Cardiology

Cardiology Department

The heart is one of the most important organs in the body. Understanding the structure and disorders of the heart, which works tirelessly without rest, is one of the most important keys to a healthy and long life. Cardiology examines the vital organ, the heart, and its disorders.

Daviva Health Group’s Cardiology Department provides services to protect your heart health with expert cardiology doctors and the latest technology of the day for the diagnosis and treatment of conditions such as high blood pressure, arrhythmia, and heart failure.

What Is Cardiology?

Cardiology is the branch of science that examines the heart’s electrical activity, blood flow, and mechanical movements. Cardiologists are doctors specialized in the diagnosis and treatment of heart diseases. They evaluate patients’ medical histories, perform physical examinations, carry out the necessary tests, and prepare individualized treatment plans. They also make lifestyle recommendations to protect heart health.

Heart and vascular diseases are still one of the leading causes of death worldwide. Thanks to advances in cardiology, heart diseases can be treated effectively and kept under control.

Which Diseases Does Cardiology Address? / What Does Cardiology Cover?

Heart diseases can seriously threaten health. Recognizing these diseases and taking preventive measures is important for protecting heart health. The diseases addressed by cardiology can generally be listed as follows.

• Hypertension (High Blood Pressure): Arteries carry blood from the heart to the rest of the body. As the blood moves through them, it exerts a certain pressure on the artery walls. This pressure is usually in the range of 120/80 mm Hg. Hypertension, or high blood pressure as it is commonly known, refers to blood pressure that is higher than normal. Depending on daily activities, blood pressure values may rise above normal levels. However, persistently elevated blood pressure is considered hypertension. High blood pressure can also progress without causing any symptoms. Common symptoms of hypertension include headache, chest pain, swelling, and heart palpitations.
• Heart Failure: The oxygen and nutrients needed by the body are delivered through the heart’s pumping of blood. In heart failure, the weakened heart cannot pump blood adequately and therefore cannot supply enough blood to the cells. To compensate for this deficiency, the heart enlarges, the muscle mass increases, and it tries to pump faster. When the heart cannot pump sufficiently, blood and fluid may accumulate in the lungs and legs over time. In addition, heart failure may present with symptoms such as shortness of breath, chest pain, heart palpitations, and fatigue. Heart failure is a serious condition and is usually not curable. However, many people with heart failure can live comfortably with medications and lifestyle changes.
• Coronary Artery Disease (Hardening / Blockage of the Vessels): Coronary artery disease, more commonly known as vessel blockage or hardening of the vessels, refers to the slowing of blood flow as the inner part of the arteries narrows for various reasons. Atherosclerosis caused by the buildup of fat and calcium, high cholesterol, high blood pressure (hypertension), smoking, and unhealthy eating are among the causes of coronary artery disease (vessel blockage). Coronary artery disease develops over a long period of time. It causes symptoms such as chest pain and shortness of breath. Diagnosis is made using various tests such as electrocardiogram (ECG) or stress test.
• Arrhythmia (Heart Rhythm Disorders): Heart rhythm disorders, also known as cardiac arrhythmia, are commonly known as a fast heartbeat (tachycardia) or palpitations. However, a heartbeat slower than normal (bradycardia) or an irregular heartbeat is also arrhythmia. These disorders result from a problem in the heart’s electrical system, which stimulates the heart to contract and relax. Cardiac arrhythmias can sometimes occur in people without heart problems and may not lead to life-threatening issues. However, arrhythmia may also be a sign of more serious problems. Underlying cardiovascular disorders can lead to complications such as stroke or sudden cardiac death. Chest pain, dizziness, fainting spells, and low blood pressure may be symptoms of arrhythmia. In addition to medications, treatment methods such as cardiac ablation and pacemakers are available.
• Heart Valve Diseases: Heart valves ensure that blood flows in one direction. The malfunction of one or more of these valves for various reasons is defined as heart valve disease. Common heart valve diseases include narrowing (stenosis), backflow (regurgitation), or loose valves (prolapse). If left untreated, heart valve disease can reduce blood flow and cause the heart to work harder. Heart valve diseases can be treated with medication, heart surgery, or interventional methods.
• Cardiomyopathy (Heart Muscle Diseases): It is a disease of the heart muscle. There are many types of cardiomyopathy, such as dilated cardiomyopathy and hypertrophic cardiomyopathy. Cardiomyopathy can cause the heart to stiffen, enlarge, thicken, and form scar tissue. These conditions make it harder for the heart to pump blood. Cardiomyopathy can also cause some other serious heart conditions. Heart palpitations, chest pain, arrhythmia, and shortness of breath are among the symptoms of cardiomyopathy. In addition to medication, heart surgery is among the treatment methods used.
• Myocarditis / Pericarditis (Inflammation of the Heart Muscle and Membrane): Myocarditis and pericarditis are inflammatory conditions that affect the heart. Myocarditis is inflammation of the myocardium, the heart muscle. Pericarditis is inflammation of the pericardium, the sac-like layer of tissue surrounding the heart. Symptoms of myocarditis include chest pain and sometimes fever. Symptoms of pericarditis include fever and usually sudden and short-lasting chest pain. Chest pain is often more severe when lying down.
• Heart Attack: A heart attack, or myocardial infarction, is an emergency heart condition that occurs when there is not enough blood flow to the heart’s muscle layer called the myocardium. Usually, because of coronary heart disease, blood flow to the heart muscle decreases or stops completely. This condition may occur without any symptoms, or it may present with very severe symptoms. The most common symptom of a heart attack is usually chest pain described as crushing, squeezing, pressing, heavy, or sometimes stabbing. Chest pain is usually concentrated in the center of the chest or just below the ribs and may spread to the arms, abdomen, neck, lower jaw, or nape of the neck. Treatment for a heart attack depends on how stable the person’s condition is and how high the risk of death is. Clot-dissolving and blood flow–improving medications may form the first step of treatment. Balloon angioplasty and stent treatment are also among the treatment methods used in heart attack.
• Peripheral Artery Disease: This is usually the narrowing or blockage of the arteries in the legs due to atherosclerosis, defined as fatty plaques. Peripheral artery disease can be seen in any vessel, but it occurs more often in the leg vessels. Medications and lifestyle changes form the first step of treatment. Angioplasty, atherectomy, and peripheral artery bypass surgery may also be used in treatment.
• Congenital Heart Diseases: These are heart abnormalities present at birth. They can affect the heart’s walls, valves, arteries, and veins. Some are mild and do not cause significant problems, while others are severe and require urgent medical intervention.

What Are the Methods Used in the Diagnosis and Evaluation of Heart Diseases?

• Blood Tests: There are a number of blood tests that may be done to rule out other causes of heart symptoms and measure different levels in the body that can affect the heart. In addition to routine blood tests, certain heart proteins gradually enter the bloodstream after a heart attack. Blood tests may be performed to check these proteins.
• Echocardiography: An echocardiogram, commonly known as an echo, is an ultrasound scan of the heart. It shows how blood passes through the heart and heart valves. An echocardiogram is usually a painless procedure performed in a hospital or outpatient clinic. Images such as the size of the heart and how well the heart muscle contracts and relaxes can be determined by echocardiography imaging.
• Stress Echocardiography: This procedure is performed while the heart is under stress, usually after exercise or after taking medications that make the heart work harder. It helps identify problems related to blood flow and heart function under pressure.
• Electrocardiogram (ECG): Also known as an ECG, this test records the heart’s electrical activity. It helps identify any problems in heart rhythm or rate. An ECG is painless and takes about 5–10 minutes. Although the names are similar, an ECG and an echocardiogram, which is a scan of the heart, are not the same test.
• Exercise Stress Test: This shows how the heart works during activity. Before the stress test, electrodes are attached to the patient’s chest to measure the heart’s responses. While walking on a treadmill, blood pressure, heart rate, oxygen levels, and electrical activity in the heart are recorded with an ECG. At first, the pace is easy. As the test continues, the exercise becomes harder. At certain intervals, the treadmill incline is increased to assess the heart’s response to activity. The stress test may be stopped if chest pain, an abnormal rise in blood pressure, or insufficient oxygen delivery to the heart occurs.
• Pharmacological Stress Test: This can be used as an alternative, especially in patients who cannot perform an exercise stress test. Medicine is given through a vein to widen the arteries. This increases heart rate and blood flow in a way similar to the effects of exercise.
• Transesophageal Echocardiogram (TEE): A diagnostic ultrasound test that provides a clear image of the heart through a small tube inserted into the esophagus. It is performed by inserting a probe down the esophagus to obtain images of the heart. TEE is used especially when other diagnostic methods do not provide sufficient information. It may be used to diagnose conditions such as mitral valve disease, blood clots or masses inside the heart, and aortic dissection.
• Tilt Test: Also known as the Tilt Table Test, this test is used to determine the cause of fainting and dizziness. During the test, the patient lies on a table that is slowly tilted upward. It measures how blood pressure and heart rate respond to gravity.
• Myocardial Perfusion Scan (Thallium Test): This is a test that shows blood flow to the heart muscle. Myocardial perfusion scans are usually divided into two parts: stress (exercise) and rest. In the stress part of the test, the patient is asked to exercise on a treadmill. If the patient is unable to exercise on the treadmill, a medication that increases heart rate may be given instead. The patient is then given a special contrast agent through a vein so that blood circulation can be detected. A camera is then placed near the patient’s chest and images of different parts of the heart are taken, similar to an X-ray.
• Holter

It is a portable device that records continuously. It is a device about the size of a mobile phone and easy to carry. It has different uses.

• ECG Holter: It is the most commonly used type of Holter monitor in clinical practice. It continuously records ECG data for 24–48 hours. It can be used to detect arrhythmias, determine the effect of the heart medications used, and monitor coronary artery disease.
• Patch Holter: Holter monitors, also known as patch monitors, are designed for long-term use and are advanced devices that can record heart activity for 7–14 days, significantly longer than traditional models. They can be used to detect infrequent arrhythmias, adjust pacemakers, and evaluate episodes of dizziness, palpitations, or fainting.
• Event Recorder Holter: These are intermittent monitoring devices used when symptoms are irregular and do not occur daily. Unlike traditional Holter devices, the patient activates the device when symptoms occur. It detects arrhythmias that appear during palpitations, dizziness, or chest discomfort. It helps identify rare rhythm disorders.
• Mobile Cardiac Telemetry (MCT): It is the most advanced among all Holter monitor types. It provides continuous ECG monitoring, automatic data transmission, and real-time alerts to monitoring centers.
• Blood Pressure Holter: It consists of a cuff attached to the patient’s arm and a small recording device attached to it and secured around the waist with a belt. It is usually worn by the patient for 24 hours.

Coronary CT Angiography: Also known as CT angiography, this imaging method examines the arteries that supply blood to the heart. CT angiography is mainly performed to check for narrowed or blocked arteries in the heart. It may be done if there are symptoms of coronary artery disease. However, CT angiography can also examine other heart conditions.

Cardiac MRI: A Magnetic Resonance imaging method used to examine heart anatomy, physiology, and pathology. It can be used to identify congenital heart diseases, heart muscle disorders such as cardiomyopathy, heart tumors, or damage to the heart muscle after a heart attack.

What Are the Interventional Treatment Methods Used in the Cardiology Department?

Interventional cardiology treatments are methods generally performed through the vessels without the need for general anesthesia. Many conditions that were until recently treated with open surgery can now be treated without surgery through interventional cardiology methods.

• Angioplasty: Used to widen narrowed areas in the coronary arteries. In an angioplasty procedure, a thin, flexible tube (catheter) with a small inflatable balloon at its tip is placed into the narrowed section of the artery. The balloon is inflated for a short time to push the plaque against the artery wall, thereby improving blood flow. A similar procedure called coronary angiography helps assess the degree of blockage in the coronary arteries.
• Stent Placement: One of the most commonly performed procedures in interventional cardiology. It involves placing a small wire tube into the narrowed area to improve blood flow. A stent can restore blood flow in a blocked blood vessel. Stent placement may prevent the risk of a heart attack and may even eliminate the need for open-heart surgery. The stent is placed at the tip of a catheter and, similar to angioplasty, is guided through an artery to the narrowed area.
• Transcatheter Aortic Valve Replacement (TAVI): This is the replacement of a problematic aortic valve without the need for heart surgery. During this minimally invasive procedure, a new valve is placed without removing the old damaged valve. The new valve is placed inside the diseased valve.
• During the TAVI procedure, the patient is usually awake and lying on their back.
• A catheter is inserted into the artery.
• The catheter is then advanced to the opening of the aortic valve.
• A new valve made of metal or animal tissue is placed inside the old valve.
• MitraClip: A procedure similar to TAVI. It is an interventional cardiology procedure performed in cases of mitral valve insufficiency between the left atrium and left ventricle of the heart.
• • A small incision is made in the groin area, and a catheter is inserted into the vessel carrying blood to the heart.
  • The catheter is advanced to the heart with the help of X-ray and echocardiography.
  • Using a small device at the tip of the catheter, a tiny hole is made in the wall separating the heart chambers.
  • By passing the clip through the catheter and placing it on the edges of the mitral valve, leakage is prevented.
• Tricuspid Clip: A method in which insufficiencies in the tricuspid valve in the heart are treated interventionally. It may be preferred especially in patients for whom medication is not sufficient. It is performed in a manner similar to TAVI and MitraClip procedures.
• ASD Closure: ASD is a condition in which there is an abnormal opening in the wall (septum) between the two upper chambers (atria) of the heart. In this congenital problem, if the opening is not too large, it may close on its own in some cases. However, if the opening, that is, the hole, is large, it can be closed by advancing a catheter placed in the groin area to the site of the opening.
• VSD Closure: Similar to ASD, a hole in the wall separating the lower chambers of the heart is defined as VSD. If this hole is too large, it may cause permanent damage to the heart and lungs. A catheter is used to reach the heart through the artery. With the help of the catheter, the hole between the chambers is closed with a device made of synthetic material.
• Ablation: Ablation treatment is used in the treatment of arrhythmia. A problem in the conduction system that sends electrical signals to the heart causes arrhythmia. Usually, the first treatment for arrhythmia is medication. However, in cases that cannot be controlled with medication, ablation may be preferred.

Ablation is performed through a small incision made in the groin or wrist area. A catheter is inserted into the artery through the incision in the groin or wrist. Heat (radiofrequency energy) or freezing (cryoablation) is used to disable the area causing the arrhythmia. This procedure helps block abnormal electrical signals in the problematic area of the heart.

• Pacemaker: A battery-powered device that regulates the heart rate is surgically placed under the skin near the collarbone.
• Carotid Stenting: Blockages in the carotid artery increase the risk of stroke. Carotid stenting is performed to eliminate this risk. Carotid stenting is usually done under local anesthesia. After the catheter is placed, a special contrast agent is injected to precisely identify the area of blockage. A stent is then placed in the narrowed area with the help of another catheter.

When Should You See a Cardiology Doctor (Cardiologist)?

One of the questions people wonder about is what symptoms indicate that they should see a cardiologist. Heart conditions can sometimes progress without causing any symptoms. However, the symptoms that generally appear in heart conditions are as follows.

• Chest Pain: One of the most obvious symptoms of heart conditions is chest pain. However, not every chest pain indicates a heart problem. In particular, a feeling of pressure in the chest that occurs with activity should be taken seriously. In such a case, a specialist cardiologist can determine the cause of the chest pain and the appropriate treatment plan.
• Hypertension (High Blood Pressure): Chronic hypertension causes the heart to work harder and may increase the risk of heart attack and stroke.
• Shortness of Breath, Palpitations, or Dizziness: These symptoms may also be signs of different conditions, but they are among the first signs of heart disease. A cardiologist can determine whether these symptoms are caused by a heart condition.
• Diabetes: There is a strong relationship between cardiovascular diseases and diabetes. Poorly controlled blood sugar affects the functioning of your blood vessels and increases the risk of developing coronary artery disease. A cardiologist can work with your primary care doctor to help determine treatment or prevention strategies that can reduce the risk.
• Smoking: It is one of the most important preventable risk factors for heart disease.
• High Cholesterol: It can cause plaque buildup in the arteries. It should be remembered that one way to lower cholesterol is to eat healthily. A cardiologist can be consulted to reduce the risk of heart disease and monitor cholesterol.
• Chronic Kidney Disease: When the kidneys do not work properly, the risk of heart disease increases. Kidney disease is associated with high blood pressure and arterial disease. A cardiologist should be consulted to determine how kidney disease affects your heart.
• Family History of Heart Disease: Some heart diseases can be genetic. If a relative has early-onset heart disease, routine heart check-ups should not be neglected.
• Peripheral Artery Disease: Arteries are blood vessels that carry oxygen-rich blood from your heart to the rest of your body. If you have a known disease in other arteries, such as the leg arteries or the large blood vessels leading to the brain (carotid arteries), you are also more likely to develop coronary artery disease.