Cardiac Consultation
The cardiovascular consultation is your introduction to the cardiologist, who will obtain a history of your problems and perform a thorough examination of your heart and vascular system. The history of your problems will also include learning information about other diseases and symptoms, a medical history of your close relatives, and information about the risk factors that lead to coronary disease, elevated cholesterol, high blood pressure, diabetes, and smoking. The cardiologist will also want an exact list of your medications and the frequency that they are taken, as well as any history of allergies. Please feel free to bring in a list of your medications, or bring the medicine containers themselves. Relevant information, especially test results from other doctors should be sent to our office for review.

The cardiovascular consultation is one of the most important parts of your visit. At its completion, Dr. Saleemi will have a practical impression about the nature of the problem and what additional testing will likely be required to further clarify the diagnosis.

Chest Pain
Chest pain is one of the most frightening symptoms a person can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life-threatening.

Chest pain, regardless of whether it is caused by a life-threatening condition, needs to be evaluated by a medical professional. Be reassured that you are making the right decision and feel comfortable seeking care whenever you experience chest pain.

Cardiac Catheterization
A diagnostic procedure used to evaluate the heart and the coronary arteries. During a cardiac catheterization, a contrast material is injected into the coronary arteries to trace the movement of blood. The portion of the test involving the injection of contrast material and the tracing of blood is called coronary angiography.

To perform cardiac catheterization, a thin flexible tube called a catheter is threaded through a blood vessel in the arm or groin and into the heart. Through the catheter, your doctor can measure pressures, take blood samples, and inject the contrast material.

The purpose of cardiac catheterization is to determine whether the coronary arteries are diseased, and if so, identify the size and location of plaque that may have accumulated from atherosclerosis. This is generally done to determine the need for bypass surgery or angioplasty.

Angina is chest pain or discomfort that occurs when an area of your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. It can feel like indigestion. Angina itself isn't a disease. Rather, it's a symptom of an underlying heart problem. Angina is usually a symptom of coronary artery disease (CAD), the most common type of heart disease.

Not all chest pain or discomfort is angina. A heart attack, lung problems (such as an infection or a blood clot), or heartburn also can cause chest pain or discomfort. All chest pain should be checked by a doctor.

A treatment in which a thin metal coil is permanently placed in the blocked artery at the time of angioplasty. Once the plaque is compressed using angioplasty, a small expandable wire tube called a stent is inserted into the artery to hold it open. Reclosure of the artery is less likely to occur after angioplasty followed by stenting than after angioplasty alone.

It is also common to use a type of stent coated with drugs. These drugs help prevent scar tissue from forming inside a stent. Studies have shown that these new stents are more likely to prevent restenosis than ordinary, non-coated stents.

Peripheral Artery Disease
Peripheral arterial disease (PAD) occurs when a fatty material called plaque builds up on the inside walls of the arteries that carry blood from the heart to the head, internal organs, and limbs.

Although PAD is serious, it is treatable. The buildup of plaque in the arteries can often be stopped or reversed with dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure. In some patients, blood flow in the vessels may be improved by medicines or surgery.

Holter Monitoring
The most common type of ambulatory monitoring is called Holter monitoring. The recording device of a Holter monitor is worn on a strap at your waist or over your shoulder. The electrical signals of the heart are picked up by two electrodes attached to your chest, which are connected to the recorder by wires. Holter monitoring provides a continuous 24- to 72-hour record of the electrical signals from your heart. While wearing the Holter monitor, you will also be asked to keep a journal of your activities and symptoms each day. After the monitoring period, your doctor will compare the timing of your activities and symptoms with the recorded heart pattern.

A standard EKG monitors only 40 to 50 heartbeats during the brief period you are monitored by the machine. A Holter monitor records about 100,000 heartbeats in 24 hours and is much more likely to detect a problem.

Stress Testing
You will be attached to an EKG machine with a blood pressure cuff placed on one arm. A clothespin-like sensor is attached to the finger to measure the amount of oxygen in the blood. After a baseline EKG is obtained, you will begin to perform a low level of exercise by walking on a treadmill. The exercise is "graded" - that is, every three minutes, the level of exercise is increased. At each "stage" of exercise, the pulse, blood pressure and EKG are recorded, along with any symptoms you may be experiencing.

With a "maximal" stress test, the level of exercise is gradually increased until you cannot keep up any longer because of fatigue, or until symptoms (chest pain, shortness of breath, or lightheadedness) prevent further exercise, or until changes on the EKG indicate a cardiac problem. Maximal stress tests should be performed when the goal is to diagnose the presence or absence of coronary artery disease.
With a "submaximal" stress test, you exercise only until a pre-determined level of exercise is attained. These tests are used in patients with known coronary artery disease, to measure whether a specific level of exercise can be performed safely.

After the test, you will remain monitored until any symptoms disappear, and until the pulse, blood pressure and EKG return to baseline.

Stress Echo
A stress Echocardiogram is a non-invasive test that combines 2 tests - a treadmill stress test and an echocardiogram. The echocardiogram is an ultrasound of the heart which enables us to visualize the heart valves, blood flow through the valves, and size and structure of the heart.

The test compares the heart’s function during exercise to its function at rest, and is used to more accurately determine the presence or absence of blockages within the heart arteries. Patient may walk on the treadmill or, if unable to walk, they will have a chemical stress test.

Nuclear Cardiology
Like a stress echo test, nuclear cardiology studies produce images of the heart at work (during exercise) and at rest. During a test, you are given an injection of a small dose of a harmless tracer. Then you spend time exercising on a treadmill or stationary bicycle and then resting. A specialized camera (called a "gamma camera") detects the tracer as it passes through the chambers of your heart, creating the pictures. The pictures may reveal problems in heart muscle and blood vessels, especially when the images of the heart at work and at rest are compared. We are now offering in-office nuclear stress testing in our Arlington, TX office.

Lipid Management
Lipid Management helps people with high cholesterol lower their risk of heart disease. If you already have heart disease, this program will help to decrease the progression of the disease. The best ways to lower your cholesterol levels are through exercise, eating low fat foods, and if necessary, taking medications.

If you already have heart disease, studies have shown that cholesterol lowering medication can decrease your risk of future heart attacks and by-pass surgery. Most people can lower their risk for heart disease by making some lifestyle changes.

Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and it contributes to hardening of the arteries or atherosclerosis and the development of heart failure.

We can tell if you have hypertension by checking your blood pressure with a special meter called a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. You should have your blood pressure checked at least once a year to make sure you don't have hypertension.

Pacemakers are battery-powered implantable devices that function to electrically stimulate the heart to contract and thus to pump blood throughout the body. Pacemakers consist of a pager-sized housing device which contains a battery and the electronic circuitry that runs the pacemaker, and one or two long thin wires that travel through a vein in the chest to the heart. Pacemakers are usually implanted in patients in whom the heart's own "spark plug" or electrical system is no longer functioning normally


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