Researcher and cardiologist Dr Ravinay Bhindi talks about treating heart attacks, and the rewards and challenges of his work.
What does your work involve?
An interventional cardiologist treats cardiovascular diseases such as angina and coronary heart disease by inserting catheters (tubes) into an artery. It's minimally invasive, and is used, for example, to open up arteries that have become blocked, causing a heart attack.
What are you researching?
My focus is on patients who've had veins grafted during bypass surgery.
I hope to understand why, in 50% of cases, their veins become blocked after 10 years. The findings could help us design a treatment to prevent the problem. This would increase the life expectancy of bypass surgery patients, and reduce the risks for those who need surgery again later on.
How does a heart attack happen?
Heart attacks happen when there is a sudden blockage (a clot) in one of the coronary arteries. As these supply blood to the heart muscle, a blockage can cause irreparable damage to the heart muscle. This can lead to disability, and is sometimes fatal.
How do you treat a heart attack?
We treat heart attacks with a medical procedure called an angioplasty. At hospitals that aren't equipped to do this, clot-busting medications may be used to help open the artery. Many of these patients are then transferred to us for angioplasty.
What is an angioplasty?
It involves mechanically unblocking the artery that is causing the heart attack. First we do an angiogram (an x-ray of the coronary arteries around the heart) to identify which artery is blocked. Then we unblock the artery by removing any clot that may be present, and inflating a balloon in the artery. Finally we insert a stent (a small piece of steel mesh) to help keep the artery open.
How has heart-attack treatment changed?
Over the last 10 years the improvements are numerous and tremendous – both the way heart attacks are treated and the technology and medication used. For example, heart-attack patients used to stay in hospital for a week at least. Today, if they are admitted promptly, they generally go home within three days.
How many patients do you see a week?
This varies. On days where I do consultations, I see around 20 patients. On days in the operating theatre, we operate on about eight patients a day, ranging from emergency cases to pre-booked operations.
What's your most common advice to patients?
Coronary heart disease doesn't happen suddenly – it takes decades to develop. Reduce your risk of heart disease with the right lifestyle choices, especially if you have a family history. Make sure to do regular aerobic exercise, keep an eye on your cholesterol and blood pressure levels, and lose weight if you are overweight.
What's the most rewarding part of your work?
As a cardiologist, it's developing relationships with patients, being a part of their journey, and knowing that you are making a difference to their lives.
As a researcher, it's being at the forefront of testing novel ideas and challenging new frontiers of science.
And the most challenging?
As a cardiologist it's seeing people unexpectedly die, or treatment not working. The very nature of a heart attack is that it's unexpected – often, it happens in the middle of the night and the family is in shock. It's very real and emotional.
As a researcher, the greatest challenge is achieving great things with limited resources.