Cardiac Hospital Design & Cath Lab Planning in Pakistan

Heart disease is a leading cause of death worldwide, and demand for angiography, angioplasty and cardiac surgery in Pakistan keeps growing. Cardiac hospital design in Pakistan has to support some of the most time-critical care in medicine: a patient with a heart attack may need to go from the ambulance to the catheterisation laboratory within minutes. This guide focuses on the cath lab and the departments around it, covering layout, radiation protection, structure, ventilation, power and approvals, so that owners and cardiologists can plan a heart unit that is safe, efficient and ready for future equipment.

Why Cardiac Facilities Are Different

A cardiac unit combines emergency medicine, high-end imaging and surgery in one service line. Three things set it apart from a general hospital department:

• Time. International guidance for heart attack care aims to open a blocked artery as quickly as possible, so the route from ambulance bay to cath lab must be short and unobstructed.
• Radiation. Fluoroscopy in the cath lab produces X-rays during every procedure, so walls, doors and windows need shielding.
• Heavy, sensitive equipment. Imaging systems, ceiling-mounted C-arms and heart-lung machines need structural support, clean power and close temperature control.

The Patient Pathway: From Ambulance to Recovery

Designing around the patient’s journey shows where delays happen and which rooms must sit together.

Arrival and diagnosis

A patient with chest pain arrives by ambulance or private car. A dedicated chest pain bay in the emergency department, with an ECG machine, monitor and defibrillator, allows diagnosis within minutes. The bay should be close to the ambulance entrance and have a clear trolley route onward.

Transfer to the cath lab

If the ECG shows a heart attack that needs angioplasty, the patient is moved directly to the cath lab. Corridors on this route should be wide enough for a bed with equipment and staff, doors should open automatically or be held open, and any lift should be a dedicated bed lift that can be called on priority.

Procedure and recovery

After the procedure, the patient goes to a recovery bay or directly to the CCU. Elective patients return to day-care bays and may go home the same day or next morning. Keeping recovery, CCU and the cath lab close shortens transfers and lets the same team respond to complications.

Families and visitors

Families wait anxiously during cardiac procedures. A waiting area close to, but outside, the restricted zone, with a counselling room where doctors can speak to relatives privately, improves the experience and keeps visitors out of clinical corridors.

Planning the Cardiac Service Line

Start with the clinical model. A diagnostic cath lab attached to a general hospital needs a different building from a dedicated heart institute with open-heart surgery. Decide early:

• Will the unit offer primary angioplasty around the clock?
• How many cath labs are needed now, and how many in future?
• Will electrophysiology and device implantation be done?
• Will there be cardiac surgery, and therefore a perfusion service and cardiac ICU?
• How many CCU beds will support the expected caseload?

A hospital feasibility study tests these assumptions against local demand, staffing and budget.

Cath Lab Layout

A cath lab suite is more than the procedure room. It is a group of spaces that must work together.

Location in the hospital

The cath lab should be on the same floor as, or one lift ride from, the emergency department and the CCU. Where cardiac surgery is offered, placing the cath lab near the cardiac theatres allows rapid transfer if a procedure becomes surgical. A hybrid theatre, combining a fixed imaging system with a full operating theatre, is an option for larger heart centres.

Radiation Shielding

Shielding is calculated, not guessed. A qualified medical physicist works out the protection needed for each wall, floor, ceiling, door and window based on the equipment, workload and the use of surrounding rooms. Typical measures include:

• Lead-lined plasterboard or lead sheet fixed to masonry walls
• Lead-lined doors with interlocks or warning lights
• Leaded glass viewing windows between procedure and control rooms
• Attention to gaps around ducts, cable trays and service penetrations

Shielding drawings and calculations form part of the licensing submission to the Pakistan Nuclear Regulatory Authority, and the installation is surveyed before clinical use.

Structure and Ceiling Coordination

Ceiling-mounted imaging systems hang from steel support grids fixed to the slab above. These must be designed to the manufacturer’s loads and tolerances, with very flat and level installation. Floor-mounted systems need level, vibration-free floors. Above the ceiling, the support grid competes for space with HVAC ducts, lighting, medical gas pipes and cable trays, so coordinated design, ideally in BIM, is essential.

HVAC, Power and Medical Gases

Ventilation

Cath labs are treated as procedure rooms, with filtered supply air, positive pressure relative to corridors and controlled temperature and humidity. The technical room needs separate cooling because imaging equipment generates a lot of heat. Cardiac theatres follow operating theatre standards.

Electrical

Imaging systems need stable power with low voltage fluctuation. A dedicated supply, UPS for the imaging system and monitoring, a standby generator and isolated power for patient-connected equipment are standard. Load-shedding makes generator capacity and automatic changeover critical in Pakistan.

Medical gases

Oxygen, medical air and vacuum are needed in the procedure room, recovery bays, CCU and cardiac ICU. Systems should be designed to HTM 02-01, explained in our medical gas pipeline guide.

CCU, Cardiac ICU and Supporting Areas

The coronary care unit needs continuous monitoring, a central nurse station with sightlines to every bed, and enough space around each bed for emergency resuscitation. Cardiac ICU beds after surgery need more equipment space, multiple gas outlets and isolation capability. Non-invasive cardiology (ECG, echocardiography, treadmill testing and Holter monitoring) sits best near the cardiac OPD so outpatients do not enter acute areas.

Cath Lab Options Compared

How a Cardiac Unit Project Runs

Common Mistakes in Cath Lab Projects

• Building the room before the imaging vendor is chosen
• Long routes or lift changes between emergency and the cath lab
• No separate cooling for the technical room
• Unsealed service penetrations that weaken radiation shielding
• Too few prep and recovery bays, causing delays between cases

Frequently Asked Questions

Conclusion

Good cardiac hospital design in Pakistan puts the cath lab at the centre of a fast, safe pathway from the emergency door to treatment and recovery. Early equipment selection, physicist-designed shielding, coordinated structure and services, and reliable power are what make the difference. ACCO plans, designs and builds cardiac units and complete hospitals through its hospital construction services, with each project priced through an itemised BOQ.