Cardiology is a branch of medicine which deals with diseases of the heart and vascular systems. The heart diseases include coronary artery disease, congenital heart defects, valvular heart disease, hypertension and cardiomyopathy. Cardiologists are different from cardiac (cardio-thoracic and cardio-vascular) surgeons in that they don’t perform surgery. However, today, cardiologists carry out various non-surgical invasive procedures as well.
What do they do?
India is not in the pinkest of health. A 2008 study in the British medical journal Lancet said India would have 60 per cent of the world’s heart disease cases by 2010. An estimated 70 million cases will make India the world’s cardiovascular disease capital by 2025. Cardiovascular diseases already cause nearly one-third of all deaths in the country.
Dr V K Bahl, professor and head, department of cardiology, All India Institute of Medical Sciences, says, “To take care of this large population of patients we require a very large number of well-trained cardiologists who can diagnose the disease, treat it medically and are well versed with latest innovations in interventional procedures.”
Cardiologists are the first port of call for most heart patients. They diagnose and decide whether the person requires an angioplasty and stenting (placing a small steel mesh-like structure in an artery) or surgery, for which s/he is referred to a cardiac surgeon. Earlier, all cardiac patients used to go under the knife — for bypass surgery. But now non-surgical solutions have come up. Then, cardiologists examined the patients, diagnosed the ailment and prescribed medicines (in line with their qualification - MD and DM). Now they perform non-surgical invasive procedures as well.
Says Dr Bahl, “With the widespread use of intervention procedures carried out percutaneously (non-surgically), the role of cardiologists has expanded tremendously as they now not only treat patients with medicines but also open narrowed and diseased coronary and other vessels, such as renal, carotid and peripheral vessels, with balloons and stents.” Cardiologists treat narrowed valves by balloons and can replace valves non-surgically. They treat disorders of cardiac rhythm by placing pacemakers and ablating abnormal pathways by radiofrequency ablation. (Ablation is a procedure done to cure the rhythm disorder of the heart). They can also treat various congenital diseases by putting devices to close holes present in the heart from birth.
Dr SS Bansal, the only cardiologist from India who was awarded a fellowship of USA’s Society for Cardiovascular Angiography Interventions in 2009, adds, “Now most cases can be handled by cardiologists due to the widespread availability of drug-coated stents, when the chances of recurrence are very low.” According to Dr Bansal, who is managing director, Metro Heart Institute, Faridabad, hardly 20 per cent of the cases now call for surgery. “Eighty-per cent of cases with blocked arteries can be handled by cardiologists.”
Opening up a blocked coronary artery by stents in the first few hours of chest pain due to a heart attack is “the most dramatic and life saving procedure carried out by cardiologists.” This makes them a saviour of millions worldwide. Do you have it in you to be one of them?
. A very caring and positive attitude
. Dedication to this demanding profession
. Good inter-personal skills to deal with patients as well as their families
. Willingness and capacity to digest large amounts of knowledge and keep learning
How do I get there?
. Opt for science (physics, chemistry and biology) at the plus-two level
. Do an MBBS programme (four-and-a-half-year) plus compulsory one-year internship training
. Three years as junior resident in internal medicine to qualify as MD (internal medicine)
. Go for a three-year DM programme or even the DNB in cardiology and you become a cardiologist