Cardiovascular Specialists offers a full range of in-office adult consultative and follow-up care and cardiac diagnostic testing, as well as hospital-based interventional cardiac care and pacemaker and ICD implantation at area hospitals including Howard County General Hospital
in Columbia and The Johns Hopkins Hospital
Our available services include:
Adult Cardiac Consultations and Follow-up Care
Patients may be referred to our office for consultation about their cardiac concerns, and may also self-refer (where permitted by their health insurance coverage). Subsequent to such consultative visits, patients may continue to be followed by our cardiologists, or may be referred back to their primary care physicians for ongoing monitoring of their cardiac needs. In all cases, our cardiologists communicate back to the original referring physician following all visits to our office in order for the primary care physician to maintain a complete picture of the patient's medical issues.
Carotid and Peripheral Vascular Ultrasound*
Vascular ultrasound is the general term for a non-invasive painless test that uses high-frequency sound waves to image blood vessels including arteries and veins. No special preparation is required for lower extremity venous or arterial ultrasounds. Other common types of vascular ultrasound performed include carotid ultrasound and abdominal aorta ultrasound. A carotid ultrasound is a non-invasive, painless test that uses high-frequency sound waves to image the neck arteries. An ultrasound of the abdominal aorta is a non-invasive, painless test that uses high-frequency sound waves to image the "aorta," the main blood vessel leading away from the heart.
Anticoagulant drugs, such as Coumadin® (warfarin) help to prevent clots from forming in the blood. They are prescribed for patients who are at risk of forming blood clots, including anyone who has atrial fibrillation (rapid heartbeat), artificial heart valves, deep vein thrombosis (DVT), a pulmonary embolism or is at risk of a heart attack recurrence. If you had a heart attack, Coumadin® may be used to lower the risk of death, lower the risk of another heart attack, lower the risk of stroke, or lower the risk of blood clots moving to other parts of the body. Our Coumadin clinic educates patients about achieving prescribed levels of anticoagulation (measured by using a blood test called an “INR”), drug interactions, diet, signs and symptoms of toxicity and what to do about a missed dose. Instead of drawing blood from an arm vein, we use a simple finger stick to obtain a drop of blood for testing..
Device Clinic (Pacemakers and ICDs)
Pacemakers and implantable cardiac defibrillators require long-term follow-up at serial intervals in a device clinic. Device checks are performed non-invasively through a monitor that can communicate with pacemakers and defibrillators, providing detailed information on the function of the device and detection of rhythm issues. Pacemaker and device batteries only last about 6 to 10 years. Our device clinic checks for battery depletion, lead malfunction, pulse generator malfunction, and pacemaker pocket erosion and provides comprehensive long-term follow-up of devices.
An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen. The picture is much more detailed than a plain x-ray image and involves no radiation exposure. An echocardiogram allows doctors to see the heart beating, and to see the heart valves and other structures of the heart.
An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart as detected by electrodes attached to the outer surface of the skin and recorded by a device external to the body. An EKG translates the heart's electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves. An EKG is used to measure the rate and regularity of heartbeats, as well as the size and position of the chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart, such as a pacemaker.
Exercise (treadmill) and pharmacologic stress testing
An exercise stress test -- also called a stress test, exercise electrocardiogram, treadmill test, graded exercise test, or stress ECG -- is used to provide information about how the heart responds to exertion. It involves walking on a treadmill at increasing levels of difficulty, while your electrocardiogram, heart rate, and blood pressure are monitored to see how far you walk and if you develop chest pain or changes in your ECG that suggest that your heart is not getting enough blood. Depending on the results of the exercise stress test, the cardiologist may recommend more tests such as a nuclear stress test or cardiac catheterization. A pharmacologic stress test is used in people who are unable to exercise. A drug is given to make the heart respond as if the person were exercising. This way the cardiologist can still determine how the heart responds to stress, but no exercise is required.
Nuclear cardiology stress testing *
Sometimes, a regular exercise stress test may not give true results, or may be less accurate in certain situations, for example if you have an abnormal EKG. For these reasons, your physician may order a nuclear cardiology stress test instead of, or after, a regular exercise stress test. The nuclear cardiology stress test helps to determine which parts of the heart are healthy and function normally and which are not. A small amount of radioactive substance is injected into the patient. Then a special camera is used to identify the rays emitted from the substance within the body; this produces clear pictures of the heart tissue on a monitor. These pictures are done both at rest and after exercise. Using this technique, areas of the heart that have a decreased blood supply can be detected. Please note that a nuclear cardiology stress test takes 4 hours from the time of your scheduled appointment.
Holter and event monitoring (24-hour and 30-day EKGs)
Holter and event monitors, which are similar to an EKG, are medical devices that record the heart's electrical activity. However, a standard EKG only records the heartbeat for a few seconds, while holter and event monitors can record the heart's rhythms for extended periods of time (24-48 hours for Holter monitors and up to 30 days for event monitors). Electrodes (small conducting patches) are placed on your chest and attached to a small recording monitor. You carry the monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated. Cardiologists most often use these monitors to diagnose arrhythmias. Holter and event monitors also are used to detect silent myocardial ischemia. In this condition, not enough oxygen-rich blood reaches the heart muscle. "Silent" means that no symptoms occur.
Interventional cardiac care
Interventional cardiology deals specifically with the catheter-based treatment of heart diseases. Dr. William Herzog is our interventional cardiologist, and offers cardiac catheterization, balloon angioplasty, cardiac stent, and related interventional coronary and peripheral vascular procedures. Elective diagnostic catheterization, and emergency angioplasty and stenting, are available with Dr. Herzog at Howard County General Hospital; elective interventional procedures, including angioplasty and stenting, are also offered at The Johns Hopkins Hospital.
Pacemaker and ICD implantation
Pacemaker insertion is for patients with abnormally slow heart rhythms, congestive heart failure and those at risk for sudden death. Pacemakers help coordinate the pumping action of the heart by sending electrical signals, allowing the heart to pump more effectively, while implantable cardioverter defibrillators (ICDs) help treat patients at high risk for sudden cardiac arrest. Implanted through a small incision near the shoulder, ICDs use electrical pulses or shocks to help control life-threatening and irregular heartbeats. Pacemaker and ICD implants are offered at Howard County General Hospital by Dr. Eric Schwartz.
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* Cardiovascular Specialists is accredited by the Intersocietal Accreditation Commission (IAC) in Vascular Testing, Echocardiography, and Nuclear Cardiology. Such accreditation provides a mechanism to encourage and recognize the provision of quality diagnostic evaluations, and is a reflection of our commitment to ensuring high quality patient care. IAC accreditation is awarded to these programs only after a rigorous review of our policies, procedures, study technical quality, and professional interpretation accuracy, and assures both referring physicians and patients of Cardiovascular Specialists' high standards and expertise in cardiovascular diagnostic testing modalities.