CARDIAC CARE

With our focus on high quality cardiac care, our dedicated healthcare team has helped thousands of patients throughout our community achieve better heart health.

We are proud to have affiliations with:

• WellStar Cobb Hospital
• WellStar Douglas Hospital
• WellStar Kennestone Hospital
• Piedmont Hospital

CARDIAC CARE OVERVIEW

Our comprehensive cardiac treatment options cover a wide spectrum of conditions and diseases affecting the heart and vascular system. As healthcare advances, new diagnostic techniques, drugs and interventions are continually being integrated into The Heart Clinic’s cardiovascular care. The testing and procedures offered by The Heart Clinic are performed at either of our offices or one of the hospitals with which we are affiliated.

Cardiac Testing and Procedures

• Arrhythmia evaluation: holter monitors, event recorders, and implantable loop recorders
• Cardioversion
• Cardiac catheterization
• Echocardiography: transthoracic and transesophageal
• Exercise and pharmacologic nuclear stress testing/myocardial perfusion scan (MPS)
• Exercise and pharmacologic stress echocardiography
• Enhanced External Counterpulsation (EECP)
• Invasive ischemia assessment: intravascular ultrasound (IVUS) and fractional flow reserve (FFR)
• Percutaneous coronary intervention (PCI): coronary angioplasty, stenting, and atherectomy
• Permanent pacemaker insertion

Chronic Cardiovascular Disease Management

• Anticoagulation/pro-time (Coumadin)
• Coronary artery disease (CAD)/angina
• Congestive heart failure (CHF)
• Permanent pacemaker and implantable cardiac defibrillator (ICD) follow-up

Peripheral Vascular Disease

• Ankle/brachial indices (ABI)
• Vascular ultrasound of carotid and lower extremity arteries
• Carotid, aortic, renal, and lower extremity angiography
• Carotid and peripheral arterial angioplasty/stenting

Cardiovascular Risk Assessment and Modification

• Evaluation and management of lipid disorders
• Dietary and lifestyle modification
• Preoperative risk assessment
• Pre-chemotherapy cardiovascular assessment
• Screening for peripheral vascular disease

OUTPATIENT DIAGNOSTIC TESTING INFORMATION

The Heart Clinic believes effective care begins with proper diagnosis. Our physicians place a high priority on appropriate and thorough diagnostic testing, which may include one or more of the following tests:

Ankle/Brachial Index (ABI)

During ABI testing, blood pressures are measured in the legs and arms to calculate a ratio which is used to diagnose blockages in the arteries to the legs. An ABI may be performed at rest or after an exercise stress test.

Arrhythmia Evaluation - Event Monitoring - Holter Monitoring

Arrhythmias, or irregular heart rhythms, are common and can occur in healthy hearts without affecting a patient's health. Some arrhythmias indicate a more serious problem and, if untreated, may lead to heart failure, stroke or even sudden death. The Heart Clinic monitors patients for arrhythmias with portable devices that record every heartbeat anywhere from 1 to 30 days to diagnose arrhythmias that may not have been detected during an office evaluation.

Echocardiography

Echocardiography is a diagnostic procedure using sound waves to image the heart. This painless and non-invasive test enables our cardiologists to evaluate a patient's heart muscle and valve function as well as structures around the heart. Sometimes, your doctor may utilize intravenous echocardiographic contrast to better visualize the chambers of your heart.

Electrocardiogram

An electrocardiogram (EKG/ECG) is a routine test performed at every patient's first visit to The Heart Clinic. Electrocardiograms measure and record electrical impulses of the heart which can reveal heart rhythm disorders, damage from a previous heart attack, and abnormalities of cardiac structures.

Enhanced External Counterpulsation (EECP)

Patients with severe coronary artery disease who continue to experience chest pain and shortness of breath from angina but are not candidates for either angioplasty/stenting or bypass surgery may benefit from Enhanced External Counterpulsation (EECP) therapy. EECP is a non-invasive and low risk outpatient therapy which has been proven to reduce anginal symptoms, increase activity level and possibly reduce or eliminate medication use. EECP therapy stimulates the growth of tiny blood vessels inside the heart muscle which act as a natural bypass around narrowed or blocked arteries. While patients rest comfortably on their backs, pulsating cuffs timed to the patient's heartbeat compress the lower extremities to stimulate this process. The EECP treatment protocol consists of 35 one-hour sessions over seven weeks and is covered by most insurance plans.

Exercise Testing

During an exercise stress test, a patient walks on a treadmill while EKG tracings, pulse and blood pressure are closely monitored. An exercise stress test can determine if blood supply to the heart is reduced. Exercise stress testing can also be used to diagnose arrhythmias and determine their response to medical therapy. In addition, exercise stress testing can be used to determine the significance and severity of valvular heart disease.

Stress Testing with Nuclear Imaging/Myocardial Perfusion Scan (MPS)

A nuclear stress test uses a painless, low intensity, intravenous radioactive tracer to visualize coronary blood flow as well as the heart's pumping function. It is most often administered immediately after an exercise or pharmacologic stress test and then again at rest. It is primarily used to detect the location and degree of blockages in the coronary arteries.

Click here for Myocardial Perfusion Scan (MPS) patient instructions.

Stress Echocardiography

During a stress echocardiogram, an ultrasound is performed before and immediately after an exercise or pharmacologic stress test. Similar to a nuclear stress test, it can detect the location and degree of blockages in the coronary arteries.

Click here for Stress Echocardiogram patient instructions.
Click here for Dobutamine Echocardiogram patient instructions.

Peripheral Vascular Ultrasound

A peripheral vascular ultrasound is used to diagnose and quantify the location and severity of blockages in the arteries to the legs and brain.

INPATIENT PROCEDURES

The following tests and procedures are performed by our cardiologists in a hospital setting:

Cardiac Catheterization

During a cardiac catheterization, dye is injected into the heart and coronary arteries via a tiny tube placed in an artery in the groin or arm. This test gives cardiologists the most definitive road map of the coronary arteries and can evaluate the heart's pumping function. The results of the cardiac catheterization help the cardiologist determine the most appropriate treatment, which may include medications, PCI, or cardiac surgery.

Percutaneous Coronary Intervention (PCI)

PCI is most often performed immediately following a diagnostic cardiac catheterization through the same tube that has already been placed in an artery. During a PCI, a cardiologist inflates a balloon inside a severe coronary blockage (i.e. an angioplasty), opening the artery to its normal size and improving coronary blood flow. To ensure that the artery remains open, a stent is usually inserted at the same site following an angioplasty. PCI has been proven effective in relieving chest pain called angina which is caused by coronary blockages.

Invasive Ischemia Assessment: Intravascular Ultrasound (IVUS) and Fractional Flow Reserve (FFR)

Occasionally, the severity of coronary blockages can be difficult to determine after a cardiac catheterization. IVUS and FFR are highly precise, modern techniques used by cardiologists to determine the severity of coronary blockages and whether PCI is indicated.

Peripheral Angiography with Angioplasty/Stenting

Peripheral artery disease (PAD) is a condition affecting the arteries outside the heart. In PAD, fatty deposits build up within the artery wall and can restrict blood flow to the brain, arms, legs and kidneys. During a peripheral angiogram, dye is injected into peripheral arteries to detect the presence and severity of PAD. In some patients, peripheral angioplasty or stenting may be performed to help keep the diseased artery open.

Pacemaker

If the heart is beating too slowly or irregularly, an electronic pacemaker may be temporarily or permanently implanted into a patient's chest using a minor surgical procedure. A pacemaker can help regulate a patient's heartbeat by sending electrical impulses to one or more chambers of the heart. This regulates the heart rhythm and enables it to more effectively pump blood throughout the body.

Primary PCI for Acute Myocardial Infarction (MI)

When a patient suffers from a particularly large and dangerous form of MI, or heart attack, performing PCI on an emergency basis can be life saving. Working closely with emergency personnel and catheterization lab staff at its affiliated hospitals, The Heart Clinic provides emergency PCI on a 24/7 basis.

Transesophageal Echo (TEE)

Since traditional echocardiograms through the chest wall often cannot visualize the smaller structures and chambers of the heart, your doctor may recommend a TEE for a more thorough assessment. After intravenous sedation has been given, the ultrasound probe is gently inserted through the mouth and into the esophagus, which is directly adjacent to the heart. After obtaining the ultrasound images, the probe is then withdrawn. During the entire procedure and for a period of time afterwards, a patient’s vital signs are continuously monitored by nursing staff. A TEE is sometimes performed in conjunction with other cardiac procedures, including cardiac catheterization or cardioversion.

Electrical Cardioversion

During an electrical cardioversion, a brief electrical shock is administered to restore the heart's normal rhythm. Cardioversion is most often performed electively as an outpatient procedure, but sometimes may be required on an emergency basis for unstable patients. Unless it is being performed in the setting of a life-threatening emergency, intravenous sedation is administered prior to a cardioversion.