Cardiology directorate

The cardiology directorate has an unrivalled international reputation for innovation and research; and utilizes the most sophisticated techniques and equipment in detecting and treating all forms of heart disease. The center for all Northern Ireland's cardiac surgery procedures, the directorate leads world trends in combating coronary heart disease, with developments such as use of the Xenos multi-wire camera- originally designed for use for American astronauts at NASA, the portable defibrillator and body surface mapping in ischaemic heart disease.

Their remit is adult and paediatric cardiology - the regional medical cardiology centre (RMCC) - and cardiac surgery

The regional medical cardiology centre

RMCC provides care for approximately 4000 inpatients per year with the mobile coronary care unit handling some 800 callouts. The unit has 66 beds, 10 of which are coronary care beds.

A wide range of cardiac patients are facilitated in these beds:

Cardiac clinical investigations

The main areas serviced by this dept are:

Ultrasound

Approx 5000 echocardiograms (both inpatient and outpatient) are performed each year by this dept on adult patients.

The full range of cardiac conditions i.e. congenital, ischaemic and valvular are investigated using 2D imaging, M mode, pulsed and continuous wave doppler and colour flow mapping, doppler tissue imaging and TOE.

Nuclear cardiology

This area also includes stress testing both exercise and pharmacological. The nuclear room is equipped with a dual headed gamma camera and performs approx. 926 myocardial perfusion imaging (MPI) scans per year and approx 150 gated scans.

Myocardial perfusion imaging scans

The patient is required to perform an exercise test during which at peak exercise Thallium 201 is injected. This isotope concentrates in the myocardium in proportion to the level of muscular activity and myocardial blood flow present. It is injected during exercise because the increased heart rate ensures a better 'take up' of the isotope.

Gated blood pool scan

The patient is connected to an ECG , injected with stannous pyrophosphate which labels red blood cells. After 20 minutes a radioisotope 99m sodium pertechnetate is injected. This isotope attaches to the stannous pyrophosphate, the blood cells then become radioactive and may be imaged under the gamma camera. The computer divides one complete cardiac cycle in 16 equal time segments and takes a picture of these for every heart beat, runs the pictures consecutively to display a moving cardiac image. From this ventricular function may be measured.

Exercise stress testing

There are two stress testing exercise rooms in this area. Stress testing is used for the assessment of cardiac patients using a treadmill, bicycle or pharmacological testing.

Reasons for stress testing:

Rapid access chest pain clinic

The rapid access chest pain clinic was established in 1999. The clinic enhances the management of patients with recent onset chest pain. The chest pain clinic provides a rapid 'one-stop' assessment of the patient with the majority of patients seen, diagnosed and subsequent management decided in a single clinic attendance.

Cardiac catheterisation

The cardiac catheterisation Suite has three fully equipped Cath theatres performing the full range of adult and paediatric invasive investigations and interventional. Techniques including:

The theatres are equipped to perform single and biplane angiography pressure measurement, blood gas analysis, oximetry and cardiac outputs.

Paediatric cardiology

Children's Clark Clinic (CCC) is an 8-bedded unit in the Royal Belfast Hospital for Sick Children (RBHSC) providing inpatient care for children with cardiac conditions. Children undergoing cardiac surgery spend a short time in the cardiac surgical intensive care unit (CSICU) following surgery and are then transferred back to CCC.

The full range of Non Invasive cardiological investigations carried out within the Children's hospital include:

Cardiac surgery

Our cardiac surgery unit is comprised of 26 inpatient beds, 3 cardiac theatres and 13 intensive care/high dependency beds (further extension is planned). We undertake cardiac surgery in both children and adults. The cardiac surgery team includes surgeons, nursing staff, anaesthetists, cardiac technicians, perfusionists and secretarial staff. We aim to carry out 1000 cardiac surgery operations per annum.