Cardiac Subspecialities
Cardiology Sub-specialities
Care is delivered across several sub-specialities including:
- Coronary Artery Disease
- Arrhythmia
- Heart Failure
- Structural Heart Disease
- Advanced Heart Failure and Transplant
- Adult Congenital Heart Disease
- Inherited Cardiac Conditions
- Cardiac Rehabilitation and Prevention
1. Coronary Artery Disease
This includes the Primary PCI (percutaneous coronary intervention) service whereby patients having an acute myocardial infarction are transferred directly to the cardiac catheterisation laboratory 24/7 for emergency re-opening of a blocked coronary artery usually with placement of a small metal scaffold called a stent
Patients with chronic coronary disease are generally managed through the clinics until they are symptom free or stable and those with new onset chest pains are generally seen through the Emergency Dept or nurse-delivered chest pain clinic with subsequent non-invasive or invasive imaging of their coronary arteries as an in– or out-patient as required
2. Arrhythmia
The Arrhythmia service looks after patients with relatively benign arrhythmias such as atrial fibrillation or supraventricular tachycardia or more dangerous ventricular which may be life-threatening.
Treatments include medications, catheter ablation and implantable device therapy as necessary.
3. Heart Failure
The heart failure service manages patients with shortness of breath or fluid overload / congestion due to reduced cardiac function. This is generally managed by careful titration of oral medication through daily nurse-delivered heart failure and consultant out-patient clinics but sometimes patients need to be admitted to hospital for intravenous therapy .
4. Structural Heart Disease
This involves the non-surgical management of structural abnormalities of the heart in particular the heart valves but also involves the occlusion of the left atrial appendage in patients with atrial fibrillation who are unable to take blood thinners and occlusion of septal defects sometimes called "holes in the heart". This can now in many cases be done with a minimally invasive approach typically through the veins or arteries in the groin.
5. Advanced Heart Failure and Transplant
Younger patients with advanced heart failure may be candidates for advanced therapies including mechanical support with Ventricular Assist devices or cardiac transplantation. The advanced heart failure service manages these patients and assesses their suitability for these complex interventions.
6. Adult Congenital Heart Disease
The ACHD (Adult Congenital Heart Disease) service manages patients who were born with congenital heart abnormalities which may have been corrected or managed medically. Most of these patients transition to the Mater after initial management in Crumlin Children’s Hospital during their childhood and adolescence.
The service performs complex interventions to correct some congenital defects which have progressed in adulthood or ‘re-do’ interventions performed in childhood.
7. Inherited Cardiac Conditions
The Inherited Cardiac Conditions service sees the families of young people who have died suddenly and unexpectedly of SADS (no abnormality found on autopsy) or cardiomyopathy. The service also sees patients diagnosed with or suspected of having a primary electrical genetic heart disorder (a channelopathy such as Long QT syndrome) or cardiomyopathy. Genetic testing through the Mater’s recently opened and INAB-approved Gene sequencing Lab is offered to those who reach diagnostic criteria for either group of conditions.
The service also arranges for molecular autopsy on SADS / Cardiomyopathy sudden death victims after consultation with family members. The primary purpose of the clinic is the prevention of sudden cardiac death in individuals and family members affected by inherited channelopathies and cardiomyopathies.
The clinic can be contacted at 01-803 4431 or fhs@mater.ie
A number of specialised clinics including a Marfan’s clinic, Amyloid Clinic and a lysosomal storage disease clinic are also run several times each year.
The Mater Family Heart Screening Clinic has been set up to cater for families affected by unexplained Sudden Cardiac Death in a young person primarily to establish the cause of death. We also assess other family members for the presence of the same condition and protect them, as needed, with medications or an implantable cardiac defibrillator. The clinic also assesses patients with or who have a family history of an inherited cardiac condition.
Access to the Family Heart Screening Clinic is by either GP referral or self-referral *
Consultation may include genetics testing and a review of your family's cardiac health (pedigree) **
8. Cardiac Rehabilitation and Prevention
Cardiac Rehabilitation is a personalised programme of exercise and education which aims to improve physical and emotional health following a Cardiac event.
It is recommended after a heart attack, coronary artery bypass and heart valve surgery but also includes people post heart transplant, stenting, cardiac arrest, ICD implant, heart failure and cardiomyopathy.
The service is nurse co-ordinated with a multidisciplinary approach.