Adult Cardiology

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Clinical Cardiology

Cardiology Deborah’s clinical cardiology services provide consultations for all patients with acute and chronic heart diseases. The scope of care includes congenital and acquired heart diseases, coronary artery disease, rheumatic heart disease, other forms of valvular and myocardial disease, cardiomyopathy and hypertensive heart disease, disorders of the coronary and non-coronary circulation systems, myocardial function, cardiac conduction system and cardiac valves.

Deborah physicians also focus on issues relating to women and heart disease and risk factor evaluation and modification. After assessment, the cardiologist always consults with the referring physician to determine the most appropriate therapy for the patient. Deborah’s physicians are specialists in both managing cardiac diseases and determining the appropriate time for surgical intervention.

TAKE THE HEART HEALTH ASSESSMENT

  1.  Are you worried about dying from heart disease? If so, are you taking any steps to prevent the condition?

Heart disease is the #1 killer of men and women in the United States. A recent study of 1000 men and women showed that 74% of Americans are not worried about dying from this disease. Only 32% of people are taking any steps to prevent heart disease. By learning about heart disease and how it is preventable, people can incorporate easy steps to avoid this life-threatening disease.

  1.  Can you name 5 things everyone can do daily to prevent heart disease?
    There are at least 5 actions that everyone to do to prevent heart disease:

    No Trans Fats – Fat is necessary for the diet, but we do not need trans-fat. Trans-fat leads to increased plaque in the arteries by raising the bad cholesterol (LDL) and lowering good cholesterol (HDL).

    Floss your teeth – it is now well known that people with gum disease and poor dental care at a higher risk of heart disease. By flossing and brushing twice a day, it is possible to eliminate the toxic bacteria that may be leading to gum disease.

    Sleep – it is important to get a good night’s sleep, with most people needing 7-8 hours per night. People with sleep apnea may be at higher risk for heart disease and should be treated.

    Stay out of the chair – research continues to show that individuals who are stationary for extended periods of time have higher rates of heart disease. Sitting for a long time can also lead to chronic swelling of the legs and blood clots.

    Avoid smoking and smokers – everyone knows that smoking can increase your risk for having heart disease. However, being around smokers and breathing secondhand smoke actually raises the risk for heart disease by 25-30%.

  2.  What are the 5 things everyone should learn about their heart health?

    Eat right – paying attention to the labels, avoiding trans fats, limiting fried food and red meat, knowing which foods have high salt content and not over indulging in simple carbohydrates and sweets, are all simple ways to adapt a heart healthy diet.

    Exercise – only 20% of Americans are aware of how much exercise is necessary to maintain a healthy lifestyle. The American Heart Association recommend 2-1/2 hours of moderate aerobic exercise per week.

    What is your cholesterol? It is important to get a copy of your cholesterol report from your doctor so you can be aware of your level of risk.

    Know your blood pressureHigh blood pressure is one of the leading reasons for strokes and heart attacks. Many people have high blood pressure and don’t even know it. It is important to check your blood pressure regularly and to note the readings.

    Know your family history although there is not any gene to test for heart disease, having a family history of heart disease is one of the most significant risk factors. Other risk factors such as high blood pressure, diabetes, high cholesterol and lack of exercise are even more important when someone has a family history of heart disease.

  1.  Do fish oil supplements and vitamins prevent heart disease?

More than half of all Americans feel that fish oil can prevent heart disease. However, there is little scientific evidence that this is the case. Although vitamins can be used to supplement a nutritional deficiency, they have not been found to prevent heart disease.

  1.  Are statin drugs risky or do they prevent heart attacks?

There is now clear-cut evidence that statin drugs such as Lipitor, Crestor, and others reduce the risk of having a heart attack or stroke. Many people know friends or family members who are on statins. Although there can be side effects, they are uncommon and not life-threatening.

Some myths about statins:

  1.  Statins hurt the ability to exercise – False, although 10% of people can have muscle aches and may need to change medications if this occurs.
  2. Statins cause muscle damage and hurt the heart – False. Muscle aches and damage are a rare complication, but these drugs do not cause heart damage.
  3. Avoid statins with diabetes – People with diabetes have less heart disease when on statins. There can indeed be a slight increase in blood sugar with statins, but the risks do not outweigh the benefits.
  4. Statins cause dementia – Although the FDA states that statin use can result in rare decreases in memory, the side effect goes away when the drug is stopped.
  5. Statins cause cataracts – No definitive study has been done to prove this, although some observational studies are suggesting increased cataracts. However, the risk of heart disease outweighs this complication.

Adult Congenital Heart Disease

Deborah’s unique adult congenital heart disease program combines the expertise of physicians trained in adult and pediatric cardiovascular medicine and surgery, with tailored management of the disease. Using a multidisciplinary approach, Deborah’s physicians evaluate both the physical limitations of the disease and psychosocial issues as well as reproductive and genetic issues. Through the ambulatory care clinic, each patient undergoes a detailed diagnostic work-up. Cardiac caths and EP evaluations are also available. Follow up visits vary from monthly to yearly as required by the consulting physician.

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Cardiac Catheterizations

Catheterizations are the most widely—performed procedure at Deborah Heart and Lung Center, used both as a diagnostic and interventional tool. A new state-of-the-art cath lab at the Center is the first in Southern New Jersey to install the Siemens Artis Zee—a system that allows physicians to visualize vessels and diseases from all sides with unprecedented flexibility and precision. This advanced technology permits rotation of a large C-arm to various positions around a patient’s body and—with high velocity—create a CT or 3D reconstructed image, showing blood flow into the heart, brain, arms, abdomen, kidneys and legs to the toes. The created images are consolidated in real time on one large monitor that combines the patient’s vitals as well as allowing for simultaneous comparison with any previous scans. This newest technology in the cath lab’s arsenal of diagnostic and treatment options-also offers additional patient comfort and peace of mind, being quieter and using less radiation.

Elective and emergent cardiac catheterizations are performed at Deborah. The majority of elective diagnostic catheterizations are outpatient procedures in which the patient arrives early in the morning, has the procedure, and is monitored until discharge (usually 4-5 hours).

Fast Track Catheterization

This program enables referring physicians to send patients for cardiac catheterization without a preliminary evaluation at Deborah. To enroll a patient, call the physician referral number, 1-800-214-3452 and inform the operator you have a “Fast Track patient.” Records/test results can be sent via mail or fax. Patients are admitted for caths at 7am, and barring complications, are discharged by 5:30pm. Patients who do not qualify for Fast Track Catheterization typically include those with significant kidney dysfunction, or complex cardiovascular problems.

Wrist Catheterizations Procedure

The “radial artery approach” threads a cath line to a patient’s heart through the artery in their wrist rather than the groin, as has been traditionally done for years. Patients who receive their catheterizations through the wrist see immediate benefits in this procedure.

Benefits

  • Greatly improves patient comfort
  • Reduces patient risk
  • Fewer complications
  • Shortens recovery time
  • Allows for quicker patient discharge (sometimes in as little as 90 minutes)

Catheterization is a key diagnostic tool for cardiac health. Traditionally, a line is threaded through the femoral artery in the groin and up into the heart, requiring patients to lie flat for several hours, and remain flat and immobile for some time after the procedure.

Deborah is performing almost all types of procedures through the radial artery, including caths for complex bifurcation stenting, vein graft stenting, and emergency care during heart attack. We also perform peripheral procedures such as kidney artery stenting, subclavian stenting, and in selected cases Iliac artery intervention through this approach. This procedure is of extreme benefit to those patients who cannot lay flat for long hours, those with back pain issues, emphysema, and congestive heart failure, among other conditions.

Deborah Physicians Expand Use of Wrist Catheterizations

wristcathDeborah has been a regional leader in performing Transradial Artery Catheterizations, wrist caths, instead of through the groin. Deborah’s physicians have now expanded the use of wrist caths to treat peripheral vascular disease in different vascular distributions. Blockages of the shoulder artery (Subclavian), kidney artery (Renal), abdominal artery (Superior Mesenteric Artery), and arteries to the legs (Iliac, External Iliac, and Femoral) can be treated through the wrist approach in patients. This new application is a tremendous plus for patients who have diseased and blocked leg arteries, and who face a much higher risk of bleeding and complications when treating peripheral artery disease with a traditional groin catheterization.

 

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