Heart Endovascular And Rhythm of Texas

Our Services

HEART PA offers a full array of Invasive as well as Non-Invase Diagnostic and Interventional Procedures.

General Cardiology, Cardiac Imaging & Testing

We specialize in treating disease of the blood vessels of the heart and cardiovascular system. We care for patients suffering from hypertension (high blood pressure), heart murmurs, irregular heart beats and rhythms, and problems with faulty heart valves. We deliver invasive and noninvasive techniques such as angiograms, electrocardiograms, echocardiograms (ultrasound of the heart). Most of these procedures can be performed in the office which mean that our patients rarely need to visit the hospital.

Holter Monitor

One of the most common issues raised by our patients is heart palpitations, a “racing” or fluttering sensation of the heart. Sometimes our patients say they feel as if their heart skips or adds a beat, taking their breath away for a second or two.

If you are experiencing heart palpitations, more than likely you will be given a Holter monitor to wear for 24-48 hours which will record the beating of your heart. Electrodes will be attached to your chest and will record the rhythm of your heart into the monitor. This is a painless test and most of our patients say it’s easy to sleep with the monitor since it’s not cumbersome.

Your cardiologist will read the results of your test and determine if any treatment is required. At times, the solution is a simple one, like cutting back on caffeine!

EKG

An electrocardiogram or EKG is a basic screening to determine if there are any problems with your heart and arteries. Typically everyone who sees one of our cardiologists will be given an EKG. This is a painless test that takes only a few minutes and requires no prior preparation before you arrive. It is important, however, to mention any medications that you are currently taking before coming for your appointment since some prescriptions can alter the accuracy of the test.

Once you are in an examining room, you will be asked to lie down while 12 small, sticky patches, called electrodes, are attached to your arms, legs, and chest. While you lie still, your heart’s electrical current will be recorded so that your physician can determine your heart’s pumping pattern.

Your doctor will be checking the rhythm of your heart and can determine if it’s beating too fast or too slow, which may indicate a problem. As soon as the test is over, your physician will give you the results. At this time, your doctor will discuss with you if any further tests or procedures are required.

Echocardiogramr

An echocardiogram is an ultrasound that gives your physician a visual picture of your heart and arteries. This test is often used in conjunction with an EKG. Just as an EKG determines your heart’s electrical pattern, an echocardiogram helps your physician to establish your heart’s pumping ability, while evaluating its size, shape, and valve function.

This test is painless and takes about 30 minutes to perform. You will be asked to lie on your back or side while a technician passes an instrument that looks like a small rod over your chest. The ultrasound waves transmitted from the device then build an image of your heart onto a screen so that your physician can see if you have any heart valve disorders or coronary heart disease. In some cases, a substance may be injected into your bloodstream to get an even clearer picture of your heart and arteries. The substance is not harmful and can indicate scar tissue or other problems. This visual snapshot of your heart will also show any defects, blockages, tumors, or previously undetected heart attacks.

The results of your test will be read either that day or shortly thereafter. Your doctor will answer any of your concerns or questions regarding your results. Should you require further treatment, your doctor will also discuss the best treatment plan for you.

Treadmill Stress Test

A treadmill stress test will reveal how your heart responds to exertion and if there are any blockages in your arteries, problems with blood flow, heart valve concerns, or coronary heart disease. You will be asked not to eat or drink anything except water for 4 hours before the test. It’s also advised that you wear comfortable clothes and shoes that will allow you to move easily. If you typically use an inhaler, it is important to bring it with you in case you need it during your appointment.

Our office will advise you about whether or not you should take your prescription medication the day of the test. If you are diabetic and taking insulin, our office will also give you instructions about insulin and food intake.

During your appointment, 10 electrodes will be positioned on your chest and attached to an EKG monitor. As you walk on the treadmill, the speed will increase gradually and the treadmill will tilt slightly which will increase your exertion and heart rate. This test will feel similar to going on a brisk walk up a small hill. If at any time you feel dizzy or overly winded and need to stop the test, our technician will be happy to do so.

Your physician will discuss your results at your appointment and will patiently answer your questions or concerns. You may need additional testing and any further tests or procedures will also be discussed with you.

Nuclear Stress Test

A nuclear stress test is a very safe and effective way to evaluate the blood flow through your heart and arteries. You may be asked not to eat or drink a few of hours before the test, and you will be given instructions about taking any of your prescription medication. It is important not to have any caffeine for 12 hours before the test (as it may interfere with the test). This test can take about two-three hours, with periods of rest during the test.

When you arrive for the test, you will be given an IV in your arm and a small amount of radioactive dye will be injected through your vein. Electrodes that feed into an electrocardiogram machine will be attached to your chest, arms, and legs tracking the electrical impulse of your heart. To begin, pictures of your heart will be taken at rest while you are lying down.

If you are unable to exercise, you will be given medicine that will stimulate your heart as if it were under exertion. You may even feel short of breath as if you have been exercising. If you are capable of exercise, you will walk on a treadmill that will gradually increase in speed and inclination. Once you have either been given medication or completed the exercise, you will be asked to lie down again and another small dose of dye will be given to you through the IV. More images of your heart will be taken which will reveal its level of functionality. The radioactive dye will show any blockages which will confirm to your doctor whether or not you have coronary heart disease. The results from this test will also help your doctor determine the next best steps regarding your heart’s health.

After the test, you can resume your normal activities and eat or drink as usual. It takes just a little while for all of the radioactive dye to leave your system, and drinking water will help to flush it out.

Cardiac Catheterization & Stenting

Your doctor may suggest a cardiac catheterization if you are experiencing chest pain. This test helps to determine any heart disease or blockages in your arteries. Before the procedure, it’s important that you communicate with your doctor about any medication you are taking and any other chronic illnesses (such as diabetes) that you may have.

During the procedure, you will be lying on your back and although you will be given medication to relax, you may remain awake. A small incision will be made in your upper thigh, neck, or arm where a catheter will be guided through your blood vessel to your heart. Because a numbing medicine will be used at the incision site, you will not feel the catheter being eased through your artery although you may feel some pressure.

Your doctor will have the visual help of a special machine so that he can place the catheter precisely in the spot that needs further tests or treatment. During your cardiac catheterization if a blockage is confirmed your doctor may fix the blockage with a balloon or stent. Stents are inserted to open a blocked vessel during cardiac catheterization. A stent is a small mesh or fabric tube used to support weak or narrow arteries and to improve blood flow. You may feel some chest pressure or even some pain when your doctor inflates the stent. Once your doctor completes the procedure, the catheter is removed and a bandage is placed on the incision site.

You will stay in our office or in the hospital for several hours or possibly overnight if a stent is performed. Nurses will check your blood pressure regularly and your incision site for bleeding. You may be sore for several days after the procedure and your doctor will advise you about when you can resume your normal activity (such as driving and lifting) and when you can return to work.

Pacemakers

Pacemakers are devices that are used when your heart is beating abnormally or too slow, a condition called arrhythmia. Using low energy electrical pulses, the pacemaker controls your heart’s rhythm so that it beats correctly.

Before your pacemaker procedure, your doctor will instruct you about taking any of your prescription medication. You’ll also be instructed not to eat or drink anything after midnight the day of your procedure. You will arrive at our office or hospital dressed comfortably and without any valuables since you will change into a hospital gown for the procedure.

At the start of your treatment, you will lie down on your back while a nurse administers an IV through your arm. You will also be connected to monitors that will record your blood pressure and other vital signs during the procedure. Another monitor will give your doctor a visual guide as he or she puts the pacemaker in place.

Although you will be awake during the procedure, you will be given medicine through the IV that will help you relax. Before your doctor inserts the pacemaker, he will inject numbing medicine to your chest so that you will not feel any pain when he makes the incision. You may feel a pulling sensation as he attaches the pacemaker and adjusts its setting, but if there is any significant discomfort or pain your doctor will want you to tell him immediately.

You may be allowed to leave after the procedure or your doctor may want you to stay overnight. You will receive instructions about lifting, exercise, and returning to work before you leave the hospital. You will also receive specific information about how and when to avoid electrical devices to ensure that your pacemaker stays in reliable working order.

Implantable Cardioverter Defibrillator (ICD)

An ICD is a solution for patients whose heart beats abnormally in such a way that it’s life-threatening. An ICD can also be used to correct arrhythmia in children and teens. The surgery typically takes a few hours, but you should expect to stay in the hospital a day or two while you recover and your cardiologist makes sure your ICD is working appropriately. Similar to a pacemaker procedure, you will be given medicine through an IV in your arm to help you relax. Your doctor will numb the area where he will make an incision to place the ICD and use a special monitor to give him a visual guide as he places the ICD and attaches it properly. The device uses low-level electrical shocks to help control the beating of your heart at a normal rate.

After the procedure, your doctor may prescribe antibiotics to help prevent infection and you may feel some discomfort where the ICD was implanted. You will be given instructions as to when you can return to work or other activities, but most people resume their normal schedule a few days after receiving their ICD.

Endovascular Procedures

Typically tests are non-invasive and can detect heart rhythm disorders, blocked arteries and structural heart and valve problems. Our highly skilled cardiologists perform both invasive diagnostic and interventional endovascular peripheral and cardiac procedures at our certified state of the art office based laboratory. This facility also allows for the insertion of pacemaker defibrillators.

Heart Rhythm/Electrophysiology

A cardiac electrophysiologist is basically an electrician for the heart. This is different from an interventional cardiologist which functions similar to a plumber for the heart. Abnormalities of the electrical system of the heart can lead to fast or slow heart beats, or the chambers of the heart beating out of sync with each other. We use special medications to treat the problems with the heart beats, burn or freeze faulty electrical tissue in the heart, and we implant devices such as pacemakers and defibrillators to prevent sudden death from lethal heart rhythms. We also treat problems that lead to passing out (syncope) or the feeling of passing out.

Venous Disease Diagnosis & Treatment

Varicose veins are caused by damaged or diseased valves in the veins. This can lead to blood flowing the wrong way (reflux) in one’s legs. Spider veins or telangiectasias are small varicose veins located just under the skin. They are a problem for millions of people. You are not alone in your desire to rid yourself of these painful and unsightly veins. They may be inherited from your parents and may worsen with weight gain, pregnancy or simply for no identifiable reason.
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Frequently, spider veins are of cosmetic concern only. Sometimes they may be related to an underlying medical problem known as venous insufficiency or reflux (backwards flow of blood in the veins). In either situation, symptoms associated with spider veins range from itching or a dull ache to throbbing pain and bleeding.

Varicose veins are superficial veins that have enlarged due to increased pressure caused by incompetent, or leaking, valves that are much larger than spider veins. They are a problem for millions of adults. They may be inherited and may worsen with weight gain, pregnancy, or may worsen for no reason at all. Varicose veins may cause an aching feeling in your legs or may result in pain, swelling, skin discoloration or even ulcers. They may be related to an underlying medical problem known as venous insufficiency or reflux (backwards blood flow in the veins). The disease is typically progressive and can eventually involve the entire saphenous vein (the vein that runs under your skin along your calf and thigh) as well as many of its branches if it is not treated.

Your insurance company will usually cover treatment of your varicose veins if they cause significant symptoms and if you have attempted conservative treatment for 3-6 months sometime in the past without relief (elevation, compression stockings, exercise and weight control).

Veins in your legs are tubes that carry blood from your feet toward your heart. One-way valves are located inside the veins and should only allow blood to flow up, out of your legs and back to your heart. When valves go bad for different reasons, blood flows backwards and builds up or pools in your leg veins. The backwards flow of blood in your veins is known as reflux and places excess pressure on the vein walls. This causes veins to expand and become varicose, and can result in leg swelling, permanent skin changes and non-healing ulcers as pressure is transferred to the skin. 

In the case of varicose veins (big bulging rope-like veins visible on the skin), they are often related to leaking valves in the Saphenous Vein (the vein which is just under the skin and runs along the inside of your calf and thigh). 

Should an ultrasound confirm reflux in the saphenous system, a procedure called endovenous radiofrequency ablation can be used to eliminate the underlying reflux by closing off the leaking vein which is the source of the problem.

Some patients require a slightly more invasive procedure known as a venogram with intravascular ultrasound. This is reserved for patients with chronic skin changes and wounds. Some people will require a stent of their iliac veins (vein in the pelvis) or their inferior vena cava (IVC). This is typically a day surgery procedure that can be performed safely in our office.

   

Peripheral Arterial Disease Diagnosis & Treatment

Peripheral Arterial Disease (PAD) is the term generally used to describe atherosclerotic disease (hardening of the arteries) affecting the circulation of the lower extremities.  Patients with PAD may be asymptomatic, or they may present with symptoms ranging from bothersome Intermittent Claudication (cramping in the calf muscles with exercise) to Rest Pain (pain in the forefoot that is most severe at night) to non-healing sores and even gangrene.  The public is generally not aware that PAD is a very common disease that has a tremendous impact on quality of life.  Therefore earlier diagnosis and intervention have great potential for improving overall outcome for patients.

Interventional Cardiology

Your doctor referred you to a specialist at Heart, Endovascular and Rhythm of Texas (HEART). Just the thought of it can be a little frightening. But you can rest assured that our doctors have excellent credentials but they are also up to date on the latest procedures and technology. Our specialists’ exceptional training and years of hands-on expertise often translates to faster recovery times and less discomfort for our patients. Knowledge, training, and compassion are the qualities that set us apart and allow you to receive the best care available.

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There are several tests that can be administered to determine your heart’s health. Many can be done right in our offices for your convenience. With multiple clinic locations within San Antonio, our patients who live outside of San Antonio often have the additional ease and comfort of our quality care close to home.



Hospital Procedures

Cardiac Catheterization & Stenting

Your doctor may suggest a cardiac catheterization if you are experiencing chest pain. This test helps to determine any heart disease or blockages in your arteries. Before the procedure, it’s important that you communicate with your doctor about any medication you are taking and any other chronic illnesses (such as diabetes) that you may have.

During the procedure, you will be lying on your back and although you will be given medication to relax, you may remain awake. A small incision will be made in your upper thigh, neck, or arm where a catheter will be guided through your blood vessel to your heart. Because a numbing medicine will be used at the incision site, you will not feel the catheter being eased through your artery although you may feel some pressure.

Your doctor will have the visual help of a special machine so that he can place the catheter precisely in the spot that needs further tests or treatment. During your cardiac catheterization if a blockage is confirmed your doctor may fix the blockage with a balloon or stent. Stents are inserted to open a blocked vessel during cardiac catheterization. A stent is a small mesh or fabric tube used to support weak or narrow arteries and to improve blood flow. You may feel some chest pressure or even some pain when your doctor inflates the stent. Once your doctor completes the procedure, the catheter is removed and a bandage is placed on the incision site.

You will stay in our office or in the hospital for several hours or possibly overnight if a stent is performed. Nurses will check your blood pressure regularly and your incision site for bleeding. You may be sore for several days after the procedure and your doctor will advise you about when you can resume your normal activity (such as driving and lifting) and when you can return to work.

Pacemakers

Pacemakers are devices that are used when your heart is beating abnormally or too slow, a condition called arrhythmia. Using low energy electrical pulses, the pacemaker controls your heart’s rhythm so that it beats correctly.

Before your pacemaker procedure, your doctor will instruct you about taking any of your prescription medication. You’ll also be instructed not to eat or drink anything after midnight the day of your procedure. You will arrive at our office or hospital dressed comfortably and without any valuables since you will change into a hospital gown for the procedure.

At the start of your treatment, you will lie down on your back while a nurse administers an IV through your arm. You will also be connected to monitors that will record your blood pressure and other vital signs during the procedure. Another monitor will give your doctor a visual guide as he or she puts the pacemaker in place.

Although you will be awake during the procedure, you will be given medicine through the IV that will help you relax. Before your doctor inserts the pacemaker, he will inject numbing medicine to your chest so that you will not feel any pain when he makes the incision. You may feel a pulling sensation as he attaches the pacemaker and adjusts its setting, but if there is any significant discomfort or pain your doctor will want you to tell him immediately.

You may be allowed to leave after the procedure or your doctor may want you to stay overnight. You will receive instructions about lifting, exercise, and returning to work before you leave the hospital. You will also receive specific information about how and when to avoid electrical devices to ensure that your pacemaker stays in reliable working order.

Implantable Cardioverter Defibrillator (ICD)

An ICD is a solution for patients whose heart beats abnormally in such a way that it’s life-threatening. An ICD can also be used to correct arrhythmia in children and teens. The surgery typically takes a few hours, but you should expect to stay in the hospital a day or two while you recover and your cardiologist makes sure your ICD is working appropriately. Similar to a pacemaker procedure, you will be given medicine through an IV in your arm to help you relax. Your doctor will numb the area where he will make an incision to place the ICD and use a special monitor to give him a visual guide as he places the ICD and attaches it properly. The device uses low-level electrical shocks to help control the beating of your heart at a normal rate.

After the procedure, your doctor may prescribe antibiotics to help prevent infection and you may feel some discomfort where the ICD was implanted. You will be given instructions as to when you can return to work or other activities, but most people resume their normal schedule a few days after receiving their ICD.

Heart Bypass Surgery

When the arteries of your heart are blocked, you may feel chest pain, pressure, or a squeezing sensation. Heart bypass surgery restores healthy circulation of blood and oxygen to your heart. Heart bypass is typically performed when stents cannot be used or the stents have blocked up. A blood vessel is removed from your chest, arm, abdomen, or leg, and attached to your coronary artery. This gives your blood a new, unobstructed passageway and will help your heart and arteries to have full functioning capacity again.

The surgery will take several hours and you will remain in the Intensive Care Unit (ICU) for some time after the operation. When you wake up from the surgery, you will be attached to several monitors and a breathing tube will be inserted in your mouth. This will be removed once you can breathe on your own and nurses will be close by to monitor you. Most likely, you will remain in the ICU for a few days until you are moved to a hospital room for another few days. Most patients are quite sore, but our caring doctors and nurses will help you to stay as comfortable as possible.

Although recovery time differs for everyone, it takes most people a couple of months to fully recuperate from heart bypass surgery. Your doctor will give you instructions about when you can drive again, recommendations for diet and exercise and specifics about medications. The closer you follow the instructions of your cardiologist, the faster your recovery time. You will also have follow-up appointments with your primary physician and surgeon who will monitor your progress. We work closely with multiple cardiac surgeons and we are happy to provide referrals if you need this surgery.

All-Inclusive, Continuous Care

We are commited not only to serving the community with the full gambit of cardiovascular care; but, also to deliver this care in a manner in which we would want our family treated.