UHS Medical Times: December 2015

UHS Medical Times 1

e-newsletter | December 2015

AT THE HEART OF HEALTH

Statistics indicate that one in four deaths in the UAE every year occurs due to a condition that falls within the spectrum of heart disease. Cardiovascular diseases such as coronary artery disease (CAD), stroke, hypertension, heart failure, disturbances in the heart and cardiomyopathy are on the rise due to sedentary lifestyles, poor nutrition and obesity. The focus of this year’s World Heart Day in September was creating heart-healthy environments and ensuring that people are able to make heart-healthy choices wherever they live and work.

University Hospital Sharjah opens new Interventional Cardiology Centre to treat growing number of heart disease patients

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e-newsletter |December 2015

About Interventional Cardiology Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. It involves using sophisticated x-ray equipment to specially look for blocked or narrow arteries which can cause chest pain or heart attack. The main advantages of using the interventional cardiology approach are the avoidance of the scars and pain, and long post-operative recovery.

Interventional cardiology procedure of primary angioplasty is now the gold standard for management of acute myocardial infarction. It involves uses of balloon to widen a blocked or narrowed artery and the inserting a stent to keep the blood vessel open. Narrowed arteries produce ischemia, reducing the blood supply to the heart.

Interventional cardiologists at UHS treat blockages in coronary arteries in the catheterization lab.

About Catheterization Laboratory (Cath Lab) The Cardiac Catheterization Laboratory, or Cath Lab, uses the latest technology to help treat emergency patients in the midst of a heart attack as well as short-stay patients undergoing diagnostic or therapeutic procedures.

At UHS our team of cardiologists, technicians and nurses knows that time is of the essence when treating heart attack. To diagnose and treat patients, they use our advanced state-of-the-art catheterization lab, which is the insertion of a catheter into a chamber or vessel of the heart to diagnose and treat heart problems in the coronary arteries or in the chambers and valves of the heart. This procedure helps cardiologist treat heart disease by measuring vital information about the heart, blood pressure, blood oxygenation, level of artery blockage and the functioning of the heart muscle and valves. Restoring coronary blood flow in this way helps many patients to avoid open-heart surgery.

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e-newsletter | December 2015

In addition, UHS cardiologists can now perform catheterization procedures through the wrist. This is called radial catheterization since it involves the radial artery.

Most catheterization laboratories are "single plane" facilities, those that have a single X-ray generator source and an image intensifier. But UHS has the latest digital cath labs are biplane (have two X-ray sources) and digital, flat panel labs, enabling us to get a more accurate and detailed view of the heart.

Using the Cath Lab, UHS’s cardiologists are able to perform: Coronary Angiography or Coronary catheterization Coronary Angioplasty or Percutaneous coronary intervention / PCI Closure of some congenital heart defect Treatment of stenotic heart valves Permanent and temporary pacemaker implantations Electrophysiological studies such as AV node ablation Rotablation of heavily Calcified vessles Left and right Sided pressure studies Radiofrequency Catheter Ablation

Non-Invasive Cardiovascular Diagnostic Imaging Non-invasive cardiologists provide diagnostic testing and imaging to help diagnose disorders of the heart. These tests are usually performed on an outpatient basis. They include: Echocardiograms.

Exercise Stress Tests including the Dobutamine Echo Stress Tests.

Cardiac CT. Holter Monitor and Loop Monitor Tests.

Peripheral Vascular Ultrasound.

Tests and Imaging studies include Stress Tests, Echocardiography, Computed Tomography Angiography (CTA), and Magnetic Resonance Ivmaging (MRI).

UHS integrated cardiac care unit, has earlier introduced new technologies using EPIQ7 to provide imaging of the heart valves and blood vessels, enabling cardiologists and surgeons make an accurate diagnosis and administer the appropriate medication, allowing for significant cuts in diagnostic cost, quicker diagnosis, and accelerated recovery.

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e-newsletter | December 2015

EPIQ7 can be also used for other tests such as the intracardiac endoscopic tests for 3D heart imaging. It can be via the mouth, using local anaesthetic, into the oesophagus for close imaging to the heart. This technology gives detailed information about the heart valves, especially the mitral valve prolapse, and is very helpful in preparation for mitral valve repair procedures.

The new device provides other important medical services such as providing a thorough study of myocardial stress using chemical drugs to closely identify cardiac ischemia, by administrating drugs that chemically induce strain in the heart to patients who are unable to exercise. This procedure helps in measuring the rate of insufficiency. The test accuracy can be increased by the new technologies, which is ideally suited for elderly patients and those who have other diseases and are not candidates for a Cardiac Stress Test.

University Hospital Sharjah also offers a cutting edge Cardiovascular X-ray CT Scan, the only of its kind in Sharjah City, which gives clear pictures of the interior of coronary arteries. This safe and non-invasive procedure is a great alternative to coronary angiogram or cardiac catheterisation, which is not always recommended for middle aged patients or low to medium risk patients.

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e-newsletter | December 2015

Multi-slice Computed Tomography (CT Scan) Device It is an advanced Computed Tomography device that offers good insight on heart arteries and calcium content in the body, via giving multiple images in multiple layers in the body. These images help detect the presence of certain diseases, as well as identify the stage of the disease. It is especially helpful in diagnosing diseases in the internal organs.

Calcium scoring gives the doctor a good idea about the degree of calcification in coronary arteries, which are the vessels responsible for delivering oxygen to the cardiac muscle. This helps in the diagnosis of sclerosis. Sclerosis presence gives rise to high risk of heart attack, and if gone untreated, could lead to complete shutdown of blood supply to the heart. This causes what we call angina pectoris, which can lead to heart attack.

The device is capable of showing the condition of coronary arteries without catheterization. It is non-invasive and quite accurate in diagnosing sclerosis, especially with the help of the colored material used with the scan.

This test is especially helpful when other tests such as ECG are not decisive of the condition. Moreover, CT scans are helpful in assessing progress after lateral coronary shunts to avoid circulation shut down.

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e-newsletter | December 2015

MEET OUR DOCTORS

QUALIFICATIONS Dr Seif is a graduate of college of medicine in Alexandria University, Egypt, from where he also achieved his MD in Cardiology. He had obtained his MRCP from Royal College of Physicians (Edinburg University, UK), Saudi Board in Cardiology, Arab Board in Cardiology, American Board certified in Echocardiography after completed his Echocardiography training from National Board of Echocardiography, USA in 2009 and lastly FRCP (Edinburg University, UK).

EXPERIENCE Dr Seif expertise extends for more than 28 years of medical experience and worked in several eminent hospitals in Egypt and Saudi Arabia like Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. He joined University Hospital Sharjah (UHS) from North West Armed Forces Hospital Saudi Arabia, were he was associated as Consultant Non Invasive Cardiologist.

Dr. Mohamed Seif

Dr Seif has extensive experience in the management of various cardiovascular diseases such as hypertension, dyslipidemia, coronary artery disease, congenital heart diseases, heart failure, rheumatic heart diseases, ischemic heart disease, valvular heart diseases and preoperative risk evaluation. His clinical practice focuses on cardiac imaging, his interests include all aspects of Adult Cardiology and he takes an active role in providing advice and treatment for the entire range of cardiology conditions as well as skilled procedures.

MD, MRCP

Dr. Seif has gained experience in dealing with various diagnostic maneuvers, he is fully trained in Echocardiography including transthoracic ,transesophageal and Dobutamine stress echocardiography, Treadmill exercise stress test, Holter monitoring, Ambulatory 24 hours BP monitoring, CT Coronary Angiography as well as invasive diagnostic tools including coronary angiography and cardiac catheterization.

Dr Seif has presented scientific papers in various national and international forum.

SPECIAL INTEREST Coronary Artery Disease and Heart Failure Cardiac Imaging (Echocardiography, TOE, Cardiac CT) Exercise Stress Testing and Dobutamine Stress Echocardiography Management of Hypertension Assessing Diabetic Patients for Heart disease Heart Valve Disease Pregnancy and Heart disease Interdisciplinary Care of Patients with Risk Factors for Heart Disease

LANGUAGE KNOWN Fluently bilingual English/Arabic.

Consultant Cardiologist

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e-newsletter | December 2015

QUALIFICATIONS Dr. Ousama Mahdi is a German Board-Certified Interventional Cardiologist. He obtained his specialty in Internal Medicine (Fachartzt) and later in Cardiology (Fachartzt) from University Hospital Homburg/Saar, Germany after earning his graduation from Damascus University, Syria He completed his residency in Cardiology from University Hospital Homburg, Saar, Germany.

EXPERIENCE Dr. Ousama Mahdi has extensive experience of 25 years as Interventional Cardiologist and has pioneered the primary percutaneous coronary intervention (PCI) in acute myocardial infarction in Syria since the year 2000 and in Fujairah (UAE) since 2013. He was the first to institute the 24/7 service for interventional management of acute myocardial infarction in the whole Syrian state and in Fujairah; and that is what he is offering now in University Hospital Sharjah.

Dr. Ousama Mahdi MD Cardiology, Facharzt (University Hospital Homburg/Saar) Facharzt (German Board) in Interventional Cardiology

Dr. Ousama has performed more than 20 thousand cases of coronary intervention for both diagnostic and therapeutic purposes over his career; 5 thousand of which were through radial artery access allowing home discharge after one hour from procedure (60% of patients couple of hour after PCI ). He worked as a Senior Specialist of Cardiology/Intervention in Eppendorf Hamburg University Hospital from 1988 to 1999. After that, he was upgraded to the position of "Consultant"from 1999 onwards. He practiced in his field of expertise in Germany, Syria and United Arab Emirates (mainly Fujairah Hospital).

Prior to joining the UHS, Dr. Ousama was the head of Interventional Cardiology Department in Al-Basel Heart Center for 3 years (from 2000 to 2003) and Dar Al-Shifa Hospital for 10 years (from 2003 to 2013); both hospitals are located in Damascus, Syria.

Dr. Ousama Mahdi is an active member of the European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Society of Cardiology (ESC), German Society of Cardiology, Syrian Society of Cardiology and Emirates Group of Interventional Cardiologist.

SPECIAL INTEREST Primary Percutaneous Coronary Intervention (PCI) in Acute Myocardial Infarction Complex Coronary Intervention Intervention Forchronic Total Occlusion (CTO) Coronary Angiography through Radial Artery Access Peripheral Vascular Intervention

LANGUAGE KNOWN Arabic, English, and German

Consultant Interventional Cardiologist

QUALIFICATIONS Al Nooryani is a graduate of the College of Medicine and Medical Sciences (ULM-Germany). He is German Board certified in Internal Medicine and Cardiology.

EXPERIENCE Dr. Arif Al Nooryani is an expert interventional cardiologist with a large experience in coronary stenting, peripheral vascular interventions and treatment of structural heart disease including TAVI and Mitral Interventions. Apart from being the special advisor and senior interventional cardiologist at UHS, Dr. Al Nooryani is Consultant Interventional Cardiologist and Chief Executive Office & Head of Cardiology at Al Qassimi Hospital Sharjah, where he has established and structured the Invasive Cardiology Unit where more than 14,000 heart patients have undergone Various Invasive Procedures including Diagnostic coronary angiograms, a wide range of complex percutaneous coronary interventions, primaries (> 600 cases), temporary- and permanent pacemaker implantations, pericardiocentesis, ICD- and CRT device implantations, peripheral artery interventions, Ablation therapy including AF ablation.

He has travelled extensively locally and internationally presenting papers, delivering lectures, international researches, workshops and as principal investigator for various studies.

SPECIAL INTEREST Trans Catheter Aortic Valve Implantation (TAVI).

Left Atrial Appendage (LAA).

Renal Derivation.

Peripheral Arterial Disease (PAD).

Coronary Chronic Total Occlusion (CTO).

Bioresorbable Vascular Scaffold (BVS).

LANGUAGE KNOWN Arabic, English and German

He is recipient of Sheikh Hamdan Excellence Award for Medical Service in 2011-2012 and Pride of Nation, UAE in 2012 and Sheikh Rashid Excellence Award for Scientific Achievements in 2004.

Dr Arif Al Nooryani German Board Certified Cardiologist (ULM- Germany)

Senior Consultant Interventional Cardiologist

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