Evolution in cardiac care: what has changed in the last decade

It is now possible to make a small incision through which surgeons use a camera to view the heart and understand where the problem lies -- robotic surgical tools allow for greater precision in treatment.

The prevalence of cardiovascular diseases (CVDs) has increased manifold in the last 10 years – both in India and on a global scale. What is alarming is that the average age has now dropped from 60 to 70 years until a decade or so ago to under 40 years. Globally, the number of heart patients has increased from 5.7 million (2012)  to about 6.5 million (2014).  CVDs is an umbrella term that encompasses coronary artery disease, heart attack, arrhythmias, heart failure, heart valve disease, congenital heart disease and cardiomyopathy, which are most common. While most CVDs can be managed through early interventions including lifestyle changes and medication, people with complications may require treatment and surgery. 

When people think of heart treatment/surgery, the first picture that comes to mind is that of opening up the heart and a large incision on the chest. However, cardiac care has evolved in the last decade and there have been great advances such as minimally invasive procedures. It is now possible to make a small incision through which surgeons use a camera to view the heart and understand where the problem lies -- robotic surgical tools allow for greater precision in treatment. With automated monitoring systems and advanced diagnostic mechanisms, doctors are able to get more insight and understanding into CVDs, thereby allowing for timely detection and treatment. Cardiac care has thus evolved across four categories: diagnostics, drugs implants, and minimally invasive interventions.

Devices that track vitals

Until the last decade, any malfunction or blockage in the heart could only be detected through simple ECGs or angiography. Now there are other options such as computerized tomography, cardiac MRI and advanced ECHO which has revolutionized the process of imaging. Apart from this, we now have what are called biosensors and other handheld devices which simplify testing and allow for faster detection of heart problems. There are also pocket-sized 6 and 12 Lead devices available now which help in checking vitals such as ECG at home. They can even be carried in the purse anywhere. Another wave of transformation has been personal technology such as smartphone apps, implants, and wearables which help in capturing patient data in real time. Several heart conditions occur silently without symptoms and these devices capture even the minutest of symptoms. 

Prevention is becoming the key

There have been considerable efforts towards preventive cardiological conditions and rehabilitation. The objective of this is to avoid the onset of heart disease much before the occurrence of a heart attack or any other associated condition. There are also several campaigns undertaken by the government and the private sector around heart health to spread awareness on the ways to reduce the burden of associated disorders like obesity and hypertension. The idea is to enable people to make relevant lifestyle changes and prevent heart problems. Rehabilitation on the other hand refers to post-surgical care that includes close monitoring of the patient after a heart procedure and following up with the doctor, etc. 

Minimally invasive treatments

From the time when open-heart surgery was the only alternative for a heart complication, we have now come to stage where treatment has become minimally invasive. Technologies such as AI and robotics have ensured that it is possible to conduct treatment with only a pin-hole incision. Other emerging options include incubated neo-organs, bioengineered patient-specific implants, bioprinting of cellular matter, and completely artificial heart. 

In conclusion

Even as the first open-heart surgery became a landmark in cardiology in India, we now have options that are marking the dawn of a new epoch in cardiac care. With AI and data analytics propelling medicine and treatment to a whole new realm, it won’t be long before we get answers to some of the perplexing questions that have been boggling researchers in cardiology. 

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CVDs Neha Rastogi cardiac care


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