Update on Local Cardiac Care

By Amit Singh, MD

Cardiac care in Tompkins County has changed dramatically in the last few years. Area cardiologists and Cayuga Medical Center have collaborated to expand local services by opening a state-of-the-art cardiac catheterization laboratory and by formalizing an affiliation with the University of Rochester and Strong Memorial Hospital, one of the region’s most highly regarded cardiac care centers.

These enhancements, coupled with other advanced local capabilities, enable area residents with cardiac disease to remain in their community under the care of their own cardiologists. In those cases where surgery is indicated, our close working relationships with cardiac surgeons in Rochester (and other regional cardiac centers, as well) provide our patients with a seamless transition of care to well established tertiary cardiac programs at major medical centers.

When is cardiac catheterization recommended?

Cardiac catheterization is an invasive procedure used to gain additional information about the anatomy of the heart’s valves and arteries, and to identify the presence of shunts (holes). This information helps us diagnose the extent of cardiac disease and make decisions about whether surgery is indicated for valve replacement or to repair blockages in the arteries or holes in the heart.

It’s important for prospective patients to know that the cardiac catheterization lab at Cayuga Medical Center is one of the newest facilities in New York State, with equipment and techn0logy identical to that of major cardiac centers in the region. The lab is entirely digitized and our computer network allows us to review cardiac images with our colleagues in Rochester for consultation during the catheterization procedure.

What happens after the procedure?

We believe that patient care is enhanced and the best decisions about treatment are made when patients review their cardiac studies with physicians who know them well and with whom they have established trusting patient-doctor relationships. For this reason, we encourage our patients to have their cardiac catheterizations performed locally. Only 30 percent of the people who undergo cardiac catheterization need immediate surgery. This means that 70 percent of cardiac cath patients do not need to travel out of town at all, either for catheterization or surgery.

What if you suspect blockages in the arteries?

During the cardiac catheterization of a patient with arterial disease, we may learn one of three things: the heart has already compensated for the blockage by creating its own bypasses; the heart has two or three blockages that are best treated with balloon angioplasty and the placement of stents to open up the arteries; or the heart requires bypass surgery. If stent or bypass surgery is indicated, we work closely with the patient and one of our colleagues from a nearby cardiac surgery center to pursue surgical treatment.

What does cardiac catheterization reveal about heart failure?

We use catheterization to aid in the diagnosis of heart failure by measuring pressures inside the heart on the right and left sides. Nearly 40 percent of people suffering from heart failure have normal pumping function; however, conditions such as high blood pressure or diabetes have caused the walls of the heart to grow thicker. This thickening increases internal pressure and compromises the heart’s ability to hold and circulate sufficient blood to meet the body’s needs.

Are there other cardiac diagnostic and treatment services area residents should know about?

Local cardiologists implant cardiac pacemakers and implantable cardioverter defibrillators (ICDs) in the cardiac catheterization lab. We also provide the entire range of cardiac stress testing, including nuclear stress testing. Transesophageal echocardiogram (TEE), a diagnostic modality that provides us with in-depth images of the heart at work, is available here, as well. These and other capabilities enhance local cardiac care and reduce the need and associated stress of out-of-town travel.

Dr. Singh is board certified in the following specialties: cardiovascular disease, nuclear cardiology, and internal medicine. He is a Fellow of the American College of Cardiology and is a member of the medical staff of Cayuga Medical Center. Dr. Singh is in practice with Ithaca Cardiology Associates and can be reached there at (607) 272-0460. Dr. Singh earned his medical degree from the State University of New York Upstate Medical University in Syracuse, and completed his internship and residency in internal medicine at Bassett Health Care in Cooperstown (a major affiliate of Columbia University). He was chief resident in his final year of training and served as a staff intensivist for one year prior to entering a three-year fellowship in cardiovascular disease at Strong Memorial Hospital, University of Rochester. Dr. Singh is a member of the American College of Cardiology.

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