Office

In case of suspected true cardiac emergency, such as acute chest pain, sudden shortness of breath, passing out, or any other emergencies, please CALL 911 immediately.

Outpatient evaluation of new patients with wide variety of cardiac problems and symptoms. We see self-referred patients, as well as patients where consultation is requested by their referring physicians. Whenever possible, appointments for our new office patients are made within two business days to allow speedy evaluation.

Follow-Up appointments are scheduled regularly in intervals as determined by the nature of cardiac problem for which a patient is followed. In addition, work-in appointments are sometimes requested by our patients for various medical reasons. We make all attempts to accommodate these requests within a few days.

Warfarin (Coumadin) Clinic Patients taking blood thinner Warfarin (Coumadin) are regularly seen in our Warfarin clinic for adjustments of the medication dose. The medication level is determined by a simple fingerstick test with results available within minutes. Your visits to our Coumadin clinic will also include detailed instructions re. any dosage adjustment, dietary education, and date of next clinic visit.

Cardiac Testing in Office

Electrocardiogram (ECG) one of the most basic and widely used tests in cardiology that records the electrical activity of your heart. It may help diagnose various cardiac rhythm problems and abnormalities, help with diagnosis of coronary artery disease (blocked arteries) and is also used to evaluate the effects of certain cardiac medications. An ECG takes only a couple of minutes to record using sticky pads (electrodes) applied on your chest, arms and legs. It is typically performed and interpreted immediately during your visit.

Holter Monitor a small device about the size of a pager, used for continuous recording of cardiac electrical activity (ECG) for 24 – 48 hours to detect changes in cardiac rhythm or rate or evaluate effects of certain medications. It is attached via three sticking electrodes (leads) to your chest. Results are called to you within a week or reviewed directly with you on your upcoming return visit.

Echocardiogram ultrasound imaging of your heart (also referred to as “sonogram”) allowing the physician to see the interior of your heart, evaluate heart muscle function, valve function, flow of blood through your heart, pressure within your heart and lung circulation, and rule out any significant structural abnormalities. We are using the most advanced digital echocardiogram technology with Tissue Doppler Imaging for best assessment and accurate measurement of cardiac function. (see pic). The test is safe, painless, takes on average 30 minutes, and is performed in a lying position by applying a warm gel and a transducer on your chest. Results are either called to you by our nurse on the next business day, or reviewed directly with you by our cardiologist on your upcoming return visit.

Nuclear Stress Test commonly referred to as “ cardiolite”, is a form of stress test using a small amount of a radioactive tracer to allow visualization of blood flow to the heart and thereby rule out severe blockages in your coronary arteries. It also helps assess heart muscle pumping function, as well as size and location of previous heart attack or an area at risk from future heart attack. The stress part of the test may be performed using a standard treadmill exercise or, for those unable to walk, using a medicine to simulate stress.




For further details about the nuclear stress test, you may review the downloadable Consent Form.

To complete all parts of this test, about 2 ½ hours are needed. Results will be called to you the following business day.

IF YOU NEED TO CANCEL, PLEASE GIVE US AT LEAST 48 HRS NOTICE. THE MEDICATION ORDERED FOR THIS TEST IS EXPENSIVE AND CAN BE USED ONLY AT YOUR SCHEDULEDED APPOINTMENT TIME


Stress Echocardiogram form of a stress test where ultrasound imaging is added before and after treadmill exercise to more accurately evaluate for presence of significant coronary artery disease (blocked arteries). It also allows assessment of the pumping function of your heart. The test is painless (see also “echocardiogram”), but requires walking on a treadmill. The completion of the test will take about an hour and the results will be called to you next business day.

Exercise Stress Test Plain treadmill exercise stress test is nowadays rarely used to detect coronary artery disease (blocked arteries) due to its limited sensitivity and specificity compared to newer imaging stress methods,such as nuclear scan. It is however very helpful to objectively assess exercise tolerance, heart and blood pressure response to exercise and is frequently used during cardiac rehab. The test is performed by treadmill exercise with gradually increasing speed and incline with continuous ECG and blood pressure monitoring. The test results are either reviewed with you after test completion or called next business day.

Pacemaker Interrogation and Follow-up If you have a permanent cardiac pacemaker implanted, it is recommended to have its proper function and remaining battery time tested in six-monthly intervals. The test is done non-invasively by applying an electronic wand over the pacemaker generator and downloading electronic data stored by your device. Appropriate setting changes (reprogramming) may be done at time of pacemaker interrogation as indicated. Status of your pacemaker will be reviewed with you at time of your pacemaker test.

Hospital

Admissions and inpatient consultations Our cardiologists have privileges at the Danville Regional Medical Center that allow them admit, evaluate, and treat their patients presenting with acute cardiac conditions such as heart attacks, heart failure, acute cardiac rhythm problems, etc. In addition, our cardiologists are available for inpatient cardiac consultations as requested by other attending physicians for assistance with acute cardiac problems of their patients.

Hospital Cardiac Testing and Procedures

Transesophageal Echocardiogram (TEE) Compared to a standard (chest) echocardiogram, a transesophageal echo offers the advantage of better image resolution and overall image quality to detect subtle structural abnormalities within your heart such as small clots, infection, valve leakage, and others. To achieve this high image quality to help with your treatment, it is necessary to swallow a flexible tube (called “probe”) after your throat has been numbed up with an anesthetic spray. The procedure also require I.V. sedation. Risk of the procedure is very small. Results are reviewed immediately post procedure.

Electrical Cardioversion often referred to as “shocking the heart back into rhythm”, this procedure is performed in the hospital with direct on-site assistance by an anesthesiologist. Typically, a cardioversion requires several weeks of preceding blood thinning therapy (Coumadin). The purpose of a cardioversion is to restore a regular (sinus) rhythm in patients with certain poorly tolerated rhythm abnormalities. It involves a brief period of intravenous general anesthesia and a delivery of an electrical shock while you are asleep through sticking pads applied to your chest and back.

Heart Catheterization (heart cath) is an invasive diagnostic test performed by our cardiologists in the cardiac Catheterization Lab of the hospital to diagnose various cardiac conditions and to establish the most appropriate treatment strategy. It may be performed on either inpatient or outpatient basis. There are many variants of this test based on your clinical condition. Most commonly, the test is done to identify and localize blockages in the coronary arteries. To obtain this information, an intravenous contrast dye is injected during the procedure through a catheter under X-ray camera. The catheter (thin, flexible tube) is typically inserted through your groin, but other access sites may sometimes be used if needed. You will not be put to sleep for your heart cath. Sedation and local anesthesia are sufficient since the test itself is not painful. Despite the invasive nature of the test, the overall risk of major complications for most patients is well below one percent. The findings are available immediately and will be related to you as well as your family if so desired. If the heart cath is performed as outpatient, you may go home after six hours. Sometimes, a coronary intervention such as a stent placement to relieve identified blockage may follow immediately after the heart catheterization.

Percutaneous Coronary and Peripheral Interventions these procedures provide treatment of severely narrowed arteries around your heart (coronary stents) or other arteries (peripheral stents). Stents are small expandable tubes that help keep the narrowed areas in your arteries open. Typically, our patients stay in hospital at least over night after successful stenting of their arteries.

Permanent Pacemaker Placement A permanent pacemaker implantation is needed in some patients to prevent severely slow heart beats. A small electronic pulse generator is inserted in a “pocket” under the skin in your upper chest with one or two wires (leads) reaching to your heart . The device monitors your electrical heart activity and helps pace your heart at higher rate when needed. Then procedure is performed under local anesthesia and may take on average 30-60 minutes. Recovery and monitoring in hospital takes 1-2 days in most cases. Regular moniroring of your pacemaker function is then provided in our office.