Abdominal Aortic Aneurysm

An aortic aneurysm is a weakened and bulging area in the aorta, the major blood vessel that feeds blood to the body. The aorta, about the thickness of a garden hose, runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured aortic aneurysm can cause life-threatening bleeding. Although you may never have symptoms, finding out you have an aortic aneurysm can be frightening.

Most small and slow-growing aortic aneurysms don't rupture, but large, fast-growing aortic aneurysms may. Depending on the size and rate at which the aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery.

Arrhythmias (V-tach, PVC’s, PAC’s, SVT, PAT, V-fib)

Arrhythmias are problems with the electrical conduction of the heart where the heart may beat too slow or too fast, or may be in an abnormal rhythm. There are many types of arrhythmias. Premature Ventricular Contractions (PVC’s) and Premature Atrial Contractions (PAC’s) are some of the most common electrical conduction problems. Other forms of arrhythmias are atrial fibrillation, paroxysmal atrial tachycardia, supraventricular tachycardia

Atrial Fibrillation

Atrial Fibrillation, also known as a-fib, is a condition where the electrical system of the heart does not work normally. The result of this is that the top part of the heart, or the right and left atria, do not contract fully. Instead the top part of the heart quivers. This can result in the pooling of blood in the atria. If blood pools and does not flow through the heart properly, blood clots can form. If blood clots form and get out into the body’s circulating blood, a stroke may occur. Patients with a-fib may remain in this abnormal rhythm indefinitely, and would require blood thinner to prevent stroke. After blood thinner therapy has been started and is at an adequate level, the doctor may choose to cardiovert, or shock the heart, back into a normal rhythm. This is done under sedation. Medications may also be used to return the heart to normal rhythm or just to control the actual heart rate.


Cardiomyopathy refers to a weakened heart muscle. The heart muscle may be enlarged or may be thickened. Some causes of cardiomyopathy are chronic ischemic heart disease (which leads to ischemic cardiomyopathy), long term alcohol abuse (which leads to alcoholic cardiomyopathy), hypertension (which leads to hypertrophic cardiomyopathy), pregnancy (which can lead to post-partum cardiomyopathy), and certain viruses, infections and inflammatory processes (which can lead to idiopathic cardiomyopathy). In some cases the cause of the cardiomyopathy cannot be determined, and this is called idiopathic cardiomyopathy. When the heart muscle becomes dilated (stretched) or becomes thickened, it cannot pump adequate amounts of blood throughout the body. The amount of blood the left ventricle can pump is measured by the ejection fraction (EF) on echocardiogram. Normal EF is greater than 55%. Cardiomyopathy results in a low EF and can often times lead to congestive heart failure.

Carotid Artery Disease

Carotid artery disease is a condition in which the carotid arteries, a pair of blood vessels that deliver blood to your brain and head, become clogged with fatty deposits called plaques.

With carotid artery disease, the danger is that clogged-up carotid arteries will block blood flow to your brain and lead to a stroke. Because carotid artery disease develops slowly and often goes unnoticed, a stroke or transient ischemic attack (TIA) — an early warning sign of a future stroke — may be the first outward clue that you have carotid artery disease.

Chronic Ischemic Heart Disease

Someone with chronic ischemia has had blockages of the arteries of the heart. Ischemia is a term used to describe loss of blood supply. For example, if someone has loss of blood supply to the foot, it can be described as an ischemic foot. With the heart, loss of blood supply leads to possible damage to the heart muscle. Chronic ischemic heart disease refers to someone who has history of having blockages in the arteries of the heart, which may lead to damage to the heart muscle.

Congestive Heart Failure (Systolic and Diastolic)

Congestive heart failure can be broken into two categories: systolic and diastolic. In order to understand these, you will need some background about heart function. During a normal heart pumping cycle the heart goes through phases. The heart has a right and left ventricle and a right and left atrium. The atria are at the top of the heart and the ventricles are at the bottom of the heart. The left ventricle is the main pumping chamber of the heart. The contraction of the ventricles is called ventricular systole (pronounced sis-toe-lee) and the relaxation of the ventricles is known as ventricular diastole (pronounced die-as-toe-lee). The same is true for atria. When the ventricles are contracting, the atria are relaxing, and vice versa.

Systolic Heart Failure may be present when there is a problem with the left ventricle and the way is pumps blood (also called left ventricular systolic dysfunction). In patients with some forms of cardiomyopathy, the left ventricle becomes dilated, stiff, or thickened and cannot properly pump the body’s circulating blood. If the left ventricle is weak, the blood will back up into the lungs causing fluid accumulation and shortness of breath or into the extremities causing swelling.

Diastolic Heart Failure may be present when there is a stiff or thickened heart muscle that cannot properly relax to allow for adequate filling of the ventricle. The overflow of circulating blood is then backed up into the lungs and extremities as well. Symptoms are shortness of breath and swelling.

Coronary Artery Disease

Coronary Artery Disease (CAD) is described as the presence of blockages in the arteries of the heart. The presence of CAD can be determined by heart catheterization, which visualizes the coronary arteries and can identify what percentage of blockage may be present. Once a person is diagnosed with CAD, they will always have this diagnosis, since the blockages do not go away. Blockages, also called areas of stenosis, can be treated by angioplasty (balloon), stent (inflatable mesh metal device), coronary artery bypass grafting (CABG or open heart surgery), or can also be treated with medications. Medication treatment involves treating the patient with a variety of medicines that will help to prevent the blockage from getting any larger. This may include aspirin and other anti-platelet drugs, statins and other cholesterol lowering medications, beta-blockers, ACE inhibitors, and other medications.

Coronary Spasm

Coronary Spasm refers to a syndrome in which the arteries of the heart actually spasm. When the artery is in spasm, it narrows resulting in loss of blood supply to the heart. The patient will experience chest pain and symptoms of heart attack. Like CAD, coronary spasm can actually lead to loss of heart muscle. Coronary Spasm, once diagnosed, can be treated with medications such as Calcium Channel Blockers and long acting nitrates which help to relax and dilate the walls of the arteries.


Coumadin, or warfarin, is a blood thinner. It is used in patients with conditions such as atrial fibrillation, deep venous thrombosis, mechanical valve replacements, and stroke. The blood is kept thin to prevent clots, which can lead to stroke. Laboratory studies called Prothrombin Time (PT) and International Ratio (INR) must be monitored for patients who are taking Coumadin. The goal is to maintain the blood clotting time in a certain range. The patient must be counseled on diet, medication interactions, side effects, warning signs, follow-up and other areas. Certain patients are not candidates for blood thinner therapy, such as those who have had previous bleeding ulcers, are at risk for falls, have history of any brain bleed, or any other bleeding disorder.


Dysautonomia is a general term used to describe a breakdown, or failure of the autonomic nervous system. The autonomic nervous system controls much of your involuntary functions. Symptoms are wide ranging and can include problems with the regulation of heart rate, blood pressure, body temperature and perspiration. Other symptoms include fatigue, lightheadedness, feeling faint or passing out (syncope), weakness and cognitive impairment.

Autonomic dysfunction can occur as a secondary condition of another disease process, like diabetes, or as a primary disorder where the autonomic nervous system is the only system impacted.


Cholesterol is made up of several particles: LDL or “bad” cholesterol, HDL or “good” cholesterol, triglycerides, and other particles. The total of the HDL and the LDL along with other particles makes up the total cholesterol. Dyslipidemia is a term used to describe high cholesterol or other abnormal lipid components, such as high triglycerides, low HDL, or high LDL. Patients with dyslipidemia may be treated with medications to help correct the abnormalities. Statin drugs (Zocor, Lipitor, Pravachol, Crestor) may be used to help lower the LDL (bad) cholesterol and total cholesterol. Other types of medications may be used to lower triglycerides or raise HDL.


Hypertension is elevated blood pressure. Blood pressure is measured as systolic over diastolic. For example the blood pressure 140/90 is 140 systolic over 90 diastolic. Ninety-five percent of hypertension is essential, or primary, hypertension, which means there is no significant disease as an underlying cause. Secondary hypertension is high blood pressure that is caused by some underlying process such as renal artery stenosis (blockage in the arteries to the kidneys), tumors, adrenal problems, pregnancy, and other causes. If hypertension goes untreated, it can lead to damage to the heart muscle and arteries, stroke, damage to the retina of the eye, kidney damage, and other problems.

Idiopathic Hypertrophic Sub-aortic Stenosis (IHSS)

Idiopathic hypertrophic subaortic stenosis (IHSS) is sometimes referred to as hypertrophic cardiomyopathy. This is a disease in which the heart muscle (myocardium) becomes abnormally thick – or hypertrophied. This thickened heart muscle can make it harder for the heart to pump blood. It may also affect the heart’s electrical system. Some people with this condition go undiagnosed because they experience no symptoms. In a small number of people with this condition, the thickened heart muscle can cause signs and symptoms, such as shortness of breath and problems with abnormal heart rhythms (arrhythmias).

Mitral Valve Prolapse

Mitral Valve Prolapse is a condition in which the mitral valve displaces back into the left atrium during systole. The valve leaflets may be thickened, which contributes to this problem. Some patients with MVP experience palpitations, dizziness, or chest pain, however most are asymptomatic (meaning they do not have any symptoms at all). Most cases of MVP require no treatment at all. Palpitations may be treated with beta-blockers. Echocardiography is used to evaluate and monitor the mitral valve.

Myocardial Infarction (MI) and The Heart

Myocardial Infarction (MI) is the medical term for “heart attack.” It actually refers to damage to the heart muscle that occurs due to loss of blood supply. This can be the result of untreated coronary artery disease, or coronary spasm. The heart has three main coronary arteries, each of which branches off into smaller arteries. The three main coronary arteries are the Left Anterior Descending (LAD), Left Circumflex (LCX), and the Right Coronary Artery (RCA). These coronary arteries are responsible for supplying the heart with blood. The heart is made up of cardiac muscle tissue. If an artery of the heart (coronary artery) becomes narrowed or blocked due to plaque build up, the muscle tissue that the artery supplies will not get enough blood supply. Just like any other part of the body, if blood supply is lost, that tissue will begin to die. When heart muscle suffers damage from loss of blood supply, it does not work properly. The muscle tissue becomes stiff and is unable to contract, or pump, the blood through the chambers of the heart for normal circulation.

Peripheral Vascular Disease

Peripheral Vascular Disease (PVD) or Peripheral Artery Disease (PAD) refers to the presence of blockage in the arteries of the arms or legs, which may obstruct blood flow. If someone has blockages in the arteries of the legs and develops a sore on the foot or leg, healing may be prolonged and an infection may occur. If infection is present, it may be very difficult to treat. The patient with PVD that is severe enough to cause a complete blockage may be at risk of losing a foot or leg. PVD occurs commonly in patients with diabetes and other known vascular diseases. PVD is also common in people who smoke.

Pulmonary Hypertension

Pulmonary hypertension affects only the arteries in the lungs and the right side of your heart. It begins when tiny arteries in your lungs, called pulmonary arteries and capillaries, become narrowed, blocked or destroyed. This makes it harder for blood to flow through your lungs, which raises pressure within the pulmonary arteries. As the pressure builds, your heart’s lower right chamber (right ventricle) must work harder to pump blood through your lungs, eventually causing your heart muscle to weaken and sometimes fail completely.

Pulmonary hypertension is a serious illness that becomes progressively worse. Although it isn't curable, treatments are available that can help lessen symptoms and improve quality of life.

Renal Artery Stenosis

Renal artery stenosis is the narrowing of the lining of the major artery that supplies the kidneys. Depending on the degree of that narrowing, patients may develop impaired kidney function (renal failure) and high blood pressure called renal vascular hypertension. This form of hypertension is the most common cause of secondary hypertension.

Renal vascular hypertension occurs when the artery to one of the kidneys is narrowed, while renal failure occurs when the arteries to both kidneys are narrowed. The decreased blood flow to both kidneys increasingly impairs renal function.