We provide chest pain pathway, the expressway for the patient with a heart attack or other cardiac emergency, with excellent care from our team of paramedics and board-certified specialists.

The Cardiac Care Unit provides 24-hour care and is equipped with the latest cardiac care technology, including Defibrillator, Pace maker, Intra aortic balloon pump (IABP). We work closely with the Heart Center and Cardiovascular Thoracic Surgery intensive care unit for continual care.

In the event of a heart attack or other cardiac emergency, you can depend on the excellent care that starts with our paramedics and board-certified Emergency Department team and continues with the medical professionals on our Coronary Care Unit.

The CCU is a state-of-the-art 29-bed unit for critically ill patients requiring the highest level of medical care. With one nurse for every two patients in the CCU, you can be sure you are getting the individualized attention you need. Your family will be kept abreast of your progress and our staff will take the time to talk with them and answer their questions. If needed, we can specially tailor visiting hours to accommodate their work schedules or other obligations.

Our ICU is staffed with plenty of specially-trained nurses and doctors who maintain constant awareness and apply all necessary treatments for their critically ill patients. All monitored beds in ICU include specialized neurological and cardiac units.

Today, the number of people with chronic conditions such as diabetes, renal disease, stroke, high blood pressure and coronary artery disease has been increasing due to our changed way of life and stress. The latest studies by the World health organization have show that coronary artery disease is a leading cause of death. One third of population dies because of this condition, especially in underdeveloped countries, including Thailand .

The main factors in coronary artery disease are the narrowing and blockage of the arteries by plaque, which consists of cholesterol and calcium. The main risk factors include diabetes, high blood pressure, high cholesterol, stress and cigarette smoking.

To diagnose coronary artery disease, doctors will evaluate patient’s risk factors and perform some tests and then will divide patients suspected to be at risk into two groups; high and low risk. After that, there are two main diagnostic procedures that will usually be performed;

Conventional Coronary Angiography,(CAG)

CAG, which accurately assesses the coronary arteries, is currently the diagnostic standard for clinical evaluation of known or suspected coronary artery disease, after which the patients can be immediately treated by Coronary Artery Bypass Graft (CABG) or placement of a stent. Although complications rarely happen, the following may occur; hematoma at the site of the arterial puncture, coronary dissection and air embolus because in this procedure, a then plastic tube is inserted into an artery in the leg and advanced through the body into the coronary arteries. It is also an expensive procedure, and the patient needs, to stay in hospital for about 4-6 hours.

Cardiovascular Examination by 128-Slice CT

“Ordinary” computerized X-Rays (16-slice CT) were not as accurate in demonstrating coronary artery problems, because the heart, unlike other structure, is moving and beating inside the chest. However today, with the advent of the most advanced form of this imaging, the multi-slice detectors and high powered computer programs call the 128-Slice CT , in around 4 seconds; we can efficiently get information on the coronary anatomical features in as few beats as possible, with 90% accuracy. The CT has various advantages. It helps doctors to make the diagnosis of certain diseases faster, more easily, and potentially more accurately. Furthermore, after this procedure, the patients do not have to stay in hospital. The 128-Slice CT is now a well known procedure leading to diagnosis of all diseases related to arteries or vessels.

Those who should have a cardiovascular check up include:

• Those with the following risk factors for heart diseases;
  • High Cholesterol – Diabetes
  • Smoking – Family history of heart disease
• Those suspected of being at high risk of narrowed coronary arteries;
  • Suffering from chest pain – Having an abnormal Stress Test
• Those having had the following treatment due to coronary artery disease;
  • Insertion of stents – Coronary artery bypass graft surgery (CABG)

There are certain groups who are not suitable for CT scanning using contrast agents as it may cause sever allergy and acute renal failure;

• Severe asthmatics
• Heart failure
• Renal disease with high creatinine or chronic renal failure
• A history of allergy to sea food and/ or contrast agents

High speed 128-Slice CT for other parts of body examination

1. To diagnose cardiovascular disease through narrowed vessels
2. To diagnose blockages in arteries/ vessels all over the body such as heart, brain, kidney, extremities, etc.
3. To diagnose pre-cancerous tumors in intestine and lungs
4. To examine bone abnormalities
5. To diagnose abnormality of brain issue
6. To diagnose abnormality of abdominal tissue
7. Others including diagnosis of abnormalities of blood vessels, such as aneurysm, and to measure abdominal fat, which is related to the quantity of calcium in arterial walls (coronary calcification) and to evaluate risk factors in the cardiovascular system.

A Cardiac catherization is a minimally invasive test that offers clear,accurate information about the heart, the coronary arteries located on the surface of the heart and possibly, the aorta. A small tube called a catheter is used to help a physician identify narrowed or clogged arteries, evaluate the heart’s four valves and assess congenital heart defects.

There are four major parts to a cardiac catheterization:

• Measuring blood pressure within the heart’s major arteries
• Taking blood samples for testing
• Performing a coronary angiogram, and x-ray of the coronary arteries
• Performing a left ventriculogram, and x-ray of the lower left chamber of the heart

A cardiac catheterization may be performed for two reasons. First, it may provide important information about the heart and major arteries, help the physician to more clearly see the source of a heart-related problem and determine whether the patient is good candidate for surgery.

In addition, cardiac catheterization are performed to help make a diagnosis. They are usually done after other, less invasive, tests have been performed on patients who may have a heart-related condition. A cardiac catheterization would follow test such as:

• An electrocardiogram (EKG), recording the heart’s electrical activity on a moving strip of paper
• An echocardiogram, using sound waves to create an image of the heart’s structure and function
• An exercise stress test, using EKG technology while the patient exercises on a treadmill or statonary bicycle

How do you prepare for a cardiac catheterization?

Typically, patients will be advised to continue taking most medications as normal, with some exceptions such as anticoagulants and antiplatelets. These medications interfere with the blood’s ability to clot, so dosage may be reduced or the medication suspended at some point prior to the test. Patients are encouraged to discuss their full medication schedule, including over-the-counter drugs and dietary supplements, with their physician so all necessary adjustments can be prescribed.

All patients should supply the physician with copies of previous test results, such as EKGs, if available. Diabetic patients may require further preparation instructions and should seek further guidance from their physician.

On the morning of the test, a light breakfast is suggested. Immediately before the test, patients will be asked various questions about their medical history. Patients should discuss any history they may have regarding blood clotting disorders or allergy reactions to:

• Iodine
• Shellfish
• Strawberries
• Dyes used in previous tests or procedures

Cardiac catheterization may be performed as either an inpatient or outpatient procedure. It takes place in a cool, sterile catheterization laboratory.

The patient is made comfortable, and then an intravenous (I.V.) tube is inserted to deliver a sedative and any other necessary medications. Heart rate and rhythms are continually monitored.

The catheter is usually invented into the femoral artery in the thigh/groin, but some physicians may choose to use the elbow or wrist. It is then fed toward the heart, which could cause some minor discomfort.

When the catheter reaches the target area, blood pressure measurements and, possibly, blood samples will be taken. A dye is injected through the catheter. This injection could cause a brief feeling of nausea, a headache, palpitations or a flushing/reddening across the body.

The physician will usually perform the ventriculogram first, followed by a coronary angiogram and, in some cases, an aortogram.

The test typically takes 30 minutes to one hour.