‘Changing lifestyle giving rise to heart ailments in India’

Doctor Ravindra Kulkarni is a renowned cardiologist from Pune who has founded Just For Hearts, a city-based organisation that works for prevention of lifestyle diseases such as obesity, heart ailments, diabetes and stress. Having a rich experience as a consultant in medicine and cardiology, he is associated with National Heart Institute, Deendayal Memorial Hospital and Moraya Multispeciality Hospital. He speaks to DNA about the education and training in cardiovascular intervention in India.

What is cardiovascular intervention?
Cardiology is a branch of medicine that deals with diseases and abnormalities of the heart. It can broadly be divided into clinical cardiology, non-invasive cardiology, cardiac electrophysiology, interventional cardiology, cardiovascular research and preventive cardiology.

Catheterisation of coronary artery diseases with procedures like angioplasty and angiography, balloon dilatation of valves, closing of congenital heart defects and measuring various chamber pressures, fall under cardiovascular intervention in layman’s terms. 

The problem mainly attended through these procedures is the blockage in the blood supply to the heart/valve disorder/congenital heart defects.

There is a lack of structured training programmes in cardiovascular intervention in India. Why has it become important to have trained expertise in our country?
Considering the existing demand, there is a huge scope for both formal and informal trainings/certificate courses in the field of cardiology. There are super specialty courses in various universities; National Board of Examination, New Delhi, as well as national & international fellowship programmes available to those who wish to pursue the subject as a field of specialisation or gain expertise in the interventional procedures. 

Various national and international societies regularly organise training activities/fellowship courses for the existing practitioners and students to learn and keep themselves updated. 

As mentioned, cardiology is a vast subject and involves various sub-specialisations. For any practitioner, it is essential to continuously learn newer techniques and advancements in the field. Thus, it is important to have trained expertise in a particular field so as to do full justice to the profession, especially in a critical area such as cardiology. 

In India, heart diseases are on a rise due to the changing lifestyle and stressful work culture. Therefore, we need trained expertise to attend to the growing number of heart patients.

Are new techniques being introduced in coronary intervention in India?
Newer technologies like IVUS (intra vascular ultrasound) and FFR (fractional flow reserve) studies are available in Pune as well as in other Indian cities. However, they are still not accessible to a large section of society considering the high costs involved.

What can be done to train more doctors in cardiovascular intervention?
More number of seats in the cardiology programmes at the university level, fellowships/education programmes by recognised national and foreign institutions can help train a large number of doctors in cardiovascular interventions. Various hospitals, from time to time, organise specialised training programmes in interventional procedures and such related subjects. 

All these can be a part of the long-term plan for educating more doctors and cardiology practitioners.

How many institutions in Pune are offering quality training in cardiovascular invention?
All major hospitals in Pune, which perform interventional procedures, offer quality education in the field. They regularly conduct formal and informal trainings, and at the same time conduct various CMEs (Continuous medical education) amongst general practitioners and consultants to create awareness about new advances in interventional cardiology.