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Welcome to Firstcare Cardiology
“We care for your heart”
Come see us
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Brownsville Clinic |
| Address: |
1215 E. College Street,
Brownsville, TN 38012 |
| Phone: |
731-772-3442 |
| Fax: |
731-772-3662 |
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Jackson Clinic |
| Address: |
168 University W. Parkway,
Suite A/B, Jackson, TN 38305 |
| Phone: |
731-512-0043 |
| Fax: |
731-512-0015 |
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Alamo Clinic |
| Address: |
281-4 Climer
Loop
Alamo, TN 38001 |
| Phone: |
731-696-2142 |
| Fax: |
731-696-2159 |
Hours of Operation: Monday – Friday (8.00am – 5.00pm)
Some
of the patient services and procedures offered by the FirstCare
Cardiology:
Ambulatory Blood Pressure Monitoring
Uncontrolled high blood pressure over many years can lead to
failure of the kidneys, heart failure and stroke.Control of
blood pressure can decrease the chances of developing these
dreaded complications. This test monitors and records the blood
pressure each hour for 24hours. This gives the doctor an idea of
how well the blood pressure medications are working.
Cardiac Catheterization
WHAT IS CARDIAC CATHETERIZATION?
WHY DO I NEED IT?Cardiac Catheterization is a long word for a special x-ray
procedure in which a small plastic tube or catheter is used to put dye
into the blood vessels around the heart and into the pumping chamber
of the heart in order to see whether blockages are present and to see
how strong is the heart muscle and how well the different parts of the
heart are working.
Once your doctor has this information, he/she will know the best
treatment for your specific condition.
Though this procedure can uncover many different problems with the
heart, it is most commonly used to tell if there are blockages in the
arteries (blood vessels bringing blood and nourishment to the heart
muscle) of the heart. By knowing how many blockages are present, how
severe the blockages are, and the location of the blockage, your
doctor can help you and your family decide the best treatment for you.
There are three main arteries around the heart. If there is only
mild blockage present, medicines can be used to treat the problem.
These medicines do not take away the blockage, but help you to live
with the blockage. If there are severe blockages in just a few areas
of each artery, a balloon (Angioplasty) can usually be used to open
the artery without surgery. Sometimes, however, the balloon is not
able to keep the artery open and is these cases; a wire device called
a stent can be placed in and left inside the artery to keep it open.
Both the Stent procedure and the Balloon (Angioplasty) procedure can
be done without surgery. If, however, you have a severe blockage in
the main heart artery that gives most of the blood to the heart, or if
you have so many blockages that the balloon or stent cannot open them
all, the best treatment is usually Open Heart Surgery (Bypass
surgery). Bypass surgery is a surgery in which a vein is taken out of
the leg or an artery is taken from the chest and sewn in around the
blockage to allow blood to go around the blockage ( in other words to
“bypass” the blockage) and allow blood to get to all the parts of the
heart.
HOW IS CARDIAC/ HEART CATHETERIZATION DONE?A heart catheterization can usually be done as an outpatient.
---You go into the hospital early in the morning and leave four to six
hours after the procedure has been done. If there are complications or
if you and your family decide that you want to stay in the hospital to
have the condition treated, (example stay to have stent, balloon, or
heart surgery) you can decide to do so.
The procedure will usually last less than a half hour. It takes
longer to be prepped or prepared for the procedure than to do the
procedure itself.
First, you will be given both pills by mouth and an injection with
medicine to help you relax/ dose during the procedure. You will be
asked to empty your bladder. You will then be taken to the place where
the procedure will be done—the Cardiac Catheterization Lab.
If you are still feeling anxious after arriving in the
Catheterization Lab, you should tell the staff so that you can be
given additional medications.
Once in the “Cath” Lab, the area that is to be used (usually the
groin or the bend of the arm) will be shaved and cleaned with
antibacterial soap. You will then be covered with a sterile sheet
which has a hole cut in it in the area to be used for the procedure.
IT IS VERY IMPORTANT NOT TO TOUCH THE AREA WHERE THE CATHETER WILL BE
PLACED SINCE THIS CAN INCREASE THE CHANCE OF INFECTION.
The doctor who will perform the procedure will first use a small
needle to numb the area to be used with Lidocaine. (The same thing the
dentist uses to numb your gums) You will feel a needle stick, then
burning, then the area will go numb within minutes. You will then only
feel pressure but should feel no pain. If you feel any discomfort at
this time, let the doctor know so that you can be given more numbing
medication.
A thin tube will then be placed into the artery. The tube will go
straight up the main artery of the body (The Aorta) and into the
heart. You will not feel the tube as it goes up, however you may feel
some fluttering in your chest when the tube first enters the heart.
The first thing that is done is the measurement of pressures inside
the heart. You will not feel anything during this part of the test.
During the next part of the test, dye will be injected into the
arteries around the heart. Most people do not feel the dye as it goes
in but a very few people feel slightly nauseated. There will be seven
to eight pictures of the arteries taken. Each time a picture is taken,
you will be asked to hold your breath. Also, each time a picture is
taken, the camera just above you will be moved in all directions. The
last picture will be the picture of the pumping chamber of the heart.
This picture will make you feel hot all over (like a hot flash) and
may even make you feel like you have urinated on yourself—this is
normal and will last only a few seconds. After this picture is taken,
you will be taken to another room where the tube will be removed from
your leg. Right after the tube is removed, the area will be held down
very tightly for about 15-20 minutes or as long as it takes for the
bleeding to stop. You will then be taken to your room.
Once in your room, it is very important not to move the area where
the catheter was placed (leg or arm). Moving around too much or trying
to stand up too soon after the procedure can cause dangerous bleeding.
Your nurse will tell you what time you may get up.
Your doctor will discuss with you and your family the findings, the
ways in which the situation can be treated, and his/her
recommendations.
Coronary angioplasty/stents
The coronary arteries can become clogged from a buildup of cells,
fats and cholesterol, called plaque. This plaque blocks the blood flow
to your heart muscle and can cause chest pains and lead to a heart
attack. Coronary angioplasty is a way of opening the clogged arteries,
so that blood can reach the heart muscle.A coronary artery angioplasty is a procedure in which a thin, flexible
catheter with a balloon on the tip is put into the blocked coronary
artery to enlarge the opening of the artery and remove the blockage.
The night before your angioplasty, you may be asked not to eat or
drink anything after midnight. You may be admitted to the hospital the
night before your procedure or you may be admitted to the hospital the
day of your procedure. You may have routine blood tests, EKG or a
chest x-ray done, if they have not been done recently. A nurse, or
technician, will clean the skin where the catheter will be inserted.
An IV (intravenous) line is inserted into a vein to give you fluids.
You will also receive medication to help you relax and dose slightly
during the procedure.
The angioplasty usually takes anywhere from 30mins to as long as one
to two hours. You will be drowsy during the procedure but if you like,
can watch the procedure on a special screen. The physician numbs up
the area with a local anesthesia (lidocaine – like the dentist uses).
Once the catheter is inserted into an artery, the physician guides
the balloon catheter into the part of the heart where the narrowed
coronary artery is located. The balloon is placed within the
narrowed artery, and by blowing up the balloon for several
seconds, the plaque can be flattened against the artery wall and
the blockage removed. Often the physician asks you to take deep
breaths and hold it during the procedure. By removing the blockage
of the coronary artery, by flattening the plaque, the heart muscle
is able to get more blood and oxygen and chest pains should be
improved.
When the physician feels that the coronary artery has been opened
sufficiently, you will be taken to a special recovery room. You will
need to lie flat for about six to ten hours from the time the balloon
catheter is removed. The nurse will check your pulse and blood
pressure and the insertion site for bleeding. You will continue to be
attached to the heart rate monitor, receive IV fluids and be monitored
closely for several hours after the procedure. You will probably spend
the night in the hospital and be allowed to go home one day after the
procedure.
After the procedure, your physician will tell you the results and give
you instructions about what you should be able to do. You should be
able to walk without much discomfort by the time you leave the
hospital. You should have someone drive you home.
Carotid Duplex Scanning
Carotid Ultrasound (Carotid Doppler) is a simple, painless way to
tell how well the blood is flowing through your carotid arteries (the
major blood vessels which carry blood to the brain).
Atherosclerotic vascular disease (hardening of the arteries) is a
progressive disease caused by a slow build-up of cholesterol deposits
(Plaque) within the arteries. The deposits of plaque that form on the
artery walls can cause a significant decrease of blood flow to muscles
and vital organs. When this condition is present in the Carotid
Arteries, there is a much higher risk of stroke. This is a treatable
and surgically correctable condition.
The Carotid Arteries are the
major blood vessels which carry blood and nutrition to the head and
brain. By finding a blockage early, we can sometimes help prevent a
stroke. The purpose of the carotid Doppler is to help find out about
blockages to the head.
- How the Carotid Ultrasound Exam is done.
- You will be asked to lie flat on your back (some adjustments can be
made for those who require a pillow for support).
- A clear gel is applied to your neck and a transducer is gently
placed to one side of the windpipe.
- The transducer is moved up and down the length of the neck to record
the entire length of the carotid artery and blood flow measurements
are recorded.
- The process is then repeated on the other side of the neck.
Generally, one hour is allotted for the exam (from entering the clinic
to leaving).
- Preparation for the exam:
- In general, there is no preparation for the exam.
- You will be asked to remove any jewelry from around the neck.
- It is advised that you wear a loose fitting, open necked shirt or
blouse.
The Carotid Ultrasound study is a safe, simple and cost effective
method of assessing blood flow through the carotid arteries and
determining significant restriction of blood flow. During this part of
the exam, the carotid arteries are seen and pictures are recorded
detailing the condition of the arteries and show any plaque deposits
that may interfere with normal blood circulation. Color Doppler and
Pulsed Wave Doppler are methods the examiner uses to measure blood
flow velocities recording any areas of restriction.
We hope this brief introduction to Carotid Ultrasound has provided
you with a better understanding of this simple, yet valuable test. The
Carotid Ultrasound continues to provide reliable and important
information in the detection of the blockages in the carotid arteries
(the arteries that deliver blood and oxygen to the brain). Like many
other diagnostic tests, the Carotid Ultrasound has undergone many
refinements. Since the development of powerful computers, its accuracy
has improved immensely.
Cholesterol and Lipid Testing
What is cholesterol?
Cholesterol is a substance produced in the liver which is needed to
form cell membranes, nerve coatings and certain hormones. Our bodies
usually produce enough natural cholesterol to take care of these
needs. We also get cholesterol from the foods we eat, such as meats,
egg yolks and whole dairy products.
The higher your blood cholesterol is, the greater your risk of
developing coronary artery disease.
Lab Schedule for Cholesterol Medications per Federal Drug
Administration Guidelines:
- After starting the cholesterol medication, have your blood checked in
four weeks.
- You do not need an appointment for lab work in our office. Come to the
office after 8:30 a.m. to have your blood drawn. Fasting (nothing to
eat or drink except water) is preferable but not necessary.
- After your blood tests return, ask when you should have your blood
rechecked again. This is usually eight weeks after the first blood
test, unless we tell you differently.
- Have your blood test for cholesterol (lipids) and a chemistry screen
(for liver function tests) every six months after your cholesterol
medication has been adjusted. This schedule continues indefinitely.
Adverse side effects to be aware of:
- Muscle aches and weakness
- Fatigue
- Abdominal pain, constipation, diarrhea, flatulence (gas).
- Headache
- Liver functions may be affected, thus the reason for follow up blood
tests, as recommended.
Echocardiography & Transesophageal
Echocardiography (TEE)
What Is An Echo?Your doctor has requested that a study known as an Echocardiogram
(echo) be performed. The echo actually consists of three different
procedures:
- Two-dimensional echocardiography imaging.
- M-mode echocardiography imaging.
- Doppler velocity and color flow mapping.
Echocardiography is a way to study the inside of the heart by using
sound waves to make a picture. These pictures tell the size and shape
of the heart, how well the heart muscle is working and whether the
blood is going through the heart in the right direction.
The Echo Exam Is Simple And Painless.
You will be asked to lie on your back or left side as a transducer,
coated with a clear gel, is applied to your chest. The gel allows the
sound waves to enter the body without passing through the air and
maintains the image quality of the echo. ECG electrodes will be
applied to your chest to monitor the heart’s electrical activity
during the study.
You will remain awake and can watch the images on the screen.
The test requires no special preparation. You may take your
medications and eat as usual.
The report of the echo interpretation is sent to your doctor usually
the next working day. The technologist performing the study will be
happy to advise you as to where and when the results will be
available.
The Echocardiogram Provides Your Doctor With Valuable Information About Your Heart:
The heart’s size; Echocardiography is an excellent method of measuring
the size of the four heart chambers as well as the thickness of the
heart muscle.
Pumping strength; Echocardiography is able to evaluate if the heart
pumps normally or is weakened.
Valve disease; All four valves are evaluated for narrowing or leakage
during the echo study.
Other uses; The echo study can also detect blood clots or tumors
inside the heart. Abnormal findings such as fluid around the heart or
abnormal holes between heart chambers can be found with the echo
study. The estimation of the pressures within the heart or adjacent to
the valves is evaluated with the echo study.
Electrocardiography
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What is an Electrocardiogram?
An electrocardiogram (ECG) is a "picture" of the conduction of
electrical impulses through the heart.
- What information may be obtained from an ECG?
An ECG can tell the physician many things about the heart such as:
- Heart Rate
- Type of heart rhythm that is present.
- Where the electrical pulses originate.
- Abnormalities of conduction.
- Heart chamber enlargement.
- Evidence of previous damage (heart attack).
- How is an ECG obtained?
For a standard ECG, 10 leads are placed on the chest and limbs of the
patient. Electrode patches with a conduction gel are applied to the
patient and lead wires are attached to the patches.
- Is there any preparation the patient must do prior to the test?
The patient should wear comfortable clothing that will allow easy
access to the chest. The skin of the patient is usually cleansed with
alcohol and hair shaved, if needed, were the electrode patches will be
applied to ensure the patches will adhere to the skin in order to get
a good lead hook-up.
When the patient is properly hooked up to the electrocardiograph the
patient is asked to just relax and within seconds the ECG is complete.
- When are electrocardiograms necessary?
Here at FirstCare Cardiology, Dr. Obi and Dr. Renee get a baseline ECG
on every new patient seen in the clinic. The ECG is like your heart’s
own "fingerprint," it is unique to you. ECGs are also obtained when a
patient is returning to the clinic from open heart surgery or
angioplasty. They may also request an ECG when a patient has
complaints of chest pain or has new onset of an irregular pulse.
- What information should the patient supply before having an ECG?
Patients should keep a current list of medications indicating their
doses and how often the medications are taken as certain medications
can have an effect on the outcome of the ECG.
In order to understand some of the information provided by an ECG the
following is a simplified explanation of the heart's anatomy and
function.
- The heart is a hollow, muscular organ that pumps blood to the lungs
for oxygenation and then back to the rest of the body. The adult heart
weighs about one pound and is approximately the size of your fist.
- The heart has four chambers: right atrium, left atrium (upper
chambers): right ventricle, left ventricle (lower chambers). The heart
is further divided by a muscular wall called the septum, which divides
the heart into the right and left side. The right side of the heart
pumps blood to the lungs to be oxygenated and the left side pumps the
oxygenated blood to the body.
- The atria contract at the same time followed by the contraction of the
ventricles. These contractions usually occur in a rhythmic beat.
- The normal electrical conduction pathway begins in a place in the
heart called the SA node, which is located in the upper portion of the
right atrium. The impulse travels downward through both the right and
left atrium to the AV node located in the lower right atrium near the
septum. From here the impulse is directed down the septum through the
Bundle of His located between the ventricles to the Purkinje’s fibers
circling the ventricles and into the ventricular muscle. The cycle is
then repeated again which will result in a normal heart rhythm.
- Any disruption in the conduction pathway will be shown in the ECG
making it possible for the physician to determine where the electrical
impulses are starting from and finishing at, as well as areas of the
heart that may have been damaged by an event such as a heart attack or
other disease processes.
- An electrocardiogram is an easy, painless diagnostic tool that can
assist the physician in determining the cardiac health of their
patients.
Nuclear Stress Testing
WHAT IS A NUCLEAR STRESS TEST?
Coronary artery disease (blockages of or narrowing of the arteries
to the heart) is the leading cause of death and disability in our
country. Any test that can help to find out about heart blockages
before a heart attack happens and before the heart muscle is damaged
is worth its weight in Gold.
The nuclear stress test is a test which tries to help detect
blockages of the arteries of the heart. A Radio-active material is
injected into your body and a picture of your heart is taken while you
are at rest. Later, a second picture of your heart will be taken after
exercise. The doctors then compare the blood flow at rest and with
exercise to determine if there may be blockages present.
- What is monitored during the test?
- Your heart rate
- Your breathing
- Your blood pressure
- Your electrocardiograph (ECG)
- Any symptoms that you may have
- How tired you are
- Before Your Test
- When you schedule your stress test, you will be asked to bring all of
your medications with you.
- Ask if there are any medications that you should not take before your
test.
- Make sure that your last meal is well digested before taking a stress
test.
- Make sure you wear comfortable walking shoes and a two-piece out fit.
- Females will be asked to wear a paper cape from the waist up.
Avoid all caffeine for 48hrs prior to test (coffee, tea, cola,
mountaindew, mello yellow)
- Although you will not have to exercise for long, the entire test takes
about 3hrs.
- You should allow extra time to check in at the front desk.
The final results will be sent to your physician within a few days.
The information that is provided by the stress test will help your
doctor make an accurate diagnosis of your heart and develop your
treatment plan. Your doctor can review your test results and your
treatment plan with you in detail.Report any symptoms
- Chest, back, arm or jaw discomfort
- Shortness of breath
- Fatigue
- Dizziness
- Leg cramps or muscle fatigue
During Your Test
- You will be asked to read and sign a consent form
- Small electrodes will be applied to your chest for monitoring your
heart.
- A blood pressure monitor will be applied to your arm.
- A pulse oximeter will be applied to one of your right fingers.
- You will be shown how to use the treadmill. The treadmill starts out
slowly and gets faster and steeper at three minute intervals.
- You should try to exercise on the treadmill as long as possible.
- It is important that you tell the physician if you have any symptoms.
- The treadmill will be stopped when you reach your target heart rate or
if you have any symptoms.
- Your blood pressure, heart rate and oximetry will be monitored before,
during and after the test.
Pharmaceutical Nuclear Stress Testing
What is a Pharmaceutical Nuclear Stress Test?
Exercise treadmill testing is the standard "screening device utilized
to try to detect the presence or absence of significant coronary
artery disease (hardening of the arteries to the heart). For many
patients, however, treadmill testing cannot be performed adequately
due to arthritic conditions of the hips or knees or sometimes other
medical conditions. For these individuals, pharmaceutical stress
testing has been developed.A variety of different medications may be used to "trick" the heart
into thinking that it is exercising. These include Dipyridamole,
Adenosine and Dobutamine.
How is the test done?An IV is placed in your arm. Through this IV a radio-active material
is injected into your body and a picture of your heart is taken while
you are at rest.
Through the intravenous (IV) line, a measured dose of Persantine or
Dobutamine (a medication that stimulates the heart) is administered in
stages to stimulate the heart as though you are exercising.
The heart is monitored with EKG and Blood Pressure devise throughout
the test.
Later, a second picture of your heart will be taken after exercise.
The doctors then compare the pictures of blood flow at rest and with
exercise to determine if there may be blockages present.Preparation for the Dobutamine Stress Echo
- Unless told otherwise do not eat or drink for three hours prior to the
test.
- Take your medications unless told otherwise (There are certain
medications which interfere with the test and must be stopped 48hrs –
72 hrs before the test).
- Wear loose comfortable clothing. Women will be asked to wear a cape
from the waist up.
- Bring a current list of medications with you.
- Report any symptoms during the test.
- Avoid all caffeine products 48hrs before test.
What to Expect During the Test:
The test will be explained to you and you will be asked to sign a
consent form. Feel free to ask any questions you may have about the
test.
Several EKG electrodes will be applied to your chest.
An intravenous line will be placed in hand or arm - Dobutamine will be
infused in stages to stimulate your heart.
A picture will be taken of your heart before and after you are given
Dobutamine.
After the Test:
You will be monitored for a short time after the test.
You will be free to resume your normal activities.
Holter Monitoring
Your doctor has recommended that you receive a test called a Holter
Monitor.While an EKG, done in your physicians office generally records 20-60
heartbeats, the Holter Monitor records closer to 100,000 heartbeats
over 24 hours.
A Holter Monitor is a 24-hour recording of the electrical activity of
the heart. The late Norman J. Holter, a native of Helena, Montana,
developed the procedure. Dr. Holter's original monitor was a 75-pound
backpack that could only record a single lead of the heart’s activity.
Modern state-of-the-art, Holter Monitors are cassette tape or digital
recorders that record three electrical leads of the heart. This
monitor enables your physician to see how your heart reacts to daily
activities such as:
walking
driving
eating
sleeping
The Holter Monitor is a simple device to apply to a patient.
Five to seven ECG electrodes will be attached to the skin to record
the electrical activity of the heart.
The Holter Monitor will be connected to the electrodes by thin
wires.
With the use of a belt or shoulder harness, the Holter Monitor can be
worn comfortably by the patient.
Patients are encouraged to perform their daily activities while
wearing the device with the exception of bathing, showering, swimming
or any activity that would get the monitor wet. If the Holter Monitor
gets wet, the electrical circuitry will be damaged.
Before you leave the physician’s office, you will be provided with a
Holter diary.It is very important that you write down any abnormal
feelings/symptoms and the times it occurred.
Proper entries in the diary are very important for the accurate
interpretation of your Holter Monitor. For example, a heartbeat of 160
beats per minute may be normal for someone who is exercising but would
be abnormal for someone who is reading a book.
| HOLTER MONITOR DIARY |
| TIME |
ACTIVITY |
SYMPTOMS |
| 9:15 am |
walking 2 miles |
chest pain |
| 1:20 pm |
having lunch |
dizzy spell |
| 3:50 pm |
watching TV |
heart fluttering |
The diary allows the proper correlation between the findings on the
Holter tape and potential heart rhythm disturbances.
You should carry the diary with you at all times while wearing the
Holter Monitor and record any activities or symptoms as well as what
time they occurred.
The time these activities or symptoms occurred should be recorded off
of the clock on the Holter Monitor itself (not your wrist watch or
wall clock since only the time on the Holter Monitor correlates to the
time on the cassette tape).
When Wearing A Holter Monitor:
- Do not use your electric blanket.
- Stay away from magnets, metal
detectors, and high voltage areas such as power lines.
- Do not get the monitor wet.
The Analyzed Holter Report Includes:
Hourly summaries of the minimum, maximum and average heart beats for
the 24-hour period.
Abnormal slowing of the heart beat (called Bradycardia) and abnormal
fast heartbeats, (called Tachycardia).
Analysis of a particular portion of the EKG signal which may indicate
a problem with poor blood flow to the heart muscle, (called ischemia).
Measurement of any pauses in the heartbeat.
Evaluation of pacemaker functioning, (if one is present).
Evaluation of the effectiveness of certain cardiac medications.
We hope this brief introduction to Holter Monitoring has provided you
with a better understanding of this simple, yet valuable test. The
Holter Monitor continues to provide reliable and important information
in the detection of the disorders of the heart. It has undergone many
refinements with age and with the development of powerful computers,
its accuracy has improved immensely. It remains one of the most
commonly utilized tests in the field of cardiology.
Laboratory Testing
Complete Laboratory services are available through our reference
laboratory.
Laboratory services that are routinely done at the FirstCare
Cardiology include prothrombin times (protimes) to monitor Coumadin
dosing and Chemistry panels for cholesterol reviews. CBC (complete
blood count), medication levels, electrolytes, thyroid testing, wound
culturing and urinalysis are just a few of our other routine
laboratory testing.
Although we draw the blood at the clinic, we do not run the tests
here. It is our policy to send the specimens daily to our reference
laboratory.
We do run a finger stick determination of protime here at FirstCare
Cardiology
We prefer that Coumadin is taken in the evening so that if adjustments
need to be made in the dosing, these adjustments can be made in a
timely manner. Please inform us at the time of your protime draw if
you are on any new medication or antibiotics. Some medications such as
antibiotics can prolong the protime and this needs to be noted before
the doctors reads the lab results.
Chemistry panels can be drawn at any time with mornings being the
preferred time and with the patient fasting especially if you are
taking cholesterol- reducing medication.
When asked to monitor the Digoxin level it is necessary to withhold
the Digoxin the morning of the lab draw or do the lab draw 6 hours
after the dosing time. This will assure an accurate level reported.
Other laboratory samples generally do not require specific directions.
If in doubt please call for clarification.In an attempt to keep all physicians involved in your care informed of
the lab results, we are able to request our reference laboratory to
forward the results to your medical or specialty doctor if requested
or if necessary.
Laboratory draws do not require an appointment and will be done on
first come, first serve basis. Our scheduled patients will have first
priority but we do make every attempt to do the lab draws as timely as
possible.
Pacemaker
Introduction
The heart has the remarkable ability to beat rhythmically
approximately 100,000 times a day and pumps about five quarts of blood
each minute or 75 gallons of blood every hour. Its steady pumping
rhythm sends oxygen-rich blood and nutrients to all of your body’s
cells with each heartbeat.
You may need a pacemaker to keep the heart contracting regularly and
pumping blood. Your body gets the blood, oxygen and nutrients that it
needs each time your heart contracts. A pacemaker is a small battery
operated unit that helps your heart beat more regularly. It does this
by generating a small electrical current which controls your
heartbeat.
You May Need A Pacemaker If:
- Your heart beats too slowly.
- Your heart doesn’t beat regularly.
- There is a block in your heart’s electrical pathways.
The heart has it’s own electrical conduction system. Special heart
tissues generate electrical signals that travel along pathways through
the heart every time it beats.
THE SINOATRIAL (SA) NODE
The heart’s natural pacemaker is called the Sinoatrial or SA node and
is located in the upper right chamber of the heart. The SA node
produces very small electrical impulses which vary in rate depending
upon your body’s demands for oxygen. Typically the SA node initiates a
heartbeat at the rate of 60 to 100 beats per minute in the average
person. If you are exercising or excited, the healthy SA node responds
to these changes in the body and increases your heart rate
accordingly. When the SA node is not working properly, it may send out
slow or irregular impulses, causing the heart to beat too slow or beat
irregularly.
THE ATRIOVENTRICULAR (AV) NODE
After the electrical impulse leaves the SA node, it travels through
the upper half of the heart causing the top half of the heart to
contract. From there it travels to a junction called the
Atrioventricular or AV node. The impulse continues down the conduction
pathways causing the bottom half of the heart to contract. This
regular contraction of the heart forces the blood out of the heart and
into all parts of the body. If the AV node and/or its electrical
pathways do not function correctly, the impulse may be blocked before
it can reach the lower half of the heart.
THE PACEMAKER
The Pulse Generator contains a battery that supplies the electrical
energy and the circuitry that transforms the energy into small
electrical impulses which stimulate the heart to pump correctly.
The Pacing Lead is an insulated wire that carries the electrical
impulse to the heart and carries information about the heart’s natural
pumping ability back to the pulse generator. One end of the lead is
connected to the pulse generator. The other end of the lead is usually
inserted through a vein and placed into the chamber or chambers of the
heart. One lead or two may be used, depending upon the type of
pacemaker prescribed by the physician.
The pacemaker Programmer has the ability to send and receive
information from the pacemaker. The programmer wand is held over the
pacemaker and it sends and receives signals to the pacemaker. A great
deal of information, about your pacemaker, can be gathered by using
the pacemaker programmer. The programmer can also be used to make
adjustments to your pacemaker.
Many pacemakers work only when needed. They’re called "demand"
pacemakers. They shut off if your heart is pumping adequately. They go
on (or pace) only if your heart beat is too slow.
How The Pacemaker Is Implanted:
- You will be admitted to the hospital and your pacemaker surgery will
be done in the cardiac catheterization laboratory or the operating
room.
- You will be given something to help you relax.
- The incision is usually made in your left shoulder.
- The lead and
pacemaker will be tested and the pacemaker will implanted into the
selected site.
- The incision will be closed.
- A dressing will be applied.
- You may or may not spend the night in the hospital.
Your Pacemaker Follow-up
- The next day the dressing will be removed, an ECG will be done to
check the heart and your pacemaker will be interrogated with a
pacemaker programmer.
- One week after your pacemaker implant, your staples will be removed
from your pacemaker incision. While you are in the office, you will be
instructed on how to check your pacemaker by telephone or (transtelephonic),
and given a follow up appointment for your pacemaker.
- You will come into the office to have your pacemaker checked, at six
months, then yearly thereafter.
The material provided at this site is for informational
purposes only. It is NOT to be construed as medical advice. Medical advice can
only be provided by trained medical personnel following a careful discussion of
the problem with the patient, a physical examination and appropriate laboratory
studies. You are strongly encouraged to see the physician of your choice to
receive such advice as well as to discuss the information available at this site
as it may apply to your particular condition. Please DO NOT send e-mail for
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