Information neurologist | Neurology

What is a neurologist?

A neurologist is a doctor who specializes in diagnosing and treating diseases that affect the nervous system. Neurology is the branch of medicine that deals with the study and treatment of disorders of the nervous system. The nervous system is a complex and sophisticated system that regulates and coordinates bodily functions.

The nervous system has two parts:

The central nervous system (CNS): CNS represents the brain and spinal cord.

The peripheral nervous system (PNS): PNS contains all the nerves outside the CNS.

Due to the complex nature of the nervous system, many neurologists focus on treating people or a specific population of people with specific neurological diseases. After completing their residency training, most neurologists will spend a year or more in a fellowship program where they will gain experience in their subspecialty.

Examples of subdivisions in the field of neurology:

  • Pediatric or child neurology
  • Neurodevelopmental disabilities
  • Neuromuscular medicine
  • Hospice Neurology and Palliative Care
  • Pain drug
  • Headache drug
  • Sleep drug
  • Vascular neurology
  • Autonomic disorders
  • Neuropsychiatry
  • Brain injury drug
  • Neurocritical attention
  • Epilepsy

What conditions do they treat?

Neurologists treat neurological conditions that affect the brain, spinal cord, and nerves. These conditions are:

  • Race
  • Epilepsy
  • Headaches and migraines
  • Brain tumors
  • Brain aneurysms
  • Peripheral neuropathy
  • Sleep disorders
  • Neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease.
  • Neuromuscular diseases such as mastenia gravis, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS)
  • Nervous system infections, encephalitis, meningitis, and HIV

What procedures do they do?

Neurologists perform a variety of tests and procedures to diagnose and treat neurological conditions. A neurologist can use a pelvic puncture to collect a sample of cerebrospinal fluid. They can use this approach to help diagnose the following conditions:

  • Meningitis
  • Encephalitis
  • Myelitis
  • Leukemia
  • Autoimmune diseases such as multiple sclerosis (MS)
  • Dementia
  • Bleeding in the brain

Neurologists can also use pelvic puncture to treat conditions that affect the spinal cord. Narcotics, antibiotics, or cancer treatments can be injected with a pelvic puncture needle.

Electromyography: One procedure that a neurologist can perform is EMG. A neurologist can use electromyography (EMG) to assess how a person’s muscles respond to the electrical stimulation of motor neurons, which are specialized nerves that control muscle movements.

During EMG, a specially trained technician inserts small needles into the muscle called electrodes. These electrodes record the different electrical activity that occurs in muscle tissue during movement and at rest. The EMG machine produces an electromyogram, which is a record of this action. Neurologists can use EMG results to diagnose neuromuscular diseases such as myasthenia gravis and ALS.

Electroencephalogram: Neurologists use electroencephalograms (EEGs) to measure and record electrical activity in the brain. Neurons in the brain communicate with other neurons through electrical impulses, which can pick up the EEG. The EEG also tracks brain wave patterns.

During the EEG, a technician places electrodes on the person’s head. These electrodes are connected to a computer that converts technical signals that technicians can view on screen or print on paper. Neurologists can use the EEG results to detect abnormal electrical activity in the brain and diagnose certain conditions:

  • Epilepsy
  • Convulsions
  • Brain tumors
  • Trouble sleeping
  • Tensilon test

Mastenia gravis is a rare neuromuscular disease that weakens the muscles of the arms and legs. The neurologist may use a blood test called a Tensilon test to diagnose Mastinia gravis.

Tensilon is the brand name for a drug called edrophonium, which inhibits the breakdown of the neurotransmitter acetylcholine, which stimulates muscle movement. Mastenia Gravis The immune system attacks acetylcholine receptors in muscle, reducing muscle fatigue and muscle mobility.

During a Tensilon test, a neurologist injects a small amount of Tensilon into the bloodstream. Then, they ask the person to do different movements, namely:

  • Got up and sat down
  • Holding hands above their heads
  • Crossing and spreading the legs

The neurologist will continue to give doses of Tensilone each time the person feels tired. If a person notices their strength returning after each Tensilon injection, this indicates that they are more likely to have myasthenia gravis.

When to see a neurologist?

If you have a diagnosed neurological disorder or one of the above symptoms, it’s time to make an appointment to see a neurologist. A specialized team of specialists at Regional Neurological Associates has advanced training in the diagnosis and treatment of neurological disorders, so you can be sure you are receiving professional care.

A primary care physician may refer a patient to a neurologist if they have symptoms that indicate a neurological condition:

  • Frequent or severe headache
  • Muscular weakness
  • Confusion
  • Dizziness
  • Loss of coordination
  • Partial or complete paralysis
  • Sensory changes that affect the sense of touch, sight, smell, or taste

5 big signs you should see a neurologist

Sleeping Problems: We know that the most obvious causes of sleep problems are having a condition like sleeping too late, sleep apnea or anxiety, nightmares, or others, some sleep problems are neurological disorders. An example of this is narcolepsy, a chronic genetic disorder that has no known cause that affects the body’s central nervous system.

These symptoms may be part of a more neurological disorder. Your primary care physician is a great resource to help you decide whether or not to see a neurologist. However, if your symptoms are severe enough, or you still don’t trust your primary care doctor’s recommendations, you may need to make an appointment with a neurologist.

You have seizures: Seizures are disturbances in your brain. They can cause strange sensations, uncontrollable movements or loss of consciousness. To find the cause, the neurologist can test the brain and obtain images. Sometimes seizures stop when the cause is treated. However, some conditions that cause seizures, such as epilepsy, can be chronic. There are many medications that can prevent or reduce seizures. There are also policies that can help. A neurologist will find the best treatment for you and help you manage the condition. 

You have a brain or spinal cord injury: Car accidents fall, and sports injuries can damage your brain or spinal cord. Symptoms depend on the type of injury and the extent of the damage. Brain injuries can cause headaches, dizziness, seizures, and loss of consciousness.

They cause changes in your behavior, thinking, and memory. Spinal cord injuries can cause weakness and numbness. You may also lose mobility below the area of injury. A neurologist can design a treatment plan for your specific condition and coordinate your care. This can include medications, physical therapy, and mental health treatment.

Migraine: Migraine is a type of headache that affects many people. If you have frequent and persistent headaches along with other symptoms, you are suffering from a migraine. Symptoms of migraine:

  • Headache on one or both sides of the head
  • Headache aggravated by physical exertion
  • Pain or throbbing pain
  • Nausea and vomiting
  • Sensitivity to light
  • Sensitivity to sounds
  • Sensitivity to odors.

According to the American Migraine Foundation, migraine affects 37 million people in the United States and more than 144 million worldwide. If you have migraine symptoms that your primary care provider cannot treat, you should see a neurologist.

Neuropathy: Peripheral neuropathy, commonly known as neuropathy, refers to a group of conditions that affect the peripheral nerves of the body. The peripheral nervous system connects the central nervous system, which is made up of the brain and spinal cord, to the rest of the body. Neuropathy can take many forms, including:

  • Chronic pain
  • Balance is difficult
  • Poor coordination
  • Burning sensations
  • Numbness, weakness, or tingling in the affected part of the body.
  • Paralysis

There is a long list of conditions that can cause neuropathy, from autoimmune diseases to vitamin deficiencies. Diabetic neuropathy is a type of neuropathy that many people have heard of and how common diabetes is in the US.


Information About Pediatric Cardiologist | Cardiology

What is a pediatric cardiologist?

If your pediatrician has any questions about your child’s heart, he or she can refer him to a pediatric cardiologist. Pediatric cardiologists specialize in diagnosing and treating heart problems in children. In children requiring cardiac surgery, pediatric cardiologists work with pediatric cardiac surgeons to determine the best treatments and interventions.

Many heart conditions affect children. Some are structural differences from where they were born. Others have an electrical system that controls the heartbeat. Pediatric cardiologists are specially trained to diagnose and manage these problems. If you are concerned about your child’s heart, talk to your pediatrician if you need a referral to a pediatric cardiologist.

Education and training

Those who wish to become pediatric cardiologists must have a four-year undergraduate degree. Then they should also have:

  • Faculty of Medicine four years
  • Three years of pediatric residency
  • Three or more years of training in the subspecialty of pediatric cardiology

Pediatric cardiologists may focus on specialized skills such as cardiac catheterization, heart transplantation, or child care in the cardiac ICU during the last year or two of their training.

Conditions treated by a pediatric cardiologist

  • The cardiovascular collapse in childhood
  • Heart failure in infants and children
  • Cyanosis in newborns and beyond (where the skin is blue due to lung, lung, or circulatory problems)
  • Children with a heart murmur
  • Children and adolescents may experience chest pain, palpitations, or fainting.
  • Patients with congenital heart disease
  • Cardiovascular abnormalities in neonatal intensive care
  • Fetal heart abnormalities
  • Pediatric heart transplant
  • Evaluate a child before heart surgery
  • Evaluation of Children with Heart Disease Undergoing Heart Surgery
  • Management of children with heart problems
  • Great arterial transfer

Types of treatment

  • “Congenital heart disease” (birth defects in children), such as perforations between the chambers of the heart, valve problems, and abnormal blood vessels.
  • “Arrhythmia” or abnormal heart rhythms caused by the electrical system that controls the heartbeat.

Some pediatric cardiologists also treat “pulmonary hypertension” (pulmonary hypertension), while in some parts of the country pulmonary hypertension is treated by pediatric pulmonologists.

Some pediatric cardiologists can treat “systemic hypertension” (hypertension), but in some parts of the country, systemic hypertension is treated by pediatric nephrologists.

What conditions and diseases does a pediatric cardiologist treat?

The pediatric cardiologist treats conditions and diseases that include:

  • Arrhythmia, abnormal heart rhythm (the heart beats too fast, too slow, or irregular)
  • Bacterial endocarditis, a type of heart infection.
  • Cardiomyopathy, weakening or dilation of the heart muscle.
  • Congenital heart defects, including patented ductus arteriosus (PAC), atrial septal defect (ASD), and ventricular septal defect (VSD)
  • Cardiac syndromes, including genetic syndromes that affect the heart, such as Down syndrome and Marfan syndrome
  • Clogged pulmonary and aortic valves with heart valve defects
  • Kawasaki disease causes heart problems such as coronary artery aneurysms, leaky heart valves, and fluid retention
  • Myocarditis, inflammation of the heart.
  • Pulmonary hypertension, high blood pressure in the blood vessels that carry blood from the heart to the lungs.
  • Serious risk factors for cardiovascular conditions, including high blood pressure and high cholesterol

Procedures and interventions

  • Electrocardiogram (ECG)
  • Advanced imaging – CT / MRI
  • Diagnostic and therapeutic catheterization
  • Exercise test
  • Recording of cardiac events
  • Pulmonary radiography
  • Balloon atrial septostomy – A small hole is created in the two upper chambers of the heart to increase oxygen saturation
  • Pediatric heart transplant
  • Ultrasound of the heart

Types of Congenital Heart Specialists | Treatments | Cardiology

Before knowing about congenital heart specialists, first of all, everyone needs to know about congenital heart disease and also types.

What Is congenital heart disease?

Congenital heart disease is one or more problems with the heart’s construction that are present from birth. Congenital means that you were born with a defect. Congenital heart disease, also called a congenital heart defect, can change the way blood flows through your heart. Some congenital heart defects may not cause any problems. However, complex defects can cause grievous complications.

Advances in diagnosis and treatment have allowed children with congenital heart disease to survive into adulthood. Former the signs and symptoms of congenital heart disease don’t appear until you’re an adult. If you have congenital heart disease, you will likely need care throughout your life. Inquire your doctor to determine how often you need to be tested.


All cardiologists are not the same. While each doctor undergoes education and training related to the heart, they specialize in different types of heart problems. It is important that you be treated by a cardiologist trained in caring for the type of heart disease you have.

There are two major types of heart problems:

Congenital: Heart abnormalities present at birth.

  • Some examples are holes in the heart, deformed valves, or pump chambers
  • It is most often diagnosed in infancy
  • Usually, there is no specific cause or prevention

Acquired: Heart abnormalities that develop over time.

  • Examples include coronary artery disease, weak heart muscles, and valve leakage
  • It is often diagnosed later in life
  • It may be caused by smoking, infection, or diseases such as diabetes

If you have congenital heart disease (CHD), it is important that your health care team understands your unique heart. Patients with coronary artery disease can have hearts that look and function differently than a normal heart. Some hearts can be underdeveloped or on the other side of the chest or with vessels in abnormal places.

While it may seem strange to the untrained eye, it may be normal for someone trained in the treatment of CHD. Congenital cardiologists understand all the unique ways hearts can be formed and the surgeries used to treat them.

Types of Congenital heart specialists

Pediatric Congenital heart specialists

  • Pediatric congenital heart specialists treat infants and children with coronary heart disease
  • Diagnosis of coronary artery disease in infants
  • Defines treatment plans
  • Cares about the growth of the heart
  • Pediatric congenital heart specialists determine whether the initial intervention (catheter or surgery) is necessary

Adult congenital heart disease (ACHD) cardiologist

  • It treats adolescents and adults with coronary artery disease
  • It takes care of the aging heart
  • Cares about hearts when the body changes like during pregnancy or illness
  • He watches hearts to make sure his childhood surgeries are still working
  • Determines whether secondary intervention is required

If you have a heart condition, it is imperative that you see a cardiologist trained in treating your type of problem. Congenital heart patients have very unique hearts and undergo specialized surgeries. Congenital heart specialists understand congenital heart disease and what treatments are best.

ACHD cardiologists or congenital heart specialists have dedicated their careers to treating adults with coronary heart disease. You care enough about your car to find the right kind of specialist, shouldn’t you do the same for your heart?

What does congenital heart specialists do?

Congenital heart disease means there is a problem with the structure of your heart that is present from birth. Congenital heart disease is usually diagnosed in infancy or childhood and people diagnosed early to deal with it throughout their lives, requiring ongoing care and potentially additional surgeries.

Others do not know about their illness until adulthood and try to understand what that means for them. The University of Michigan Adult Congenital Heart Program has experience caring for both types of patients and our program also works closely with the Michigan Congenital Heart Center.

Reasons you might need adult congenital heart care by Congenital heart specialists

Congenital heart disease affects at least 1 in 100 live births. Its severity ranges on a wide range, from small holes between the heart chambers that close naturally, to abnormal, life-threatening structures, such as hypoplastic left heart syndrome, which require a series of complex surgeries. As an adult with congenital heart disease, you may need our program sponsorship for a number of reasons; For example, you can:

  • Be at risk of developing an arrhythmia (arrhythmia)
  • You had surgery as a child and it would require another surgery as an adult
  • You underwent a transplant as a child and are now too small for your adult body
  • The valve was replaced as a child which had worn off over time
  • You are pregnant or want to become pregnant, and you and your baby need to be monitored regularly

What Medications Give by the Congenital heart specialists?

Some mellow intrinsic heart imperfections can be treated with meds that help the heart work all the more proficiently. You may also need medicines to prevent blood clots or to control an irregular heartbeat.

Surgeries and other procedures

A few medical procedures and methodologies are accessible to treat grown-ups with inherent coronary illness.

  • Implantable heart devices: A device that helps control the heart rate (pacemaker) or that corrects a life-threatening irregular heartbeat (an implantable cardioverter-defibrillator or cardioverter and defibrillator) may help improve some complications associated with heart defects Congenital.
  • Catheter-based treatments: Some congenital heart defects can be repaired using catheterization techniques. These treatments allow repair without open-heart surgery. Instead, the doctor inserts a thin tube (catheter) into a vein or artery in the leg and guides it to the heart with the help of X-ray images. Once the catheter is in place, the doctor passes small tools through the catheter to repair the defect.
  • Open-heart surgery: On the off chance that catheter methodology can’t fix your heart deformity, your primary care physician may suggest an open-heart medical procedure.
  • Heart transplant: If a serious heart defect cannot be repaired, a heart transplant may be an option.

Follow-up care is given by congenital heart specialists

If you are an adult with congenital heart disease, you are at risk of developing complications – even if you underwent surgery to repair a defect during childhood. Lifelong follow-up care is important. Ideally, congenital heart specialists or cardiologist trained in treating adults with congenital heart defects will care for you.

Follow-up care may include regular check-ups of the congenital heart specialists and occasional blood and imaging tests to detect complications. How often you will need to see your doctor depends on whether your congenital heart disease is mild or complex.


Information about Cardiac Imaging Specialist | Cardiology

What is a cardiac imaging specialist?

The cardiac imaging specialist team is made up of a team of pediatric cardiologists, radiologists, cardiac sonographers, and imaging technicians.

What kinds of procedures do cardiac imaging specialists do?

The cardiac radiologist uses imaging techniques such as X-rays, ultrasound (echocardiograms), CT scans (computed tomography), and MRIs (magnetic resonance imaging).

These tests are used to detect heart disease, determine the cause of your symptoms, and monitor your heart to see if your treatment is working.

Cardiac imaging specialist procedures

Coronary CT angiography (CTCA)

Coronary CT angiography or “CTCA” is a scan that records pictures of your heart. The procedure is done by a cardiac imaging specialist. Before taking pictures, the dye is injected into the vein (usually in the hand). The color highlights any blockages in the coronary arteries, helping to diagnose coronary artery disease.

How to prepare for a CT angiogram?

  • You should wear comfortable, loose-fitting clothing for your exam. You will need to wear a gown during the procedure.
  • Metallic objects, such as jewelry, glasses, teeth, and hairpins, can affect CT images. Keep them at home or remove them before the test. You may also be asked to remove hearing aids and removable dental work. Women are asked to remove bras that contain metallic underwear. You may be asked to remove the stitches if possible.
  • If contrast material is used in your test, you will be asked not to eat or drink anything for a few hours. Tell your doctor about all the medicines you are taking and if you have any allergies. If you have a known allergy to contrast material, your doctor may prescribe medications (usually steroids) to reduce the risk of an allergic reaction. To avoid unnecessary delays, consult your doctor before the exact time of your test.
  • Also, tell cardiac imaging specialists about recent illnesses or other medical conditions and if you have a history of heart disease, asthma, diabetes, kidney disease, or thyroid problems. Any of these conditions increase the risk of adverse effects.
  • Women should always inform their doctor and CT technicians if they are likely to become pregnant.

Why do I need a CT angiography?

CT angiography is done to:

  • Narrowing (stenosis) or blockage of the coronary arteries. It occurs when fats (cholesterol) and calcium form in the arteries. This structure is called a plate.
  • Heart problems such as pericarditis (formation of fluid around the heart) and damage or injury to the heart valves
  • An abscess (tear) or tear (dissection) in the aorta, which is a large blood vessel that carries blood from the heart to the rest of the body
  • C Blood clots in the lungs (pulmonary embolism)
  • Arterial narrowing (peripheral artery disease) in the legs and other parts of the body
  • An abnormal pattern of blood vessels indicative of a tumor

What happens during a CTCA?

During the test, you lie on a table inside a large donut-shaped CT scan machine. As the table slowly moves through the scanner, the x-rays rotate around your body. It is common to hear a swirling or grinding noise. The movie clip is blurry, so you are being asked to be very consistent. You may need to hold your breath at times. It is done by cardiac imaging specialists.

What happens after a CTCA?

  • As soon as the procedure is complete, you will be able to continue your normal activities.
  • If the needle is in your hand, the staff should remove it.
  • The staff will give you special instructions.
  • The color disappears from your body in the urine. It is colorless so you will not notice it
  • Drink plenty of fluids to help remove discoloration.

What are the benefits?

  • Cardiac and vascular CT angiography can eliminate the need for surgery. If surgery is needed, it can be done with greater precision.
  • Cardiac and vascular CT angiography can detect narrowing or blockage of blood vessels, allowing corrective treatment.
  • CT angiography can provide more accurate anatomical details than other images, especially in small blood vessels.
  • Most patients undergo cardiac and vascular CT angiography to diagnose vascular problems.
  • Cardiac and vascular CT angiography can be quick, non-invasive, and have fewer complications.
  • CT angiography is a useful way to diagnose arteries (narrowing of the heart’s blood vessels) and veins, as well as before symptoms appear or when structural abnormalities of the heart appear, or when symptoms are not associated with vascular disease.
  • There is also less discomfort since the contrast material is injected into the vein in the arm.
  • There is no radiation to the patient’s body after cardiac and vascular CT angiography.
  • The x-rays used in standard CT scans have no immediate side effects.

What are the risks?

If a coronary CT angiogram is a safe procedure, the potential risks are:

An allergic reaction to the contrast medium, which can range from mild to severe and may include:

  • Itching
  • Red
  • Urticaria
  • Nausea
  • Difficulty breathing
  • Renal insufficiency
  • Due to exposure to radiation, especially if you have multiple scans over many years, your chance of getting cancer increases slightly
  • X-ray dye allergy (tell your doctor if you have a history of allergy)
  • Kidney problems as a result of death by X-ray (in patients with kidney problems)
  • Headache from medications administered during the procedure.

Cardiac MRI (Heart MRI)

Heart MRI provides comprehensive information on the type and severity of heart disease to help your doctor determine the best way to treat heart problems, such as heart disease, heart valve problems, pericarditis, heart tumors, or attack damage cardiac. Cardiac MRI can help interpret the results of other imaging tests, such as chest x-rays and chest CT scans. The information is interpreted by cardiac imaging specialists.

How to prepare for a cardiac MRI?

You don’t need to do a lot of homework to prepare for your MRI. You can usually eat and drink in the days leading up to the test. Before starting your MRI, you must remove all jewelry and any metallic objects. You will be asked to wear a hospital gown.

Why do you need a cardiac MRI?

The cardiac imaging specialists may suggest an MRI of the heart if he thinks you are at risk for heart failure or less serious heart problems.

Cardiac MRI is a simple test used to diagnose and diagnose many conditions. Some of them are:

  • Congenital heart defects
  • Coronary heart disease
  • Heart attack damage
  • Heart failure
  • Heart valve defects
  • Inflammation of the lining of the heart (pericarditis).

Since MRIs show cross-sections of the body, they can also help explain or clarify the results of other tests, such as CT scans and X-rays.

What happens during a cardiac MRI?

  • You put on a hospital gown first. Small, sticky electrode patches are placed on your chest and back. If you are a person, you will need to partially shave your chest. The electrodes are paired with an electrocardiogram (EKG) monitor, which lists the electrical activity of your heart during the test.
  • Most likely, a nurse will insert an intravenous (IV) line into your vein to inject an iodine-based dye called contrast material. This will make your limbs more visible in the images.
  • The MRI scanner unit is a long tube that scans your body while you are lying on a platform. It is open at both ends and is well ventilated and fully lit. You lie on your back on the scanner bed, raising your head and legs for comfort. You can speak to the person doing the MRI during the test through the intercom system.
  • During the test, you should lie down as much as possible. The technician will ask you to hold your breath from time to time for a while to reduce the blurring of the images due to the movement of your body while you inhale.
  • During the scan, the devices make a loud noise. You can muffle the sound by using the headphones or earplugs that you have before the test.

What happens after the cardiac MRI?

  • You can return to normal activities on the same day. If you have a sedative, you will stay in the MRI center until the effects of the sedative wear off. You need someone to drive you home.
  • The radiologist will review the images and send a copy of the report to your doctor. Make an appointment with your doctor to discuss the test results.

What are the benefits of cardiac MRI?

  • An MRI is a safe and painless scan that produces clear images of the body from any angle. Images are clearer than those obtained by many other methods, including echo and SPECT scanning. It does not use radiation and therefore eliminates significant x-ray doses from cardiac CT.
  • Cardiac MRI is useful in a wide variety of heart conditions. It can demonstrate the structure and function of the chambers of the heart and helps estimate the blood flow through the heart valves. It is valuable in evaluating damage to the abnormal heart muscle (cardiomyopathy) and a previous heart attack.

What are the risks of cardiac MRI?

Cardiac MRI does not use radiation. The magnetic fields and radio waves used in cardiac MRI have no significant side effects and are not harmful to most people.

For those with the lowest risk of complications, our Stanford care team works with all of our patients to ensure a safe experience. In some cases, different procedures are suggested. People should talk to their doctor before having a cardiac MRI:

  • Have a pacemaker or other adjustable device. The doctor can determine if the device is safe for MRI tests.
  • They are in the first trimester of pregnancy. Although there are no reports of adverse effects on the mother or baby, doctors recommend avoiding MRI unless the potential benefits outweigh the potential risks.
  • It is used in breastfeeding and contrast MRI. Women can express breast milk before the test to feed their babies and after the color has disappeared from their bodies (24 hours).
  • You have moderate kidney or liver disease. The color used during the test can lead to nephrogenic systemic fibrosis, a rare disease that reduces organ function and causes serious skin problems.

Although it is very rare, the color can cause side effects,

  • Allergic reactions
  • Changes in taste
  • Dizziness
  • Headache
  • Nausea

Overview of Electrophysiologist | Cardiology

What is an electrophysiologist?

An electrophysiologist is eligible to perform specialized tests of your heart’s electrical system, such as electrophysiology or ablation. Blood pumping is a mechanical problem that involves the heart muscle and vessels. Many cardiologists deal with the mechanical function of the heart. Remembering to pump blood is an electrical problem. The heart has an electrical system that sends impulses for muscle contraction.

When there are problems with the electrical signals in the heart, the result is an arrhythmia-irregular heartbeat. These problems are treated by electrophysiologists.

Electrophysiologists can use many tests and treatments just like other cardiologists. However, electrophysiologists can also perform specialized tests called electrophysiology studies (EPS), which can also allow procedures such as pacemaker placement, insertion of an implantable cardioverter-defibrillator (ICD), or catheter ablation to treat arrhythmia.

Difference between a cardiologist and an electrophysiologist?

The heart has two main functions: to pump blood throughout the body and to do it efficiently and rhythmically. The actual pumping of blood is very mechanical and the problems that arise in this area are of a circulatory or structural nature.

Cardiologists are medical professionals who treat and correct problems such as coronary heart disease, congestive heart failure, cardiac arrest, or peripheral artery disease.

Heart rhythm disorders, on the other hand, arise from problems in the heart’s electrical system that controls the heartbeat. When there is a problem here called arrhythmia, the heart beats too fast, too slow, or with inconsistent manipulations.

Due to the nature of electricity, treating arrhythmias requires additional and specialized training by the physician, who must complete one to two years of additional training beyond the standard cardiology scholarship. Cardiac electrophysiologists are doctors who have completed this unique cardiovascular workout.

What does an electrophysiologist do?

The heart muscle produces electrical signals that travel through the heart muscle to contract. These signals are small but can be taken on an EKG machine. The electrocardiogram (ECG) can help, but often the signs that doctors need to see are so small that they cannot be seen or hidden on the ECG. The electrophysiologist can perform ablation studies and/or procedures on your heart’s electrical system and timing.

When do you need an electrophysiologist?

In a normal, healthy heart, the upper chambers (atria) and the lower chambers (ventricles) work together, alternately contracting and pumping blood. Sometimes your rhythm shoots up and you have an irregular heartbeat, either too fast (more than 100 beats per minute) or too slow (less than 60 beats per minute). An electrophysiologist can help you cope with arrhythmia, the most common of which is atrial fibrillation, where the upper two chambers shake without coordinating their contractions.

Purpose of electrophysiologists

A cardiologist may recommend an EP study when a standard EKG, Holter monitor, event recorder, stress test, echocardiogram, or angiogram do not provide adequate information to evaluate an abnormal heart rhythm known as an arrhythmia.

The EP study may also help diagnose suspected arrhythmia in a patient with arrhythmia symptoms, but this has not been found in other tests.

The purpose and great value of the EP study are that it provides the physician with more detailed information about the electrical activity of the heart than the non-invasive tests mentioned above because the electrodes are placed directly on the heart tissue.

EP studies may help assess:

  • Some tachycardia or bradycardia of unknown cause
  • Resuscitated patients after experiencing sudden cardiac death
  • Various symptoms of unknown causes such as chest pain, shortness of breath, fatigue, or syncope
  • Response to antiarrhythmic therapy

Conditions of electrophysiology

Common conditions that we treat in our laboratory, including atrial fibrillation and other types of arrhythmias. Using cardiac maps, our electrophysiologists can identify the cause of irregular heartbeat and often correct it by ablation. This procedure corrects electrical conduction problems that cause a problematic and abnormally fast heart rate.

Our electrophysiologists can perform additional treatments as needed in the laboratory. For example, if you are experiencing a cardiac defibrillator that provides a slow heart rate or electrical impulses, pacemakers can be set to help the patient’s heart return to a normal rhythm after experiencing a severe arrhythmia.

Electrophysiologists procedure

The EP study is an invasive test similar to angiography and is performed in a catheterization laboratory. After the patient is operated on under local anesthesia (or in some cases, general anesthesia), the catheter is inserted into a blood vessel through a site in the groin or neck and guided through the catheter and images of the myocardial fluoroscopy.

Once the catheter reaches the heart, the electrodes on its tip collect data and a variety of electrical measurements are made. This “electrical mapping” helps the cardiac arrhythmia specialist to locate the area where the current is interfering.

The electrophysiologist then administers various medications or electrical stimuli to determine the ability to terminate the arrhythmia and restore normal heart rhythm. Sometimes a specialist will perform cardiac ablation or insert an implanted cardioversion device (ICD) or pacemaker. The procedure usually takes about two hours.

Treatments of electrophysiologists

  • Atrial fibrillation ablation
  • Device interrogation
  • Electrical cardioversion
  • Monitoring
  • Implantable cardioverter-defibrillator (ICD)
  • Pacemaker implantation

Study of electrophysiologists

When an abnormal heartbeat is found, your doctor or cardiologist may recommend an electrophysiology study (EPS).

This study is performed by an electrophysiologist who inserts one or more specialized electrode catheters in the groin or neck into the blood vessel leading to the heart.

Using catheters, the electrophysiologist sends electrical signals to your heart and records the electrical activity of your heart.

The EPS will help determine:

  • Source of abnormal heartbeat
  • What medicines work to treat your arrhythmia
  • If you need an ICD (implantable cardioverter-defibrillator) or pacemaker
  • If you need catheter ablation (using a catheter to destroy a very small part of the heart that causes arrhythmia).
  • Your risk of complications such as cardiac arrest

New technology and Innovative procedures

Our ability to perform 3-D models of the heart in real-time can help us determine the best treatment options, such as medications, surgical procedures, or devices such as defibrillators or pacemakers with remote monitoring by specialized personnel.


Information About Interventional Cardiologist | Cardiology

What is an Interventional cardiologist?

An interventional cardiologist is a cardiologist who has one to two years of additional education and training in diagnosing and treating cardiovascular diseases as well as congenital (congenital) and catheter-based procedures for structural heart conditions, such as angioplasty and stenting.

What kinds of procedures do interventional cardiologists do?

Cardiac catheterization

This test assesses the presence, size, and location of plaque deposits in the arteries, the strength of the heart muscle, and the function of the heart valves. During cardiac catheterization, the catheter is inserted into a blood vessel in the leg or wrist and gently guided into the heart. Contrast dye is injected into the coronary arteries so the cardiologist can detect the movement of blood through the arteries and chambers of the heart.

Percutaneous coronary intervention (PCI)

The goal of PGI, also known as angioplasty, is to open the coronary artery to restore blood flow. PCI is a procedure scheduled for the emergency treatment of a heart attack patient or adequate blood flow to the heart. The cardiologist selects the most suitable tool to repair the cardiac vessels based on the specific anatomy of the patient.

Balloon angioplasty

Balloon angioplasty improves blood flow to the heart. The balloon-tipped catheter is guided into the blocked artery. The balloon inflates the blocked area and opens the arterial walls.


This procedure uses a special spray device to open hardened blockages in the coronary arteries. Atherectomy is often performed during balloon angioplasty. In many cases, a stent is then inserted into the blockage.

Stent implantation

After balloon angioplasty or atherectomy, a small metal coil or mesh tube called a stent may be placed in the artery. The stent is placed at the end of a catheter, inserted through a blood vessel in the leg or wrist, and guided to the heart, where the newly opened arteries do not collapse.

What is the difference between an interventional cardiologist and a cardiologist?


Cardiologists must complete a residency in internal medicine after obtaining a medical degree. After residency, it will take two years to complete a fellowship in cardiology. The standard role of cardiologists is to act as non-invasive cardiologists and recommend lifestyle changes, such as performing diagnostic tests and treating patients by prescribing medication or improving their condition.

Those who train to become invasive, non-interventional cardiologists can do similar work with patients but are also eligible to undergo medical tests for arterial blockages. However, non-interventional invasive cardiologists do not perform the procedures performed by interventional cardiologists.

Job responsibilities of a cardiologist:

  • Evaluation of the cardiovascular and cardiac health of patients
  • Explain the results of ECGs and other tests
  • Refer patients to other specialists
  • Cardiac catheterizations (invasive, interventional non-cardiologists only)

Interventional cardiologists

Interventional cardiologists spend three years completing a fellowship in Interventional cardiology after graduating from medical school, completing a residency in Internal medicine, and completing a fellowship in cardiology. Interventional cardiologists often work in hospitals and can work at any time of the day or night on weekends or weekends. They can treat patients with conditions like heart disease or clogged arteries. Interventional cardiologists need to have good communication and leadership skills so that they can work effectively when performing procedures with other medical professionals. They also benefit from being physically fit and capable because they can stand longer and the procedures often require precision.

Job responsibilities of an interventional cardiologist:

  • Check referrals
  • Explain procedures to patients
  • Perform procedures such as inserting stents into arteries and repairing valves
  • Follow up with patients after treatment

Is Interventional cardiology invasive?

Interventional cardiology often appears invasive but does not require surgery. A small flexible tube called a catheter is inserted into the body to repair damaged or weakened blood vessels, narrow arteries, or other parts of the structure.

Benefits of Interventional cardiologists

Increase comfort, reduce problems

Before the advent of transradial cardiac catheterizations and interventions, catheterizations were inserted through the groin to access the arterial system, causing many problems for patients. This treatment, which is still practiced by doctors who are not certified to use interventional cardiology, generates a high level of discomfort in patients.

This often increases recovery time as patients struggle with the painful consequences of the procedure. Also, due to the nature of the treatment, patients often experience bleeding, bruising, and pseudoanaemia at the surgical site along the femoral artery. Problems associated with common catheterizations, such as retroperitoneal hemorrhage, have also been shown to be fatal in some patients. Fortunately, this is not the case in interventional cardiology.


Treatment and Diagnosis of Pericardial disease | Cardiology

What is a pericardial disease (pericarditis)?

Pericardial disease or pericarditis is an inflammation of any layer of the pericardium. The pericardium is a clash of thin tissue around the heart and includes:

  • Visceral pericardium: The inner layer that covers the entire heart. Fluid layer between the visceral pericardium and parietal pericardium to avoid friction
  • Parietal pericardium: The outer layer made of fibrous tissue.

Signs and symptoms of pericardial disease

You may not have symptoms. This occurs most often in the case of a mild spill. You may have symptoms from the causes of pericardial disease. For example, you may have a fever if you have a pericardial infection.

When the stroke is more severe, you may have symptoms similar to:

  • Chest pain or discomfort
  • Dilation of the neck veins.
  • Epilepsy
  • Breathe faster
  • Increase in cardiac frequency
  • Nausea
  • Pain in the upper right abdomen
  • Difficulty breathing
  • Swelling of the hands and feet

If the stroke is too severe, it can even lead to very low blood pressure. It causes symptoms of shock. In addition to:

  • Mild headache or dizziness
  • Cold hands and feet
  • Clammy skin
  • Weakness
  • Fast breathing
  • Nausea or vomiting
  • Pale skin
  • Less urination
  • Shock is a medical emergency.

The symptoms of the pericardial disorder are similar to other health problems. See your healthcare provider for a diagnosis.

Types of pericardial disease

Idiopathic pericarditis: The cause of acute pericarditis is very difficult to establish and idiopathic pericarditis remains the most common diagnosis. In most cases, a viral etiology is assumed.

Viral pericarditis: Coxsackievirus B and Echovirus are the most common viruses and diagnosis requires a four-fold increase in antiviral titers. Patients often experience a prodrome of upper respiratory infection. The prognosis for viral pericarditis is generally good, with a self-limited course, and if uncomplicated, patients can be treated on a patient basis.

Pure pericarditis: Before the age of antibiotics, pneumonia was the leading cause of purulent pericarditis. Currently, there are extensions of thoracic surgery, chemotherapy, immunosuppression, and hemodialysis, as well as pneumonia and emphysema. The appearance is usually severe with high fever, chills, night sweats, and dyspnea, but the classic findings of chest pain or friction rub are very rare. Cardiac tamponade is common (42–77% of patients in the selected series) and mortality is high.

If the purulent pericardial disease is suspected, hospitalization, treatment with broad-spectrum intravenous antibiotics, and emergency drainage are recommended. Pericardial fluid analysis findings include a high protein level (> 6 g / dL), a low glucose level (<35 mg / dL), and a very high white blood cell count (6,000 to 240,000 / mm3).

Tuberculous pericarditis: Tuberculous pericarditis occurs in 1% to 2% of pulmonary tuberculosis cases. It is the leading cause of pericardial disease in some developing countries. Human immunodeficiency or immunosuppressed virus (HIV): Patients are at risk. Special symptoms such as dyspnea, fever, chills, night sweats develop slowly and often there is no rubbing or chest pain. A patient with suspected or diagnosed pericardial tuberculosis should be hospitalized and antituberculous treatment started immediately.

Analysis of the pericardial fluid shows a high specific gravity, a very high protein level (often> 6 g / dl), and mainly lymphocytic cells. Pericardial biopsy with an acid-fast bacilli polymerase chain reaction test is recommended for all patients with tuberculous pericarditis. However, a simple pericardial biopsy does not rule out the diagnosis.

Uremic and dialysis-associated pericarditis: Uremic pericarditis occurs with moderate renal failure in 6% to 10% of patients before the start of hemodialysis; Blood urea nitrogen levels are usually above 60 mg / dL. Normal ST-segment elevation on ECG is usually absent. Although tamponade is very rare, heavy bleeding can occur, facilitated by impaired platelet function. Alternatively, a serous pericardial effusion related to fluid overload may occur. With both forms, the onset or severity of hemodialysis is indicated, which generally leads to improvement in 1 to 2 weeks5,6.

Pericarditis after myocardial infarction: Pericarditis after myocardial infarction is a common complication (25% to 40% of patients with myocardial infarction) and begins within 3 to 10 days after myocardial infarction. Its development is associated with the extent of necrosis, is more common earlier than malignant infarcts, and is associated with a 1-year mortality rate and an increased risk of circulatory heart failure.

The diagnosis of post-myocardial infarction pericarditis requires symptoms or new pericardial friction; Pericardial effusion alone is not specified. In addition to the general ST elevation seen with severe pericarditis, which is difficult to distinguish from true MI in this setting, ECG findings show normalization of positive T waves more than 2 days after MI or T waves previously transversal.

Post-cardiac injury syndrome: Dressler syndrome usually occurs 2 to 3 weeks after a heart attack or open-heart surgery. The sensitive autoimmune component is believed to be responsible for myocardial infarction during infarction. Fully expressed syndromes include pleurisy chest pain, fever, leukocytosis, and pericardial rubbing. Pleural effusions or pulmonary infiltrates may be observed.

Malignancy: Malignant pericarditis is caused mainly by metastatic disease. Bronchogenic metastatic pericarditis or breast carcinoma, common in Hodgkin’s disease and lymphoma 

Causes of pericardial disease

  • Pericardial disease is caused by inflammation of the pericarditis in response to illness or injury.
  • The pericardial disease also occurs when the flow of pericardial fluid is blocked or blood collects at the pericardium from a chest injury.
  • Sometimes the cause cannot be determined (idiopathic pericarditis).
  • Inflammation of the pericarditis after heart surgery or a heart attack.
  • Autoimmune disorders such as rheumatoid arthritis or lupus.
  • Cancer (metastasis), especially lung cancer, breast cancer, melanoma, leukemia, non-Hodgkin’s lymphoma, or Hodgkin’s disease
  • Heart cancer.
  • Radiation therapy for cancer if the heart is in the radiation field.
  • Chemotherapy treatments for cancer include doxorubicin (Doxil) and cyclophosphamide.
  • Dysfunctional thyroid (hypothyroidism).
  • Viral, bacterial, fungal, or parasitic infection.
  • Trauma or puncture wound near the heart after open-heart surgery.
  • Some prescription drugs, including hydrolyzing, a drug for high blood pressure; Isoniazid, a drug for tuberculosis; And phenytoin (Dilantin, Fenitech, et al.) and Antiepileptic drug.

Risk factors of pericardial disease

Pericarditis affects people of all ages, but men in their 20s and 50s are more likely to develop it.

The cause of pericarditis is unknown in many cases. However, some factors can trigger pericarditis:

  • Recovering from a heart attack
  • Autoimmune diseases
  • Injury or injury from an accident
  • Some bacterial, viral, and fungal infections
  • Renal insufficiency
  • In rare cases, some medicines, such as phenytoin to treat seizures and procainamide to treat irregular heartbeat

Diagnosis of pericardial disease

The doctor will do a physical exam and listen to your heart with a stethoscope. If you have signs or symptoms of pericardial disease, a series of blood and imaging tests will be done to confirm the diagnosis, identify possible causes, and determine treatment. Sometimes a pericardial disease is found when testing is done for other reasons.

  • Echocardiogram: An echocardiogram uses sound waves to create real-time images of your heart. This test allows your doctor to see how much fluid has accumulated in the space between the two layers of the pericardium. The echocardiogram also shows how well your heart is pumping blood and diagnostic tamponade or shock in one of the heart’s chambers.
  • There are two types of echocardiograms: Transthoracic echocardiogram. This test uses a sound-emitting device (transducer) that is placed on your chest and your heart.
  • Transoesophageal echocardiogram: A small transducer is placed in a tube in your digestive system that goes from your throat to your stomach (esophagus). Because the esophagus is so close to the heart, placing the transducer there provides a more detailed image of the heart.
  • Electrocardiogram: An electrocardiogram, also known as an ECG or EKG, records electrical signals as they travel through your heart. Your cardiologist can look for samples that indicate tamponade.
  • Chest x-ray: If you have too much fluid in the pericardium, a chest X-ray will show an enlarged heart.
  • Other imaging technologies: Computed tomography (CT) and magnetic resonance imaging (MRI) can detect pericardial effusion, although they are not commonly used to look for it.

Treatment for pericardial disease

Treatment for pericardial disease depends on the underlying condition causing it and whether the effusion produces severe symptoms, such as shortness of breath or shortness of breath. Medical history, the examination of the patient, diagnosis, examination of the pericardial fluid, and the physician will help determine the cause and treatment.

Depending on the cause, excess fluid may be high in protein (exudate) or water (translate). Both categories help doctors determine the best course of treatment for pericardial effusion.

Medical administration

The goal of medical treatment for the pericardial disease is to treat the underlying cause. Medical treatments for pericardial effusions:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to treat pericardial disease caused by inflammation. These medications include ibuprofen or aspirin.
  • Diuretics can be used to treat pericardial effusions caused by heart failure.
  • Antibiotics are used to treat pericardial disease caused by infection.
  • However, if the pericardial effusion is related to the presence of cancer, treatment may include chemotherapy, radiation therapy, or intramuscular injection.

Procedures for the treatment of pericardial disease

Regardless of whether the pericardial disease is transudative (watery fluid) or exudative (made from a protein-rich fluid), the large pericardial disease is caused by respiratory symptoms or cardiac tamponade may be the main cause of the elimination of excess fluid, to avoid its return or to increase the liquid.

Large pericardial effusions can be drained through:

  • Ultrasound-guided pericardiocentesis: It is a safe and effective procedure to remove excess fluid from the pericardium. This is more common after fluoroscopy.
  • Video-assisted thoracoscopic surgery (VATS): Also known as thoracoscopy, is the least invasive technique performed under general anesthesia. VATS allows visual evaluation of the pericardium and is used when the diagnosis of pericardial effusion has not yet been made despite previous less invasive tests. It is also used to drain excess fluid and prevent relapse. A pericardial disease that may not be treated with medical maintenance or drainage of excess fluid may require surgical treatment.
  • The pericardial window (subluxated pericardiotomy): It is a minimally invasive procedure in which an opening is made in the pericardium to drain fluid that has accumulated around the heart. The pericardial window can be completed with a small incision under the end of the breastbone or with a small incision between the ribs on the left side of the chest.
  • Percutaneous balloon pericardiotomy: It is a non-surgical procedure performed with an x-ray guide to view the pericardium and place the balloon dilator catheter. This approach is not common.

Complications of pericardial disease

  • Pericarditis can be one of two serious problems: cardiac tamponade and chronic gastric pericarditis.
  • Cardiac tamponade a medical emergency and, if left untreated, can quickly become fatal.
  • It develops when there is excess fluid between the heart muscle (myocardium) and the pericardium, putting obstructive pressure on the heart to prevent it from working properly.

Cardiac tamponade causes several symptoms, including:

  • Anxiety
  • Breathing problems and chest pain.
  • Dizziness and epilepsy
  • Swelling of the abdomen
  • Drowsiness
  • Weak pulse
  • Rare, even chronic, chronic constrictive pericarditis can be fatal if left untreated.

Pericarditis develops slowly when scar (fibrous) tissue forms on the pericardium, causing the sac to become thicker, harder, and firmer. Scar tissue shrinks over time, preventing the heart from fully expanding and filling with blood. Chronic constrictive pericarditis can lead to weakness and fatigue, shortness of breath, and swelling in the abdomen and extremities.

Prevention of pericardial disease

In general, acute pericarditis cannot be prevented. You can take steps to reduce the chance of another serious episode, complications, or chronic pericarditis. Getting prompt treatment during these stages, following your treatment plan, and getting ongoing medical care as advised by your doctor.