A non-invasive procedure that records the electrical activity of the heart through a series of electrodes placed on the skin. It can used as a screening study to detect underlying cardiac issues.

For patients on Warfarin (Coumadin), we have a dedicated Coumadin Clinic that would be delighted to draw and trend your INR levels on weekly, biweekly, or monthly intervals, and make any necessary dose adjustments. We can also work with our patients who prefer to have their own home monitoring system to ensure they are staying in a therapeutic window.

A Holter Monitor is type of portable heart monitor that records and stores your heart rhythm, typically for a 24 to 48-hour period, so they can be coincided with symptoms. It is useful for identifying heart rhythm disturbances that are sporadic.

A portable event monitor is similar to a holter, but it is worn for a longer duration of time. Over the study period, the monitor is directly recording and transmitting information to your healthcare provider. It also stores information regarding symptoms so they can be correlated with any rhythm disturbances.

An “echo” is a non-invasive test which uses sound waves to visualize the structure and function of the heart and great vessels. It is a valuable screening tool that can be combined with a stress test to diagnose a variety of heart conditions. It typically takes no more than 30 minutes to complete.

The Exercise Stress Test (EST) is a widely used screening study that can be help identify blockages in the heart’s arteries (the coronary arteries), and provide a monitored assessment of exercise capacity. During the test, our patients exercise on a treadmill with gradual increases in the speed and slope with continuous monitoring of their electrocardiograms and blood pressures.

A stress echo is a procedure that combines echocardiography with exercise stress tests to evaluate the heart's function at rest and after exercise. The combination provides a much more accurate assessment for problems with the heart’s arteries.

This is a non-invasive nuclear cardiology imaging test that shows how well blood flows through the heart's muscles. It can show areas of the heart that are not getting enough blood flow, indicative of a heart artery blockage, in addition to areas of the heart muscle that are scarred. In an appropriately selected patient, these studies can be the most reliable forms of stress tests.

This is a non-invasive screening study used to evaluate for peripheral artery disease (PAD). Blood-pressure cuffs are applied to the arms and at specific points in the lower limbs. Based on the ratio of the blood pressure measurements in the legs, compared to the arms, we can screen for blockages in the peripheral arteries. Coronary Artery Disease (CAD) has a very strong correlation with peripheral artery disease, and patients diagnosed with one of these conditions should also be screened for the other.

This test uses sound waves to scan the veins and arteries in the body to help detect a plaque build-up and/or clot. The results help guide management of peripheral arterial and venous disease.

Transesophageal Echocardiograms are invasive ultrasound studies done in a hospital setting, which provide more in-depth information about cardiac anatomy when an abnormality is suspected. A long, flexible tube containing an ultrasound is passed into portions of the gastrointestinal tract that the heart resides close to. From these positions, the heart is visualized much more clearly, and valvular abnormalities and blood clots can be confidently assessed.

A loop recorder is a small device, typically less than the size of a USB-drive, that is implanted just under the skin of the chest in a minimally invasive procedure. These monitors can continuously record and transmit the heart's electrical activity for several years at a time.

Also known as a “Heart Cath”, this is an invasive test performed at the hospital when there is suspicion of Coronary Artery Disease (CAD). A long hollow tube, or catheter, is threaded into the heart’s arteries through the large arteries in either the groin or the wrist. Dye is injected into the coronary arteries while taking images. Unlike non-invasive stress tests, which provide an indirect assessment of coronary disease, a “heart cath” offers a direct assessment for coronary blockages. In most instances, the blockage can be corrected by balloon angioplasty and stenting, as described in the 'PCI' section of this page.

An invasive procedure that is performed in the hospital through a major vein in the groin or the arm. A long hollow tube, or catheter, is advanced to the heart artery that connects to the lungs, and is then gradually withdrawn to adjacent portions of the heart. Through the catheter we are able to measure pressures and oxygen consumption in these structures to diagnose a variety of problems.

Manufactured by St. Jude Medical, the CardioMEMS device is the only FDA-approved monitoring system for heart failure patients. The wireless device is implanted directly into the pulmonary artery (the heart artery that connects to the lungs) via a catheter introduced into one of the body’s major veins. From there, the device regularly transmits data regarding heart pressures and rates to a dedicated Cardiovascular Care Associates staff-member. This information provides an early warning sign to the build-up of fluid in the body. It has been shown to improve quality of life and decrease rehospitalization in heart failure patients.

A therapeutic procedure performed in adjunct with a left heart catheterization when a significant narrowing is detected in the heart’s arteries. The operator restores blood flow by inflating a balloon (balloon angioplasty) at that narrowed segment, often times this is followed by the insertion of a stent to keep the blockage from reforming. These blockages are due to the buildup of cholesterol plaque and/or blood clots, and can lead to debilitating symptoms and/or result in a heart attack.

Also performed in adjunct with a left heart catherization when a significant narrowing is detected in the heart’s arteries. A coronary atherectomy is a therapeutic intervention performed for a coronary blockage that would not yield with a conventional balloon angioplasty and stent, alone. During an atherectomy, a small rotating device is used to break up particularly hard and calcified cholesterol plaques inside an artery, restoring blood flow.

Peripheral Angiograms are invasive procedures that can be performed in both the outpatient and inpatient laboratory setting. For this study, a catheter is advanced to the arterial segment of concern to help visualize, diagnose, and treat disease involving the arteries of the abdomen, kidneys, legs, and neck (carotid arteries- which supply the brain). If a blockage is identified, in many instances this can be addressed with balloon angioplasty in conjunction with atherectomy and stenting.

Carotid Arterial Disease is very prevalent in patients with coronary disease, and can be associated with strokes. Traditionally, open surgical repair was the treatment of choice for this condition. However, for patients felt to be at an intermediate or high risk for Carotid Endarterectomy (surgical correction of the carotid arteries), Carotid Arterial Disease can be treated with angioplasty and stenting performed via a catheter inserted through a major blood vessel of the body.

During fetal development, oxygen is supplied through the placenta and the developing lungs are bypassed with the assistance of a channel between the upper two chambers of the heart. This channel normally closes in infancy. However, for approximately a quarter of the population, this closure does not occur, resulting in a Patent Foramen Ovale. In the majority of patients, this is of no consequence, but in patients with unexplained or recurrent strokes, where medical therapy has failed, closure can be performed with the assistance of a catheter directed to the heart through a major blood vessel.

An ASD is a birth defect that results when the wall between the upper two chambers of the heart is incompletely formed, resulting in a shunt. In some patients, this shunt can predispose to problems later in life, including Congestive Heart Failure (CHF) and high blood pressure in the lungs (Pulmonary Hypertension). Certain ASDs can be closed without open-heart surgery, with the assistance of a catheter directed to the heart through a major blood vessel.