• TRUST

    we aim to build a culture of integrity and trust in our patient-doctor relationships and staff relationships.

  • COMPASSION

    we value a culture of care and compassion for our patients and staff, empathising with their needs and concerns. We want to treat the patient, and not just the disease.

  • COMPETENCE

    we strive for excellence in all that we do and aim to manage our patients with the most updated treatments and cutting edge technology in Cardiology medicine.

We aim to be a Cardiology Practice that provides Holistic Care for All our Patients, guided by our Core Values of Trust, Compassion and Competence.

Articles

this weeks info

Heart Attack and Cardiac Arrest – Are You at Risk?

He was at the peak of his career. He has a loving wife and lovely children. But his work was demanding, he smoked to relieve stress and he had little time to exercise.

What is a heart attack?

A “heart attack” happens when an artery (blood vessel) that supplies blood to the heart muscle becomes suddenly blocked causing part of the heart muscle to die. A heart attack carries a high risk of death.

What are the symptoms of a heart attack?

Heavy, squeezing chest discomfort, breathlessness and a cold sweat are the typical symptoms of a heart attack. Some elderly patients or diabetics may only feel breathless or upper abdominal discomfort.

Our services

Our primary mission is to deliver high quality, cardiovascular care to all of our patients.

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Patients with symptoms suspicious of heart disease will undergo a specialist consultation with a full and detailed history obtained by our Cardiologist. Thereafter, a full physical examination will be performed including measurements of vital signs, weight, height and body mass index. Our Cardiologist will make an initial diagnosis and suggest further evaluation and treatment options.

Our hearts serve us every moment of the day and for the average person in Singapore, it would have pumped more than 3 billion times at the end of our lives. It is hence prudent that some patients at some stage may benefit from screening evaluation to assess their heart health. Patients who might benefit from screening include those with pre-existing diseases e.g. hypertension, diabetes or high cholesterol as well as patients with family history of heart disease or who are smokers. Our Heart Doctor will give an expert opinion of which test(s) are required and suitable for the specific patient.

We provide general health screening services which includes a detailed history, physical examination, blood test screening and other relevant tests or investigations.

Receive expert care in the treatment of your high cholesterol or high blood pressure. Some patients may developed complex forms of high cholesterol and/or high blood pressure that is not of the garden variety. Our Cardiologist can make a specialist assessment of these conditions and provide an advanced level of care, in partnership with your family physician.

We are able to provide access to a full and comprehensive range of blood tests and at the same time, tailor these tests to your needs.

ECG stands for an “electrocardiogram”. This is a tracing of the electrical activity within your heart. The resting ECG is a valuable initial test in revealing various disorders of the heart and is required in all patients with suspected heart disease.

A treadmill stress ECG is performed to screen patients for suspected significant blockage of their heart arteries. It is also useful in assessing exercise tolerance and stability of heart rhythm during exercise. This test however is not able to detect minor narrowing of your heart arteries.

An echocardiogram is an ultrasound scan of your heart. Among other things, it assesses the structure, size, and strength of your. In addition, it is the gold standard test in assessing the valves of the heart. This test is extremely useful and importantly, without risk. It takes about 20 minutes to perform. It cannot however, see the arteries of the heart.

This is an assessment of every beat of your heart within 24 hours. It is a simple and safe test whereby ECG leads are taped to your chest and are attached to a small recording device about the size of a small mobile phone. The device is aimed at assessing your heart rhythm during your usual daily activity. You do not need to be admitted in the hospital.

Similar to the 24 hour Holter ECG, the ambulatory blood pressure device is carried for a whole day. It automatically measures your blood pressure throughout the day at regular intervals. This test is meant to assess your blood pressure during your usual activity and in your usual environment. It will provide useful information about your blood pressure pattern and average readings.

A CT calcium score is a plain CT scan that does not require an injection of contrast. It calculates the amount of calcium in your heart arteries as an indirect indication of blockages. It cannot visualize the heart arteries or the narrowing within these arteries. A CT coronary angiogram is a non-invasive way to assess the heart arteries for blockages. This test usually incorporates a CT calcium score as well. It requires a contrast injection via a venous cannula in your arm. Medications to reduce your heart rate and dilate your heart arteries may be injected as well. This test is able to visualize the heart arteries and give a rough indication of the severity of blockages if seen. It is very accurate if no blockage is seen but can sometimes be inaccurate if moderate or severe narrowing is seen.

This is a form of stress test of your heart. It uses a small and safe amount of nuclear material that is injected into your blood stream and picked up on a scan of your heart. You may be required to walk on the treadmill or receive a medication to dilate the arteries of your heart or speed up your heart rate. This test assesses the amount of blood flow to your heart and does not directly look at your heart arteries. It is very useful in deciding whether you need to unblock arteries in your heart, and especially useful for patients who cannot run on the treadmill stress test.

A coronary angiogram is the gold standard TEST to assess the heart arteries for blockages. However, it is not performed in all patients presenting with chest pain because of the very small risk involved in this test. It is a minimally invasive procedure. A catheter (small but long tube) is inserted via an injection usually through a blood vessel in your wrist but sometimes in your groin if your wrist artery is not suitable. The catheter is advanced through your blood vessel all the way to your heart arteries under x-ray guidance. Thereafter, a contrast (dye) is injected the through this catheter into your heart arteries so that the arteries can light up under x-ray. This enables our Cardiologist to visualize the heart arteries and assess for blockages. Coronary angioplasty (ballooning) and stenting are parts of the same procedure to TREAT the heart artery blockages. It is also performed using a catheter that enters through the same puncture site for the coronary angiogram, hence also minimally invasive. No surgery is performed. It can be performed during the same procedure after a coronary angiogram has been performed. During this treatment, a tiny wire is inserted into the heart artery across the blockage. Thereafter a small balloon fixed on the tip of a smaller catheter is thread over the wire and inflated at the site of the blockage. Almost always, a stent is then placed at the site of the blockage and inflated. A stent is a cylindrical wire mesh the shape of a tube. A non expanded stent is mounted on a small deflated balloon on the tip of another small catheter. It is also advanced over the wire to the site of blockage. The balloon is inflated causing the stent to inflate and anchor on the inside of the artery wall. Everything is removed at the end of the procedure except the stent which is left in the artery permanently as it acts as a scaffold to keep the artery patent. Not all blockages need to be unblocked and not all patients with blockages are suitable for stenting. Our Cardiologist will discuss the most appropriate treatment after the coronary angiogram test. Sometimes, patients only need medications but a small proportion of patients may require bypass surgery which is an open heart surgery.

Transcatheter Aortic Valve Implantation, in short TAVI, is a relatively new technology to implant an artificial heart valve in the position of a diseased original valve. It is to treat Aortic Stenosis which is a condition whereby the aortic valve is severely narrowed usually due to aging. A valve is a “door” in the heart that allows blood to flow in one direction. Patients with this condition experience breathlessness on exertion and sometimes chest pain and dizziness or fainting. Without treatment, the risk of death is very high. Previously, the only treatment option is open heart surgery to replace the valve. However, because this condition usually occurs in the elderly, many patients do not receive surgery because they are at high risk for surgery. But today, there is an effective and relatively safe alternative to treat these patients using TAVI. Briefly, TAVI is performed using an artificial animal skin valve that is mounted on a tube/catheter. This tube is inserted usually through an injection in the groin and advanced through the blood vessel all the way to the heart where it is deployed over the original heart valve.

Pericardiocentesis is an emergency procedure to remove fluid from around the heart. It is used to treat Cardiac Tamponade which is a condition whereby fluid or blood collects between the small space outside of the heart muscle but within the pericardium which is a layer of covering outside of the heart. The accumulated fluid can press on the heart muscle and cause reduced blood being pumped out of a “squeezed” heart. Without treatment, the risk of death is high. Pericardiocentesis is performed using a needle that is inserted in the lower central chest or left lower chest. Usually a small tube is left inside to drain residual fluid for a few days.

A temporary pacemaker is a wire that is inserted into the heart chamber via an injection in the groin of neck. The function of the wire is to cause the heart to beat faster if the heart rate is too slow. It is a temporary measure to treat patients with electrical heart blocks or severe slowing of their hearts.

A permanent pacemaker is a treatment for patients with electrical heart blocks or severe slowing of their hearts. It is a minor surgery procedure whereby a small pacemaker device is implanted below the skin in the left or right upper chest. One or two wires are inserted into the heart chamber(s) via an injection in these areas. The wire(s) are then connected to the above pacemaker device called a pulse generator. The pacemaker will cause the heart to beat faster whenever it slows down.

A permanent pacemaker is a treatment for patients with electrical heart blocks or severe slowing of their hearts. It is a minor surgery procedure whereby a small pacemaker device is implanted below the skin in the left or right upper chest. One or two wires are inserted into the heart chamber(s) via an injection in these areas. The wire(s) are then connected to the above pacemaker device called a pulse generator. The pacemaker will cause the heart to beat faster whenever it slows down.

An electrophysiological study is a minimally invasive procedure whereby wires are inserted into the heart via injections in the groin and neck to assess the electrical activity in the heart. When there are abnormalities in the electrical pathways found, sometimes treatment to disrupt these abnormal pathways are performed using radiofrequency heat called an ablation procedure, also performed using wires. Radiofrequency ablation is a useful treatment for conditions such as supraventricular tachycardia, Wolff-Parkinson-White syndrome, atrial fibrillation, atrial flutter and ventricular tachycardia.

The implantable cardioverter defibrillator (ICD) is a device somewhat like a pacemaker that is implanted under the skin in the left or right upper chest. One or two wires are inserted into the heart chamber(s) via an injection in these areas. The wire(s) are then connected to the above ICD. The function of the ICD is to detect abnormal life-threatening rhythms in the heart and if necessary automatically “shock” the heart in an attempt to save the patient. It is implanted in patients with a weak heart and high risk of sudden cardiac death. The cardiac resynchronization therapy with or without a defibrillator (CRT/D) is implanted in a similar fashion as an ICD. However this device requires 3 wires to be inserted. It has an additional function of synchronizing the timing of the right and left heart contraction. In selected patients, it can help to strengthen weak hearts. Our Cardiologist will discuss with you if you are likely to benefit from a CRT. It can also “shock” the heart like an ICD when needed.

A small proportion of patients have blockages of their heart arteries that may have better long term results if they are treated with coronary artery bypass surgery (open heart surgery). This decision can only be made after a coronary angiogram is performed by a cardiologist. Thereafter, our Cardiologist will discuss with the patient regarding the benefits and risk of surgery vs angioplasty and stenting. If the patient is agreeable to consider surgery, our Cardiologist will refer the patient to a Cardiothoracic Surgeon to perform the surgery. Other heart conditions that may require referral to a Cardiothoracic Surgeon are heart valve abnormalities such as severe leakage or narrowing of the mitral or aortic valves. To determine if surgery is needed, the patient will need to be assessed by a Cardiologist. An echocardiogram is essential and in many patients, a coronary angiogram is required to exclude heart artery blockages. This is because if blockages are also present, it can be treated with a bypass during the same valve surgery. In patients who are at high risk for surgery, there are new minimally invasive procedures that may potentially be suitable treatments as an alternative to surgery. Examples are transcatheter aortic valve implantation (TAVI) for aortic valve disease and the Mitra-clip procedure for patients with leaking mitral valves.

TRUST

About us

Baldev & Ong The Cardio Clinic

Baldev & Ong The Cardio Clinic

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Core Values of The Cardio Clinic (TCC)

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COMPASSION

Meet our team

Dr. Baldev Singh

Consultant Cardiologist and Physician MBBS, MRCP (UK), M. Med. (Int Med), FACC (USA), FRCP (Glasg), FRCP (Edin), FAMS (Internal Medicine and Cardiology)

Dr. Ong Sea Hing

Consultant Cardiologist and Physician MBBS, MRCP (UK), M. Med. (Int Med), FAMS (Cardiology)

Our Staff

We have a team of dedicated and experienced staff consisting of nurses, administrative staff and a cardiac technologist.

COMPETENCE

Contact us

Address:

Parkway East Medical Centre, Suites #02-01/02
319, Joo Chiat Place,
Singapore 427989

Phone:

Appointments/Enquiries: +65-63452232
Fax: +65-63444798
24hrs Urgent Calls: +65-65358833

Opening hours:

Mon-Fri 9am - 5pm
Saturday 9am - 1pm Sun/PH closed
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