An interdisciplinary approach to heart disease

 

Heart disease is the leading cause of death in the world. And particularly with Thailand’s rapidly ageing society, and the rise of diabetes, hypertension and NCD, it will continue to be the leading cause of death for the foreseeable future. Bumrungrad International Hospital’s Heart Institute approaches heart disease from an interdisciplinary angle, bringing together all cardiology subspecialists, cardiothoracic surgeons, internists, geneticists and cardio-rehabilitation experts to successfully treat over 40,000 patients each year.

 

The different types of heart disease

There are many types of heart disease, and therefore many specialties within cardiology. Some of the main ones are:

• Coronary artery disease: a common but serious condition that is caused by the build-up of plaque in the arteries, lessening the supply of blood, oxygen and nutrients to the heart muscles.
• Cardiac arrhythmia: an arrhythmia is an irregular heartbeat caused by faulty electrical signaling, which can result in either too fast or too slow beating of the heart.
• Cardiomyopathy: a group of diseases that affect the heart’s size, shape or thickness, making it weaker to pump blood around the body.
• Structural issues: In addition to the heart’s vascular and electrophysiological systems, there are other structures, such as valves and membranes, which are prone to malfunction.
• Genetic conditions: conditions such as arrhythmia and high cholesterol are in fact inherited.
• Congenital conditions: conditions from malformation of cardiac development during fetal development.

 

Diagnosis

Bumrungrad International Hospital has consistently been a pioneer in investing in and utilizing the best medical technology available. To screen for heart disease, we go beyond the basic stress and treadmill tests. Our advanced imaging includes CT scans, cardiac MRIs, Electrophysiology (EP) Lab and the latest nuclear imaging. The results are then analyzed by an entire team consisting of different specialists.

Treatment

Depending on the type of heart disease diagnosed, there are many options for treatment. For example, for coronary artery disease, if medication and lifestyle modifications are not enough, we would proceed to performing a balloon angioplasty and inserting a stent. In more severe cases, bypass surgery is an option.
To treat complex cardiac arrhythmia, we rely on one of the most advanced electrophysiology mapping systems in the world, and we have state-of-the-art technology for advance electrophysiology mapping.
We are also the only centre in Thailand with a cardiologist specializing in inherited diseases, and can provide genetic screening for at risk patients.

What makes us unique

The Heart Institute works on a multidisciplinary approach, and we have recruited the best from each cardiology specialty. As a team, we don’t just treat a specific disease, but we look at the whole disease and the whole life of each patient, treating them from birth until old age. It’s not about which patient belongs to which physician, or who the primary physician is. Especially for complex cases, the team will evaluate together and collaborate between sub-specialties. At the end of the day, it is always about prioritizing the patient’s best interests and providing the best care possible.

A recent success

As the only private hospital in Thailand with the capability to do heart transplantations. We performed the hospital’s first heart transplant on a patient who was just 15 years old, and whose heart was very weak. After the transplant, this girl who had nearly died went home and celebrated her birthday with her family. It is moments like these that make all our efforts worthwhile.
 

Prevention

Regular screenings are recommended for all patients starting from age 40 for men and age 45 for women. If there is a strong family history of heart disease, such as heart attack, arrhythmia, and death from cardiac causes as yet undetermined, our recommendation is to consult a cardiologist or even a cardiac geneticist to investigate further.

As with most diseases, a healthy lifestyle is key: avoid high-sugar foods, smoking, and drinking in excess. Try to minimize the stress in your life. And exercise regularly! While previous generations used to only prioritize family, work and success, remember that health and overall wellbeing are also important.
 
*Based on an interview of Dr. Achirawin Jirakamolchaisiri by Masala in June 2022.