Electrocardiogram

If there is an acute emergency, the best thing to do is immediately contact 911. If you think you may be having a heart attack, also immediately call 911. When the paramedics arrive, or you are seen in the emergency room, you should notify them who your cardiologist is so they can directly notify our physicians.

Yes. We have physicians available 24 hours a day for acute care needs. A physician from our group is also always available to perform an emergency procedure for an acute heart attack. Please let the paramedics or emergency room staff know who your cardiologist is so they can notify the physician on call.

Yes. Physicians are available every weekend and holiday to care for all your inpatient needs. This may not be your primary cardiologist; however, he has informed the on-call physician about your current in-hospital stay, and outpatient records are always available if needed.

Yes. After every visit, a letter is dictated and sent to your primary care physician. We are also in frequent telephone contact with them. Our physicians also work closely with your primary care physician in the hospital setting if you are hospitalized. Your cardiologist can recommend one if you do not have a primary care physician. If you switch primary physicians, please notify our staff so we can arrange to have further evaluations sent correctly.

We offer a complete blood lab in our office. If we cannot accommodate a specific lab test for you, our front office staff will happily arrange it.

If you need a refill of your heart medicines, please contact our medical assistants or log on to your account through the Patient Portal (here). They will then notify your physician, who can authorize refills for you. When you see your physician in the office, bringing your medications with you is always best. Our medical assistants will update your chart and notify the doctor if drugs must be reordered.

No. While we work closely with many primary care physicians in the community, you do not need a referral to have an evaluation with our physicians.

We strive to be as accessible as possible to our patients. In addition to participating in most insurance plans in our area, we offer flexible payment plans and accept MasterCard, Visa, American Express, and Discover.

If you have any questions about our participation in a particular plan or network, call us at 770-962-0399.

If this is the case, please get in touch with our business department. They can often assist you with a payment program tailored to your needs.

Unfortunately, it can be confusing for a patient when experiencing chest pain, especially if it's on the left side. The concern is whether it's related to the heart. While we know the typical description of heart chest pain, it doesn't always conform to textbook explanations. It can feel like indigestion, with burning sensations, not necessarily on the left side but also behind the breastbone or on the right side. Heart pain due to lack of blood supply doesn't usually last for a few seconds; it often occurs during physical exertion.

There are different characteristics and precipitating factors that we, as physicians, ask the patients when trying to determine whether the chest pain is truly due to a lack of blood to the heart. There are multiple other causes of chest pain. Concerning the heart, one can also experience chest pain secondary to inflammation of the outer sac of the heart, called pericarditis. This pain is typically worse when one lies down and better when sitting up. The most common cause is a viral syndrome. Therefore, it is usually preceded by a fever, cold, or flu-like symptoms.

Chest discomfort post-meal or lying down is often from indigestion or heartburn—a burning sensation behind the breastbone that may extend to the jaw. Gallbladder pain, especially after fatty meals, is typically on the right side and may spread to the shoulder blade, often with nausea. Pain below the breastbone or left side of the upper abdomen that eases with eating is likely stomach inflammation or an ulcer. Chest pain worsening with deep breaths or coughing may stem from a lung issue like pleurisy, often caused by a viral infection. Superficial chest wall pain from muscle, bone, or nerve injury can occur. In females, chest pain from the breasts can mimic heart-related pain.

An EKG is a snapshot of the electric patterns in your heart that make it beat. It is a routine test in any cardiac evaluation. You can expect one during an initial assessment and any time symptoms change. It is also used to monitor the effects of certain medications. A medical assistant or nurse in the office administers the test. It allows us to look for irregularities in the electrical rhythm of your heart and gives us clues to structural abnormalities of the heart.

Heart failure occurs when the heart cannot pump efficiently to circulate oxygen-rich blood to different body organs. Simply put, the heart cannot keep up with its workload.

- Shortness of breath

- Easy fatigue

- Coughing, particularly when lying down

- Swelling in the ankles

- Weight gain

- Loss of appetite

- Rapid heartbeat

- Difficulty tolerating exercise

Common causes of heart failure include:

- Heart muscle weakness (Cardiomyopathy)

- Stiffness of the heart

- Valvular abnormalities such as leaky or narrowed valves

- Issues with the heart's electrical system (Arrhythmias)

- Arterial blockages and heart attacks

- Hypertension

- Congenital heart defects

- Infections

- Obesity

- Nutritional deficiencies

Treatment for heart failure varies based on the cause and symptoms. Lifestyle changes can reduce signs, sometimes even reversing heart failure causes. Medications such as ACE inhibitors, beta-blockers, angiotensin receptor blockers, diuretics, and antiarrhythmics are common. Implanting devices like pacemakers, defibrillators, or an artificial heart (LVAD) may be necessary for severe cases. In refractory instances, a heart transplant could be considered for certain patients.

Preventing heart failure hospitalizations involves key steps:

- Adhering to prescribed medications consistently.

- Monitoring weight regularly for any sudden gain exceeding 2 pounds daily.

- Notifying your doctor of increased shortness of breath, lower limb swelling, or notable weight gain.

- Adopting a low-salt diet.

- Manage blood pressure and blood sugar levels and address underlying issues like sleep apnea.

To prevent heart failure, consider these steps: Embrace dietary adjustments such as opting for a low-salt diet. Avoid smoking and alcohol abuse, and prioritize physical activity—address underlying conditions like high blood pressure, diabetes, sleep apnea, and arrhythmias. Manage stress effectively, as it can elevate blood pressure and heighten the risk of heart attacks.

The outlook for individuals with heart failure can vary significantly based on factors such as the cause, risk factor management, lifestyle adjustments, and adherence to prescribed medications. If left untreated or if underlying issues are unaddressed, heart failure can deteriorate over time, potentially leading to a fatal outcome. It is crucial to consult your healthcare provider to explore tailored treatment options.

Various heart diseases can increase the risk of sudden cardiac arrest. A cardiac arrest typically occurs due to an electrical storm in the ventricles, the heart's main pumping chambers. When this occurs, the heart essentially stops beating, and if left uninterrupted, it results in almost immediate death. An implantable defibrillator (or ICD) can protect you.

Implantation closely resembles pacemaker insertion. The ICD is usually placed under the skin via a small incision beneath the collarbone. A lead is then guided through a vein to the heart, making contact with its lining. This lead enables the defibrillator to monitor the heartbeat. Upon detecting any cardiac electrical irregularities, the defibrillator can charge and deliver a shock to reset the heart, akin to having a paramedic ready. The procedure is performed under sedation and local anesthesia. You may be discharged on the same day or require an overnight stay, depending on the circumstances.

After the implantation, you may experience minimal pain and slight swelling at the site. Pain medication will be provided if needed. Expect to wear a sling for a few days, avoid lifting more than 10 pounds, and keep your elbow below shoulder level for 3 weeks. Steer clear of strenuous activities like a full golf swing for several months. Follow-up appointments are typically scheduled in the next couple of weeks, with regular check-ins at our device clinic once or twice a year. Home monitoring can complement these office visits.

Pacemakers are used to prevent a slow heartbeat. A slow heartbeat is caused either by the natural pacemaker of your heart, the sinus node, firing too slowly or because those electrical impulses don't make it reliably from the upper chambers, the atria, the lower chambers, and the ventricles.

A pacemaker is typically implanted beneath the skin through a small incision below the collarbone. Pacemaker leads are then threaded through a vein to the heart, where they touch the heart's lining. These wires allow the pacemaker to sense the heartbeat and stimulate the heart to beat if it is too slow. The procedure is done with sedation and local anesthetic. Depending on the situation, you may be able to go home the same day or may need to stay overnight.

After implantation, the site usually has minimal pain and mild swelling. Pain medication will be provided if needed. A sling is worn for a few days. For three weeks, avoid lifting over 10 lbs. and keep the elbow below shoulder level. Refrain from vigorous activity like a full golf swing for a few months. Follow-up appointments are typically scheduled within a couple of weeks. Pacemakers are usually monitored in our device clinic once or twice a year, with the option of home monitoring for additional checks.

The main pumping chamber of the heart is the left ventricle. However, the effectiveness of that pump is compromised if the sides of the left ventricle don't squeeze simultaneously. This lack of synchronization affects the heart's output and can lead to progressive weakening and enlargement of the heart. When that lack of synchronization is caused by a delay in the electrical signal directing the heartbeat, it can be corrected by a special pacemaker known as a biventricular pacemaker. This is also referred to as cardiac resynchronization therapy. This pacing technique can be applied to both pacemakers and implantable defibrillators.

During either pacemaker or defibrillator implantation, an extra “third wire,” also known as a left ventricular lead, is placed. This is threaded to the heart the same way as other pacemaker or defibrillator leads, except it is then further threaded from the right atrium into another vein that leads to the surface of the left ventricle. Getting that third wire in place is trickier but achievable in about 95% of cases. Otherwise, the rest of the procedures are the same as a standard pacemaker or defibrillator implantation. Please see the descriptions of those procedures.

Please see the details for the defibrillator or pacemaker implantation. However, unique to biventricular pacing, the left ventricular lead passes very close to a nerve that runs along the surface of the heart from the spine down to the diaphragm. This is called the phrenic nerve. If the left ventricular leave stimulates it, it can cause a twitch of the left side of the diaphragm with every heartbeat. This is not dangerous but can be quite aggravating. It can usually be corrected by reprogramming the pacemaker or defibrillator in the office. We frequently watch people overnight because of the potential for phrenic nerve stimulation.

Heart disease is the primary cause of death in the United States, accounting for 1 in 4 female deaths. The number of women and men succumbing to heart disease each year is equal. Surprisingly, two-thirds of women who passed away suddenly from heart disease had no prior symptoms. Approximately 6% of white women, 8% of African-American women, and 6% of Mexican American women are affected by coronary artery disease.

More women present with atypical symptoms than men, and some women have no symptoms of heart disease. Common Heart attack symptoms in women can be pressure in the chest, shortness of breath, jaw pain, throat pain, and pain in the upper abdomen or back. Pain can be sharp, dull, burning, or indigestion-like. These episodes can occur during rest or physical activity or can be triggered by mental stress.

Hypertension. High cholesterol. Smoking. Diabetes. Excessive alcohol use. Physical inactivity. Overweight and obesity. Poor diet.

Women usually develop heart disease a decade later than men. Microvascular disease, impacting the heart's small arteries, is more common in women. Mitral valve prolapse is also more frequent in women. Additionally, women are more prone to conditions like broken heart syndrome, where extreme stress can cause heart muscle failure and palpitations. By modifying risk factors, changing lifestyles, using medical treatments, and considering surgeries, women can decrease heart disease mortality risk and improve symptoms like men. Early prevention, accurate diagnosis, and timely treatment are crucial for better survival rates.