How Aadicura Is Transforming Cardiac Care So That Patients Don't Miss a Beat

This World Heart Day, the World Heart Federation's global campaign carries a simple message: Don't Miss a Beat!

It's a warning about hidden symptoms such as the fatigue dismissed as overwork, the breathlessness blamed on fitness, the chest tightness written off as acidity and if left unexamined can turn into cardiac emergencies.

At Aadicura Superspeciality Hospital, doctors say that gap is already visible in their own clinic. Over the past few years they've watched heart disease arrive in patients who, by the old assumptions about age and risk, shouldn't be showing up in a cardiology clinic at all.

The Symptom-Delay Problem

Aadicura's cardiology OPD is witnessing noticeably younger patient base with growing frequency, a shift they attribute to lifestyle, stress and dietary changes rather than any single cause.

A large share of the patients we see in OPD have had symptoms for weeks before they come in. Someone will tell you they've been more breathless on the stairs for a month, or they've had a dull ache in the chest they've been managing with antacids. That gap between when the heart sends a signal and when someone acts on it is where we lose the most ground”, says Dr. Nirav Panchani, Interventional Cardiologist at Aadicura.

The gap is wider than textbook chest pain suggests. In people with diabetes, in women and in patients above 60 a heart problem often presents without the classic crushing pain and is often occurs as unexplained tiredness during routine work, a sense of fullness in the upper abdomen, belching or nausea that looks like indigestion.

“Treating those symptoms as acidity without an ECG, an echocardiogram or a treadmill test, is how early heart disease gets missed. Any of these tests can be done in a single visit and none of them is invasive”, says Dr. Darshan Mevada, Interventional Cardiologist at Aadicura.

Aadicura's cardiology department runs on advanced Philips catheterisation labs equipped with Intravascular Ultrasound (IVUS) and Fractional Flow Reserve (FFR), an imaging technology that lets cardiologists see not just whether an artery is blocked but also tells the severety and whether a blockage that looks borderline on a standard angiogram is functionally significant enough to need intervention. FFR measures the pressure drop across a narrowing; a reading above 0.8 generally means the artery is still supplying the heart adequately and a stent can be avoided. IVUS is used after angiography and images the vessel wall from inside and helps the operator choose the right stent size and confirm it sits properly against the artery.

The approach is deliberately conservative. The department's stated position is to follow current international guidelines and avoid procedures that are not warranted a stance that FFR makes measurable rather than rhetorical.

“An angiogram shows a shadow, FFR tells us whether that shadow is actually starving the heart. Some of the most useful decisions we make end with no stent at all”, says Dr. Darshan Mevada, Interventional Cardiologist.

Around the cath labs sits a full non-invasive diagnostic layer: colour Doppler echocardiography, transoesophageal echo for valve and clot assessment, treadmill and dobutamine stress tests, 24-hour Holter and ambulatory blood pressure monitoring, and a head-up tilt table test for patients whose fainting has no obvious cause. Paired with a dedicated electrophysiology service — EP studies, radiofrequency ablation for arrhythmias, and a device follow-up clinic for pacemaker and defibrillator patients — the department is built to catch the full range of things that go wrong with a heart, not just blocked arteries.

When Surgery is the answer

Dr. Apurv Vaidya is one of a shrinking number of Indian surgeons who still operates on both the heart and the lungs, a dual specialisation the field has seen fewer surgeons pursue as cardiac and thoracic surgery have professionalised into separate tracks elsewhere. His team performs the full range of coronary artery bypass techniques including beating-heart (off-pump) CABG, minimally invasive approaches, and total arterial grafting alongside valve repair and replacement, aortic surgery, and pericardial surgery. The Limca Book of Records recognised his removal of a 9.5 kg chest tumour as a new national record.

“A cardiologist and a surgeon aren't in competition for the same patient rather we are two stages of the same decision. My job starts where a cath lab's options ends, i.e. when a blockage is too diffused for a stent, when a valve has degenerated past repair, when the safest path for a patient is a bypass rather than a second angioplasty”, says Dr. Apurv Vaidya, Cardiothoracic Surgeon.

Every case at Aadicura where a surgery was performed involved specialists from every field so that every due caution is taken before surgery is performed after exhausting all the options.

“Patients often arrive afraid of the word 'surgery'. What changes their mind is seeing that the decision was taken jointly, on the same angiogram, and that the operation is the safer route for them and not the last resort”, says Dr. Chaitya Shah, Cardiothoracic Surgeon.

One Team, One File

“In borderline cases, where angioplasty is possible but a bypass may be the better long-term option, I'd rather have a surgeon's opinion before deciding. Having a surgeon look at the same angiogram changes what we recommend”, says Dr. Arpan Desai, Interventional Cardiologist.

"This teamwork continues after surgery too. Aadicura's Cardiac Care Unit and Cardiothoracic Care Unit work together so that patients recover under the same team that treated them rather than a new one that has to start from scratch

Beyond the Blocked Artery

Some conditions that traditionally meant an operation can now be managed without one. Holes in the heart present from birth  atrial and ventricular septal defects and a patent ductus arteriosus  can be closed through a catheter in suitable patients, and rhythm disorders are treated with single and dual-chamber pacemakers, implantable defibrillators and biventricular pacemakers for chronic heart failure.

Aadicura's cardiology and cardiothoracic surgery services sit within a wider multi-specialty hospital offering advanced diagnostics, a dedicated physiotherapy and rehabilitation department and structured wellness and health-screening programmes. Outreach clinics in Dahod, Godhra, Anand, Bharuch, Bodeli, Lunawada and Surat/Valsad feed patients from across the region into the Vadodara cath labs and operating theatres.

For Vadodara, that's what 'Don't Miss a Beat' looks like in practice at Aadicura: a cardiologist and a surgeon working from the same file, so a patient's heart problem is caught and treated without losing time moving between doctors."

For more details - https://aadicura.com/