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What You Need to Know about Heart Disease

Your body’s blood vessels perform a vital function: carrying oxygen-rich blood to your cells. Vascular disease generally refers to any condition that affects the body’s major blood vessels. Vascular surgeons treat a range of diseases, from blockage of the carotid arteries in the neck and aneurysms of the abdominal aorta to atherosclerosis (sometimes called arteriosclerosis) and blood clots affecting the legs and feet. The Jobst Vascular Institute treats many forms of vascular disease, including: abdominal aortic aneurysm, aortic dissection, carotid artery disease, chronic venous insufficiency, critical limb ischemia, deep vein thrombosis (DVT), peripheral arterial disease (PAD), renovascular hypertension and varicose veins.

Cardiologists treat disease and disorders of the heart and circulatory system. To identify blockage, valve and rhythm problems, cardiologists perform non-invasive testing such as nuclear stress testing, echocardiograms and Holter and cardiac event monitoring. Cardiologists consult with patients on treatment options, which can vary from simple lifestyle changes and drug therapy to procedures such as heart catheterizations, angioplasty and stent insertion. ProMedica Physicians cardiologists are supported by expert clinicians at all of our ProMedica hospitals. To show the depths of our dedication to your health, ProMedica Toledo Hospital is the only hospital in the region with a cardiologist on-duty in our hospital 24 hours a day, seven days a week.

Diagnoses

Peripheral Arterial Disease

Peripheral arterial disease (PAD) is typically defined as atherosclerotic disease involving the arteries of the legs. PAD is highly prevalent yet frequently underdiagnosed. A common symptom of PAD is a type of leg pain known as claudication: calf pain that occurs during exercise but that stops during rest. Some patients who have more advanced PAD experience what is called ischemic pain while resting. For example, when the legs are elevated (such as during sleep), they have leg pain and will only find relief by sitting up or standing. It is absolutely vital that you seek a diagnosis for PAD if you are experiencing its common symptoms.

PAD is a marker for systemic atherosclerotic disease, and patients with PAD are at high risk for heart attack, stroke and death. Most patients with PAD are accurately diagnosed with a good history and physical examination. There is also a simple, reliable test for diagnosing PAD that is known as the ankle-brachial index (ABI). Physicians are encouraged to perform the ABI on appropriate patients; they should also feel comfortable referring suspected or high-risk PAD patients to vascular laboratories or specialists. Talk to your physician about PAD if you are concerned that you may be at risk. You can manage your PAD through lifestyle changes such as exercise and quitting smoking. Pharmacologic treatment such as antiplatelet therapy can also help you manage your PAD. Studies have shown that smoking cessation and a formal exercise program can slow the progression of the disease and improve your quality of life.

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Abdominal Aortic Aneurysms

The aorta, which is the main artery in the chest and abdomen, carries blood from the heart to all organs. An aneurysm occurs when a blood vessel wall is weakened or damaged and forms a bulge or balloon. Although aneurysms can occur in any blood vessel, they occur most frequently in the abdominal portion of the aorta. This type of aneurysm is known as an abdominal aortic aneurysm (AAA). Three out of four AAAs have no symptoms, although some patients may feel abdominal or lower back pain or experience a pulsating feeling in the abdomen. Most AAAs occur in men between the ages of 50 and 60 (they are less likely in women but can occur in women as well). Risk of abdominal aortic aneurysm increases with age, family history of AAA, high blood pressure and smoking. Treatment of AAA depends upon its size and how quickly it is growing. Treatment might include monitoring, surgical repair, or endovascular repair.

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Deep Vein Thrombosis

Deep vein thrombosis (DVT) occurs when a blood clot (also known as a thrombus) forms in a deep vein. The most common place in the body for DVT to develop is the leg. DVT can be caused by injury to a vein, by illnesses (such as cancer), by immobility (such as prolonged bed rest) or from a blood disorder. A DVT may cause symptoms such as swelling and pain, although many patients have no symptoms. A dangerous complication of a DVT occurs if a clot breaks loose (called an embolus) travels through the venous system to the lungs and obstructs a blood vessel. This is called a pulmonary embolism (PE) and can be fatal.

Chest pain or shortness of breath are classic symptoms of a PE and require immediate medical attention. If you are concerned you may be at risk for DVT, talk to your physician. Your physician can identify your personal risk factors for DVT and give you advice on how to prevent it. If you are at risk for or suffering from DVT, your physician can refer you to the Jobst Vascular Institute for treatment.

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Disciplines

Electrophysiology

Electrophysiology is the fasting growing cardiovascular discipline. Cardiac electrophysiologists are experts in the heart’s electrical function. They evaluate, diagnose and treat abnormal heartbeats or heart rhythms such as atrial fibrillation, heart arrhythmias and syncope. You’ll be glad to know that the region’s top electrophysiologists care for patients at ProMedica hospitals and offer these diagnostic and treatment options: electrophysiology studies, holter and event monitoring, radiofrequency ablation (including afibablation), implantable cardioverter defribrillators and pacemakers.

Find your ProMedica cardiac electrophysiologist

Interventional Cardiology

Interventional cardiology deals specifically with catheter-based treatment of heart diseases. ProMedica Heart and Vascular Institutes specialists offer patients nonsurgical treatments for blocked or narrowed passages in one or more of their coronary arteries. Treatments include: heart catheterization; angioplasty, bachytherapy; radial artery catheterization; percutaneous transluminal coronary angiography (PTCA); stents, therectomy; rotoblation; and percutaneous valvuloplasty. Interventional cardiologists perform these procedures in our sophisticated interventional cardiac labs at Bixby Hospital, Defiance Regional Hospital, St. Luke’s Hospital and Toledo Hospital.

Treatments

Vascular Robotic Surgery

Though not a common ailment, thoracic outlet syndrome can be a real pain in the neck. If your doctor has given you this diagnosis, you are probably familiar with its symptoms: chronic neck and shoulder pain or tingling and numbness in the fingers. These painful, distracting symptoms occur when the blood vessels or nerves in the thoracic outlet become compressed. (The thoracic outlet is the name for the space between the collarbone and first rib.)

Usually, physical therapy is used to relieve the symptoms. In some cases, however, a physician may recommend surgery. Thoracic outlet syndrome surgery is one area in which the small, precise instruments of the da Vinci Surgical System excel. Using the micro-instruments of the da Vinci robotic system, your surgeon can safely and precisely remove the compressive and cervical bands of the scalene muscle to relieve pressure and alleviate discomfort and numbness.

Robotic surgery is the least invasive form of surgery today. The incisions your surgeon makes with the da Vinci® system are much smaller than incisions made by traditional surgery. After surgery, you recover faster because your incisions heal more quickly. The incisions’ small size also makes complications (blood loss, infection and scarring) less likely.

If your physician has recommended surgery to thoracic outlet syndrome symptoms be sure to ask if robotic vascular surgery at ProMedica Toledo Hospital or ProMedica St. Luke’s Hospital is right for you. We are happy to answer any questions you have about vascular robotic surgery. Please call us at 419-291-4575 or email us for more information.

Anticoagulation Service

You may have heard the phrase “blood thinner” to refer to an anticoagulation medication. Actually, anticoagulants do not thin the blood; rather, they are designed to cut down on clotting factors in the blood. If you have a condition such as atrial fibrillation or valvular heart disease, you may be prescribed anticoagulation treatments. It is common for patients to receive anticoagulation treatments after a myocardial infarction or a mechanical valve replacement. Anticoagulation also can treat and/or prevent pulmonary embolism and deep venous thrombosis.

If you have a condition that requires anticoagulation treatments, the Jobst Anticoagulation Service can facilitate, monitor and manage your anticoagulation therapy. Our team consists of specially trained physicians, nurses and caring support staff. Studies consistently show that patients who are monitored by a dedicated anticoagulation service receive the most effective treatment. We provide you with:

  • Warfarin dosing instructions
  • Prothrombin time (PT) and international normalized ratio (INR) monitoring
  • Pre-procedure therapy
  • Post-procedure bridge therapy
  • Outpatient point-of-care testing
  • Patient and family education
  • On-call staff after hours, weekends and holidays

If you are a patient who needs anticoagulation treatment, ask your physician about the benefits of anticoagulation service at Jobst Vascular Institute. Physicians interested in referring patients should call 1-866-JVC-COAG (582-2624) to request a referral form.

Transcatheter Aortic Valve Replacement (TAVR)

Up to 1.5 million people in the United States suffer from aortic stenosis, a condition where the aortic valve in the heart is narrowed. When one of the valves of the heart is damaged, it puts pressure on the heart to work harder to pump the same amount of blood. Usually, surgery through the breastbone is required to replace the narrowed valve. But for patients who are elderly or who have other medical conditions, this type of surgery may not be possible. Patients who do not receive an aortic valve replacement have no effective, long-term treatment option to prevent or delay their disease progression. Thanks to TAVR, these patients now have an effective treatment option.

With TAVR, the aortic valve is replaced using a catheter, which is inserted through a small incision. The artificial valve is expanded inside the existing valve by inflating a balloon. This new treatment brings hope to individuals who are at high-risk for traditional surgery. ProMedica is proud to lead the way with this amazing, new procedure.

Michael Moront, MD, Cardiothoracic Surgeons for Northwest Ohio, ProMedica Heart and Vascular Institutes, explains more about TAVR, a new lifesaving heart procedure available at only a few centers in the United States.

VeinSolutions

Good health and self confidence go hand in hand. Taking care of yourself involves more than monitoring how you feel physically: you also want to feel good about yourself and how you look. Whether you are suffering from the discomfort of varicose veins or simply feeling self-conscious about spider veins, the VeinSolutions office at Jobst Vascular Institute has an effective, technologically sophisticated treatment for you. Our board-certified physicians are dedicated to the diagnosis and treatment of cosmetic and therapeutic vein problems. If you'd like to know more, please visit VeinSolutions. There, you can learn more about the treatments we offer and find out how to make an appointment.

Learn more about the heart conditions and diagnostic techniques mentioned on this page at our online health dictionary:

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ProMedica Physicians are experts who provide care in a variety of specialties, including cardiac electrophysiology, cardiology, vascular surgery and cardiothoracic surgery. As part of a large network of providers, ProMedica Physicians work to approach your health as a whole. Find the ProMedica heart expert that’s right for you.

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