional procedures, (home care) etc., Obstetric, gynecological clinic: antenatal and post natal care, and other management, Geriatric clinic: help in ADL activity, pain free activity, Fitness clinic, Posture correction clinic, Ergonomics clinic, etc.

Plastic, Cosmetic & Reconstructive Surgery

Best Plastic, Cosmetic & Reconstructive Surgery

The department has highly experienced specialists in cosmetic and plastic surgery, state-of -the-art infrastructure ensuring world class medical attention and care. It is an acknowledgement center of excellence providing advanced and intricate treatment. The center also offers the world superior quality cosmetic treatment at costs that are highly affordable, with results comparable to those at the best centers across the globe.

Psychiatry

Best Psychiatry

With the mission of spreading mental health awareness, we provide a variety of services ranging from awareness programmes to rehabilitations. The services provided are Pharmacotherapy, Electroconvulsive Therapy, Narcoanalysis, Biofeedback, Detoxification and Rehabilitation Programmes, Deaddiction Counseling, Stress Management, Couples/ Marital Counseling and many more.

Psychology

Best Psychology

We have a long experience in addressing the mental health conditions. Our experienced psychologists analyze the reasons behavioral disorder, emotional problem or psychiatric disease, and suggest and implement a valid solution to the problems customized to individual needs. The privacy of the patient is taken seriously during the total course of treatment.

Pulmonology & Sleep Medicine

Best Pulmonology & Sleep Medicine

World-renowned specialists and comprehensive advanced setup helps treat disorders related to the lungs, breathing and sleep with high success rate. The services include treatment of Asthma, COPD, Chronic Respiratory Failure, Sleep Disorders, Interstitial Lung Diseses, Tumours and Cancers of the Lung and Chest, Allergic Disorders, Laparoscopic Assisted Thoracic Surgeries.

Radiology

Best Radiology

A highly skilled team of experience Radiologists and Technicians comprises our Radiology Team. The highly advanced technology combined with high expertise ensures 100% accurate results which helps build right diagnosis. The facilities include: CT Scan (500 Slice), Advanced MRI (1.5 Tesla), 4D Ultrasound, Digital X-Ray, Bone Densitometry, Colour Doppler.

Rheumatology

Best Rheumatology

Immensely qualified team of experts is always available to accord the diseases of musculoskeletal system. The service include the treatment of various auto immune diseases like Rheumatoid Arthritis, SLE, Ankylosing spondylosis, gout and other immunological diseases, New Biological Treatments. We do have 24*7 physiotherapy department which deal with musculoskeletal problems with special emphasis on the correction of joint deformity.

Stem Cell Therapy

Best Stem Cell Therapy

coming soon

Urology

Best Urology

The Centre for Uro-Sciences boasts of experienced and renowned Urologists having thorough exposure to all urological disorders including complicated conditions. It is has good track record for high success rates. The treatment includes Laser prostatic surgery, Urologic Cancer Surgeries, Laparoscopic Urological Surgeries, Percutaneous Renal Surgery, Urethral Reconstructive Surgery, etc. and the facilities include ESWL (Extra corporeal shock wave Lithotripsy), Uroflowmetry, Uro Radio diagnosis, etc.

Pick Speciality Skip To Hospital
Hospitals in Metro Group offering Cardiology Service
Pick This Hospital Edit Speciality
List of doctors in Metro Hospital, Noida practicing Cardiology
Request Timings Edit Hospital
Appointment Request to Dr. ABC at Hospital
Back