METRO PLUS

Heart-to-heart

WHEN DR. Navin. C. Nanda, the eminent cardiologist, visited the Madurai Meenakshi temple, before coming to Kochi for the Cardiologists Conference there was a small incident, which is interesting. At the temple, the priest who is a `heart' patient was awaiting the visit of the prestigious doctor. Knowing the doctor's unfamiliarity with temple rules, he kept an `angavastram' ready for the distinguished guest, to cover him with, after he takes off his shirt.

The Doctor was taken by the priest to his room and asked to remove his shirt. Then having the last word, the Man of God told the Man of Science, "Every time when I visit a cardiologist, I have to remove my shirt. But today a cardiologist has to remove his shirt in my office. It feels different!!"

Dr. Navin. C. Nanda, who presented a number of papers at the recently concluded cardiologists' conference, needs no introduction in the medical field, but for us laymen, who have not had a tryst with heartache of the wrong kind, he is perhaps the final word on Echocardiography.

Explaining in very simple terms Dr Nanda, said, "Echocardiography makes use of high frequency sound waves to view the innards of the heart. Something used by bats and in submarines."

Echocardiography is a diagnostic modality, beyond the stethoscope and before surgery. The aim of this method is to avoid invasive procedure on the patient and completely do away with any risk to him. It is highly effective in investigating heart disease and only in a very small per cent (when coronary arteries have to be looked at in minute detail) the patient has to undergo an invasive probe.

Dr Nanda, presenting newer methods to use this diagnostic procedure, says, "It is the unconventional view of the heart from the right side that will help pick up coronary arteries and see the defects clearly. This will help prevent cardiac catheterisation or any invasive procedure".

The latest equipment in this field which is being developed by him gives a three dimensional view of the heart. Working closely with the manufacturers it will be another two years before this technique comes to India.

Stress echocardiogram was another presentation given by the doctor. This takes a look at the blood supply to the heart muscles when under stress. Stress may lead to chest pain due to the narrowing of a certain blood vessel. All this can be detected clearly with the new technique. The Colour Doppler Method, which was first developed in Japan, was improved upon by Dr. Nanda and his group, and is now widely used the world over. It helps in the assessment of leakages or narrowing of various cardiac valves and helps doctors decide on the need for cardiac surgery on the patient.

For such distinguished service in the medical field, Dr Nanda has been honoured from time to time with awards, the latest being, Lifetime Achievement award "for magnificent contributions in the field of echocardiography the world over". Last month the Union minister of Health, Mr Shatrughan Sinha accorded him the `special millennium award'.

"India is almost at par with the rest of the world in medical technology, especially in metro cities of Mumbai, Chennai and Delhi. As soon as we improved on the Colour Doppler method, I came to India to teach about it. In 1971 when I first went to America, only three valves could be seen via echocardiogram. Along with my group we found the pulmonary valve. This paved the way for echo assessment of various cardiac lesions in the newborn and other patients. After that my team-mates would not let me come back to India. The low-end machines do not give very good pictures of the heart but with the more sophisticated ones we can, besides looking at the walls of the heart, also see the flow in the heart, any fluid collection or aneurysm. We try to avoid any probe through the oesophagus, which is discomfiting for the patient. Besides being used as a diagnostic modality, Echocardiography is very helpful in postoperative procedures and of course in paediatric patients

In this heart-to--heart chat with the eminent personality one was tempted to know," Doctor, where does your heart lie, in USA or India"?

The unassuming doctor smiled and said, "Oh in both places, but you see it is an Indian heart". Yes doctor, it is an Indian heart that has done us proud, and though `doc' does not spell it out explicitly, `phir bhi dil hai Hindustani.'

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