Cardiology

Interventional cardiology involves using catheter-based, minimally invasive techniques to both diagnose and treat heart, valve and vascular conditions. Using a thin, flexible tube inserted through a blood vessel, specialists can evaluate heart function, open blocked arteries and repair or replace damaged heart valves. These approaches typically involve shorter procedures, less discomfort and quicker recovery times compared to traditional surgery.

In addition, if you experience a heart attack or cardiac arrest, our cardiac catheterization lab is available 24/7 to perform potentially lifesaving interventions. Our interventional cardiologists are among the area's most experienced in using innovative treatments for complex heart and valve diseases.

CAD is caused by plaque buildup in the walls of the coronary arteries, which supply blood to the heart. It can develop in two ways:

• Acute CAD — Sudden rupture of plaque that causes a blood clot, which can block blood flow and lead to a heart attack
• Chronic CAD — Gradual narrowing of the arteries over time, reducing blood flow to the heart muscle

Risk factors for CAD

You have heightened odds of developing this condition if you are a man over 45 years old or a postmenopausal woman. CAD may also be more likely for you if you smoke, are obese or have:

• Diabetes
• Family history of heart disease
• High blood pressure
• High low-density lipoprotein (LDL) cholesterol
• Low high-density lipoprotein (HDL) cholesterol

Symptoms of CAD

In some situations, common warning signs might include:

• Chest pain
• Fatigue
• Heart palpitations
• Shortness of breath

If you experience any of these symptoms, please call 911 immediately.

Diagnosis and treatment for CAD

To detect CAD, we will use cardiac catheterization or coronary intravascular ultrasound (IVUS) and flow measurement. Treatments are likely to include one or a combination of the following:

• Medication
• Minimally invasive procedures, such as coronary stenting or intravascular lithotripsy
• Surgery, such as coronary artery bypass grafting (CABG)

If your condition progresses to complex CAD, treatment can become more challenging because of additional health factors, such as:

• Advanced age
• Chronic kidney disease
• Chronic obstructive pulmonary disease (COPD)
• Inability to tolerate CABG surgery
• Peripheral vascular disease
• Significant calcium buildup and thickening in the vessels

In this situation, we could elect to perform advanced treatments that include:

• Atherectomy
• Chronic total occlusion percutaneous coronary intervention (CTO PCI)
• Left ventricular assist device (LVAD) placement

Structural heart disease refers to abnormalities in the heart's valves, walls or chambers that impact function. When your valves don't properly open or close, it can cause a narrowed valve to restrict blood (stenosis) or a leaky valve to allow blood to flow backward (regurgitation).

Treatment may include:

• Lifestyle changes
• Medication
• Valve repair or replacement surgery, often done with minimally invasive techniques

At the Aortic Center, we specialize in the early detection, monitoring and treatment of complex aortic conditions. The aorta is the largest blood vessel in the body, carrying blood from the heart to all the major organ systems. It is under tremendous pressure and can sometimes become enlarged (aneurysm) or tear (dissection). If discovered early, many of these problems can be treated through minimally invasive or endovascular procedures.

Diagnosing an aneurysm

Screening is the only way to detect an aortic aneurysm before symptoms appear. You are considered at risk if you meet the following criteria:

• Family history of AAAs
• Have smoked at least 100 cigarettes in your lifetime
• Male between 65 and 75 years old

If you meet the above qualifications, please call (603) 361-9604 to schedule your abdominal aortic screening.

Cardiometabolic risk refers to the likelihood of experiencing a cardiovascular event, such as a heart attack or stroke, due to one or more cardiovascular risk factors. It applies to you if you have cardiovascular disease and continue to remain at risk.

At the Center for Cardiometabolic Health and Preventive Cardiology, our team has expertise in cardiovascular risk reduction. We provide personalized, comprehensive care if you are looking to decrease your risk of developing or worsening cardiovascular disease.

Cardiometabolic risk factors

Several conditions can raise your risk for heart attack and stroke. Common risk factors that increase the likelihood of cardiovascular disease include:

• Diabetes
• High blood pressure
• High cholesterol
• Inactivity
• Inflammation
• Obesity
• Smoking

Cardiometabolic treatment

Many cardiometabolic risk factors are controllable and may even be reversible through lifestyle changes and medicine. Our cardiovascular risk reduction, cholesterol management and diabetes specialists will guide your treatment. When appropriate, we can also partner with:

• Endocrinologists
• Exercise physiologists
• Nutritionists
• Sleep medicine specialists
• Vascular surgeons
• Weight loss specialists

Congestive heart failure (CHF) is a condition where weakened or stiff muscles reduce the heart’s ability to pump blood effectively, impacting the delivery of oxygen and nutrients to the body. It can result from CAD, heart attacks, high blood pressure and cardiomyopathy.

If you’re referred to the Heart Failure Clinic for CHF, you will start with an initial consultation. Thereafter, we give you access to coordinated services to address your unique needs. Your care team may include:

• Cardiac rehabilitation specialists
• Cardiologists
• Nutritionists
• Transitional care specialists

Our nurses will play a crucial role on this team, as they monitor your symptoms, adjust your medications and educate you about disease management. Each of our specialists are focused on helping you effectively manage your condition, stay out of the hospital and increase your awareness about your overall health.

CHF symptoms

Warning signs of CHF vary widely and may include:

• Dizziness
• Fatigue
• Fluid buildup
• Irregular heartbeat
• Shortness of breath
• Weight gain

Complex and advanced heart failure treatment

If you have advanced CHF, you are less likely to live symptom-free and need more services and treatments than those who have been recently diagnosed or are successfully managing their condition.

For advanced heart failure, we offer several treatment options, such as:

• At-home heart failure system
• Infusion therapy
• Temporary heart pump

If you develop complex heart failure and need an advanced procedure, we can seamlessly transition you to Boston for further care. This enables local follow-up in a shared model if you use an LVAD device, take anti-rejection medication or underwent a heart transplant.

Our support group

If you or a loved one has heart failure and underwent an LVAD procedure or heart transplant, talking with others who have experienced similar challenges can help you feel better physically, mentally and emotionally.

Our free support group offers:

• Comfort in knowing you're not alone in your journey
• Encouragement for family members to attend meetings to learn how to cope with your condition
• Guidance and tips for managing your condition and lifestyle
• Opportunities to share experiences and learn from one another
• Support for you at all stages

We meet bimonthly and topics and speakers change each month. For referral or support group information, please call (603) 669-0413.