Precision Driven IVUS-NIRS Technology is Transforming Cardiac Care

Dr Balbir Singh, Chairman and Head of Cardiology at Max Healthcare, is a recipient of numerous prestigious honours, including the Padma Shri, for his exceptional skills and contributions in interventional cardiology and electrophysiology. Dr Singh has performed thousands of Intra-Vascular Ultrasound (IVUS) driven Angioplasties. IVUS is used in angioplasty to provide doctors with a detailed, real-time, three-dimensional view of the artery's interior, which helps them to precisely assess blockages, guide stent placement, and confirm the success of the procedure.

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Heart attack incidence amongst fit and young people, many of whom are regular gym goers, is on the rise. The sudden death of young people considered to be fit has brought heart attacks into the spotlight. What are the reasons for such incidents and their correlation, if any, with vulnerable plaque? How do we detect susceptible plaque, and how does it help prevent sudden cardiac deaths? Has it got something to do with vulnerable plaque?

Vulnerable plaque occurs when a patient has mild stenosis, yet the vessels are prone to rupture. Those who smoke, have high cholesterol, a family history or do not exercise are the ones who have vulnerable plaques. This plaque can rupture under stress and vigorous exercise, causing sudden blockage in the artery, which cannot be controlled like the arrhythmias in acute heart attack cases. Many do not get the time to recognise the symptoms and reach the hospital, leading to their sudden death. Thus, vulnerable plaque is far more severe than stenosis, which develops over time and is predictable. Multiple factors, such as extreme cold, early morning hours, strenuous exercise, stress, and alcohol consumption, contribute to these conditions, which we are aware of.

You have been quite vocal about the use of dual modality imaging, specifically with IVUS NIRS. How do you see technologies like IVUS-NIRS shaping the future of cardiac care in our country?