Coronary Angiography (CAG) is a specialized diagnostic procedure used to visualize the coronary arteries — the blood vessels that supply the heart muscle. It helps detect blockages, narrowing, or abnormalities in the arteries that may cause chest pain, heart attacks, or other cardiac conditions. What is CAG? CAG is performed using a contrast dye and X-ray imaging (fluoroscopy). A thin, flexible catheter is inserted through the wrist or groin artery and guided to the coronary arteries. Once the contrast dye is injected, X-ray images are taken to show the flow of blood through the coronary vessels. When is Coronary Angiography recommended? Chest pain (angina) or tightness Positive stress test or abnormal ECG Suspected or confirmed heart attack (MI) Coronary artery disease risk in diabetic or high-risk patients Prior to angioplasty (PCI) or cardiac surgery What does it reveal? Location and severity of arterial narrowing or blockage Condition of the heart chambers and valves Need for further intervention such as angioplasty or bypass surgery Procedure Highlights Minimally invasive, typically done under local anesthesia Takes about 20–30 minutes Most patients are discharged the same or next day Performed in a dedicated Cath Lab by expert interventional cardiologist Dr.Chetan Jain

CHIP Angioplasty refers to complex, high-risk coronary interventions performed in patients with severe or advanced heart disease who are not ideal candidates for routine angioplasty or surgery. What is CHIP Angioplasty? CHIP stands for Complex High-Risk Indicated Percutaneous Coronary Intervention. These procedures are done in critically ill, elderly, or high-risk patients who often have: Severely calcified arteries Multiple blockages or left main disease Poor heart function (low ejection fraction) History of failed bypass surgery (CABG) or inoperable disease Chronic total occlusion (CTO) of coronary arteries What makes it different? CHIP angioplasty goes beyond standard procedures by using advanced tools and techniques, such as: Rotational atherectomy (ROTA) Intravascular Lithotripsy (IVL) Intravascular Ultrasound (IVUS) Mechanical circulatory support (e.g., Impella, IABP) if needed Benefits: Offers life-saving treatment to patients deemed too high-risk for surgery Provides a less invasive option compared to bypass surgery Improves quality of life and heart function in patients with limited options

Congenital Heart Disease – Pediatric Overview Overview Congenital heart disease (CHD) refers to structural abnormalities in the heart present from birth. These defects can vary from mild (requiring only observation) to severe (requiring intervention). Treatment and follow-up depend on the specific defect and its impact on heart function. Types of Congenital Heart Defects Atrial Septal Defect (ASD) Ventricular Septal Defect (VSD) Patent Ductus Arteriosus (PDA) Pulmonary or Aortic Valve Stenosis Coarctation of the Aorta Ebstein’s Anomaly Single Ventricle Defects (e.g., Hypoplastic Left Heart Syndrome) Tetralogy of Fallot Total Anomalous Pulmonary Venous Connection (TAPVC) Transposition of the Great Arteries (TGA) Symptoms Symptoms vary by defect but may include: Breathing difficulties Poor feeding and growth Fatigue Cyanosis (bluish skin) Frequent respiratory infections Heart murmur Causes Most congenital heart defects arise from unknown causes, though genetics and environmental factors during pregnancy (e.g., infections, medication use, or maternal conditions) may play a role. Diagnosis Echocardiography (ECHO) Electrocardiogram (ECG) Chest X-ray Cardiac MRI or CT Cardiac catheterization Treatment Treatment depends on the severity and type of defect: Observation: For small, asymptomatic defects Medication: To control symptoms or stabilize the patient before surgery (e.g., diuretics, digoxin, prostaglandins) Catheter-Based Interventions: For PDA, ASD, VSD closures, and valvuloplasty Surgery: Required for more complex or severe defects Multistage Surgery: For single ventricle conditions (e.g., Norwood, Glenn, Fontan procedures) Valve Replacement: In stenotic or leaky valves, either surgically or via catheter Arterial Switch Operation: For TGA within the first month of life Complications Heart rhythm issues Heart failure Valve dysfunction Need for repeat procedures Pulmonary hypertension Endocarditis Growth and development delays Prevention While not all CHDs are preventable: Prenatal care and screening Managing maternal health conditions Avoiding teratogenic drugs Genetic counseling for high-risk families