Our Services

 

Tests

Miranda Cardiology offers a wide range of tests to assess your cardiac health, and is able to provide expert and timely advice regarding treatment and/or procedure options. Our tests include:

 

Clinical Consultations

During a consultation at Miranda Cardiology, your cardiologist will discuss any symptoms and your medical history as well as perform a physical examination. Your cardiologist will discuss an appropriate management and/or treatment plan according to your diagnosis. 

 

Echocardiography

Echocardiogram (often simply referred to as an echo) is a sonogram of the heart. Echocardiography uses two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart. Miranda Cardiology performs Transthoracic Echocardiograms. 

 

Electrocardiography (ECG)

An ECG is a test used to detect cardiac abnormalities by measuring the electrical activity generated in the heart as it contracts. An ECG is performed by placing electrical sensors onto the chest which produces a recording of the heart's electrical activity.

 

Exercise Stress Echocardiography

Exercise Stress Echocardiography is a test conducted by your cardiologist to measure the performance and capacity of the heart, lungs and blood circulation during exercise. This test is used in the diagnosis and monitoring of coronary artery disease and cardiac arrhythmia, and involves using electrocardiogram, echocardiogram, blood pressure and symptom monitoring during exercise on a treadmill. 

 

Procedures

Our cardiologists are highly-trained surgeons and can perform a wide range of cardiac procedures, including:

 

Coronary Angiography

Coronary Angiography is the most accurate test used to assess the coronary arteries. This test is performed under local anaesthesia with sedation and is a day-stay procedure in hospital. A coronary angiograph involves the insertion of a cathater (small tube) into the groin or wrist, which is then navigated through the blood vessels until it reaches the heart. Radiographic contrast dye is then injected and X-ray images are obtained to assess the arteries. 

 

Coronary Stenting

Coronary angioplasty is a procedure used to open clogged arteries. This procedure involves temporarily inserting and inflating a tiny balloon into the clogged artery to widen it up. Angioplasty is often combined with the permanent placement of a stent (small wire mesh tube) to help keep the artery open and decrease its chance of narrowing again. Angioplasty can effectively improve symptoms associated with blocked arteries, such as shortness of breath and chest pain. This procedure can also be used during a heart attack to quickly open a blocked artery and reduce the amount of damage caused to the heart. 

 

Pacemaker Implantation

A pacemaker is a small, sealed metal and plastic device which contains a battery and electronic circuits. The device is connected to your heart by one or more wires (called leads). These leads are passed along a blood vessel to your heart and the pacemaker box is usually implanted under the skin in your upper chest, near your collarbone. The pacemaker can monitor your heart and produce electrical impulses to treat abnormal heart rhythms. The procedure to implant a pacemaker is usually quick and performed under local anesthesia.

 

ICD Implantation

ICD stands for Implantable Cardioverter Defibrillator. It is made up of a small box-shaped device which contains a battery and electronic circuits. The device is connected to your heart by one or more wires which are passed through a vein to your heart. The ICD box is usually implanted under the skin or muscle in your upper chest, near your collarbone. The ICD can recognise and monitor your heart rhythm and can deliver various electrical treatments if needed. The procedure will either be performed under a general anaesthetic or you will be given sedation.

 

Loop Recorder Implantation

Your cardiologist may have referred you for an implantable loop recorder (ILR). This may be because you have been having symptoms such as dizzy spells, black-outs or palpitations that may be caused by an abnormal heart rhythm. An ILR is a small metal device that is placed under the skin usually close to the breastbone. It continuously monitors the heart’s activity and can remain in place for up to 3 years. If you experience any symptoms you hold a hand held activator over the device and record the event which will be stored. These events can then be analysed by your cardiologist to see if an abnormal heart rhythm was the cause of the symptoms. Some ILRs allow you to send the recording to the ECG department by holding the activator over the phone. This will allow the doctors or technicians to look at the recording and take action if necessary. You will be advised on the day of your procedure about the type of ILR you have had implanted and how to use it.

 

Electrophysiology Studies

An electrophysiology study (EPS) is a detailed evaluation of the electrical activity in your heart. Cardiac catheters and computers are used to create electrocardiogram (ECG) tracings and electrical measurements from inside your heart. During the test, your cardiologist may safely reproduce your abnormal heart rhythm, then give you medications to see which one best controls the rhythm. Your doctor may recommend an EP study when other tests, such as a standard ECG, Holter monitor, event recorder, stress test, echo or angiogram cannot provide enough information to thoroughly evaluate your abnormal heart rhythm.The procedure is performed in an electrophysiology laboratory under controlled clinical circumstances and usually takes about an hour.

 

Atrial Septal Defect Closure

An atrial septal defect (ASD) is an abnormal hole between the two top chambers of the heart usually present since birth. It is a form of congenital heart disease and can eventually lead to heart failure if left untreated. Closure of the ASD may be recommended to reduce the chance of heart failure. This can be performed either with open heart surgery or with keyhole techniques. 

 

Left Atrial Appendage Closure

The left atrial appendage is a small pocket protruding from the side of the left atrium, one of the upper chambers of the heart. In patients with certain heart rhythm disturbances, blood clots can form in the atrial appendage, and if the clot moves it can then cause stroke or other problems in the body. If a patient is unable to be treated with blood-thinning medication, another alternative is to close the left atrial appendage so clots cannot escape. Closure can be performed as a keyhole technique under general anaesthesia and patients usually spend one night in hospital. 

 

Rotablator Rotational Atherectomy

Blockages in the coronary arteries can cause symptoms such as chest pain and breathlessness and can increase the risk of heart attack. Sometimes part of the process in forming the blockage involves calcium being deposited in the arterial wall. Calcium is rigid and can prevent successful treatment with standard techniques such as coronary stenting. Rotablator treatment involves passing a small device into the coronary artery via a catheter introduced via the wrist or groin. The Rotablator rotates at very high speed and can remove calcification from the arterial wall. Following this the artery is usually treated with a stent.

 

TAVI

Transcatheter Aortic Valve Implantation (TAVI) is used to treat severe Aortic Stenosis, a condition in which the aortic valve becomes narrowed, obstructing the outflow of blood from the heart and thereby requiring the heart to work harder to pump blood around the body.The procedure involves implantation of an artificial heart valve designed to be inserted into your heart so that it holds open and replaces your diseased aortic valve. It consists of a metal stent which secures the device in its intended position inside your own valve, and valve leaflets to direct the flow of blood out of your heart.TAVI now offers effective treatment to patients who are at high risk for conventional open heart surgery. It is also intended to prevent further damage to the heart from Aortic Stenosis and to prolong life, which medical therapy cannot do.

 

Renal Denervation

Renal sympathetic denervation (RSDN), or renal denervation (RDN), is a minimally invasive, endovascular catheter based procedure using radiofrequency ablation or ultrasound ablation aimed at treating resistant hypertension (high blood pressure not controlled by medication). Catheter-based interventional strategies that interrupt the renal sympathetic nervous system have shown promising results in providing better blood pressure control in patients with resistant hypertension.