Heart Specialist - Interventional Cardiologist
Mount Elizabeth Novena Hospital, Novena, Singapore
20 Years of experience
Dr. Paul Chiam is a cardiologist at Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital, Singapore. He has pursued a Bachelor of Medicine, Bachelor of Surgery, Master in Medicine. He has also been a Member of the Royal College of Physicians, and Fellow of the American College of Cardiology.
Dr. Paul continues to teach at the Yong Loo Lin School of Medicine, NUS, in his capacity as an adjunct associate professor. He is a known name in the field of Cardiology in Singapore and has been invited as a guest faculty or speaker to major international cardiovascular conferences such as the American College of Cardiology Scientific Sessions, the American Heart Association Scientific Sessions, Transcatheter Cardiovascular Therapeutics (TCT) (USA), EuroPCR, PCR London Valves, Complex Cardiovascular Therapeutics, Transcatheter Cardiovascular Therapeutics Asia Pacific (TCTAP) and China Interventional Therapeutics (CIT) among others. Apart from his contribution to medical sciences, he has published extensively in top cardiovascular journals. Dr. Chiam was awarded a Bronze Service Quality award in December 2009 and another Bronze Service Quality award in March 2011. At the SingLIVE Interventional Cardiology conference 2009, he was the first runner-up in the Best of Young Interventionalist case competition. He also won the SingHealth Publish! Award in 2012 for a paper published in a major cardiovascular journal.
Most physicians advise their patients to undergo the angiogram procedure (also known as angiography and arteriogram) when certain symptoms such as a heart attack or chest pain become a source of worry. A stress test is performed on patients who report chest pain, which is then followed by an angiogram test.
Angiography procedure aims at testing the blockages in the coronary arteries apart from any other cardiovascular-related ailments. Angiography and angiogram procedure can both locate narrowing arteries or blockages that may exist in different parts of the body.
Angiography is recommended for patients with coronary heart diseases (CHD), which can cause the heartbeat to stop suddenly and abruptly. The patient may also suffer from severe chest pain. Angiography can also be performed on patients on an emergency basis when they experience a heart attack. If the blockage is not treated immediately, then healthy tissues around the heart start perishing and turn into scar tissue. It can give rise to several long-lasting problems. Angiography may also be required in the case of a patient with aortic stenosis or those who have had an abnormal heart stress test.
Coronary artery disease (CAD) is one of the most common heart diseases reported across the world. It results due to blood clot formation and plaque accumulation in the major blood vessels of the heart.
Balloon angioplasty is the most common endovascular procedure (procedure performed inside the blood vessel) carried out to treat coronary artery disease. In this procedure, the blood clots in the major arteries of the heart are detected and cleared by inserting a catheter into an artery of the hand (radial artery) or leg (femoral artery). This catheter consists of a balloon at its tip, which dislodges the clot to the periphery of the blood vessel after inflation.
Angioplasty may or may not be followed by coronary stent placement, depending on the angiography findings. This procedure is performed in patients with fewer blood clots in the vessels and those who do not respond to medications. It may also be carried out as an emergency procedure to treat a heart attack.
Radiofrequency ablation (RFA) is a surgical procedure in which heat generated from medium frequency alternating current is used to ablate a tumour, a part of the electrical conduction system of the heart, or any other dysfunctional areas. The ablation therapy requires local anaesthesia and is done in an outpatient setting.
RFA is a popular treatment for the correction of any abnormality in the electrical system of the heart, which is confirmed during electrophysiology studies (EPS). During this test, the electrophysiology of heart is studied and any abnormalities are noted. The procedure used to correct the identified abnormalities associated with electrophysiology of heart is known as the cardiac ablation procedure.
Pacemaker implantation is a common surgery and it significantly improves the quality of life led by the patient. The blood-pumping organ, heart, is essentially made of a few groups of muscles. These muscles are controlled by electrical signals to ensure that the heart beats naturally and effectively to circulate blood to all parts of the body. When this electrical signal gets disrupted due to some reason, then an individual may experience tachycardia (where hear beats abnormally slow), heart block, arrhythmia (irregular heartbeat), or a cardiac arrest (abrupt and sudden stopping of the heartbeat).
The contractions happen as a result of triggered electrical pulses generated by sinoatrial node or the SA node. It acts like a pacemaker of the heart. This electrical pulse is then sent to the atrioventricular node or the AV node for relaying the pulse to the ventricles. Pacemaker implantation is suggested when this electrical signaling network is disrupted.The faulty functioning of the natural pacemaker of the heart may lead to the following:
Sick sinus syndrome: It is characterized by a slow heartbeat (bradycardia) or fast heartbeat (tachycardia) or a combination of both. It can happen due to age, a previous history heart attack, and thyroid problem, too much of potassium accumulation in blood, heart surgery, or sleep apnea.
In this case, the impulse is either delayed or absent.
The heart can stop beating. It may result because of the presence of coronary artery disease and muscle problems in the heart, which can happen after the age of 35.
Some of the symptoms observed in patients requiring pacemaker implantation are:
A pacemaker implant is a small device that weighs around 20 g to 50 g and is the size of a matchbox. It has a pulse generator with a battery, a tiny computer circuit and a few wires called pacing leads. This system is attached to the heart and it emits signals through the wires. The pacing rate or the rate of electrical impulses can be adjusted as per the requirement of the body and be accordingly programmed. It can sense if a heartbeat is missed or if the heart is beating too slow. Accordingly, it starts sending a steady signal to normalize the beating of the heart. If the beats are normal, then it simply does not send any signal.
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