Organization of a Successful Cardiology Center

For a successful heart center structuring, the center's presence of angiography and detailed noninvasive diagnostic units are basic needs. Since CT coronary angiography and cardiac MRI examinations have been used frequently in patients recently, having these services in coordination with the radiology department also increases the quality of diagnosis and treatment. It is necessary to organize an on-call/on-call physician at the center for emergency angiography and intervention 24/7. Organizing coronary intensive care with an intra-aortic balloon pump and monitoring intubated patients when necessary is a factor that reduces mortality in patients. It is important that the cardiology team includes at least one cardiologist specialized in imaging, one interventional cardiologist and one electrophysiologist. The cardiology department's interventions are not limited to coronary vessels only, but also valve interventions, structural interventions, carotid interventions and other peripheral interventions, which greatly increases the quality of the work done in the department. The ability of cardiology and cardiovascular surgery to work together and be compatible is also a factor that increases success for patients.

Our patient profile is mostly patients over the age of 50 who have had a heart attack and have vascular problems. The group coming for electrophysiology and structural heart interventions has a slightly lower average age. Bypass and valve replacement patients with valve problems or who have been operated on in cardiovascular surgery also constitute a separate group. Smoking, inactivity, diabetes, obesity, stress caused by life in a big city and economic difficulties are the factors that play the biggest role in cardiovascular diseases.

Diagnosis and treatment of cardiovascular diseases are not very costly for the social security institution compared to the rest of the world. Since material and drug prices have decreased significantly recently, treatment costs are also within acceptable limits. Compared to world standards, the costs seem lower. The best students in Turkey go to medical faculties, and the manpower accumulated over the years trains world-class physicians in medical faculties. When well-trained physicians use the pragmatic side of Turkish people, they provide a quality health service compared to the rest of the world.

In the field of cardiology, the method of imaging coronary vessels with cardiac MR imaging and CT angiography and determining the level of stenosis with CT-FFR in a virtual environment are exciting developments that can change the field. Coronary pressure measurement, optical coherence tomography imaging, and intravascular ultrasound imaging also help the physician in making the diagnosis and correct treatment decision. It is a very exciting field that valve diseases, which could only be treated with open heart surgery before, can be treated with angiography. In our daily practice, in addition to TAVI for the aortic valve, mitral and tricuspid valve replacement treatments seem to be routine.

Cardiology is a field that can find solutions to many diseases even now, so getting fast and satisfactory results makes our job more enjoyable. It can provide a comfortable working environment as a noninvasive cardiologist, even for a physician who does not want to endure the hassle of being called to the hospital 24/7. Newly developing treatment methods for valvular and structural heart diseases will make cardiology a more popular field in the future. Half of the newly graduated physicians who are among the top 100 in the cardiology specialty exam prefer departments such as radiology, dermatology, ophthalmology and physical rehabilitation, which have fewer shifts, no malpractice lawsuits, and less violence in healthcare. Although new graduates have many good reasons to choose cardiology, the fact that they do not choose cardiology under the conditions of our country should be reviewed and the underlying reasons should be corrected.