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Heart, Vascular & Vein Care
We offer a wide range of cardiac care services and treatments and a full array of diagnostic tests that are quality driven, accessible, and patient-centered.
A nuclear exercise test, also known as a nuclear stress test, is a diagnostic test used to evaluate blood flow to the heart muscle. The test is performed by injecting a small amount of a radioactive tracer into the bloodstream and then using a special camera, called a gamma camera, to take pictures of the heart.
The test is usually performed in two parts: a rest portion and an exercise portion. During the rest portion, the patient lies still while the gamma camera takes images of the heart. During the exercise portion, the patient performs physical activity, such as walking on a treadmill, to stress the heart and increase blood flow. The gamma camera then takes additional images of the heart.
The test helps determine if there are any areas of the heart muscle that are not receiving enough blood during physical activity, which can indicate a blockage in the coronary arteries. If a blockage is identified, further tests may be necessary to determine the best course of treatment, such as angioplasty or bypass surgery.
Overall, a nuclear exercise test is a non-invasive and valuable tool for diagnosing and evaluating heart disease. The test provides important information that helps healthcare providers make informed decisions about the best treatment options for their patients.
A cardiology stat consultation is a medical consultation requested immediately or on an urgent basis for patients with suspected or known cardiovascular conditions. It is a time-sensitive evaluation performed by a cardiologist to diagnose and treat critical or life-threatening cardiac problems.
The cardiology stat consultation may include:
Based on the results of these evaluations, the cardiologist will diagnose the patient’s condition and provide immediate treatment or refer the patient for further evaluation and treatment if necessary. The goal of the cardiology stat consultation is to provide prompt and effective care for patients with critical cardiac conditions.
An EKG (electrocardiogram) is a test that records the electrical activity of the heart. It is used to detect problems with the heart’s rhythm and structure. The test is non-invasive and is typically done in a doctor’s office or a hospital setting.
During the test, small electrodes are placed on the chest, arms, and legs. The electrodes are connected to an EKG machine, which records the electrical activity of the heart. The test is painless and usually takes only a few minutes to complete.
The EKG can detect a variety of heart conditions, including:
The results of an EKG are typically available within a few days. The test results are interpreted by a healthcare professional, usually a cardiologist. They will be able to detect any abnormalities in the electrical activity of the heart and can use the results to make a diagnosis or to monitor treatment progress.
It is important to note that EKG is not always the only diagnostic test, and other tests such as echocardiogram, stress test, or coronary angiography may be needed to have a better understanding of the cardiovascular status of the patient.
A vascular ultrasound is a medical imaging test that uses high-frequency sound waves to produce images of the blood vessels and the blood flow within them. The test is used to diagnose and evaluate a wide range of vascular conditions, including peripheral artery disease, deep vein thrombosis, and aneurysms.
During a vascular ultrasound, a transducer, which is a small handheld device, is placed on the skin over the area of the body being examined. The transducer sends out high-frequency sound waves that bounce off the blood vessels and create echoes, which are captured by the transducer and used to create images of the blood vessels and the blood flow within them.
Vascular ultrasound is a non-invasive and painless procedure that does not use ionizing radiation, making it a safe and effective alternative to other imaging tests such as angiography. The test can be performed quickly and easily in a doctor’s office or an outpatient setting, and the results are typically available immediately.
Overall, vascular ultrasound is a valuable tool for diagnosing and evaluating a wide range of vascular conditions. The test provides important information that helps healthcare providers make informed decisions about the best treatment options for their patients.
Varicose vein therapy is a medical treatment used to alleviate symptoms and improve the appearance of varicose veins, which are swollen and enlarged veins that can be seen just under the surface of the skin. Varicose veins are commonly found in the legs and can cause symptoms such as pain, swelling, and fatigue.
Our In-clinic treatments:
The type of varicose vein therapy that is right for a particular patient depends on several factors, including the location and severity of the varicose veins, the patient’s age and health, and the patient’s personal preferences.
In general, varicose vein therapy is a safe and effective way to alleviate symptoms and improve the appearance of varicose veins. The procedure is usually performed on an outpatient basis, and patients can usually return to their normal activities soon after the procedure. However, it is important to discuss the benefits and risks of each type of varicose vein therapy with your cardiologist to determine the best treatment option for each individual patient.
A cardiology telemetry test is a diagnostic test used to monitor the electrical activity of the heart. The test involves the use of a portable device, often referred to as a Holter monitor or telemetry monitor, that is worn by the patient and connected to electrodes placed on the skin. The device records the electrical signals produced by the heart and transmits this information to a computer for analysis.
The purpose of the test is to identify any irregular heart rhythms or other electrical problems that may be causing symptoms such as palpitations, shortness of breath, or dizziness. The test may also be used to monitor the effectiveness of treatments for heart conditions such as arrhythmias.
During the test, the patient carries out their normal daily activities while wearing the telemetry monitor. The monitor typically records the heart’s electrical activity for 24-48 hours. After the test, a cardiologist will analyze the data to identify any abnormal heart rhythms and make any necessary recommendations for further treatment.
Overall, a cardiology telemetry test is a non-invasive and convenient way to monitor the electrical activity of the heart and identify any potential issues that may require treatment.
A blood pressure clinic is a medical facility or service that focuses on measuring and monitoring a person’s blood pressure levels. Blood pressure is the force of blood pushing against the walls of arteries and is a key indicator of cardiovascular health. Blood pressure clinics can offer services such as regular blood pressure screenings, diagnosis and treatment of high blood pressure, and guidance on lifestyle changes to manage blood pressure. The goal is to help people maintain healthy blood pressure levels and reduce their risk of cardiovascular disease.
Cardiovascular implantable device interrogation refers to the process of obtaining information from a cardiovascular medical device that has been implanted in a patient’s body. This type of device may include a pacemaker, implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy (CRT) device. The goal of the interrogation is to assess the device’s performance, detect any potential issues, and make necessary adjustments to optimize the patient’s treatment. Interrogation is typically performed using a specialized device that communicates wirelessly with the implanted device and retrieves information such as battery status, lead impedance, and electrogram recordings. This information helps healthcare providers to monitor the device’s performance and ensure that it is delivering the appropriate therapy to the patient.
A subcutaneous cardiac rhythm monitor is a type of medical device used to monitor a patient’s heart rhythm. Unlike traditional external heart monitors, this device is implanted under the patient’s skin and does not require leads or wires to be attached to the patient’s chest. The device uses electrodes to detect and record electrical signals from the heart, which can then be transmitted wirelessly to a remote monitoring system. This allows healthcare providers to monitor a patient’s heart rhythm over a prolonged period of time, even when the patient is at home or engaging in normal activities. The goal of the subcutaneous cardiac rhythm monitor is to provide continuous, real-time monitoring of heart rhythm and detect any abnormal rhythms that may require medical intervention.
Cardiovascular oncology is a subspecialty within cardiology and oncology that deals with the management of cardiovascular complications in patients with cancer. It focuses on the evaluation and treatment of heart problems that can arise as a result of cancer treatment or the presence of cancer in the body. Cancer treatments such as chemotherapy, radiation therapy, and immunotherapy can cause cardiovascular side effects such as heart damage, arrhythmias, or heart failure. Cardiovascular oncologists work with oncologists and other healthcare providers to manage these complications and optimize the patient’s overall health. They also focus on developing strategies to prevent or reduce the risk of cardiovascular complications in cancer patients and improving their quality of life. This can involve assessing cardiovascular risk factors, modifying cancer treatment plans, and prescribing medications to protect the heart.
Cardiology pre-operative clearance is a process that is conducted prior to any surgical procedure to ensure the safety and health of the patient. It involves a thorough evaluation of the patient’s cardiovascular system to determine any underlying conditions, such as heart disease, hypertension, or arrhythmias, that may affect the outcome of the surgery.
The cardiology pre-operative clearance process typically includes:
Based on the results of these evaluations, the cardiologist will provide recommendations and clearance for the patient’s surgery or refer the patient to a specialist for further evaluation if necessary. The goal of cardiology pre-operative clearance is to ensure the patient’s safety and to minimize the risk of complications during and after the surgical procedure.
A cardiology consultation is a meeting between a patient and a specialist in heart health, also known as a cardiologist. During a cardiology consultation, the cardiologist assesses the patient’s symptoms, medical history, and risk factors for heart disease. They may also conduct physical examinations and perform diagnostic tests such as electrocardiogram (ECG), echocardiogram, or stress tests to evaluate the patient’s heart function. The goal of the consultation is to diagnose any heart problems and develop a treatment plan to manage or improve the patient’s cardiovascular health. This may include lifestyle modifications, medications, procedures, or surgery, depending on the nature and severity of the patient’s condition. Cardiology consultations can be used to manage a wide range of heart conditions, such as high blood pressure, heart failure, arrhythmias, and coronary artery disease.
Angioplasty is a medical procedure used to widen narrowed or obstructed arteries or veins, typically to treat conditions such as coronary artery disease or peripheral artery disease. During the procedure, a small balloon catheter is inserted into the narrowed vessel and inflated to compress the plaque against the vessel wall, restoring blood flow. In some cases, a stent may be inserted to help keep the artery or vein open after the balloon is removed. Angioplasty is often performed as a less invasive alternative to surgery and can help alleviate symptoms such as chest pain or leg pain caused by reduced blood flow.
Cardiac catheterization is a medical procedure used to diagnose and treat certain heart conditions. During the procedure, a thin, flexible tube called a catheter is inserted into a blood vessel, usually in the groin or wrist, and threaded through to the heart. This allows doctors to measure pressures and oxygen levels within the heart chambers and blood vessels, as well as to inject contrast dye to visualize the arteries and chambers of the heart using X-ray or fluoroscopy.
Cardiac catheterization is commonly used to:
It’s an important tool in the diagnosis and treatment of various heart conditions, providing valuable information to guide further management. While generally considered safe, there are risks associated with cardiac catheterization, such as bleeding, infection, and damage to blood vessels or the heart.
Balloon valvuloplasty, also known as balloon valvotomy, is a medical procedure used to treat certain types of heart valve diseases, particularly stenosis, where the valve becomes narrowed and obstructs blood flow through the heart.
During the procedure, a catheter with a deflated balloon at its tip is inserted into a blood vessel, typically in the groin area, and guided to the heart. Once positioned across the narrowed heart valve, the balloon is inflated. The inflation helps to stretch and widen the valve opening, improving blood flow through the valve.
Balloon valvuloplasty is most commonly performed on the mitral valve and the aortic valve. It can provide significant relief of symptoms such as shortness of breath, chest pain, and fatigue in patients with valve stenosis.
Cardioversion is a medical procedure used to restore a normal heart rhythm in individuals who have certain types of abnormal heart rhythms, particularly atrial fibrillation (AFib) or atrial flutter.
There are two main types of cardioversion:
Electrical cardioversion: In this procedure, a controlled electric shock is delivered to the heart through pads or paddles placed on the chest. This shock briefly stops the heart’s electrical activity, allowing the heart’s natural pacemaker to regain control and hopefully establish a normal rhythm.
Chemical (or pharmacological) cardioversion: Instead of using electric shocks, medications are administered intravenously to help restore a normal heart rhythm. These medications, such as anti-arrhythmic drugs, work by affecting the electrical activity of the heart and promoting the restoration of a normal rhythm.
Cardioversion is typically performed in a hospital setting under monitored conditions to ensure safety and effectiveness. The choice between electrical and chemical cardioversion depends on various factors including the patient’s overall health, the type and duration of the abnormal rhythm, and the presence of other medical conditions.
While cardioversion can be highly effective in restoring normal heart rhythm, it’s important to recognize that it may not be a permanent solution. In many cases, additional treatments such as medications or procedures may be necessary to maintain a normal rhythm over the long term.
Transcatheter Aortic Valve Replacement (TAVR), also known as Transcatheter Aortic Valve Implantation (TAVI), is a minimally invasive procedure used to treat aortic valve stenosis, a condition where the aortic valve becomes narrowed, obstructing blood flow from the heart to the rest of the body.
During the TAVR procedure:
Preparation: The patient is typically given anesthesia to ensure they are comfortable and pain-free during the procedure. The medical team inserts a catheter into a blood vessel, usually in the groin or chest, and guides it to the heart.
Valve Placement: Once the catheter is positioned within the heart, a replacement valve is delivered to the site of the diseased aortic valve. This replacement valve is typically made of biological material (such as cow or pig tissue) or synthetic material and is compressed onto a balloon at the end of the catheter.
Expansion of the Valve: Once the replacement valve reaches the site of the diseased valve, the balloon is inflated, expanding the replacement valve and pushing the diseased valve leaflets out of the way. The new valve effectively takes over the function of the old valve, allowing for improved blood flow.
Monitoring and Recovery: Throughout the procedure, the medical team monitors the patient’s vital signs and heart function. After the valve is successfully implanted, the catheter is removed, and the incision site is typically closed with stitches or a closure device. The patient is then monitored closely during the recovery period.
TAVR is considered a less invasive alternative to traditional open-heart surgery for eligible patients, particularly those who are at higher risk or considered inoperable for surgical valve replacement. It often results in shorter hospital stays, quicker recovery times, and reduced risk of complications compared to open-heart surgery.
Stenting is a medical procedure used to treat narrowed or blocked blood vessels, typically arteries, to restore normal blood flow. The procedure involves the placement of a small, mesh-like tube called a stent into the affected vessel.
Here’s how the process generally works:
Preparation: The patient is typically given local anesthesia at the insertion site, often in the groin or wrist, where the catheter will be inserted. In some cases, general anesthesia may be used.
Insertion of Catheter: A thin, flexible tube called a catheter is inserted into a blood vessel and guided to the site of the blockage using imaging techniques such as fluoroscopy or angiography.
Placement of Stent: Once the catheter reaches the narrowed or blocked area of the blood vessel, a deflated balloon attached to the catheter is positioned within the blockage. The balloon is then inflated, expanding the stent and pressing it against the vessel walls. This expansion opens up the narrowed area, allowing improved blood flow.
Stent Deployment: After the stent is expanded, the balloon is deflated and removed, leaving the stent in place to hold the artery open. Some stents are designed to gradually release medication to help prevent re-narrowing of the artery, a process known as drug-eluting stenting.
Monitoring and Recovery: Throughout the procedure, the patient’s vital signs and heart function are monitored closely. After the stenting is complete, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is typically observed for a short period before being discharged, often on the same day or after an overnight stay.
Stenting is commonly used to treat coronary artery disease, peripheral artery disease, and other conditions that cause narrowing or blockage of blood vessels. It can help alleviate symptoms such as chest pain (angina), leg pain, and shortness of breath, and may reduce the risk of heart attack or stroke.
Coronary atherectomy is a medical procedure used to treat coronary artery disease by removing plaque buildup from the arteries that supply blood to the heart muscle. This plaque buildup can restrict blood flow, leading to chest pain (angina) or increasing the risk of a heart attack.
During a coronary atherectomy procedure:
Preparation: The patient is typically given local anesthesia, and a small incision is made in the groin or wrist area to access the blood vessel.
Insertion of Catheter: A thin, flexible tube called a catheter is inserted into the blood vessel and guided to the site of the blockage in the coronary artery using imaging techniques such as fluoroscopy or angiography.
Plaque Removal: Once the catheter reaches the narrowed area of the artery, a special device attached to the catheter is used to remove the plaque buildup. There are different types of atherectomy devices, including rotational atherectomy, directional atherectomy, orbital atherectomy, and laser atherectomy. These devices use various mechanisms, such as cutting, shaving, or vaporizing, to remove the plaque and restore blood flow.
Monitoring and Recovery: Throughout the procedure, the patient’s vital signs and heart function are monitored closely. After the plaque removal is complete, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is typically observed for a short period before being discharged.
Coronary atherectomy is often used as an alternative or adjunct to balloon angioplasty and stent placement in cases where the plaque is too hard or calcified to be adequately treated with balloon angioplasty alone. It can help improve blood flow through the coronary arteries, relieve symptoms, and reduce the risk of complications such as heart attack or stroke.
Fractional flow reserve (FFR) is a diagnostic technique used to assess the severity of narrowings or blockages in the coronary arteries. It measures the pressure difference across a stenosis (narrowing) in a coronary artery to determine if it is significantly impeding blood flow to the heart muscle.
During an FFR procedure:
Catheterization: A catheter is inserted into a blood vessel, usually in the groin or wrist, and advanced to the coronary arteries under X-ray guidance.
Measurement: Once the catheter is in place, a pressure-sensitive wire is threaded through it and positioned just beyond the narrowing in the coronary artery. The wire measures the pressure before and after the narrowing.
Inducing Hyperemia: A medication, such as adenosine, is administered to induce hyperemia, which dilates the coronary arteries and increases blood flow. This allows for more accurate measurement of pressure differences across the stenosis.
Calculation of FFR: The FFR is calculated by dividing the pressure measured beyond the stenosis by the pressure measured before the stenosis. An FFR value of 1.0 indicates normal blood flow, while values less than 0.80 typically indicate significant narrowing and reduced blood flow.
FFR provides valuable information to help guide treatment decisions, particularly in cases where the severity of a coronary artery narrowing is uncertain. It helps identify lesions that are causing ischemia (inadequate blood supply) and may benefit from interventions such as angioplasty and stenting.
The use of FFR has been shown to improve patient outcomes and reduce the need for unnecessary interventions, such as stenting, in lesions that are not causing significant ischemia. It allows for a more targeted approach to treatment, focusing on lesions that are truly causing symptoms or posing a risk to the patient’s health.
Acute coronary syndrome (ACS) is a term used to describe a group of conditions that are associated with sudden, reduced blood flow to the heart. These conditions include:
Unstable angina: Chest pain or discomfort that occurs at rest or with minimal exertion. It may be a new symptom, or a change from stable angina, which is chest pain that occurs with predictable patterns of activity.
Non-ST segment elevation myocardial infarction (NSTEMI): A type of heart attack where there is evidence of heart muscle damage, but the characteristic changes on an electrocardiogram (ECG) called ST-segment elevation are not present.
ST-segment elevation myocardial infarction (STEMI): A type of heart attack where there is complete blockage of a coronary artery, leading to significant damage to the heart muscle. This is characterized by changes on an ECG showing elevation of the ST segment.
ACS occurs when there is a sudden rupture or erosion of a plaque within a coronary artery, leading to the formation of a blood clot that partially or completely blocks blood flow to the heart muscle. This can result in symptoms such as chest pain or discomfort, shortness of breath, nausea, sweating, or lightheadedness.
ACS is considered a medical emergency and requires prompt evaluation and treatment to minimize damage to the heart muscle and prevent complications such as heart failure, life-threatening arrhythmias, or death. Treatment for ACS may include medications to relieve symptoms, thin the blood and prevent further clot formation, and procedures such as angioplasty and stent placement or coronary artery bypass surgery to restore blood flow to the heart.
Coronary imaging refers to various techniques used to visualize the coronary arteries, which are the blood vessels that supply oxygen-rich blood to the heart muscle. These imaging techniques are important for diagnosing and assessing coronary artery disease (CAD), which is a condition characterized by narrowing or blockages in these arteries.
Some common coronary imaging modalities include:
Coronary Angiography: This is the gold standard for imaging the coronary arteries. It involves injecting a contrast dye into the arteries and taking X-ray images (angiograms) to visualize any blockages or narrowings. It provides detailed information about the location and severity of coronary artery disease and is often performed during cardiac catheterization.
Intravascular Ultrasound (IVUS): IVUS uses a tiny ultrasound probe attached to the tip of a catheter to create detailed images of the inside of the coronary arteries. It provides information about the structure of the artery walls, plaque buildup, and the size of the vessel lumen. IVUS can be particularly useful in guiding interventions such as angioplasty and stent placement.
Optical Coherence Tomography (OCT): OCT is similar to IVUS but uses light instead of sound waves to create high-resolution images of the coronary arteries. It provides detailed information about plaque composition and can help guide treatment decisions during interventions.
Coronary Computed Tomography Angiography (CCTA): CCTA involves obtaining detailed images of the coronary arteries using computed tomography (CT) scanning. It can provide information about the presence, location, and severity of coronary artery disease without the need for invasive procedures. CCTA is often used to screen for CAD in individuals with chest pain or other symptoms suggestive of heart disease.
Fractional Flow Reserve (FFR): FFR is a physiological measurement rather than an imaging modality, but it is often used in conjunction with coronary angiography. It involves measuring pressure differences across a coronary artery stenosis to assess its significance and determine if intervention (such as angioplasty or stenting) is warranted.
These imaging modalities play a crucial role in diagnosing and managing coronary artery disease by providing detailed information about the structure and function of the coronary arteries. The choice of imaging technique depends on factors such as the patient’s symptoms, clinical presentation, and the information needed to guide treatment decisions.
Percutaneous coronary intervention (PCI), also known as coronary angioplasty or balloon angioplasty, is a minimally invasive procedure used to treat narrowed or blocked coronary arteries, which are the blood vessels that supply oxygen-rich blood to the heart muscle.
During a percutaneous coronary intervention:
Preparation: The patient is typically given local anesthesia, and a small incision is made in the groin or wrist to access the femoral or radial artery.
Insertion of Catheter: A thin, flexible tube called a catheter is inserted into the artery and guided through the blood vessels to the coronary arteries using X-ray guidance.
Angiography: Once the catheter reaches the coronary arteries, a contrast dye is injected through the catheter, and X-ray images (angiograms) are taken to visualize any blockages or narrowings in the arteries.
Balloon Angioplasty: If a significant blockage is identified, a balloon-tipped catheter is inserted into the narrowed artery and positioned across the blockage. The balloon is then inflated, compressing the plaque against the artery walls and widening the artery to improve blood flow.
Stent Placement: In many cases, a stent—a small, mesh-like tube—is placed in the artery to help keep it open after the balloon is deflated and removed. The stent acts as a scaffold, preventing the artery from collapsing or becoming blocked again.
Monitoring and Recovery: Throughout the procedure, the patient’s vital signs and heart function are monitored closely. After the intervention is complete, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is typically observed for a short period before being discharged.
Percutaneous coronary intervention is often performed as a treatment for angina (chest pain) or to improve blood flow to the heart in individuals with coronary artery disease. It can help alleviate symptoms, improve heart function, and reduce the risk of heart attack or other complications associated with blocked arteries.
Coronary physiology testing refers to a group of diagnostic tests that assess the functional significance of coronary artery disease (CAD) by evaluating blood flow and pressure within the coronary arteries. These tests provide valuable information about the severity of blockages or narrowings in the arteries and help guide treatment decisions for individuals with CAD.
Some common coronary physiology tests include:
Fractional Flow Reserve (FFR): FFR is a technique used during coronary angiography to measure the pressure difference across a blockage in a coronary artery. It helps determine if the blockage is causing a significant reduction in blood flow to the heart muscle and if intervention (such as angioplasty and stenting) is warranted. FFR values less than 0.80 typically indicate significant narrowing and reduced blood flow.
Instantaneous Wave-Free Ratio (iFR): iFR is a newer technique similar to FFR that also measures the pressure difference across a blockage in a coronary artery but does so during a specific part of the cardiac cycle known as the wave-free period. iFR can provide similar diagnostic information to FFR but may be easier to perform and less dependent on the use of adenosine, a medication used to induce hyperemia during FFR.
Coronary Flow Reserve (CFR): CFR is a measure of the ability of the coronary arteries to increase blood flow in response to increased demand, such as during exercise or medication-induced stress. It is typically assessed using Doppler ultrasound or other imaging techniques and provides information about the overall health and function of the coronary arteries.
Index of Microcirculatory Resistance (IMR): IMR is a measure of microvascular function that assesses resistance to blood flow in the small blood vessels of the heart. It provides information about the health of the microcirculation and can help identify individuals at risk of adverse outcomes, such as heart attack or heart failure.
These coronary physiology tests play a crucial role in the management of CAD by providing additional information beyond traditional angiography about the functional significance of coronary artery narrowings
Cardiovascular disease (CVD) refers to a group of conditions that affect the heart and blood vessels. It’s the leading cause of death globally and encompasses a range of disorders, including:
Coronary artery disease (CAD): CAD occurs when the blood vessels that supply oxygen-rich blood to the heart muscle become narrowed or blocked due to the buildup of plaque (atherosclerosis). This can lead to chest pain (angina), heart attack, or other complications.
Hypertension (high blood pressure): Hypertension is a condition characterized by elevated blood pressure levels, which can strain the heart and blood vessels over time, increasing the risk of heart attack, stroke, and other cardiovascular complications.
Heart failure: Heart failure occurs when the heart is unable to pump enough blood to meet the body’s needs. It can result from various underlying conditions, including CAD, hypertension, and cardiomyopathy, and can lead to symptoms such as shortness of breath, fatigue, and swelling of the legs and ankles.
Arrhythmias: Arrhythmias are abnormal heart rhythms that can cause the heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly. They can occur as a result of CAD, hypertension, heart failure, or other underlying conditions and can increase the risk of complications such as stroke or sudden cardiac arrest.
Valvular heart disease: Valvular heart disease occurs when the valves of the heart do not function properly, leading to problems with blood flow within the heart. It can result from conditions such as rheumatic fever, congenital heart defects, or age-related changes in the heart valves.
Peripheral artery disease (PAD): PAD occurs when the arteries that supply blood to the limbs become narrowed or blocked, typically due to atherosclerosis. It can cause symptoms such as leg pain, numbness, or weakness, and increases the risk of complications such as gangrene or limb amputation.
These are just a few examples of cardiovascular diseases, and there are many other conditions that fall under the broader category of CVD. Risk factors for CVD include age, family history, smoking, unhealthy diet, physical inactivity, obesity, diabetes, and high cholesterol levels. Prevention and management of CVD typically involve lifestyle modifications (such as regular exercise, healthy diet, smoking cessation), medications to control risk factors, and in some cases, procedures or surgeries to treat underlying conditions. Early detection and treatment of CVD are crucial for reducing the risk of complications and improving outcomes.
Left atrial appendage occlusion (LAAO) is a procedure used to reduce the risk of stroke in individuals with atrial fibrillation (AFib) who are at high risk of blood clot formation in the left atrial appendage (LAA). AFib is a type of irregular heart rhythm that can cause blood to pool in the LAA, increasing the risk of stroke due to the formation of blood clots.
During the LAAO procedure:
Preparation: The patient is typically given sedation or anesthesia to ensure comfort during the procedure. The procedure is often performed in a catheterization laboratory (cath lab) or hybrid operating room.
Insertion of the Device: A catheter is inserted into a blood vessel, usually in the groin or wrist, and guided to the heart under X-ray or ultrasound guidance. A special device, such as a Watchman™ device, is then delivered through the catheter to the opening of the LAA.
Closure of the LAA: The device is deployed at the opening of the LAA, where it forms a barrier to prevent blood from entering the appendage. Over time, tissue grows over the device, permanently sealing off the LAA.
Monitoring and Recovery: After the device is successfully implanted, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored closely for a short period before being discharged. Blood-thinning medications (anticoagulants) are typically continued for a period of time after the procedure to prevent blood clots while the tissue grows over the device.
LAAO is an alternative to long-term anticoagulant therapy (such as warfarin or direct oral anticoagulants) for stroke prevention in individuals with AFib who are at high risk of bleeding complications from blood thinners or who have other contraindications to anticoagulant therapy. It has been shown to be effective in reducing the risk of stroke in these individuals and may also reduce the risk of bleeding complications associated with long-term anticoagulant use.
Percutaneous valve repair refers to minimally invasive procedures used to treat heart valve disorders without the need for open-heart surgery. These procedures are typically performed in a catheterization laboratory (cath lab) and involve the use of specialized devices to repair or replace dysfunctional heart valves.
There are several types of percutaneous valve repair procedures, including:
Transcatheter Aortic Valve Replacement (TAVR): TAVR is used to treat aortic valve stenosis, a condition where the aortic valve becomes narrowed and obstructs blood flow from the heart to the rest of the body. During TAVR, a replacement valve is delivered to the site of the diseased aortic valve through a catheter and deployed, effectively replacing the diseased valve.
Transcatheter Mitral Valve Repair (TMVR): TMVR is used to treat mitral valve regurgitation, a condition where the mitral valve does not close properly, causing blood to leak backward into the left atrium of the heart. TMVR procedures typically involve the use of devices such as the MitraClip®, which clips together the leaflets of the mitral valve to reduce regurgitation.
Transcatheter Pulmonary Valve Replacement (TPVR): TPVR is used to treat pulmonary valve stenosis or regurgitation, conditions where the pulmonary valve becomes narrowed or leaky. TPVR procedures typically involve the use of a balloon-expandable or self-expanding valve that is delivered to the site of the diseased pulmonary valve through a catheter and deployed, effectively replacing the diseased valve.
Transcatheter Tricuspid Valve Repair (TTVR): TTVR is used to treat tricuspid valve regurgitation, a condition where the tricuspid valve does not close properly, causing blood to leak backward into the right atrium of the heart. TTVR procedures typically involve the use of devices such as the TriClip®, which clips together the leaflets of the tricuspid valve to reduce regurgitation.
Percutaneous valve repair procedures offer several advantages over traditional open-heart surgery, including shorter recovery times, reduced risk of complications, and the ability to treat high-risk patients who may not be candidates for surgery.
Septal closure, also known as atrial septal defect (ASD) closure, is a procedure used to treat a hole in the wall (septum) between the upper chambers of the heart, known as the atria. This hole is called an atrial septal defect (ASD), and it can lead to abnormal blood flow between the atria, which may cause symptoms or complications over time.
During an ASD closure procedure:
Preparation: The patient is typically given sedation or anesthesia to ensure comfort during the procedure. The procedure is often performed in a catheterization laboratory (cath lab) or hybrid operating room.
Insertion of the Device: A catheter is inserted into a blood vessel, usually in the groin or wrist, and guided to the heart under X-ray or ultrasound guidance. A special device, such as an ASD closure device, is then delivered through the catheter to the site of the ASD.
Closure of the ASD: The device is deployed at the site of the ASD, where it expands and covers the hole in the septum. Over time, tissue grows over the device, permanently closing the ASD and restoring normal blood flow between the atria.
Monitoring and Recovery: After the device is successfully implanted, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored closely for a short period before being discharged. Blood thinning medications (anticoagulants) are typically continued for a period of time after the procedure to prevent blood clots while the tissue grows over the device.
ASD closure is usually recommended for individuals who have symptoms related to their ASD, such as shortness of breath, fatigue, or recurrent respiratory infections, or for those who have an increased risk of complications such as heart failure, arrhythmias, or stroke due to the ASD. Closure of the ASD helps prevent abnormal blood flow between the atria, reduces symptoms, and lowers the risk of complications associated with the defect.
Transcatheter mitral valve repair (TMVR) is a minimally invasive procedure used to treat mitral valve regurgitation, a condition where the mitral valve does not close properly, causing blood to leak backward into the left atrium of the heart.
During a TMVR procedure:
Preparation: The patient is typically given sedation or anesthesia to ensure comfort during the procedure. The procedure is often performed in a catheterization laboratory (cath lab) or hybrid operating room.
Insertion of the Device: A catheter is inserted into a blood vessel, usually in the groin or wrist, and guided to the heart under X-ray or ultrasound guidance. A special device, such as the MitraClip®, is then delivered through the catheter to the site of the mitral valve.
Clipping of the Valve Leaflets: The MitraClip® device consists of a small clip that is attached to the leaflets of the mitral valve, reducing the amount of regurgitation by bringing the leaflets closer together. Multiple clips may be used to optimize the repair.
Assessment and Adjustment: The position and placement of the clips are assessed using echocardiography (ultrasound imaging of the heart). The clips may be adjusted as needed to achieve an optimal result.
Monitoring and Recovery: After the clips are successfully placed and adjusted, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored closely for a short period before being discharged.
TMVR offers several advantages over traditional open-heart surgery for mitral valve repair, including shorter recovery times, reduced risk of complications, and the ability to treat high-risk patients who may not be candidates for surgery.
Carotid artery stenting is a minimally invasive procedure used to treat carotid artery stenosis, which is the narrowing of the carotid arteries, the major blood vessels in the neck that supply blood to the brain. This narrowing can increase the risk of stroke by restricting blood flow to the brain or by causing plaque to break off and travel to smaller blood vessels in the brain.
During carotid artery stenting:
Preparation: The patient is typically given local anesthesia, and a small incision is made in the groin or wrist to access the femoral or radial artery.
Insertion of the Catheter: A thin, flexible tube called a catheter is inserted into the artery and guided through the blood vessels to the carotid arteries using X-ray guidance.
Placement of the Stent: Once the catheter reaches the narrowed area of the carotid artery, a balloon-tipped catheter with a stent mounted on it is positioned across the blockage. The balloon is inflated, expanding the stent and pressing it against the artery walls. The stent remains in place to hold the artery open and improve blood flow.
Monitoring and Recovery: After the stent is successfully implanted, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored closely for a short period before being discharged.
Carotid artery stenting is often used as an alternative to carotid endarterectomy, which is a surgical procedure to remove plaque buildup from the carotid artery. It may be preferred in certain patients who are at higher risk for complications from surgery, such as those with significant medical comorbidities or previous neck surgery.
Myocardial biopsy is a medical procedure used to obtain a small sample of heart muscle tissue (myocardium) for diagnostic purposes. It is typically performed to investigate the cause of certain heart conditions or to monitor the progression of heart diseases.
During a myocardial biopsy:
Preparation: The patient is typically given local anesthesia to numb the area where the biopsy will be taken. In some cases, sedation or general anesthesia may be used.
Insertion of the Biopsy Needle: A thin, flexible biopsy needle is inserted into a blood vessel, usually in the groin or neck, and guided to the heart under X-ray or ultrasound guidance.
Collection of Tissue Sample: Once the biopsy needle reaches the heart, a small sample of myocardial tissue is obtained by using the needle to remove a tiny piece of tissue. Multiple samples may be taken from different areas of the heart if needed.
Monitoring and Recovery: After the biopsy samples are obtained, the needle is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored closely for a short period before being discharged.
Myocardial biopsy samples are typically examined under a microscope by a pathologist to look for abnormalities such as inflammation, infection, tumors, or other changes in the heart tissue. The results of the biopsy can help diagnose conditions such as myocarditis, cardiomyopathy, or rejection of a heart transplant.
Alcohol septal ablation (ASA) is a minimally invasive procedure used to treat hypertrophic cardiomyopathy (HCM), a genetic condition characterized by abnormal thickening of the heart muscle (myocardium), particularly the ventricular septum—the wall that separates the two lower chambers of the heart (ventricles).
During an alcohol septal ablation:
Preparation: The patient is typically given sedation or anesthesia to ensure comfort during the procedure. The procedure is often performed in a catheterization laboratory (cath lab) or hybrid operating room.
Insertion of the Catheter: A catheter is inserted into a blood vessel, usually in the groin or wrist, and guided to the heart under X-ray or ultrasound guidance.
Identification of the Septal Artery: Once the catheter reaches the area of the heart with the thickened septum, a special dye is injected through the catheter to visualize the septal artery, which supplies blood to the thickened portion of the septum.
Delivery of Alcohol: After the septal artery is identified, a small amount of pure alcohol is injected through the catheter into the septal artery. The alcohol causes controlled damage to the septal tissue, reducing the thickness of the septum and relieving symptoms of HCM.
Monitoring and Recovery: After the alcohol is injected, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding. The patient is monitored closely for a short period before being discharged.
Alcohol septal ablation is an alternative to surgical septal myectomy, which involves open-heart surgery to remove a portion of the thickened septum. ASA is typically recommended for individuals with obstructive HCM who have symptoms such as chest pain (angina), shortness of breath, or heart failure that are not well controlled with medications. The procedure can help alleviate symptoms, improve exercise capacity, and reduce the gradient of pressure across the obstructed septum.
A specialized procedure used to diagnose and treat heart rhythm disorders, also known as arrhythmias. During these tests, physicians evaluate the electrical activity of the heart to identify any abnormalities that may be causing irregular heartbeats.
There are various types of electrophysiology tests, including:
These tests play a crucial role in diagnosing and managing various heart rhythm disorders, including atrial fibrillation, ventricular tachycardia, and atrioventricular nodal reentrant tachycardia, among others. Treatment options may include medication, lifestyle changes, catheter ablation, pacemaker implantation, or cardioverter-defibrillator placement, depending on the specific arrhythmia and its underlying cause.
Pacemaker insertion, also known as pacemaker implantation or pacemaker placement, is a surgical procedure performed to implant a small electronic device called a pacemaker into the chest or abdomen of a patient. Pacemakers are commonly used to treat heart rhythm disorders, particularly bradycardia (a slow heartbeat) or certain types of arrhythmias where the heart’s natural pacemaker is not functioning properly.
Here’s an overview of the pacemaker insertion procedure:
Pacemaker insertion is a safe and effective procedure that can significantly improve the quality of life for patients with certain heart rhythm disorders.
Defibrillator insertion, also known as implantable cardioverter-defibrillator (ICD) implantation, is a surgical procedure performed to implant a small electronic device called an implantable cardioverter-defibrillator. ICDs are used to monitor and regulate heart rhythm, delivering electrical shocks to restore normal rhythm in case of dangerous arrhythmias or sudden cardiac arrest.
Here’s an overview of the defibrillator insertion procedure:
Preparation: Before the procedure, the patient undergoes a comprehensive evaluation, including a medical history review, physical examination, and possibly additional tests such as electrocardiogram (ECG), echocardiogram, or cardiac catheterization. The patient may need to stop certain medications before the procedure.
Anesthesia: Defibrillator insertion is typically performed under local anesthesia, which numbs the area where the incision will be made. In some cases, sedation may also be given to help the patient relax.
Incision: The surgeon makes a small incision (usually about 5-7 centimeters long) in the chest or abdomen, typically just below the collarbone (for chest implantation) or beneath the skin of the abdomen (for abdominal implantation).
Placement of Leads: Thin, flexible wires called leads are inserted through a vein and advanced into the heart. The leads are guided to the appropriate location within the heart chambers and secured in place. These leads are connected to the defibrillator device, which is implanted under the skin near the incision site.
Testing: Once the leads are in position, the defibrillator is tested to ensure proper function and pacing parameters. The device is programmed with specific settings for detecting and treating abnormal heart rhythms.
Closure: After confirming the proper function of the defibrillator, the incision site is closed with sutures or adhesive strips, and a sterile dressing is applied.
Recovery: The patient is usually monitored for a brief period in a recovery area before being discharged home. Recovery time varies depending on the individual and the type of defibrillator implantation performed. Most patients can resume normal activities within a few days to a week after the procedure.
Follow-up: Regular follow-up appointments are scheduled to monitor the function of the defibrillator, adjust settings if necessary, and ensure the overall health of the patient.
Defibrillator insertion is a safe and effective procedure that can significantly improve the prognosis and quality of life for patients at risk of sudden cardiac death due to certain heart rhythm disorders.
Minimally invasive procedure used to treat certain types of abnormal heart rhythms, known as cardiac arrhythmias. During the procedure, thin, flexible tubes called catheters are inserted into a blood vessel (usually in the groin or arm) and guided to the heart. Once in the heart, the catheters are used to deliver energy, typically in the form of radiofrequency or cryotherapy, to destroy (ablate) small areas of heart tissue that are causing the abnormal electrical signals responsible for the arrhythmia.
Here’s an overview of the catheter ablation procedure:
Preparation: Before the procedure, the patient undergoes a thorough evaluation, including a medical history review, physical examination, and possibly additional tests such as electrocardiogram (ECG), echocardiogram, or cardiac MRI. The patient may need to stop certain medications prior to the procedure.
Anesthesia: Catheter ablation is usually performed under local anesthesia, which numbs the area where the catheters will be inserted. In some cases, sedation or general anesthesia may also be used to help the patient relax or sleep during the procedure.
Insertion of Catheters: The catheters are inserted into a blood vessel (usually the femoral vein in the groin or the subclavian vein in the arm) and carefully threaded through the blood vessels to reach the heart. X-ray or other imaging techniques are used to guide the catheters to the precise location within the heart where the arrhythmia originates.
Mapping: Specialized catheters with electrodes at their tips are used to map the electrical activity of the heart and identify the specific areas causing the arrhythmia. High-resolution mapping systems create detailed maps of the heart’s electrical signals, helping the electrophysiologist pinpoint the target area for ablation.
Ablation: Once the target area is identified, the catheter delivers energy (such as radiofrequency energy or extreme cold from cryotherapy) to create small scars or lesions on the heart tissue. These lesions disrupt the abnormal electrical pathways responsible for the arrhythmia, restoring normal heart rhythm.
Monitoring: Throughout the procedure, the patient’s heart rhythm and vital signs are continuously monitored to ensure safety and efficacy.
Assessment and Post-procedure Care: After the ablation is completed, the catheters are removed, and pressure is applied to the insertion site to prevent bleeding. The patient is typically monitored for a period of time in a recovery area before being transferred to a regular hospital room or discharged home.
Catheter ablation is generally safe and effective for treating a variety of cardiac arrhythmias, including supraventricular tachycardia (SVT), atrial fibrillation (AFib), atrial flutter, and ventricular tachycardia (VT).
Peripheral artery disease (PAD) is a common circulatory condition in which narrowed arteries reduce blood flow to the limbs, usually the legs. It’s often caused by atherosclerosis, a buildup of plaque in the arteries, leading to reduced blood flow to the affected areas. Here’s a breakdown of peripheral artery disease:
PAD is a chronic condition that requires ongoing management and monitoring to prevent complications and maintain overall health and well-being. With proper treatment and lifestyle changes, many people with PAD can lead active, fulfilling lives.
Watchman procedure is a minimally invasive treatment option for patients with atrial fibrillation (AFib) who are at risk of stroke and are unable to take long-term oral anticoagulant medication. The Watchman device is designed to reduce the risk of stroke by sealing off the left atrial appendage (LAA), which is a small pouch in the heart where blood clots often form in patients with AFib.
Here’s an overview of the Watchman procedure:
1. Preparation: Before the procedure, the patient undergoes a thorough evaluation, including medical history review, physical examination, and imaging tests such as transesophageal echocardiography (TEE) to assess the size and shape of the LAA.
2. Anesthesia: The procedure is typically performed under general anesthesia to ensure the patient remains comfortable and still during the placement of the device.
3. Insertion of the Watchman Device: A catheter (thin, flexible tube) is inserted into a vein in the groin and guided to the heart. Using real-time imaging techniques such as fluoroscopy and TEE, the catheter is advanced into the left atrium and positioned near the opening of the LAA.
4. Deployment of the Device: The Watchman device is delivered through the catheter and guided into the LAA. Once properly positioned, the device is expanded to seal off the opening of the LAA, preventing blood clots from forming inside.
5. Confirmation and Assessment: After the device is deployed, its position and stability are confirmed using imaging techniques such as TEE or fluoroscopy. The catheter and delivery system are then removed, and the insertion site in the groin is closed with sutures or a closure device.
6. Recovery Following the procedure, the patient is monitored in a recovery area for a few hours to ensure there are no immediate complications. Most patients are able to go home the same day or the following day.
7. Follow-up: Regular follow-up appointments are scheduled to monitor the placement of the device, assess its effectiveness in preventing stroke, and adjust medications as needed.
The Watchman procedure offers an alternative to long-term oral anticoagulation therapy for patients with AFib who are at risk of stroke but are unable to take blood thinners due to bleeding risk or other factors. Like any medical procedure, there are risks associated with the Watchman procedure, including bleeding, stroke, device migration, and pericardial effusion (fluid buildup around the heart). However, clinical trials have demonstrated that the Watchman device is effective in reducing the risk of stroke in patients with AFib while also potentially reducing the need for long-term anticoagulant therapy.