Nuclear cardiology can be effectively used to diagnose blockages in the coronary arteries in patients in India, feels Malayali Cardiologist Dr Prem Soman who was recently appointed Director of Nuclear Cardiology at the Heart and Vascular Institute of the University of Pittsburgh Medical Center in Pittsburgh, USA.
Dr. Prem says nuclear cardiology techniques are a noninvasive alternative to cardiac catheterisation, which is widely used to diagnose coronary artery disease (CAD) in India. “The technique uses radioactive dye injected during a stress test to diagnose CAD, a condition that is highly prevalent in the South Asian countries including India. In addition, this approach also helps determine who is at risk for heart attacks and death from CAD, and thus can help plan treatment,” he said.
Nuclear cardiology is widely accepted in mainstream cardiology in the US, where approximately eight to ten million such tests are performed each year.
“Although the test (sometimes referred to as a thallium scan) is offered in large centers in India, it is used much less by the cardiology community here. This is due to a combination of regulatory hurdles, cost, lack of wide availability, and the fact that it is not uniformly incorporated into cardiology training programs in India, where most of these tests are performed by Nuclear Medicine physicians,” he said.
But nuclear cardiology tests could be used to advantage, especially in areas where cardiac catheterization facilities are scarce, said Dr. Prem, who delivered the Homi Bhaba Oration of the Society of Nuclear Medicine, India in Nov 2011 at New Delhi. He will chair the 2013 annual meeting of the American Society of Nuclear Cardiology. Among immigrant communities in the US and UK, Dr. Prem says, South Asians are recognised as having a tendency to develop coronary artery blockages at a comparatively young age.
“The occurrence of CAD in India is almost double that in the US, partly because of the high rate of diabetes, dietary habits, and perhaps as yet unidentified genetic factors,” he added.
A native of Kozhikode and son of Mr R Soman and a retired company executive in the city and Mrs. Prabha Soman, Prem is all set to cast his vote in the upcoming US presidential election on November 6. He has been staying in US since 2000. “Health care issues are a major focus of the upcoming presidential election in the United States and the high cost of health care in the US dominates the financial debates.
President Obama’s administration was successful in passing one of the most impactful health care reform bills in US history. It guarantees that health insurance cannot be denied for patients with pre-existing medical conditions and provides coverage for children under their parent’s policy until they reach adulthood. The republican ticket with Mitt Romney and Paul Ryan has also proposed wide ranging reform of the existing Medicare system, through which the US government provides health care to its senior citizens,’’ he said.
Prem had his schooling from Kendriya Vidyalaya in the city and studied MBBS at the JN Medical College, Belgaum. He took his MD with a gold medal from PGIMER, Chandigarh and then pursued higher studies including PhD and FRCP from England. He is Internal Medicine and Cardiology trained in the US.