Normally blood flows easily through the arteries to all parts of the body. However, fatty clumps called ” plaque” can build up inside the walls of arteries becoming narrowed or blocked, preventing blood flow from flowing normally. When muscles do not get enough blood symptoms can occur.

Peripheral artery disease (PAD) is a condition that can cause leg pain that can get worse with activity. Muscle pain that gets worse with activity and better with rest is called ” claudication”. PAD effects the vessels ( called arteries) that bring blood to the legs. PAD can cause wounds to heal more slowly then usual.

Percutaneous coronary intervention is a procedure used to treat narrowing of the coronary arteries of the heart found in coronary artery disease. During an angioplasty, a thin tube into a blood vessel will be advanced to the coronary arteries. A tiny balloon inside the clogged artery will inflate to reopen it. Often, a tiny mesh tube called a stent may be used to maintain patency.

Your doctor may recommend an angioplasty if you have coronary heart disease and/or have: 1) Chest pain that does not get better when you take medicines. 2) One or more heart arteries that are very narrow.

A patent foramen ovale is a small opening inside the heart. The opening is between the upper 2 chambers of the heart, which are called the right atrium and left atrium. A patent foramen ovale lets blood flow between these chambers. A PFO can lead to a stroke if a formed blood clot travels through the heart and into the brain.

In order to assess for a PFO, a test called a “bubble test” will be conducted. An Intravenous catheter (IV) will be placed and salt water with microbubbles will be administered. Your doctor will assess how the bubbles flow through your heart. If further evaluation is warranted, an ultrasound may be ordered.

Treatments such as pharmacological management and/or surgical closure will may depend symptomology.

An aortic aneurysm occurs when the walls of the main blood vessel that carries blood away from the heart (the aorta) bulge or dilate. Aneurysms can occur in any area of the aorta, but the abdomen is the most common site.

A screening test to determine if an AAA is present is recommended based upon the increased risk of developing an AAA, particularly among older men, especially those who smoke or who have a family history of AAA.

AAA screening involves a noninvasive, abdominal ultrasonography. This test is painless and involves the use of an ultrasound probe applied to the abdomen to create and identify an image of the abdominal aorta.

Vascular imaging of the arterial outflow may be necessary to identify appropriate targets for intervention, and for ongoing surveillance following intervention.

Contrast arteriography remains the gold standard for the evaluation of the threatened limb. A complete, bilateral study of the aorta, iliac, femoral, popliteal, and run-off vessels should be performed in patients who are expected to undergo revascularization, provided there are no contraindications.

Your doctor may recommend an arterial evaluation for common associated symptoms such as: 1) pain in the calf, thigh, or buttock brought on with activity and relieved with rest 2) atypical leg pain, or constant pain in the forefoot aggravated by elevation and relieved by dependency 3) Non-healing wound/ulcer 4) skin discoloration.

Detailed evaluation of the venous anatomy is an important aspect of vascular mapping in to assess venous outflow. The entire extent of the vein and its drainage must be assessed. Vein Mapping is performed using noninvasive ultrasound, allowing detailed measurements of the central veins’ diameter/depth.

Your doctor may recommend a venous evaluation for common associated symptoms such as: 1) Leg discomfort (i.e, tired, heavy), or pain, 2) Physical findings including abnormal venous dilation, swelling, inflammation, and/or ulcerations.

Breathing tests are a group of tests that measure how well your lungs are working. Specifically, breathing tests measure:

  • How much air you can breathe in and out of your lungs
  • How fast you can breathe the air out of your lungs
  •  How much oxygen gets into your blood from your lungs

Your doctor may recommend a pulmonary function test to evaluate the following:

  • Find the cause of symptoms such as a long-term cough, noisy breathing (wheezing), or trouble breathing
  • Check if a known lung condition is mild or severe, or changes over time – Lung conditions that are commonly followed with breathing tests include asthma, chronic bronchitis, pulmonary fibrosis, and chronic obstructive pulmonary disease (also called “COPD”).
  • Check how well your inhaler medicines are working
  • Check how well your lungs are working before you have surgery

A sleep study is a test that measures how well you sleep and checks for problems occurring throughout the night. During your overnight evaluation, adequate monitoring will assess movement, brain activity, breathing, and other body functions while you sleep.

Your doctor may recommend a Polysomnography if he/she suspects a condition that makes you stop breathing for short periods while you are asleep, called “sleep apnea.”  Symptoms that may warrant a sleep study include:

1) Feel very sleepy/fatigue during the day and fall asleep

2) Excessive Snoring

3) Have an uncomfortable feeling in your legs when you try to fall asleep 0r sudden jerking leg movements while you sleep

4) Doing odd things while you sleep, such as moving your arms and legs, shouting, or walking.

Multiple gated cardiac blood pool imaging (MUGA), is a type of Radionuclide
ventriculography (RVG), used to accurately assess and quantify cardiac function
and volume ejection. It is performed using a radioactive tracer, administered via
an IV catheter, attaching to red blood cell pool and allowance of image capturing
of the blood circulation through the heart.

MUGA scans provide accurate results that are highly reproducible and capable of
detecting subtle changes in cardiac function.

External counter pulsation (ECP), also referred to as enhanced external
counter pulsation (EECP), is a technique that increases arterial blood pressure
and retrograde aortic blood flow during diastole (diastolic augmentation). Cuffs
are wrapped around the patient’s calves, thighs, and pelvis and, using
compressed air, sequential pressure (up to 300 mmHg) is applied in early
diastole to propel blood back to the heart.

The aim of ECP is to provide/improve cardiac perfusion and peripheral arterial
flow-mediated dilation.



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Copyright© Desert Cardiovascular Consultants, Las Vegas 2019 – 2020.

Copyright© Desert Cardiovascular Consultants, Las Vegas 2018.