Cardiology

The Department of Cardiology at Ankara Güven Hospital provides uninterrupted healthcare services to our patients 24/7. All necessary clinical examinations, diagnostic evaluations, and laboratory investigations required for the diagnosis and treatment of patients with cardiovascular diseases are performed both in our outpatient clinics and inpatient wards.

Our department continues to deliver comprehensive cardiovascular care through individualized treatment plans and long-term follow-up programs tailored to all types of cardiac conditions, particularly those commonly observed in the general population, such as cardiac disorders and rhythm abnormalities associated with hypertension and hypercholesterolemia. Our physicians develop and implement condition-specific treatment protocols for hypertension, hyperlipidemia, and cardiac rhythm disorders in accordance with current medical standards.

CARDIOLOGICAL DIAGNOSTIC METHODS

What is an ECG?

An ECG (Electrocardiography) is one of the most frequently used diagnostic tests in cardiology. It records the electrical activity of the heart through adhesive electrodes placed on the chest wall, arms, and legs. ECG plays a crucial role in evaluating the cardiac conduction system and is particularly important in the diagnosis of myocardial infarction. In addition, it can be used to detect chamber enlargement, thickening of the heart muscle, and conditions in which the heart receives insufficient blood supply due to coronary artery narrowing (ischemia).

How is an ECG Performed?

During the ECG procedure, a nurse or qualified healthcare professional places 10 electrodes on the patient’s body to obtain the recording. The procedure is painless. Although the recording itself takes only seconds, the entire process, including preparation and completion, may take approximately 10 minutes. Male patients with excessive chest hair are advised to shave the chest area prior to the test to prevent discomfort during electrode removal.

What is a Holter Monitoring Device?

Similar to an ECG, a Holter monitoring device evaluates the electrical activity of the heart. Unlike a resting ECG, which records data for only a few seconds, Holter monitoring records continuously for 24 to 48 hours. The battery-operated device is attached and removed in our outpatient clinic and is frequently used in patients with suspected or known cardiac arrhythmias.

How is Holter Monitoring Applied?

• Prior to device placement, electrodes are attached to the chest wall by a nurse.

• The patient is informed about the use of the device.

• Patients are advised to continue their normal daily activities during the recording period.

• Showering or bathing is not recommended, as it may detach the electrodes.

• Patients should avoid high-voltage lines, MRI devices, and microwave ovens.

• If symptoms occur during the recording, the patient should press the event button on the device to correlate symptoms with rhythm abnormalities.

• The device is removed at the hospital after 24 or 48 hours.

• Holter recordings are evaluated by a cardiologist.

• The report is delivered to the referring physician within 24 hours, depending on workload.

What is an Event Recorder?

An event recorder is another device used to assess the heart’s electrical activity, particularly in patients with intermittent arrhythmias. The battery-operated device is worn for 4–5 days. Patients are instructed to press the device button when symptoms occur, allowing the device to store the cardiac rhythm at that moment.

How is an Event Recorder Applied?

• Electrodes are placed on the chest wall by a nurse before device attachment.

• The patient receives instructions on device usage.

• Normal daily activities may be continued.

• Showering or bathing is not recommended.

• Patients should avoid strong magnetic fields and high-voltage sources.

• When symptoms occur, the recording button should be pressed.

• The device is removed at the hospital after 4–5 days.

• Recordings are evaluated by a cardiologist.

• The report is delivered to the physician within 24 hours, depending on workload.

What is an Exercise Stress ECG?

Unlike a resting ECG performed in a lying position, an exercise stress ECG records cardiac activity while the patient is standing and exercising. A treadmill is used in our clinic. This test is primarily used for the diagnosis of coronary artery disease. By increasing the heart’s workload through exercise, the presence of symptoms such as chest pain and ECG changes suggestive of coronary disease are evaluated. It may also be used to provoke arrhythmias or assess cardiac valve disease under stress.

How is an Exercise Stress ECG Performed?

• Patients are advised to wear comfortable clothing suitable for exercise.

• Except for water, no food or drink should be consumed for 4 hours prior to the test. Caffeinated beverages should be avoided for 12 hours beforehand.

• Patients with known heart disease should inform their physician about current medications and receive guidance on which medications should be discontinued.

• Before starting, a resting ECG, heart rate, and blood pressure are recorded.

• The patient begins walking on a slowly moving treadmill; speed and incline are increased every 2–3 minutes.

• Heart rhythm is continuously monitored, and blood pressure is measured regularly.

• Patients should immediately report symptoms such as chest, back, or arm pain; shortness of breath; dizziness; fainting; or excessive fatigue.

• After peak exercise, a 1–2 minute active recovery phase is completed.

• Exercise duration ranges from 3–4 minutes to 12–15 minutes, depending on capacity.

• The total test duration is approximately 30 minutes.

What is Ambulatory Blood Pressure Monitoring?

Ambulatory Blood Pressure Monitoring (ABPM) is used in patients suspected of hypertension or to assess the effectiveness of antihypertensive therapy. Blood pressure is measured using an arm cuff over a 24-hour period. The device records measurements every 30 minutes during daytime and hourly at night.

How is Ambulatory Blood Pressure Monitoring Applied?

• Device placement and removal are performed by nursing staff in the cardiology clinic.

• The first measurement is taken together with healthcare personnel.

• Showering, bathing, swimming, and sea activities are not permitted.

• The patient should keep the arm still and at heart level during measurements.

• Measurements continue during sleep; discomfort should be reported to the physician.

• The device is removed after 24 hours.

• Results are evaluated by a cardiologist, and the report is delivered within 10–20 minutes, depending on workload.

What is Echocardiography (ECHO)?

Echocardiography is a painless, radiation-free imaging test that uses ultrasound waves to visualize the heart. It provides valuable information about heart size, chamber function, wall thickness, and valve structure. It is one of the most commonly used diagnostic tools in cardiology alongside ECG. Coronary arteries are not directly visualized with this test.

How is Echocardiography Performed?

• The patient is asked to undress from the waist up.

• The examination is performed by cardiology specialists.

• The patient lies on the left or right side, depending on the physician’s preference.

• Ultrasound gel is applied to the chest, and images are obtained using a probe.

• Cardiac images can be viewed on the monitor throughout the procedure.

• The report is delivered within 15–20 minutes, depending on workload.

What is Transesophageal Echocardiography (TEE)?

Transesophageal Echocardiography (TEE) is an ultrasound-based imaging technique similar to endoscopy. After sedation, a specialized probe is inserted through the mouth into the esophagus to obtain high-resolution images of the heart. TEE is particularly useful for evaluating intracardiac thrombi, septal defects, prosthetic valves, and valve infections when standard echocardiography is inconclusive.

How is TEE Performed?

• Patients must fast for at least 4 hours before the procedure.

• An intravenous line is established.

• Throat anesthesia is applied using a spray.

• Sedation is administered to induce sleep.

• The probe is inserted into the esophagus, and imaging is performed for 10–15 minutes.

• Patients are monitored until fully awake.

• Driving is not recommended on the day of the procedure, and alcohol should be avoided for 1–2 days.

What is Dobutamine Stress Echocardiography (DSE)?

Dobutamine Stress Echocardiography is used in patients with suspected coronary artery disease who are unable to undergo exercise testing. Dobutamine is administered intravenously to increase heart rate and workload. Resting and stress images are compared to assess coronary artery disease, cardiac function, and valvular conditions. ECG and blood pressure are monitored throughout the test.

How is Dobutamine Stress Echocardiography Performed?

• Patients must fast for at least 4 hours prior to the test.

• Caffeine-containing products should be avoided for 24 hours.

• Certain cardiac medications must be discontinued as advised by the physician.

• An IV line is established, and continuous ECG, blood pressure, and echocardiographic monitoring is performed.

• Patients may experience warmth, headache, or palpitations during the infusion.

• Symptoms such as chest pain, shortness of breath, dizziness, or fainting should be reported immediately.