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Cardiology | Counties Manukau | Te Whatu Ora

Public Service, Cardiology

Description

Formerly Counties Manukau Health Cardiology

What is Cardiology?

Cardiology is the specialty within medicine that looks at the heart and blood vessels.  Your heart consists of four chambers, which are responsible for pumping blood to your lungs and then the rest of your body. The study of the heart includes the heart muscle (the myocardium), the valves within the heart between the chambers, the blood vessels that supply blood (and hence oxygen and nutrients) to the heart muscle, and the electrical system of the heart which is what controls the heart rate.

Cardiology Services Provided by Counties Manukau Health
Cardiology services are provided at Middlemore Hospital, Manukau SuperClinic™ and Botany SuperClinic™.

Consultants

Note: Please note below that some people are not available at all locations.

  • Dr Peter Barr

    Interventional Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Kok Lam Chow

    Interventional Cardiologist

    Available at all locations.

  • Dr Ruvin Gabriel

    Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Wil Harrison

    Interventional Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr David Heaven

    Cardiologist / Cardiac Electrophysiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Patrick Kay

    Interventional Cardiologist

    Available at all locations.

  • Dr Andrew Kerr

    Associate Professor - Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Jen-Li Looi

    Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Mayanna Lund

    Cardiologist - Clinical Head of Department

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Mariana Macedo Lamacie

    Cardiologist

    Available at all locations.

  • Dr Douglas Scott

    Interventional Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Timothy Sutton

    Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Jamie Voss

    Cardiologist / Cardiac Electrophysiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

  • Dr Selwyn Wong

    Cardiologist

    Available at Middlemore Hospital, Manukau SuperClinic™

Referral Expectations

Your GP will send a referral letter to the Department explaining your condition. Your appointment time will be prioritised on your health need and an appointment time will be sent directly to you. The appointment will be in the outpatient clinic.

You may be sent a questionnaire prior to your clinic visit to assist us with making a diagnosis and determining if any tests need to be done prior to you seeing a specialist.

You will be assessed by specialised doctors. Recommendations and options regarding your future treatment plan will be discussed with you.

You need to bring to your appointment:

  1. Any letters or reports from your doctor or another hospital.
  2. Any X-Rays, CT or MRI films and reports.
  3. All medicines you are currently taking including herbal and natural remedies.
  4. Your pharmaceutical entitlement card.

Services provided at Middlemore Hospital include:

  • Coronary angiography
  • Coronary angioplasty
  • CT coronary angiography
  • Coronary Care Unit and the Step Down Unit
  • Cardiology Ward (Ward 2)
  • Echocardiography (transthoracic, transoesophageal and stress)
  • Magnetic Resonance Imaging (MRI)
  • Exercise testing
  • Tilt table testing
  • Holter monitoring
  • Pacemaker insertion and follow-up clinic
  • Cardiac rehabilitation
  • Cardioversion

Outpatient Clinics for patients referred by their GP are held at the Manukau and Botany SuperClinics™ and provide:

  • Outpatient consulting
  • Outpatient echocardiography
  • Outpatient exercise testing

Charges

There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the Eligibility Directions specified criteria set by the Ministry of Health.  If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.

To check whether you meet the specified eligibility criteria, visit the Ministry of Health website.

For any applicable charges, please phone the Accounts Receivable Office on (09) 276 0060.

Common Conditions / Procedures / Treatments

Cardiac Rehabilitation Programme Timetables

Click on the following links to open more information for patients on Cardiac Rehabilitation Healthy Heart programmes: Cardiac Rehabilitation Flyer Manukau SuperClinic Healthy Heart Programme 2020 Pukekohe Programme 2020 Cardiac Rehabilitation Flyer (PDF, 396.3 KB) Manukau SuperClinic Healthy Heart Programme 2020 (DOCX, 37.3 KB) Pukekohe Programme 2020 (DOCX, 38.3 KB)

Click on the following links to open more information for patients on Cardiac Rehabilitation Healthy Heart programmes:

Angioplasty

Once the angiogram reveals the exact nature of the problem, decisions can be made on the best form of treatment. Angioplasty usually involves opening the narrowed areas with a tiny balloon and then the insertion of a fine metallic mesh tube called a coronary stent. Special drug-eluting stents have expanded the range and number of narrowings that can be successfully treated. Regardless, there are some narrowings which will still be best treated using coronary bypass surgery. Angiography and angioplasty do not require a general anaesthetic. People are admitted to hospital on the day of the procedure and may be discharged in the late afternoon or stay overnight.

Once the angiogram reveals the exact nature of the problem, decisions can be made on the best form of treatment. Angioplasty usually involves opening the narrowed areas with a tiny balloon and then the insertion of a fine metallic mesh tube called a coronary stent.

Special drug-eluting stents have expanded the range and number of narrowings that can be successfully treated. Regardless, there are some narrowings which will still be best treated using coronary bypass surgery. 

Angiography and angioplasty do not require a general anaesthetic. People are admitted to hospital on the day of the procedure and may be discharged in the late afternoon or stay overnight.

Blood Tests

You are likely to have blood tests done before coming to clinic to check your cholesterol level and looking for evidence of diabetes. These blood tests are done "fasting" which means you have the blood taken in the morning on an empty stomach before breakfast.

You are likely to have blood tests done before coming to clinic to check your cholesterol level and looking for evidence of diabetes.  These blood tests are done "fasting" which means you have the blood taken in the morning on an empty stomach before breakfast.

Cardiac Arrhythmias

Your heart rate is controlled by a complex electrical system within the heart muscle which drives it to go faster when you exert yourself and slower when you rest. A number of conditions can affect the heart rate or rhythm. Heart rate simply refers to how fast your heart is beating. Heart rhythm refers to the electrical source that is driving the heart rate and whether or not it is regular or irregular. As some types of arrhythmias can cause you to faint without warning, your doctor may restrict your driving until the condition is controlled. Some common terms Sinus rhythm is the normal rhythm Arrhythmia means abnormal rhythm Fibrillation means irregular rhythm or quivering of one part of the heart Bradycardia means slow heart rate Tachycardia means fast heart rate Paroxysmal means the arrhythmia comes and goes Tachycardia The most common of these is atrial fibrillation. This is where your heart rhythm is irregular and often too fast. Symptoms include fatigue, palpitations (where you are aware of your heart racing or pounding), dizziness and breathlessness. Other tachycardias include supraventricular tachycardia (SVT) or ventricular tachycardia (VT). These have similar symptoms as atrial fibrillation but can also cause you to lose consciousness (faint). Bradycardia The most common form of this is called heart block. This is because messages from the electrical generator of the heart do not get through efficiently to the rest of the heart and hence it goes very slowly or can pause. Symptoms of the heart going too slowly include feeling tired, breathless or fainting. Tests Tests to diagnose what sort of arrhythmia you have include: an electrocardiogram (ECG). This trace of the heart's electrical activity gives the diagnosis of the source of the arrhythmia. This is often normal at rest and more extensive testing is needed to try and catch the arrhythmia especially if it is intermittent. an Ambulatory ECG. This can be performed with a Holter monitor which monitors your heart for rhythm abnormalities during normal activity for an uninterrupted 24-hour period. During the test, electrodes attached to your chest are connected to a portable recorder - about the size of a paperback book - that's attached to your belt or hung from a shoulder strap. Another form of ambulatory ECG test is an Event recorder which covers 1-2 weeks. You wear a monitor (much smaller than a Holter monitor) and if you have any symptoms, such as dizziness, you press a button on a recording device which saves the recording of your heart rhythm made in the minutes leading up to and during your symptoms. Because you can wear this for a longer period of time it has a higher chance of catching your abnormal rhythm. Treatment Most treatments for tachycardias consist of medication to stop the abnormal rhythm or make it slower if and when it occurs. Atrial fibrillation, if you have other problems, can increase your risk of stroke so blood-thinning medication is often used as well. If you have bradycardia you may be referred to the surgeons for a pacemaker. This is a small operation where a battery powered device is placed under the skin with wires that lead to your heart and provide it with electrical stimulation to prevent it from going too slow. You can't feel it doing this but will be aware of a small flat lump under your skin just below your collar bone.

Your heart rate is controlled by a complex electrical system within the heart muscle which drives it to go faster when you exert yourself and slower when you rest.  A number of conditions can affect the heart rate or rhythm.  Heart rate simply refers to how fast your heart is beating.  Heart rhythm refers to the electrical source that is driving the heart rate and whether or not it is regular or irregular.

 As some types of arrhythmias can cause you to faint without warning, your doctor may restrict your driving until the condition is controlled.
 
Some common terms
  • Sinus rhythm is the normal rhythm
  • Arrhythmia means abnormal rhythm
  • Fibrillation means irregular rhythm or quivering of one part of the heart
  • Bradycardia means slow heart rate
  • Tachycardia means fast heart rate
  • Paroxysmal means the arrhythmia comes and goes
Tachycardia
The most common of these is atrial fibrillation.  This is where your heart rhythm is irregular and often too fast.  Symptoms include fatigue, palpitations (where you are aware of your heart racing or pounding), dizziness and breathlessness.
 
Other tachycardias include supraventricular tachycardia  (SVT)  or ventricular tachycardia (VT).  These have similar symptoms as atrial fibrillation but can also cause you to lose consciousness (faint).
 
Bradycardia
The most common form of this is called heart block.  This is because messages from the electrical generator of the heart do not get through efficiently to the rest of the heart and hence it goes very slowly or can pause.  Symptoms of the heart going too slowly include feeling tired, breathless or fainting.
 
Tests
Tests to diagnose what sort of arrhythmia you have include:
  • an electrocardiogram (ECG).  This trace of the heart's electrical activity gives the diagnosis of the source of the arrhythmia. This is often normal at rest and more extensive testing is needed to try and catch the arrhythmia especially if it is intermittent.
  • an Ambulatory ECG. This can be performed with a Holter monitor which monitors your heart for rhythm abnormalities during normal activity for an uninterrupted 24-hour period. During the test, electrodes attached to your chest are connected to a portable recorder - about the size of a paperback book - that's attached to your belt or hung from a shoulder strap. Another form of ambulatory ECG test is an Event recorder which covers 1-2 weeks.  You wear a monitor (much smaller than a Holter monitor) and if you have any symptoms, such as dizziness, you press a button on a recording device which saves the recording of your heart rhythm made in the minutes leading up to and during your symptoms.  Because you can wear this for a longer period of time it has a higher chance of catching your abnormal rhythm.
 
Treatment
Most treatments for tachycardias consist of medication to stop the abnormal rhythm or make it slower if and when it occurs.  Atrial fibrillation, if you have other problems, can increase your risk of stroke so blood-thinning medication is often used as well.
 
If you have bradycardia you may be referred to the surgeons for a pacemaker.  This is a small operation where a battery powered device is placed under the skin with wires that lead to your heart and provide it with electrical stimulation to prevent it from going too slow.  You can't feel it doing this but will be aware of a small flat lump under your skin just below your collar bone.
Cardiovascular Disease

This refers to narrowing of the arteries that supply blood to the heart muscle. The heart, like all other organs in the body, needs a constant supply of oxygen and energy. Narrowed arteries are unable to keep up with the demand needed to supply the heart muscle with blood. This can cause damage to the heart muscle if prolonged. The most common symptom of this problem is chest pain that occurs when you exert yourself (angina). Typical angina chest pain is a heavy sensation in your chest associated with shortness of breath. It sometimes radiates to your arms and can make you feel like being sick, dizzy or sweaty. Not everybody experiences the same sensation and any one of those symptoms can represent angina. If your GP thinks you may have angina they will refer you for an assessment to plan treatment. Heart Attack (Myocardial Infarction) If an attack of angina lasts for more than 20 minutes then you may be having a heart attack. This is when a piece of the heart muscle has been deprived of oxygen for so long that it can die, resulting in permanent damage to your heart and in some cases death. There are treatments available in hospital that can prevent heart attacks and save lives so if you have chest pain or symptoms of angina that last for more than 20 minutes, you should call an ambulance and go to hospital as soon as possible. Am I likely to have cardiovascular disease? There are several risk factors that are scientifically proven to be associated with this disease. However, even if you don’t have any of the following, it could still happen to you. You are more likely to have cardiovascular disease if you have any of the following: Are or have been a smoker Diabetes High blood pressure High cholesterol A family history of the disease Are older (your risk increases as you get older). Treatment consists of medications to protect the heart and its blood vessels. These include aspirin which makes the blood less sticky and prone to clots, medication to lower your cholesterol (even if it isn’t very high this is still helpful), medication to make your heart go slower and to open the blood vessels. You will be given a nitrolingual spray to carry with you with instructions of what to do if you have angina. You will be given advice on diet changes that can protect the heart as well as stop smoking programs. If you have had a heart attack you will be offered cardiac rehabilitation classes with a trained physiotherapist. Depending on tests you may have procedures offered to surgically correct the narrowed blood vessels. The Cardiology Department and your GP often share follow-up for this condition.

This refers to narrowing of the arteries that supply blood to the heart muscle. The heart, like all other organs in the body, needs a constant supply of oxygen and energy.  Narrowed arteries are unable to keep up with the demand needed to supply the heart muscle with blood. This can cause damage to the heart muscle if prolonged.

The most common symptom of this problem is chest pain that occurs when you exert yourself (angina).  Typical angina chest pain is a heavy sensation in your chest associated with shortness of breath.  It sometimes radiates to your arms and can make you feel like being sick, dizzy or sweaty.  Not everybody experiences the same sensation and any one of those symptoms can represent angina.  If your GP thinks you may have angina they will refer you for an assessment to plan treatment.

 
Heart Attack (Myocardial Infarction)
If an attack of angina lasts for more than 20 minutes then you may be having a heart attack.  This is when a piece of the heart muscle has been deprived of oxygen for so long that it can die, resulting in permanent damage to your heart and in some cases death. 
There are treatments available in hospital that can prevent heart attacks and save lives so if you have chest pain or symptoms of angina that last for more than 20 minutes, you should call an ambulance and go to hospital as soon as possible.

Am I likely to have cardiovascular disease?
There are several risk factors that are scientifically proven to be associated with this disease.  However, even if you don’t have any of the following, it could still happen to you.
 
You are more likely to have cardiovascular disease if you have any of the following:
 
  • Are or have been a smoker
  • Diabetes
  • High blood pressure
  • High cholesterol
  • A family history of the disease
  • Are older (your risk increases as you get older).
 
Treatment consists of medications to protect the heart and its blood vessels.  These include aspirin which makes the blood less sticky and prone to clots, medication to lower your cholesterol (even if it isn’t very high this is still helpful), medication to make your heart go slower and to open the blood vessels.  You will be given a nitrolingual spray to carry with you with instructions of what to do if you have angina.

You will be given advice on diet changes that can protect the heart as well as stop smoking programs.

If you have had a heart attack you will be offered cardiac rehabilitation classes with a trained physiotherapist.

Depending on tests you may have procedures offered to surgically correct the narrowed blood vessels.

The Cardiology Department and your GP often share follow-up for this condition.

Coronary Angiogram

This test is performed by a cardiologist in a sterile operating theatre environment. Most people will need to have routine tests before the procedure. These tests may require separate appointments and are usually planned the day before or the day of the procedure. You will be asked not to eat or drink after midnight the evening before the procedure. You are not given a general anaesthetic but may have some medication to relax you if needed. Local anaesthetic is put into an area of skin to the side of your groin. A needle and then tube are fed into an artery in the groin and advanced through the blood vessels to the heart. Dye is then injected so that the heart and blood vessels can be seen on x-ray. X-rays and measurements are then taken giving the doctors information about the state of your heart and the exact nature of any narrowed blood vessels. This allows them to plan the best form of treatment to prevent heart attacks and control any symptoms you may have. After the procedure you will have to lay flat (without bending your legs) while the groin sheath is in place. After the groin sheath is removed, you must lay flat for a period of time to prevent bleeding.

This test is performed by a cardiologist in a sterile operating theatre environment. 
 
Most people will need to have routine tests before the procedure. These tests may require separate appointments and are usually planned the day before or the day of the procedure.
 
You will be asked not to eat or drink after midnight the evening before the procedure.

You are not given a general anaesthetic but may have some medication to relax you if needed.  Local anaesthetic is put into an area of skin to the side of your groin.  A needle and then tube are fed into an artery in the groin and advanced through the blood vessels to the heart.  Dye is then injected so that the heart and blood vessels can be seen on x-ray.  X-rays and measurements are then taken giving the doctors information about the state of your heart and the exact nature of any narrowed blood vessels.  This allows them to plan the best form of treatment to prevent heart attacks and control any symptoms you may have.
 
After the procedure you will have to lay flat (without bending your legs) while the groin sheath is in place. After the groin sheath is removed, you must lay flat for a period of time to prevent bleeding.
Coronary Care Unit and Step Down Unit

The Coronary Care Unit (CCU) is where intensive investigation, monitoring and treatment for cardiac patients occurs. The Step Down Unit is a unit that provides an intermediary level of care between the intensive CCU and the ward. It is for those patients who do not need the intensive care of the CCU but who require more monitoring etc than provided in general wards.

The Coronary Care Unit (CCU) is where intensive investigation, monitoring and treatment for cardiac patients occurs.
 
The Step Down Unit is a unit that provides an intermediary level of care between the intensive CCU and the ward. It is for those patients who do not need the intensive care of the CCU but who require more monitoring etc than provided in general wards.
CT Coronary Angiography

CT coronary angiography at Counties Manukau Health is performed using a modern CT scanner developed specifically to provide accurate images of the coronary arteries around the heart. We are able to detect the build up of plaque or thickening within the arteries and determine if there are any significant blockages. The test is best suited when we need to rule out coronary artery disease. We most commonly perform the test in patients that we have seen through our chest pain clinic when initial tests like the exercise treadmill test have not been conclusive. The test is performed in the CT Department at Middlemore Hospital. You may need to take a medication called a beta-blocker to slow the heart before the scan. The appointment time takes between 1-2 hours and you can drive afterwards. It is a safe test with low levels of x-ray radiation used and you will be monitored to ensure there are no side effects from the x-ray contrast/dye that we use. The scan is reported by a cardiologist and a radiologist and the specialist who has referred you for the test will then arrange the follow up required.

CT coronary angiography at Counties Manukau Health is performed using a modern CT scanner developed specifically to provide accurate images of the coronary arteries around the heart. We are able to detect the build up of plaque or thickening within the arteries and determine if there are any significant blockages.

The test is best suited when we need to rule out coronary artery disease. We most commonly perform the test in patients that we have seen through our chest pain clinic when initial tests like the exercise treadmill test have not been conclusive.

The test is performed in the CT Department at Middlemore Hospital. You may need to take a medication called a beta-blocker to slow the heart before the scan.  The appointment time takes between 1-2 hours and you can drive afterwards. It is a safe test with low levels of x-ray radiation used and you will be monitored to ensure there are no side effects from the x-ray contrast/dye that we use.

The scan is reported by a cardiologist and a radiologist and the specialist who has referred you for the test will then arrange the follow up required.

Echocardiogram

Echocardiography is also referred to as cardiac ultrasound. This test is performed by a specially trained technician. It is a test that uses high frequency sound waves to generate pictures of your heart. During the test, you generally lie on your back; gel is applied to your skin to increase the conductivity of the ultrasound waves. A technician then moves the small, plastic transducer over your chest. The test is painless and can take from 10 minutes to an hour. The machine then analyses the information and develops images of your heart. These images are seen on a monitor. This is referred to as an echocardiogram. Echocardiography can help in the diagnosis of many heart problems including cardiovascular disease, previous heart attacks, valve disorders, weakened heart muscle, holes between heart chambers and fluid around the heart (pericardial effusion). If doctors are looking for evidence of coronary artery disease they may perform variations of this test which include: Exercise echocardiography. This technique is used to view how your heart works under stress. It compares how your heart works when stressed by exercise versus when it is at rest. The ultrasound is conducted before you exercise and immediately after you stop. Either a stationary bicycle or standard treadmill is used. Dobutamine stress echocardiography. If you're unable to exercise for the above test, you might be given medication to simulate the effects of exercise. During this test, an echocardiogram initially is performed when you're at rest. Then dobutamine is given to you via a needle into a vein in your arm. Its effect is to make your heart work harder and faster just like with exercise. After it has taken effect, the echocardiogram is repeated. The effect wears off very quickly. Depending on the results of these tests you may go on to have an angiogram at a later date.

Echocardiography is also referred to as cardiac ultrasound. This test is performed by a specially trained technician. It is a test that uses high frequency sound waves to generate pictures of your heart.  During the test, you generally lie on your back; gel is applied to your skin to increase the conductivity of the ultrasound waves. A technician then moves the small, plastic transducer over your chest. The test is painless and can take from 10 minutes to an hour.
The machine then analyses the information and develops images of your heart. These images are seen on a monitor. This is referred to as an echocardiogram.
Echocardiography can help in the diagnosis of many heart problems including cardiovascular disease, previous heart attacks, valve disorders, weakened heart muscle, holes between heart chambers and fluid around the heart (pericardial effusion).
If doctors are looking for evidence of coronary artery disease they may perform variations of this test which include:
  • Exercise echocardiography. This technique is used to view how your heart works under stress. It compares how your heart works when stressed by exercise versus when it is at rest. The ultrasound is conducted before you exercise and immediately after you stop. Either a stationary bicycle or standard treadmill is used. 
  • Dobutamine stress echocardiography. If you're unable to exercise for the above test, you might be given medication to simulate the effects of exercise. During this test, an echocardiogram initially is performed when you're at rest. Then dobutamine is given to you via a needle into a vein in your arm.  Its effect is to make your heart work harder and faster just like with exercise.  After it has taken effect, the echocardiogram is repeated.   The effect wears off very quickly.
Depending on the results of these tests you may go on to have an angiogram at a later date.
Electrocardiogram (ECG)

An ECG is a recording of your heart's electrical activity. Electrode patches are attached to your skin to measure the electrical impulses given off by your heart. The result is a trace that can be read by a doctor. It can give information of previous heart attacks or problems with the heart rhythm. Depending on your history, examination and ECG, you may go on to have other tests.

An ECG is a recording of your heart's electrical activity. Electrode patches are attached to your skin to measure the electrical impulses given off by your heart. The result is a trace that can be read by a doctor.  It can give information of previous heart attacks or problems with the heart rhythm.
Depending on your history, examination and ECG, you may go on to have other tests. 
Exercise ECG

An ECG done when you are resting may be normal even when you have cardiovascular disease. During an exercise ECG the heart is made to work harder so that if there is any narrowing of the blood vessels resulting in poor blood supply it is more likely to be picked up on the tracing as your heart goes faster. For this test you have to work harder which involves walking on a treadmill while your heart is monitored. The treadmill gets faster with time but you can stop at anytime. This test is supervised and interpreted by a doctor as you go. This test is used to see if you have any evidence of coronary artery disease and can give the doctor some idea as to how severe it might be so as to direct further tests and possible treatment.

An ECG done when you are resting may be normal even when you have cardiovascular disease.  During an exercise ECG the heart is made to work harder so that if there is any narrowing of the blood vessels resulting in poor blood supply it is more likely to be picked up on the tracing as your heart goes faster.  For this test you have to work harder which involves walking on a treadmill while your heart is monitored.  The treadmill gets faster with time but you can stop at anytime.  This test is supervised and interpreted by a doctor as you go.  This test is used to see if you have any evidence of coronary artery disease and can give the doctor some idea as to how severe it might be so as to direct further tests and possible treatment.
Heart Failure

Heart failure refers to the heart failing to pump efficiently. There are many diseases that cause this including cardiovascular disease, high blood pressure, viral infections, alcohol, and diseases affecting the valves of the heart. When the heart is inefficient a number of symptoms occur depending on the cause and severity of the condition. The main symptoms are tiredness, breathlessness on exertion or lying flat, and ankle swelling. Doctors often refer to oedema, which means fluid retention usually in your feet or lungs as a result of the heart not pumping efficiently. Tests looking for possible causes of heart failure include: Chest X-ray Electrocardiogram (ECG) Echocardiogram (Cardiac ultrasound) Angiogram. Treatment You are likely to have several medications over time, started and monitored by your cardiologist and GP. These include medication to control the amount of fluid that builds up (diuretics), medication to protect your heart and slow it down as well as to thin your blood. You will often be referred to a dietitian or given advice about restricting the amount of fluid and salt you take as this can contribute to symptoms. You can also be involved in cardiac rehabilitation programmes run by trained physiotherapists. You will be given reading material to learn more about your disease. The cardiologist and your GP usually share follow-up for this condition.

Heart failure refers to the heart failing to pump efficiently.  There are many diseases that cause this including cardiovascular disease, high blood pressure, viral infections, alcohol, and diseases affecting the valves of the heart.  When the heart is inefficient a number of symptoms occur depending on the cause and severity of the condition.  The main symptoms are tiredness, breathlessness on exertion or lying flat, and ankle swelling.  Doctors often refer to oedema, which means fluid retention usually in your feet or lungs as a result of the heart not pumping efficiently.
 
Tests looking for possible causes of heart failure include:
  •  Chest X-ray
  •  Electrocardiogram (ECG)
  •  Echocardiogram (Cardiac ultrasound)
  •  Angiogram.
 
Treatment
You are likely to have several medications over time, started and monitored by your cardiologist and GP.  These include medication to control the amount of fluid that builds up (diuretics), medication to protect your heart and slow it down as well as to thin your blood.  You will often be referred to a dietitian or given advice about restricting the amount of fluid and salt you take as this can contribute to symptoms. You can also be involved in cardiac rehabilitation programmes run by trained physiotherapists.  You will be given reading material to learn more about your disease.
 
The cardiologist and your GP usually share follow-up for this condition.
Valve Disease

Your heart consists of four chambers that receive and send blood to the lungs and body. Disorders affecting valves can either cause stenosis (a narrowing) or regurgitation (leakage after the valve has closed). Depending on what valve is involved and how severe the damage is, it may result in symptoms of heart failure (see above), as it makes the heart pump inefficiently. Suspicion of a heart valve problem is usually picked up by your doctor when they listen to your heart and hear a murmur. A murmur is heard with the stethoscope and is turbulence of blood flow that occurs through a narrowed or leaky valve. Not all heart murmurs mean serious problems but are best investigated further. The echocardiogram is the main test to diagnose what valve is involved and how severe it is. Treatment depends on the type and severity of the valve lesion. You may simply be monitored over years to see if anything changes. Some conditions require medication to thin the blood or treat any complicating heart problems. You may be referred to a heart surgeon for consideration of a valve replacement or dilatation of a narrowed valve.

Your heart consists of four chambers that receive and send blood to the lungs and body. 

Disorders affecting valves can either cause stenosis (a narrowing) or regurgitation (leakage after the valve has closed).  Depending on what valve is involved and how severe the damage is, it may result in symptoms of heart failure (see above), as it makes the heart pump inefficiently.
 
Suspicion of a heart valve problem is usually picked up by your doctor when they listen to your heart and hear a murmur.  A murmur is heard with the stethoscope and is turbulence of blood flow that occurs through a narrowed or leaky valve.  Not all heart murmurs mean serious problems but are best investigated further.
 
The echocardiogram is the main test to diagnose what valve is involved and how severe it is.
 
Treatment depends on the type and severity of the valve lesion. You may simply be monitored over years to see if anything changes. Some conditions require medication to thin the blood or treat any complicating heart problems. You may be referred to a heart surgeon for consideration of a valve replacement or dilatation of a narrowed valve.
Heart Health Patient Information

The Heart Foundation is the charity that works to stop New Zealanders dying prematurely from heart disease. They are committed to funding vital research, promoting heart healthy lifestyles and advancing cardiac care in this country. Click on the following link to open heart health patient information from The Heart Foundation - http://www.heartfoundation.org.nz/

The Heart Foundation is the charity that works to stop New Zealanders dying prematurely from heart disease. They are committed to funding vital research, promoting heart healthy lifestyles and advancing cardiac care in this country.

Click on the following link to open heart health patient information from The Heart Foundation - http://www.heartfoundation.org.nz/

Visiting Hours

Coronary Care Unit and Step Down Unit visiting times are between 11am and 1pm and then between 3.30pm and 8pm.

Ward 2 visiting times are between 2pm and 8pm.

Visitors are restricted to two at a time.
Children are welcome, but must be supervised by an adult.

Other

Charge Nurses

Ronita Narayan - Ward 2

Jill Gilmore - Coronary Care Unit

Sandi Graham - Cath Lab


Cardiac Investigation Charges

Kirsten Jacobsen - Charge Physiologist/Technician

Rathibala Natarajan - Charge Cardiac Sonographer

 

Nurse Practitioners

Andy McLachlan - Cardiology Nurse Practitioner

Chris Aldridge - Cardiology Nurse Practitioner

Renee McEwing - Cardiology Nurse Practitioner

 

Nurse Specialists

Kylie Beehre - Cardiology Nurse Specialist

Lani Ioelu - Cardiology Nurse Specialist

Katherine McLean - Cardiology Nurse Specialist

Sreedevi Manmadhan - Cardiology Specialty Nurse

Kiruthika Manorahan - Cardiology Registered Nurse

Mary Morgan - Cardiac Nurse Specialist

Chanthie Thach - Cardiology Specialty Nurse

Marian Tuitama - Cardiology Registered Nurse

Marieke can der Heiden - Cardiology Specialty Nurse (Pacing)

Tina Thomas - Cardiology Specialty Nurse (CTCA)

Ally Choi - Cardiology Specialty Nurse (CTCA)

Chanelle Broyd - Cardiology Nurse Educator

 

Health Psychology Service

Jordine Romana - Cardiology Health Psychologist

Contact Details

Manukau SuperClinic™

South Auckland

901 Great South Road
Manurewa
Auckland

Information about this location

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Get directions

Street Address

901 Great South Road
Manurewa
Auckland

Postal Address

Manukau SuperClinic™
PO Box 98743
Manukau City
Manukau 2241

This page was last updated at 11:46AM on February 19, 2024. This information is reviewed and edited by Cardiology | Counties Manukau | Te Whatu Ora.