Central Florida Heart Care

Each first visit to Central Florida Heart Care is designated as a Cardiac Evaluation. It gives your Cardiologist the opportunity to get to know you and assess your initial cardiovascular health. Since cardiovascular disease is the product of both genetics and lifestyle choices, please be prepared to share your past medical history, surgical history, family history, social history, and all medications with your cardiologist. Once a complete medical history is obtained and any current symptoms that you are experiencing are addressed, your cardiologist will make plans for any necessary next steps for further evaluation or treatment.

What is a Cardiac Catheterization?
Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart. Using this catheter, diagnostic tests can be performed as part of a cardiac catheterization. Usually, you'll be awake during cardiac catheterization, but given medications to help you relax. Recovery time for a cardiac catheterization is quick, and there's a low risk of complications.

Why is a catheterization done?
Cardiac catheterization is done to see if you have a heart problem, or as a part of a procedure to correct a known heart problem. If you're having cardiac catheterization as a test for heart disease, your doctor can:

• Locate narrowing or blockages in your blood vessels that could cause chest pain (angiogram)
• Find out the amount of oxygen in your heart (hemodynamic assessment)
• Test the pressure inside your heart
• Take a sample of tissue from your heart (biopsy)
• Diagnose heart defects present from birth (congenital heart defects)
• Look for problems with your heart valves

Cardiac catheterization is also used as part of some procedures to treat heart disease. These procedures include:

• Angioplasty with or without stent placement. Angioplasty involves temporarily inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery. Angioplasty is usually combined with implantation of a small metal coil called a stent in the clogged artery to help prop it open and decrease the chance of it narrowing again (restenosis).
• Closure of holes in the heart. Some congenital heart defects involving holes in the heart can be treated by threading a catheter to the hole to close it, rather than having open-heart surgery.
• Repair or replace leaky heart valves. Using cardiac catheterization, leaking or narrowed heart valves can be repaired or replaced.
• Balloon valvuloplasty. This procedure can open narrowed heart valves by threading a balloon-tipped catheter to the part of your heart valve that's narrowed and inflating it.
• Heart arrhythmia treatment (ablation). Ablation is a procedure that scars your heart tissue to re-route the electrical signals that cause your heart to beat. Radiofrequency energy (heat), a laser or nitrous oxide (extreme cold) is applied through the catheter tip to the abnormal heart tissue. The energy destroys (ablates) the abnormal heart tissue causing the heart rhythm disorder.
• Blood clot treatment (thrombectomy). In this procedure, your doctor inserts a catheter into an artery and guides it to a blood clot in a blood vessel. Attachments on the catheter remove the blood clot.

What is an Echocardiogram?
An echocardiogram or echo is a sonogram of your heart. An ultrasound machine is used to take 2D pictures of the size, shape, and function of the heart. It is used to diagnose both structural and functional types of cardiovascular disease.

What to Expect When Having an Echo
An echo should take approximately 30 to 40 minutes. You will be asked by the echo technologist to change out of your shirt so that the ultrasound gel and probes can be placed directly on the skin over your heart. Females will be given a chest cover for the procedure. You may also have electrodes placed on your chest to monitor heart rate throughout the test. During the echo, the technologist is recording a video of your heart function and is taking measurements of different parts of your heart’s anatomy. After the echo, your cardiologist will view the video, study the measurements, and produce a final interpretation of your procedure.

What is a Nuclear Stress Test?
A nuclear stress test usually involves taking two sets of images of your heart — one set while you are at rest and another set after you're exercising on a treadmill. It's performed similar to a routine exercise stress test, but provides images that can show areas of low blood flow through the heart and areas of damaged heart muscle. If you are unable to do the stress/exercise portion on the test, you may be injected with an intravenous medication that increases blood flow to your heart muscle — simulating exercise — for the test. A nuclear stress test is used to gather information about how well your heart works during physical activity and at rest. It's performed similar to a routine exercise stress test, but provides images that can show areas of low blood flow through the heart and areas of damaged heart muscle.

Initially, the patient is injected intravenenously with a nuclear isotope and then placed under the nuclear camera where images at rest are taken. These images serve as the baseline functionality of the heart at rest. Then, the patient will have electrodes placed on his or her chest to record an electrocardiogram throughout the duration of the exercise portion of the test. The patient will be asked to walk on the treadmill for a few minutes. During this time, the difficulty of the test may increase to further gage the heart’s response to stress. Medical staff will be interacting with the patient throughout the exercise portion in order to record any symptoms being experienced. During the treadmill exercise, the patient will be injected again with a dose of the nuclear isotope. Once the exercise portion is completed, patients will be allowed to leave and will be given a return time or 1 to 2 hours later. Upon return, patients will go under the nuclear camera to capture the final stress images post exercise. The entire test should last 4-6 hours.

What are Vascular Ultrasound Studies?
A vascular study is an ultrasound of an area of the body designed to specifically capture images of the main arteries in that area. They are performed to help physicians identify blockages to blood flow (clots), narrowing of the vessels (stenosis), and enlargement of arteries (aneurysm). Types of vascular studies include: carotid duplex, ankle-brachial index, lower extremity arterial duplex scan, upper extremity arterial duplex scan, renal arterial duplex scan and abdominal aortic ultrasound.

What to Expect During a Vascular Study
You will be asked by the vascular technologist to lie face up on the examination table. A clear water-based gel will be applied to the area of the body being studied. The technologist will move the ultrasound probe over the gelled area to capture the images. The test is expected to last from 25-45 minutes depending on which type of vascular study is ordered by your physician.

What is a Pacemaker?
A pacemaker is a small device that is implanted in the upper chest to help control slow heart rates (bradycardia), fast heart rates (tachycardia), and abnormal heart rhythms. This device uses painless electrical pulses to prompt the heart to beat at a normal rate.

What is a Defibrillator?
An ICD is a small device that is implanted in the chest to control fast heart rates. It uses electrical pulses or shocks to help control life-threatening, irregular heartbeats, especially those that could cause sudden cardiac arrest. All ICDs have a built in pacemaker.