Conditions We See and Treat

Our physicians specialize in the diagnosis and treatment of the following:

• Arrhythmias

  Arrhythmias

  Your heart normally beats in a regular rhythm and rate that is just right for the work your body is doing at any moment. The usual resting heart rate for adults is between 50 to 100 beats per minute. Children have naturally higher normal heart rates than adults.

  The heart is a pump made up of four chambers: two upper chambers (atria) and two lower chambers (ventricles). It is powered by an electrical system that puts out pulses in a regular rhythm. These pulses keep the heart pumping and keep blood flowing to the lungs and body.

  When the heart beats too fast, too slow, or with a skipping (irregular) rhythm, a person is said to have an arrhythmia. A change in the heart's rhythm may feel like an extra-strong heartbeat (palpitation) or a fluttering in your chest. Premature ventricular contractions (PVCs) often cause this feeling.

  A heartbeat that is occasionally irregular usually is not a concern if it does not cause other symptoms, such as dizziness, lightheadedness, or shortness of breath. It is not uncommon for children to have extra heartbeats. In healthy children, an extra heartbeat is not a cause for concern.

  When heart rate or rhythm changes are minor

  Many changes in heart rate or rhythm are minor and do not require medical treatment if you do not have other symptoms or a history of heart disease. Smoking, drinking alcohol or caffeine, or taking other stimulants such as diet pills or cough and cold medicines may cause your heart to beat faster or skip a beat. Your heart rate or rhythm can change when you are under stress or having pain. Your heart may beat faster when you have an illness or a fever. Hard physical exercise usually increases your heart rate, which can sometimes cause changes in your heart rhythm.

  Dietary supplements, such as goldenseal, oleander, motherwort, or ephedra (also called ma huang), may cause irregular heartbeats.

  It is not uncommon for pregnant women to have minor heart rate or rhythm changes. These changes usually are not a cause for concern for women who do not have a history of heart disease.

  Well-trained athletes usually have slow heart rates with occasional pauses in the normal rhythm. Evaluation is usually not needed unless other symptoms are present, such as lightheadedness or fainting (syncope), or there is a family history of heart problems.

  When heart rate or rhythm changes are more serious

  Irregular heartbeats change the amount of blood that flows to the lungs and other parts of the body. The amount of blood that the heart pumps may be decreased when the heart pumps too slow or too fast.

  Changes such as atrial fibrillation that start in the upper chambers of the heart can be serious, because they increase your risk of forming blood clots in your heart. This in turn can increase your risk for having a stroke or a blood clot in your lungs (pulmonary embolism). People who have heart disease, heart failure, or a history of heart attack should be more concerned with any changes in their usual heart rhythm or rate.

  Fast heart rhythms that begin in the lower chambers of the heart are called ventricular arrhythmias. They include ventricular tachycardia and ventricular fibrillation. These types of heart rhythms make it hard for the heart to pump enough blood to the brain or the rest of the body and can be life-threatening. Ventricular arrhythmias may be caused by heart disease such as heart valve problems, impaired blood flow to the heart muscle (ischemia or a heart attack), a weakened heart muscle (cardiomyopathy), or heart failure.

  Symptoms of ventricular tachycardia include palpitations, feeling dizzy or lightheaded, shortness of breath, chest pain or pressure, and fainting or near-fainting. Ventricular fibrillation may cause fainting within seconds and causes death if not treated. Emergency medical treatment may include medicines and electrical shock (defibrillation).

  Taking illegal drugs (such as stimulants, like cocaine or methamphetamine) or misusing prescription and nonprescription medicines can cause serious heart rhythm or rate changes and may be life-threatening.

  The U.S. Food and Drug Administration (FDA) has banned the sale of ephedra, a stimulant sold for weight loss and sports performance, because of concerns about safety. Ephedra has been linked to heart attacks, strokes, and some sudden deaths.

• Coronary Artery Disease

  Coronary Artery Disease

  What is coronary artery disease?
  Coronary artery disease is the most common type of heart disease. It's also the number one killer of both men and women in the United States.

  When you have it, your heart muscle doesn't get enough blood. This can lead to serious problems, including heart attack.

  It can be a shock to find out that you have coronary artery disease. Many people only find out when they have a heart attack. Whether or not you have had a heart attack, there are many things you can do to slow coronary artery disease and reduce your risk of future problems.

  What causes coronary artery disease?
  Coronary artery disease is caused by hardening of the arteries, or atherosclerosis. This means that fatty deposits called plaque (say "plak") build up inside the arteries. Arteries are the blood vessels that carry oxygen-rich blood throughout your body.

  Atherosclerosis can affect any arteries in the body. When it occurs in the ones that supply blood to the heart (the coronary arteries), it is called coronary artery disease.

  When plaque builds up in the coronary arteries, the heart may not get the blood it needs to work well. Over time, this can weaken or damage the heart. If a plaque tears, the body tries to fix the tear by forming a blood clot around it. The clot can block blood flow to the heart and cause a heart attack.

  What are the symptoms?
  Symptoms can happen when the heart is working harder and needs more oxygen, such as during exercise. Symptoms include:

  • Angina (say "ANN-juh-nuh" or "ann-JY-nuh"), which most often is chest pain or discomfort or a strange feeling in the chest.
  • Shortness of breath.
  • Heart attack. A heart attack is sometimes the first sign of coronary artery disease.

  Less common symptoms include a fast heartbeat, feeling sick to your stomach, and increased sweating. Some people don't have any symptoms. In rare cases, a person can have a "silent" heart attack, without symptoms.

  How is coronary artery disease diagnosed?
  Your doctor will do a physical exam and ask questions about your past health and your risk factors. Risk factors are things that increase the chance that you will have coronary artery disease.

  Some common risk factors are being older than 65; smoking; having high cholesterol, high blood pressure, or diabetes; and having heart disease in your family.

  If your doctor thinks that you have coronary artery disease, you may have tests to check how well your heart is working. These tests include an electrocardiogram (EKG or ECG), a chest X-ray, an exercise electrocardiogram, and blood tests. You may also have a coronary angiogram to check blood flow to the heart.

  How is it treated?
  Treatment focuses on lowering your risk for heart attack and stroke and managing your symptoms. Lifestyle changes, medicine, and procedures are used.

  • Lifestyle changes include quitting smoking (if you smoke), eating heart-healthy foods, getting regular exercise, staying at a healthy weight, lowering your stress level, and limiting how much alcohol you drink. A cardiac rehab program can help you make these changes.
  • Medicines can help you lower high cholesterol and high blood pressure, manage angina, and lower your risk of having a blood clot.
  • Procedures that improve blood flow to the heart include angioplasty and bypass surgery.
• Heart Failure

  Heart Failure

  What is heart failure?
  Heart failure means that your heart muscle doesn't pump as much blood as your body needs. Failure doesn't mean that your heart has stopped. It means that your heart is not pumping as well as it should.

  Because your heart cannot pump well, your body tries to make up for it. To do this:

  • Your body holds on to salt and water. This increases the amount of blood in your bloodstream.
  • Your heart beats faster.
  • Your heart may get bigger.

  Your body has an amazing ability to make up for heart failure. It may do such a good job that you don't know you have a disease. But at some point, your heart and body will no longer be able to keep up. Then fluid starts to build up in your body, and you have symptoms like feeling weak and out of breath.

  This fluid buildup is called congestion. It's why some doctors call the disease congestive heart failure.

  Heart failure usually gets worse over time. But treatment can slow the disease and help you feel better and live longer.

  What causes heart failure?
  Anything that damages your heart or affects how well it pumps can lead to heart failure. Common causes of heart failure are:

  • High blood pressure.
  • Heart attack.
  • Coronary artery disease.

  Other conditions that can lead to heart failure include:

  • Diabetes.
  • Diseases of the heart muscle (cardiomyopathies).
  • Heart valve disease.
  • Disease of the sac around the heart (pericardial disease), such as pericarditis.
  • A slow, fast, or uneven heart rhythm (arrhythmia).
  • A heart problem that you were born with (congenital heart defect).
  • Long-term heavy alcohol use, which can damage your heart.

  What are the symptoms?
  Symptoms of heart failure start to happen when your heart cannot pump enough blood to the rest of your body. In the early stages, you may:

  • Feel tired easily.
  • Be short of breath when you exert yourself.
  • Feel like your heart is pounding or racing (palpitations).
  • Feel weak or dizzy.

  As heart failure gets worse, fluid starts to build up in your lungs and other parts of your body. This may cause you to:

  • Feel short of breath even at rest.
  • Have swelling (edema), especially in your legs, ankles, and feet.
  • Gain weight. This may happen over just a day or two, or more slowly.
  • Cough or wheeze, especially when you lie down.
  • Feel bloated or sick to your stomach.

  If your symptoms suddenly get worse, you will need emergency care.

  How is heart failure diagnosed?
  Your doctor may diagnose heart failure based on your symptoms and a physical exam. But you will need tests to find the cause and type of heart failure so that you can get the right treatment. These tests may include:

  • Blood tests.
  • A chest X-ray.
  • An electrocardiogram (EKG or ECG) to check your heart's electrical system.
  • An echocardiogram to see the size and shape of your heart and how well it is pumping.
  • Magnetic resonance imaging (MRI) to see the structure of your heart and check how well it is pumping.

  Echocardiogram
  An echocardiogram can help show if you have heart failure, what type it is, and what is causing it. Your doctor can also use it to see if your heart failure is getting worse.

  This test can measure how much blood your heart pumps to your body. This measurement is called the ejection fraction. If your ejection fraction gets lower and you are having more symptoms, it means that your heart failure is getting worse.

  How is it treated?
  Most people with heart failure need to take several medicines. Your doctor may prescribe medicines to:

  • Help keep heart failure from getting worse. These drugs include ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and vasodilators like hydralazine and a nitrate.
  • Reduce symptoms so you feel better. These drugs include diuretics (water pills) and digoxin.
    Treat the cause of your heart failure.

  It is very important to take your medicines exactly as your doctor tells you to. If you don't, your heart failure could get worse.

  Pacemaker or defibrillator
  A pacemaker or a defibrillator (such as an ICD) may be an option for you if you have a problem with your heart rhythm. A pacemaker can help your heart pump blood better. A defibrillator can prevent a dangerous heart-rhythm problem.

  Care at home
  Lifestyle changes are an important part of treatment. They can help slow down heart failure. They may also help control other diseases that make heart failure worse, such as high blood pressure, diabetes, and coronary artery disease.

  The best steps you can take are to:

  • Eat less sodium. Sodium causes your body to hold on to water and may make symptoms worse. Your doctor may also ask you to limit how much fluid you drink.
  • Get regular exercise. Your doctor can tell you what level of exercise is safe for you, how to check your pulse, and how to know if you are doing too much.
  • Take rest breaks during the day.
  • Lose weight if you are overweight. Even a few pounds can make a difference.
  • Stop smoking. Smoking damages your heart and makes exercise harder to do.
  • Limit alcohol. Ask your doctor how much, if any, is safe.

  Ask your doctor if cardiac rehab is right for you. Rehab can give you education and support that help you learn self-care and build new healthy habits, such as exercise and healthy eating.

  To stay as healthy as possible, work closely with your doctor. Have all your tests, and go to all your appointments. It is also important to:

  • Talk to your doctor before you take any new medicine, including nonprescription and prescription drugs, vitamins, and herbs. Some of them may make your heart failure worse.
  • Keep track of your symptoms. Weigh yourself at the same time every day, and write down your weight. Call your doctor if you have a sudden weight gain, a change in your ability to exercise, or any sudden change in your symptoms.

  What can you expect if you have heart failure?
  Medicines and lifestyle changes can slow or even reverse heart failure for some people. But heart failure often gets worse over time.

  Early on, your symptoms may not be too bad. As heart failure gets worse, you may need to limit your activities. Treatment can often help reduce symptoms, but it usually doesn't get rid of them.

  Heart failure can also lead to other health problems. These may include:

  • Trouble with your heart rhythm (arrhythmia).
  • Stroke.
  • Heart attack.
  • Mitral valve regurgitation.
  • Blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism).

  Your doctor may be able to give you medicine or other treatment to prevent or treat these problems.

  Heart failure can get worse suddenly. If this happens, you will need emergency care. To prevent sudden heart failure, you need to avoid things that can trigger it. These include eating too much salt, missing a dose of your medicine, and exercising too hard.

  Knowing that your health may get worse can be hard. It is normal to sometimes feel sad or hopeless. But if these feelings last, talk to your doctor. Antidepressant medicines, counseling, or both may help you cope.

• Heart Valve Disorders

  Heart Valve Disorders

  What is a heart murmur?
  A heart murmur is an extra sound that the blood makes as it flows through the heart. Your doctor uses a stethoscope to listen to your heartbeat. When you have a heart murmur, your doctor can hear an extra whooshing or swishing noise along with your heartbeat.

  It can be scary to learn that you or your child has a heart murmur. But heart murmurs are very common, especially in children, and are usually harmless. These normal murmurs are called "innocent" heart murmurs. There is nothing wrong with your heart when you have an innocent murmur. Up to half of all children have innocent murmurs.footnote 1 They usually go away as children grow.

  Adults can have innocent murmurs too. Innocent murmurs are often found in adults over 50 years of age. Murmurs also happen when your blood flows harder and faster than usual—during pregnancy, for example, or a temporary illness, such as a fever.footnote 1

  Sometimes, though, a heart murmur is a sign of a heart problem. This is called an abnormal heart murmur.

  What causes an abnormal heart murmur?
  Abnormal murmurs are signs of a heart problem. In children, abnormal heart murmurs are usually caused by problems they are born with, such as a heart valve that doesn't work right or a hole in the wall between two heart chambers.

  In adults, abnormal murmurs are most often caused by damaged heart valves. Heart valves operate like one-way gates, helping blood flow in one direction between heart chambers as well as into and out of the heart. See a picture of blood flow through a normal heart.

  When disease or an infection damages a heart valve, it can cause scarring and can affect how well the valve works. The valve may not be able to close properly, so blood can leak through. Or the valve may become too narrow or stiff to let enough blood through. When a damaged heart valve cannot close properly, the problem is called regurgitation. When the valve can't let enough blood through, the problem is called stenosis.

  Heart valves can be damaged by heart disease or by infections like rheumatic fever or endocarditis. The normal wear and tear that comes with aging can also cause some damage.

  Some heart murmurs are caused by a thicker than normal heart. When the heart muscle grows too large, it can get in the way of normal blood flow and cause a murmur.

  How is a heart murmur diagnosed?
  Most heart murmurs are found during regular doctor visits. During exams, doctors listen to each part of the heartbeat, including any extra sounds, or murmurs, that may be there.

  If a doctor hears a murmur, he or she can often tell whether it is innocent by how loud the noise is, what part of the heart it is coming from, and what kind of sound it is. He or she will also look for signs of a heart problem—for example, shortness of breath when the person is active, lightheadedness, a fast or irregular heartbeat, or a buildup of fluid in the legs or lungs. If your doctor thinks your murmur may be a sign of a problem, you will have tests to check your heart. You may also be sent to a heart specialist, called a cardiologist, for more tests.

  • An echocardiogram is a type of ultrasound test. It turns sound waves into pictures that show how well your heart is working.
  • An electrocardiogram, also called an EKG or ECG, checks the electrical activity of your heart. It translates your heart's electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves.
  • A chest X-ray shows the size and shape of your heart and the position and shape of your large arteries.
  • Cardiac catheterization can check for defects in the heart. A thin tube is inserted into an artery in your leg or arm. The tube, called a catheter, is slowly pushed up to your heart. A small amount of dye is injected, and the pictures show the heart chambers and valves as the dye moves through them.

  How is it treated?
  If you have an innocent murmur, you do not need treatment, because your heart is normal.

  If you have an abnormal murmur, treatment depends on the heart problem that is causing the murmur and may include medicines or surgery. Not all abnormal murmurs need to be treated. If you have an abnormal murmur and have no other symptoms, your doctor may only monitor your condition with an echocardiogram.

  If you have symptoms, you may need to take medicine to lower your blood pressure and reduce your heart's workload. You may need surgery to replace a valve or repair a heart defect.

  Can you prevent a heart murmur?
  Most heart murmurs are normal, and there is nothing you can do to prevent them or cause them. They just happen.

  Most abnormal murmurs cannot be prevented, either. They are often caused by infections or by problems that run in families.

  What you can do is take good care of your heart by living a heart-healthy lifestyle. This includes eating heart-healthy food, being active, staying at a healthy weight, and not smoking.

• Hypertension

  High Cholesterol

  What is cholesterol?
  Cholesterol is a type of fat (lipid) in your blood. Your cells need cholesterol, and your body makes all it needs. But you also get cholesterol from the food you eat.

  If you have too much cholesterol, it starts to build up in your arteries. (Arteries are the blood vessels that carry blood away from the heart.) This is called hardening of the arteries, or atherosclerosis. It is the starting point for some heart and blood flow problems. The buildup can narrow the arteries and make it harder for blood to flow through them. The buildup can also lead to dangerous blood clots and inflammation that can cause heart attacks and strokes.

  There are different types of cholesterol.

  • LDL is the"bad" cholesterol. It's the kind that can raise your risk of heart disease, heart attack, and stroke.
  • HDL is the "good" cholesterol. It's the kind that is linked to a lower risk of heart disease, heart attack, and stroke.

  Why does cholesterol matter?
  Your cholesterol levels can help your doctor find out your risk for having a heart attack or stroke. But it's not just about your cholesterol. Your doctor uses your cholesterol levels plus other things to calculate your risk. These include:

  • Your blood pressure.
  • Whether or not you have diabetes.
  • Your age, sex, and race.
  • Whether or not you smoke.

  What affects cholesterol levels?
  Many things can affect cholesterol levels, including:

  • The foods you eat. Eating too much saturated fat and trans fat can raise your cholesterol.
  • Being overweight. This may lower HDL ("good") cholesterol.
  • Being inactive. Not exercising may lower HDL ("good") cholesterol.
  • Age. Cholesterol starts to rise after age 20.
  • Family history. If family members have or had high cholesterol, you may also have it.

  How is cholesterol tested?
  You need a blood test to check your cholesterol.

  A cholesterol test, also called a lipid panel, measures all of the fats in your blood, including total, LDL, and HDL cholesterol.

  High cholesterol levels don't make you feel sick. So the blood test is the only way to know your cholesterol levels.

  How can you lower your risk of heart attack and stroke?
  A heart-healthy lifestyle along with medicines can help lower your risk.

  The way you choose to lower your risk will depend on how high your risk for heart attack and stroke is. It will also depend on how you feel about taking medicines. Your doctor can help you know your risk. Your doctor can help you balance the benefits and risks of your treatment options.

  Heart-healthy lifestyle changes can help lower risk for everyone. They include:

  • Eating a heart-healthy diet that is rich in fruits, vegetables, whole grains, fish, and low-fat or nonfat dairy foods.
  • Being active on most, if not all, days of the week.
  • Losing weight if you need to, and staying at a healthy weight.
  • Not smoking.

  Changing old habits may not be easy, but it is very important to help you live a healthier and longer life. Having a plan can help. Start with small steps. For example, commit to adding one fruit or one vegetable a day for a week. Instead of having dessert, take a short walk.

  Statin medicine can lower the risk of heart attack and stroke.

  • For people whose chance of having a heart attack or stroke is high, taking a statin can be helpful.
  • For other people, it's not as clear if they need to take a statin. You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.
• Lipid Disorders

  High Cholesterol

  What is cholesterol?
  Cholesterol is a type of fat (lipid) in your blood. Your cells need cholesterol, and your body makes all it needs. But you also get cholesterol from the food you eat.

  If you have too much cholesterol, it starts to build up in your arteries. (Arteries are the blood vessels that carry blood away from the heart.) This is called hardening of the arteries, or atherosclerosis. It is the starting point for some heart and blood flow problems. The buildup can narrow the arteries and make it harder for blood to flow through them. The buildup can also lead to dangerous blood clots and inflammation that can cause heart attacks and strokes.

  There are different types of cholesterol.

  • LDL is the"bad" cholesterol. It's the kind that can raise your risk of heart disease, heart attack, and stroke.
  • HDL is the "good" cholesterol. It's the kind that is linked to a lower risk of heart disease, heart attack, and stroke.

  Why does cholesterol matter?
  Your cholesterol levels can help your doctor find out your risk for having a heart attack or stroke. But it's not just about your cholesterol. Your doctor uses your cholesterol levels plus other things to calculate your risk. These include:

  • Your blood pressure.
  • Whether or not you have diabetes.
  • Your age, sex, and race.
  • Whether or not you smoke.

  What affects cholesterol levels?
  Many things can affect cholesterol levels, including:

  • The foods you eat. Eating too much saturated fat and trans fat can raise your cholesterol.
  • Being overweight. This may lower HDL ("good") cholesterol.
  • Being inactive. Not exercising may lower HDL ("good") cholesterol.
  • Age. Cholesterol starts to rise after age 20.
  • Family history. If family members have or had high cholesterol, you may also have it.

  How is cholesterol tested?
  You need a blood test to check your cholesterol.

  A cholesterol test, also called a lipid panel, measures all of the fats in your blood, including total, LDL, and HDL cholesterol.

  High cholesterol levels don't make you feel sick. So the blood test is the only way to know your cholesterol levels.

  How can you lower your risk of heart attack and stroke?
  A heart-healthy lifestyle along with medicines can help lower your risk.

  The way you choose to lower your risk will depend on how high your risk for heart attack and stroke is. It will also depend on how you feel about taking medicines. Your doctor can help you know your risk. Your doctor can help you balance the benefits and risks of your treatment options.

  Heart-healthy lifestyle changes can help lower risk for everyone. They include:

  • Eating a heart-healthy diet that is rich in fruits, vegetables, whole grains, fish, and low-fat or nonfat dairy foods.
  • Being active on most, if not all, days of the week.
  • Losing weight if you need to, and staying at a healthy weight.
  • Not smoking.

  Changing old habits may not be easy, but it is very important to help you live a healthier and longer life. Having a plan can help. Start with small steps. For example, commit to adding one fruit or one vegetable a day for a week. Instead of having dessert, take a short walk.

  Statin medicine can lower the risk of heart attack and stroke.

  • For people whose chance of having a heart attack or stroke is high, taking a statin can be helpful.
  • For other people, it's not as clear if they need to take a statin. You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.
• Vascular Diseases

  Vascular Disease

  Vascular disease is a common medical condition, affecting approximately half of the US population. A wide range of vascular disorders exist, from cosmetic spider veins to more advanced conditions causing many different symptoms.

  Contributing factors include age (40+), family history, obesity, smoking, heavy lifting, multiple pregnancies and professions that require standing or sitting for long periods of time. If left untreated, venous reflux disease may worsen over time.

  Our interventional cardiologists use state-of-the-art technology to diagnose and treat all forms of vein disease. When left untreated, even varicose veins can lead to more serious concerns due to the progressive nature of the disease. Visit us for an evaluation if you are experiencing these signs and symptoms of venous disease:

  • Spider or "broken" veins
  • Bulging varicose veins
  • Leg or ankle swelling
  • Painful, aching, cramping legs
  • Leg heaviness and fatigue
  • Dry, flaky skin
  • Discolored skin (brown, purple, red)
  • Skin breakdown or ulcers

  What Causes Vascular Disease?
  The single most frequent cause of vein disease is heredity. Approximately 70% of all patients with varicose veins have parents with the same condition. Pregnancy, especially multiple pregnancies, is a contributing cause of vein disease. Other factors influencing vein disease are age, obesity, smoking, and jobs that require long periods of standing.

  Treatments for Vascular Disease
  Fortunately, treatments for vascular problems have a high success rate with little down time and easy recovery. Treating symptoms early is an important key.

  Treatments depend on the nature and severity of the problem and can include:

  • Lifestyle changes
  • Compression stockings
  • Sclerotherapy for spider and small varicose veins
  • Micro-phlebectomy for bulging varicose veins
  • Minimally-invasive thermal ablation (radio-frequency and laser)

  Using minimally-invasive techniques, our physicians treat

  • Swelling in the legs or ankles
  • Tight feeling, itching, or inflammation in the calves
  • Leg pain, heaviness or fatigue
  • Painful leg cramps
  • Skin changes such as itchy, dry skin or brownish discoloration
  • Discomfort in the legs with the urge to move frequently (restless leg syndrome)
  • Varicose veins (spider veins or bulging veins)
  • Bleeding from varicose veins
  • Leg ulcers

  Benefits of treatment

  • Significant relief of symptoms
  • Better cosmetic results
  • Less postoperative pain
  • Ability to resume normal activities within one to two days

  Treatment for venous reflux disease is performed on an outpatient basis, and the recovery time is minimal.

  Vascular Services
  All procedures are done on an outpatient basis. Check with your insurance company regarding policy coverage for venous reflux disease.

  For more information, please visit www.PVDProgram.com

In-Office Services

• Consultation

  General Physical Exams

  A physical examination, medical examination, or clinical examination is the process by which a medical professional investigates the body of a patient for signs of disease.  It generally follows taking of the medical history—an account of the symptoms as experienced by the patient.  Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.

  • Here’s how often you should have a complete physical by your doctor.

  

• Pre-operative Evaluation

  Pre-operative evaluation

  A history and physical examination, focusing on risk factors for cardiac, pulmonary and infectious complications, and a determination of a patient's functional capacity. In addition, the type of surgery influences the overall perioperative risk and the need for further cardiac evaluation. The purpose of a preoperative evaluation is to evaluate and, if necessary, implement measures to prepare higher risk patients for surgery. Pre-operative outpatient medical evaluation can decrease the length of hospital stay as well as minimize postponed or cancelled surgeries.

• Dobutamine Stress Test

  Dobutamine Echocardiogram

  Dobutamine echocardiogram measures your heart's tolerance to work and the heart wall movement when it is working very hard. This is a stress test of the heart using the medicine dobutamine to make it beat faster and harder. An echocardiogram is performed during the test. Your heart rate is measured by an electrocardiogram (ECG), and your blood pressure is taken while you are being given the medicine.

  Before The Test

  • You will be asked to sign a consent form after your doctor has explained the procedure and its risks to you.
  • You may be asked to refrain from eating or drinking (except water) for three hours before the test. Some foods may affect the test results. You should refrain from tobacco usage (cigarettes, chewing tobacco) for three hours before this test.
  • If you are being tested as an outpatient, please bring a list of your medications or the prescription bottles with you. If you are unsure whether to take your medications, please consult your doctor.
  • Please avoid using body lotion or body powder on your chest the day of the test. Lotions and powders interrupt the signals the monitor is picking up from your heart.

  During The Test

  • You will need to undress from the waist up; women will be given a hospital gown or a blanket with which to cover.
  • A staff member will place electrodes on your chest to monitor your heart rate. The skin may need to be lightly scraped and chest hair shaved on men to obtain clear test results.
  • Blood pressure cuffs will be used during this test. If your doctor has asked you to avoid using a blood pressure cuff on one or both arms, please inform the staff about this when you are getting prepared for the test.
  • A small intravenous catheter (IV catheter) will be placed in your hand or arm.
    The medicine given during the test will be given through this catheter. If you are an Inpatient and already have a catheter in your hand or arm, the staff nurse may first try to use this IV site.
  • You will first receive a resting echocardiogram. A trained technician will place a small instrument called a probe on the outside of your chest to obtain an image of your heart and its blood flow.
  • You will be asked to lie on your left side for the echo portion of the test. The technologist may ask you to change positions periodically.
  • You may hear a loud "whooshing" sound during the test. This sound occurs when the technologist is recording your blood flow.
  • Once this information is collected, the nurse or staff member will give you dobutamine, a medicine that quickens your heartbeat and increases your blood pressure. Lie quietly while this medicine is being given; however, if you have any discomfort or pain or shortness of breath, please let the staff know immediately. Sometimes this medicine can cause nausea. If you begin to feel bad, please tell the staff. Other medicines may be given to help you with symptoms or to assist doctors in obtaining additional information.
  • Once the medicine is given, the technologist will perform another echo ultrasound procedure with you lying on your side. This study usually takes only 15 - 20 minutes; once the medicine is stopped, your heart rate and blood pressure should gradually slow down. Your heart rate and blood pressure will be monitored during this time.

  Immediately After the Test

  • When the technologist has collected all the necessary data, the electrodes will be removed and you may get dressed.
  • Depending on your doctor's request, the catheter may be removed by a nurse or technologist from the arm or hand. Light pressure will be applied to the site to decrease any bleeding. If you are on medications that keep your blood from clotting, please tell the nurse so that pressure can be held a little longer.
  • You will probably feel tired after the test. You should avoid heavy exercise or physical work for the reminder of the day. If you have any symptoms or discomfort after you have left the Heart Center, you should contact your doctor immediately.
  • Your test results will be sent to your doctor, who will explain them to you.
• Echocardiogram

  Echocardiogram

  Similar to the sonograms used during pregnancy, an echocardiogram uses a transducer that is gently moved across the chest. The transducer emits sound waves that are converted into moving images of the heart. These images are displayed on a screen and can be recorded. This test allows our doctors to learn how the heart functions at rest. It provides valuable information about the structure, size, and how well your heart is pumping.

  Before The Test

  • You should allow one hour, which includes preparation and the imaging portion.
  • Wear comfortable attire, as you will be lying on an exam table, while the sonographer obtains your images.
  • There are no dietary restrictions for this test.
  • Bring your medications in their original containers with you to the test, so we may obtain an accurate list.

  During The Test

  • You will be asked to lie on an examination table. To improve the quality of the pictures, a colorless gel is applied to the area of the chest where the transducer will be placed.
  • We will apply electrodes (small sticky patches) to your chest, so we can record the electrical activity of your heart. This is called an EKG.
  • The sonographer moves the transducer to various places over the left side of your chest. Pictures of your heart at rest are recorded.

  Immediately After the Test

  • A written report will be sent to your referring physician.
  • Information gained from this test helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.
• Electrocardiogram

  Electrocardiogram

  An electrocardiogram or ECG is a graphic record of the electrical impulses of the heart. These impulses are conducted to the external surface of the body where they are detected by electrodes. It is important to realize that the ECG does not depict the actual physical state of the heart, or its function, but rather the electrical activity. These impulses (or your heart rate) are normally discharged 60 to 100 times per minute.

  Before The Test

  • There are no dietary restrictions prior to this test.
  • Please bring all of your current medications with you, or provide us with an accurate list. Include dosage and number of times you take medication in a day. Certain cardiac medications can slow the heart rate, and it will be helpful to know if you are on any of this medication. In contrast, certain cold and sinus medicine can increase your heart rate, and this information will be valuable to your physician.
  • Do not wear a one-piece jumpsuit, as you will be asked to undress from the waist up. Women will be provided a half gown, or cape to wear.

  During The Test

  • A trained medical assistant (or nurse) will place several electrodes (small sticky patches) on your chest. Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.
  • The electrodes are connected by wires to an ECG machine.

  After The Test

  • Immediately after the test, the physician can give you a complete interpretation.
  • If the test is abnormal or inconclusive, you doctor may order additional tests.
• Electrophysiology Study

  Electrophysiology Study

  The purpose of an Electrophysiology Study is to review the electrical system of the heart so the physician will know best how to treat you. The heart has an electrical system that controls how your heart beats. When this electrical system is working properly, the heart usually beats between 60 and 100 times per minute. The electrical impulse travels a pathway from the top of the heart to the bottom of the heart. Sometimes, the electrical system is not following a normal pathway, and the heart may beat too rapidly or too slowly. When this happens, the heart may not be able to pump adequate amounts of blood to your body.

  Before The Test

  • You may be asked to stop taking any medicines that affect your heart
  • Your heart will be monitored prior to the procedure.
  • You will be asked to sign consent forms after your doctor has answered all of your questions.
  • Most patients are not allowed to eat or drink after midnight prior to the procedure. Ask your nurse.
  • You will be asked to empty your bladder prior to the procedure and to wear only a hospital gown.
  • You may be given some medicine to help you relax before the procedure.
  • You will be taken to the cardiac cath lab by wheelchair or stretcher.

  During The Test

  • You will be lying on a padded flat table. Your heart will be monitored, and x-ray equipment will be around you. The equipment is sensitive to heat so therefore, the room is kept cold.
  • A numbing medicine (local anesthetic) will be injected into your groin area and a small catheter (tube) will be inserted into the vein in your groin.
  • Small wires will be guided into your heart through the catheters in the groin. X-ray equipment will be used to tell if the wires are in the correct position in your heart.
  • The doctor will use the wires to attempt to determine what is wrong with the electrical system in your heart.
  • Inform your doctor how you are feeling during the procedure.

  Immediately After The Test

  • The catheter in your groin may be removed before you return to your room, or it may remain in place for a short time. When this catheter is removed, a bandage will be applied and the site will be checked. You will be ordered to stay on bed rest for several hours after the procedure.
  • The doctor will talk to you about the results of the study and any necessary treatment plan.

   

• Exercise Echocardiogram (Stress Echo)

  Exercise Echocardiogram (Stress Echo)

  An exercise echocardiogram (also known as a stress echo) is a test that combines an ultrasound study of the heart with an exercise test. The test allows the doctor to learn how the heart functions when it has to work harder. This test is useful in diagnosing heart problems, such as coronary artery disease (blockages in the coronary arteries).

  Before The Test

  • You should allow an hour to an hour and a half for this test.
  • Wear or bring comfortable attire and walking/running shoes.
  • Refrain from eating at least two hours before the test. This will prevent the possibility of nausea, which may accompany vigorous exercise after eating.
  • Make your last meal light and without tea, coffee or alcohol.
  • If you are currently taking any heart medication, check with your CCT doctor. He or she may ask you to stop certain medications a day or two before the test. This may help obtain more accurate tests results.
  • Before the test, you will be given an explanation of the test and you will be asked to sign a consent form. Feel free to ask any questions about the procedure.
  • Several areas on your chest and shoulders will be cleansed with alcohol and an abrasive pad will be used to prepare the skin for the electrodes (small sticky patches). Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.

  During The Test

  • The test is divided into three parts. First, a resting echocardiogram is performed. Next, you will walk on a treadmill, and then another echocardiogram is performed while your heart is still beating rapidly after exercise.
  • Resting echocardiogram - You will be asked to lie on an exam table. To improve the quality of the pictures, a colorless gel is applied to the area of the chest where the transducer will be placed. Pictures of your heart are recorded on videotape.
  • Exercise test - You will walk slowly in place on a treadmill, on which the speed is increased to a faster pace and is then tilted to produce the effect of going up a small hill. The doctor will stop the test when you reach your peak heart rate, when you get too tired, or have significant symptoms.
  • After exercise echocardiogram - You will be asked to very rapidly return to the examining table, and lie once again on your left side. The sonographer will then record a second set of images while your heart is still beating rapidly. The CCT doctor can then compare the two sets of images. This will be before and after exercise side by side to see how your heart responds to the stress of exercise.

  After The Test

  • The doctor conducting the test can give you results before you leave. A complete interpretation will be sent to your referring physician.
  • If the test is abnormal or inconclusive, then additional tests may be ordered.
  • The information gained from the stress echo helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.
• Exercise Stress Test

  Exercise Stress Test

  This test, typically involving the patient walking on a treadmill while attached to an electrocardiogram, measures a patient's ability to exercise and the electrical waves of the heart during exercise. This test can help detect heart problems that may not be apparent at rest.

  Before The Test

  • You should allow one hour, which includes preparation for the test, the exercise portion, and the recovery period.
  • Wear or bring comfortable attire and walking/running shoes.
  • Refrain from eating at least two hours before the test. This will prevent the possibility of nausea, which may accompany vigorous exercise after eating.
  • Make your last meal light and without tea, coffee or alcohol.
  • If you are currently taking any heart meditation, check with you Baylor Scott & White Cardiology Consultants of Texas doctor. He or she may ask you to stop certain medications a day or two before the test. This can help-get more accurate test results.
  • Before the test, you will be given an explanation of the test and you will be asked to sign a consent form. Feel free to ask any questions about the procedure.
  • Several areas on your chest and shoulders will be cleansed with alcohol and an abrasive pad will be used to prepare the skin for the electrodes (small sticky patch). Men may need to have areas of their chest shaved, to ensure that the electrodes stay in place.

  After The Test

  • After the exercise portion of the test is over, you will still be monitored for another 5 to 10 minutes while you recover. The medical assistant or nurse will remove the electrodes and cleanse the electrode sites.
  • The doctor conducting the test can give you results before you leave. A complete interpretation will be sent to your referring physician.
  • If the test is abnormal or inconclusive, then additional tests may be ordered.
  • The information gained from the exercise test helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.
• Exercise Thallium

  Exercise Thallium

  A thallium scan is a test that uses a radioactive substance (known as a tracer) to produce images of the heart muscle. When combined with an exercise test, the thallium scan helps determine if areas of the heart do not receive enough blood.

  Purpose
  The exercise thallium test is especially useful in diagnosing coronary artery disease, the presence of blockages in the coronary arteries. These arteries supply oxygen to the heart muscle. Tracers, other than thallium, can be used for this type of scan. Your Baylor Scott & White Cardiology Consultants of Texas doctor will decide if your situation warrants a different type of tracer.

  Before The Test
  IF YOU ARE NURSING OR IF YOU THINK YOU MAY BE PREGNANT, INFORM THE BSW Cardiology Consultants of Texas DOCTOR OR NUCLEAR TECH BEFORE THE EXAMINATION.

  • You will receive an instruction sheet that pertains to the specific type of tracer your physician plans to use. If you have any questions, please ask your doctor or the nuclear technician.
  • You may be asked to fast (not eat or drink anything) for three to four hours or longer prior to your exam. If you cannot fast, or are diabetic, ask your BSW Cardiology Consultants of Texas doctor or nurse for special instructions.
  • You will be instructed not to have food or drink prior to the test that contains caffeine. For example, coffee, tea, colas (even "caffeine-free"), and chocolate foods all contain different amounts of caffeine.
  • Be sure to notify our office nurse or nuclear tech of all the medicines you are taking. Some medicines may affect the test results.
  • Wear loose, comfortable clothing that is suitable for exercise. You should also wear comfortable walking shoes or tennis shoes.
  • Before the test, you will be given an explanation of the test and you will be asked to sign a consent form. Feel free to ask any questions about the procedure.

  During The Test

  • The test has two parts: the exercise imaging portion and the rest imaging portion.
  • Several electrodes (small sticky patches) will be placed on your chest to obtain an electrocardiogram (ECG). This will record your heart's electrical activity.
  • An intravenous (IV) line will be started in a vein in your arm. This will allow injection of the radioactive tracer during exercise.
  • Depending on the type of exam that is ordered, you will be exercising several minutes on a treadmill. If you cannot walk on a treadmill, then a prescribed medication will be injected over several minute periods. In either case, the purpose is to increase the workload being placed on your heart.
  • You will be instructed to report any symptoms, such as chest pain, shortness of breath, or dizziness. Try to exercise for as long as you are able to, as this will increase the accuracy of the test.
  • Tell the nuclear technician when you are almost to the point when you can no longer exercise. At this point, the tracer will be injected into the intravenous line. You will be asked to continue to exercise for another minute or so after the injection.
  • Imaging portion: You will then lie flat on a special table under a scanning camera. Several pictures of the heart will be taken at various angles. You should remain still while the pictures are being taken. This part can take up to 20 minutes.
  • After this initial set of pictures, you will be asked to return in 2 to 4 hours to have additional pictures taken without repeating the exercise. These images are compared to the images obtained during the first part of the test. The technician will give you specific instructions regarding when to return, and what food you can eat.

  After The Test

  • No sedation is given during this test; therefore, you will be able to drive home directly after the test.
  • The BSW Cardiology Consultants of Texas doctor conducting the test may be able to give you preliminary results before you leave. However, a complete interpretation usually takes several days.
  • In addition to being called, a copy of your test results is sent to your referring physician.
  • This test generally provides more information than an exercise stress test. This will help your doctor make an accurate diagnosis and develop a treatment plan that is best for you.
• Holter Monitoring

  Holter Monitoring

  Holter monitoring is a continuous recording of your ECG, usually for 24 hours, while you go about your usual daily activities. It is especially useful in diagnosing abnormal heart rhythms. The Holter monitor itself is a small, portable cassette recorder, worn on a strap over the shoulder. Several electrodes (small sticky patches) are placed on your chest and connected by wires to the recorder.

  Purpose

  • To detect abnormal heart rhythms that may now occur during a standard ECG test.
  • To assess recurring symptoms such as dizziness, fainting, and palpitations.
  • To evaluate the effectiveness of treatments, such as medications and pacemakers, that help control abnormal heart rhythms.

  Before The Test

  • Wear a loose fitting blouse or shirt, with the buttons in the front.
  • Do not use lotions or bath oil on your skin. This will prevent the electrodes from sticking on your skin for 24 hours.
  • There are no dietary restrictions.
  • Ask your physician if you are to take your medication as ordered.

  During The Test

  • Several areas on your chest will be cleansed with alcohol and an abrasive pad, to ensure good electrode contact. Men may need to have areas of their chest shaved.
  • Please inform the medical assistant or nurse if you are allergic to cloth or paper tape. This will be used to help secure the electrodes on your skin.
  • The electrodes are connected by wires to the recorder. The nurse or medical assistant will check the system to make sure it is working properly.
  • You can do anything you would normally do, except take a bath or shower while the monitor is on. Do not get the electrodes, wires, or recorder wet.
  • The nurse will show you a button on the recorder to press if you have a symptom that you want the physician to especially note. When you press this button, it marks the tracing for the doctor. This will help the doctor correlate your symptoms with your ECG tracing.
  • Try to sleep on your back, with the recorder positioned at your side so that the electrodes are not pulled off.
  • You will keep a diary (or log) in which you enter your activities, any symptoms you experience, and the time at which the symptoms occurred. The diary is very important, because it enables the doctor to correlate your activities and symptoms with the ECG tracing. DO NOT FORGET TO BRING THE DIARY BACK WHEN YOU RETURN THE RECORDER.

  After The Test

  • Once you return the monitor, the cassette is analyzed by a computer, and scanned by a technician. The report is printed for the CCT doctor to review.
  • The information gained will help your Baylor Scott & White Cardiology Consultants of Texas doctor make an accurate diagnosis and develop a treatment plan for you. A full report will be sent to your referring physician.
• Nuclear Medicine Test

  Nuclear Medicine Test

  A nuclear medicine test is a study aimed at measuring whether the blood flow to your heart is normal or abnormal. The study utilizes a radioactive tracer to create an image of how well blood is reaching your heart muscle, both during exercise and while at rest. During a nuclear medicine test a radioactive dye is injected into the blood stream while a special scanner that detects the radioactive material takes pictures of the heart.

  At Central Cardiology Medical Center, we perform 3 types of Nuclear Medicine tests: 1) Lexiscan, 2) SPECT and 3) PET scan. During a lexiscan a medication that is a stress agent is injected into the bloodstream and increases blood flow in the arteries of the heart while a scanner takes pictures of the heart. A SPECT (Single Photon Emission Computed Tomography) uses a radioactive agent that is injected into the bloodstream while a scanner takes pictures of the heart. A cardiac PET (Positron Emission Tomography) scan is similar to a SPECT except it uses a different radioactive agent as the markers that are injected into the bloodstream while pictures are taken.

• Transesophageal Echocardiogram

  Transesophageal Echocardiogram

  An echocardiogram is an ultrasound of the heart. It uses sound waves that are bounced off the heart, reflected back and converted to images on the screen. A trained cardiologist will pass a flexible tube through the mouth and into the esophagus to obtain more information about your heart. This gives clearer pictures of the values, structures and size of the heart as opposed to an echocardiogram done from outside the chest wall.

  Purpose
  The images reflect the structure of the heart and the function and movement of the valves and heart chambers.

  Before The Test

  • If done as an outpatient we advise you to have someone drive you to the hospital and take you home. You may receive sedation.
  • Do not eat for several hours before the test (your Baylor Scott & White Cardiology Consultants of Texas doctor will instruct you as to the exact amount of time).
  • If you accidently do eat, please notify the lab, as your test may need to be rescheduled.

  Day Of The Test

  • You will be asked to sign a special permit after the test has been explained to you.
  • Electrodes will be attached to your chest to monitor your heart.
  • The oxygen in your blood will be monitored using a monitoring device attached to a finger.
  • An intravenous (IV) line will be started so that medications can be given to you.
  • You will be asked to lie on your left side.
  • A "numbing medicine" will be sprayed into the back of your throat.
  • Medications to induce drowsiness will be given through an IV line.
  • Once sedated, a tube will be passed down the patient's throat into the esophagus.
  • Images are then taken of the heart.
  • The test lasts approximately 15 minutes.

  Immediately After The Test

  • Patient begins to wake up shortly after scope is removed.
  • Liquids are given once throat is no longer numb (your BSW Cardiology Consultants of Texas doctor will instruct you as to the exact amount of time).
  • Patient is observed until the doctor okays your return to hospital room or leaving the hospital.

  Reactions

  • Most patients notice a mild sore throat after the procedure.
  • A cardiologist will review the study and inform you or your doctor of the results.
• Ultrasounds

  Ultrasounds

  A sonogram is a test that sends high-pitched sound waves through your skin, and the echoes form a picture on a TV monitor. This test measures blood flow through your arteries. It is useful for locating blockages. This test is non-invasive (there is no penetration of the skin by needles, etc.).

  At Central Cardiology Medical Center we perform venous ultrasounds (studying the veins), arterial ultrasounds (studying the arteries), carotid scans (study of the carotid arteries), general ultrasounds and AAA (Abdominal Aortic Anuerysm ultrasounds to study the abdominal aortic artery) tests.

  Before The Procedure
  There are no special preparations for this test. You will be taken to the Vascular Lab in a wheelchair or by stretcher.

  During The Procedure
  If you go by wheelchair, you will then lie on a bed in an exam room for the test. There will be a short wait while the Vascular lab technician reviews your chart. A water-based gel is used to keep contact with the skin. The sound waves then produce a visual and sound image on a monitor.
  While the technician does the test, he/she may be making a video tape for your physician to watch. The technician will be talking into the machine telling your physician what the test shows about your vascular system. You may hear your heartbeat and/or a whooshing sound as your blood flows.

  After The Procedure
  After a brief wait, you will be taken back to your room by wheelchair or stretcher. Your physician will explain the results of the tests after he/she views the video.

• Ankle Brachial Index (ABI)

  Ankle Brachial Index (ABI)

  The Ankle Brachial Index (ABI) is the systolic pressure at the ankle, divided by the systolic pressure at the arm. It has been shown to be a specific and sensitive metric for the diagnosis of Peripheral Arterial Disease (PAD). Additionally, the ABI has been shown to predict mortality and adverse cardiovascular events. The major cardiovascular societies advise measuring an ABI in every smoker over 50 years old, every diabetic over 50, and all patients over 70.
  
  Before The Procedure
  There are no special preparations for this test. You will be taken to the Vascular lab.
  
  During The Procedure
  You will be asked to lie on a bed in an exam room for the test. There will be a short wait while the technician reviews your chart. Blood pressures will be taken on your arms and ankles. The changes in pressures will help your physician locate any suspected blockages. The technician will chart out the pressures on a map of the vascular system, and place it in your chart for your physician to review.
  
  After The Procedure
  After a brief wait, you will be taken back to your room. Your physician will explain the results of the test after he/she reviews the charted pressures.

• Vein Ablations

  Vein Ablations

  Vein ablation is an image-guided, minimally invasive treatment that uses radiofrequency or laser energy to cauterize and close varicose veins in the legs. It is most commonly used to help ease varicose vein related symptoms such as aching, swelling, skin irritation, discoloration or inflammation. Vein ablation is safe, less invasive than conventional surgery, and leaves virtually no scars.

  Varicose veins are abnormally large veins commonly seen in the legs. Normally, blood circulates from the heart to the legs via arteries and back to the heart through veins. Veins contain one-way valves which allow blood to return from the legs against gravity. If the valves leak, blood pools in the veins, and they can become enlarged or varicose. Using ultrasound guidance, a catheter or vascular access sheath is inserted through the skin and positioned within the abnormal vein. The laser fiber or radiofrequency electrode is inserted through the catheter and the tip of the fiber or electrode is exposed by pulling the catheter back slightly. Local anesthetic is injected around the abnormal vein with ultrasound guidance. Laser or radiofrequency energy is applied as the catheter is slowly withdrawn. Pressure will be applied to prevent any bleeding and the opening in the skin is covered with a bandage. This procedure is usually completed within an hour.

  A follow up ultrasound examination is essential in order to assess the treated vein and to check for adverse outcomes. Within one week, the target vein should be successfully closed.

  When To Arrive
  • Please arrive at least 15 minutes ahead of your scheduled appointment time.
  • We ask that you please notify us at least 24 hours prior to your appointment if you need to cancel your appointment.

  What To Wear
  • Wear comfortable loose-fitting clothing and do not wear jewelry

  How Long Will The Test Last
  • The test lasts approximately 30 minutes

  Medications
  • Please bring all of your medications or a complete list with you the day of the study.
  • Please notify us if you are diabetic, hypoglycemic, or asthmatic. If you are diabetic, please adjust your insulin or oral medication to your dietary intake.
  • If you use an inhaler, please bring this with you.
  • Your physician may advise you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners for a specified period of time before your procedure.

  You should plan to have a relative or friend drive you home after your procedure.

• Vascular Catheterization

  Vascular Catheterization

  Our Cath Lab is staffed by specially trained physicians and medical personnel to provide high-quality care and beneficial treatment for patients with peripheral vascular disease. A catheterization procedure permits your physician to more clearly define your vascular problem. Specific imaging helps us see the condition of your arteries and veins of the extremities, arterial supply to your brain and kidneys and other organs and to detect the presence of disease or blockages.

  Peripheral Angiography: This procedure allows the physician to evaluate the presence of plaque build-up (Atherosclerosis) or blockages in the peripheral arteries located in the legs. Build-up of plaque in the peripheral arteries can cause pain, especially in the legs when walking, and other conditions are often identified, like aneurysms or complete vascular occlusions.

  Peripheral Revascularization: This procedure allows the doctor to treat severe peripheral arterial disease (PAD) by using devices to improve the blood supply to your extremities. Device options include atherectomy devices which remove plaque, balloons, and/or stents. This treatment helps to increase the blood flow where needed. By increasing the arterial blood flow to the patient’s extremities, this procedure helps in the treatment of non-healing wounds, discomfort from walking, swelling and or cramping.

  What To Expect
  Once the date for your procedure has been arranged by our scheduling department, a Cath Lab team member will call you before the procedure and set up an arrival and estimated start time. If your procedure is scheduled to start before noon, please do not to eat or drink anything after midnight the night before. If your procedure is scheduled to begin in the afternoon, a “small” light breakfast is permitted. You may take your daily medications with small sips of water, except for patients with diabetes. Patients on Metformin or blood thinners should discuss cessation dates prior to all procedures with our staff.

  Important: The procedure start time is a projected time based on the types of cases scheduled for that particular day. Sometimes, cases may take longer than expected due to the severity of a patient’s illness. We are dedicated to all of our patient’s health and safety and we take our time with each case to ensure the best available outcome. Procedures usually last 30 minutes to 2 hours. After the procedure, you will rest in one of our recovery rooms for approximately 1 to 4 hours. Your recovery time will be dependent on several factors including the complexity of the procedure, if you were given blood thinners or other medications during the procedure, and whether vascular access closure devices were used. A meal will be provided for our patients during the recovery time. You may have your family stay in the recovery room with you.

  Follow-up Testing:
  Central Cardiology Medical Center is committed to the treatment of our patients with peripheral vascular disease, and we believe that monitoring with ultrasound and regular office visits are vital to the success of your cardiovascular health.

• Anti-Coagulant Clinic (Coumadin Clinic)

  Anti-Coagulant Clinic (Coumadin Clinic)

  Central Cardiology Medical Center offers a Coumadin Clinic to our patient. Anti-coagulant medication (often referred to as Coumadin, Warfarin or blood thinners) is sometimes necessary to prevent or treat conditions related to improper blood flow or clotting. It is important for patients taking Coumadin to get regular and timely blood tests to assure the effect of the blood thinner remains in the desired range.

  Our patients benefit from one-on-one counseling and education regarding Coumadin side effects as well as the effects of various foods and other medications that can affect the test results.

  We improve the comfort of these blood draws by using a finger stick method with the Protime/INR monitoring system rather than a venous blood draw. We provide our patients with immediate test results and dosing instructions.