Coronary Artery Disease
Coronary artery disease develops when your coronary arteries the major blood vessels that supply your heart with blood, oxygen and nutrients become damaged or diseased. Cholesterol deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.
When plaques build up, they narrow your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.
Peripheral Vascular/Arterial Disease
Peripheral artery disease is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease your extremities — usually your legs — don’t receive enough blood flow. The most common symptom is leg pain when walking (intermittent claudication). The arteries of the legs can be blocked with cholesterol plaque which can be opened up with balloons, stents, and/or atherectomy devices. If you have been having leg cramping or a decrease in the distance you can walk then an evaluation to look for blockages may be warranted.
Angiography Angiography is the use of radiologic contrast dye in an artery to look for blockages. Typically, iodine based dye is employed and if you are allergic to iodinated dye you should inform us prior to the procedure. Angiography can be done in the cardiac catheterization lab where (upon review) blockages can be addressed with either medical or a procedural strategy. We can use balloons, stents, and other devices to help open arteries if required after an angiographic diagnosis. If medical management is best for you a steady regimen of dietary modifications, blood pressure and cholesterol control is advised.
Percutaneous Coronary Intervention
PCI is a procedure used to open clogged heart arteries that involves temporarily inserting and inflating a tiny balloon where your artery is clogged to help widen the artery. Angioplasty is often combined with the permanent placement of a small wire mesh tube called a stent to help prevent the stent from forming blockages and decrease its chance of narrowing again. Some stents are coated with medication to help keep your artery open (drug-eluting stents), while others are not (bare-metal stents). If you require such therapy we will give a detailed consultation
Peripheral Vascular Disease Screening
Ankle brachial Index/Pulsed Volume Recording is a noninvasive test to assess for peripheral arterial blockages. The ABI compares the blood pressure of the ankle to the blood pressure in the arm to assess for disease. We can assess your risk for peripheral vascular disease at the time of your visit in our diagnostic laboratory.
Ultrasound can also be used to asses the peripheral arteries of the body and of the neck for obstructive blockages. Ultrasound is also utilized to assesses the veins of the body for swelling and blood clots.
A nuclear stress test measures blood flow to your heart at rest and while your heart is working harder as a result of exertion or medication. The test provides images that can show areas of low blood flow through the heart and damaged heart muscle.
The test usually involves taking two sets of images of your heart — one while you’re at rest and another after you heart is stressed, either by exercise or medication.
You may be given a nuclear stress test, which involves injecting a radioactive dye into your bloodstream, if your doctor suspects you have coronary artery disease or if a routine stress test didn’t pinpoint the cause of symptoms such as chest pain or shortness of breath. A nuclear stress test may also be used to guide your treatment if you’ve been diagnosed with a heart condition.
Nuclear Stress Test (Exercise or Pharmacological) and Cardiac PET Imaging are two different types of testing that we offer here at our office.
Exercise Stress Test
A stress test, also called an exercise stress test, gathers information about how your heart works during physical activity. Because exercise makes your heart pump harder and faster than usual, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise.
An exercise stress test usually involves walking on a treadmill while your heart rhythm, blood pressure and breathing are monitored.
Your doctor may recommend an exercise stress test if he or she suspects you have coronary artery disease or an irregular heart rhythm (arrhythmia).
We provide diagnostic evaluation with echocardiography, the use of sound waves to identify structures, function, valvular integrity and blood flow. Through this noninvasive approach we can provide more accurate diagnosis of and ease of mind with curtailed therapy.
Sometime cardiac structures are best visualized from the backside of the heart. Transesophageal, or through the esophagus, places the ultrasound probe in the esophagus where certain structures such as the mitral valve can be visualized more accurately.
We provide Transesophageal Echocardiography or TEE in the hospital setting.
EKG or Electrocardiography
This is a simple test that records the electrical activity of the heart. The electrical system of the heart will send out signals that can be recorded as the heart muscle contracts and relaxes in normal and abnormal ways for the diagnosis of electrical/conduction system disease or arterial blockages.
Holter and Event Monitoring
Holter monitors are used to diagnose rhythm problems with heart. We have a variety of monitoring systems in office that patients can take with them and wear for 48 hours up to 30 days to provide us with a complete snapshot of cardiac electricity of the heart during that period of time. If you have been having palpitations, heart fluttering, dizziness or syncope (passing out) you may need a thorough evaluation.
Advanced Lipid Screening
High cholesterol levels often are a significant risk factor for heart disease. A lipid panel or lipid profile is a blood test that shows your total cholesterol, HDL-cholesterol (often referred to as good cholesterol), LDL-cholesterol (often referred to as bad cholesterol), and triglyceride levels. This test can help determine your risk of the buildup of plaques in your arteries that can lead to narrowed and blocked arteries throughout your body called atherosclerosis. Remember, high cholesterol levels usually don’t cause any signs or symptoms, so a cholesterol test is an important tool in detection. We also offer advanced cholesterol screening which detects other atherogenic molecules.