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  • Cardiovascular Group and Northside Hospital are pleased to announce the signing of a Practice Services Agreement, signifying a major leap forward in cardiovascular patient care and clinical leadership in the Atlanta region.

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    Electrocardiogram

    Check For Signs Of Heart Disease With An Electrocardiogram

    An electrocardiogram, called an EKG or ECG, is a quick and painless test that records your heart’s electrical activity to check for signs of heart disease. A technician attaches multiple electrodes to your skin in various places of the body, which track electrical impulses.

    What Can An EKG Check For?

    With an EKG, your doctor will be able to check for multiple potential heart problems. These include irregular heart rhythms, poor blood flow, thickened heart muscle, electrolyte abnormalities, or even heart attack. Any of these heart problems are risk factors for heart disease.

    Heart disease is a catch-all term that includes many types of heart problems, such as arrhythmias, pulmonary hypertension, and most commonly, coronary artery disease (CAD). With an EKG, you can catch these early before they develop into more serious issues like heart failure.

    How Does An EKG Work?

    A technician attaches multiple electrodes to the skin on your chest, arms, and legs. During a resting EKG, you’ll lie flat while a computer records your electrical impulses as they move through your heart, and this will create a picture of the activity. A stress test can also be conducted, where the same test is administered to check your heart rate while you exercise. Besides the standard EKG tests, there are other kinds to test your heart as well.

    A holter monitor is a portable EKG that monitors the electrical activity of your heart 24/7 over the course of 1 to 2 days. This test may be suggested if your doctor suspects that you have an irregular heart rhythm, heart palpitations, or low blood flow to the heart. During this test, you can go about your daily routine except for showering. You’ll record your activities and any symptoms you noticed during this time.

    An event monitor is a less intensive test that is used for occasional symptoms. This device has a button you can press whenever you notice symptoms, which will record and store your heart’s electrical activity for a few minutes. Because of the low frequency involved with this test, you may need to wear the device for weeks or even months.

    A loop recorder is a device implanted into your body, under the skin of your chest. It has the same functions as an EKG but it allows for continuous remote monitoring of your heart’s electrical activity. This device is searching for irregularities that cause more severe symptoms, such as fainting and heart palpitations.

    What Symptoms Should You Get Checked With An EKG?

    If you have any of the following symptoms, it may be time to get an EKG test:

    • Chest pain
    • Dizziness or lightheadedness
    • Heart palpitations
    • Shortness of breath
    • Rapid pulse
    • Weakness or fatigue
    • Inability to exercise

    If your family has a history of heart disease, your doctor may suggest an electrocardiogram even if you aren’t displaying any symptoms.

    Risks Of An EKG

    There are little to no risks involved with EKG testing. Some people with skin sensitivity can experience a rash where the electrodes were placed, however, this usually goes away on its own. Patients who undergo the stress test may be at risk of a heart attack, although this is related to the exercise and not the EKG itself.

    An EKG only monitors the electrical activity of your heart, it does not emit any electricity of its own. This means the device is completely safe, even during pregnancy.

    How To Prepare For An EKG

    While getting ready for your EKG, there are a few things to consider:

    • Remove any jewelry
    • Shave hair in areas the electrodes will be placed
    • Avoid drinking cold water directly before the test (this can cause changes in electrical patterns)
    • Do not participate in any exercise or other activity that will increase heart rate before the test
    • Keep the room at a moderate temperature to avoid shivering (movement will affect the accuracy of the results)

    Results Of An EKG

    Your EKG results can sometimes be available the same day as your test, or by the next appointment. The results of an EKG will give your doctor more details about the following issues:

    • Heart rate: Heart rate can typically be measured by simply checking your pulse. An EKG is helpful if your pulse is irregular, either too fast or too slow, or at odd moments. In these instances, your pulse will be difficult to determine regularly. An EKG can help determine an abnormally fast heart rate (tachycardia) or an abnormally slow heart rate (bradycardia).
    • Heart rhythm: An EKG can determine if you have an irregular heartbeat (arrhythmias). Arrhythmias can occur if parts of the heart’s electrical system aren’t working properly.
    • Heart attack: An EKG can show evidence of previous heart attacks or one currently happening. An EKG helps to give detailed results on which part of the heart has been damaged along with the extent of the damage.
    • Blood and oxygen supply: An EKG that’s done while you’re experiencing symptoms will help your doctor determine if the cause of chest pain is due to reduced blood flow to the heart.
    • Heart structure: An EKG can provide doctors with more information about whether you have an enlarged heart, heart defects, or other heart issues.

    How CVG Can Help

    CVG offers electrocardiograms to assess your risks of heart disease. We offer various EKGs so that we can determine how your heart is functioning, and what steps you will need to take to prevent further problems. If these tests determine a problem, we offer treatment solutions to help against heart disease.

    Learn more about our services here, or schedule an appointment to talk to our doctors.

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    Electrocardiogram

    Frequently Asked Questions

    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 then 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. There is also a physician always available from our group 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. We have physicians available every weekend and holiday to care for all of 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 out patient 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 as well. Our physicians also work closely in the hospital setting with your primary care physician if you are hospitalized. If you do not have a primary care physician you cardiologist can recommend one for you. 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 are not able to accommodate a specific lab test for you our front office staff will be happy to arrange testing for you.

    If you need a refill of you 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 it is always best to bring your medications with you. Our medical assistants will then update your chart and notify the doctor if medications will need to 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 also offer flexible payment plans and accept MasterCard, Visa, American Express and Discover for payments.

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

    If this is the case please contact our business department. They can often assist you with a payment program fitted to your needs.

    Unfortunately, this can be rather confusing for a patient. Certainly when one complains of chest pain but tickly on the left side of the chest When's immediate concern is whether this is coming from the heart or not. We are all aware of the typical description of hot chest pain. This is a pressure a band like sensation across the chest which may be associated with radiation of the pain to the neck or the left arm. There are also associated symptoms of shortness of breath, cold clammy sweat and nausea which could occur along with the symptoms. However, unfortunately for patients and doctors, the heart does not always abide by the textbook explanation. Heart chest pain can mimic indigestion in that it could be burning in sensation. It does not necessarily have to be left sided. It can be located behind the breastbone or even on the right side of the chest. In addition it could be stabbing in nature. Heart pain coming from a lack of blood to the heart doesn't typically last seconds in time. The heart is a muscle and works on supplied and demand. Usually chest discomfort originating from the heart, will first occur when one is exerting oneself.

    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 or not. There are multiple other causes of chest pain. With respect to 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 on sitting up. The most common cause is a viral syndrome. Therefore, it is usually preceded by a fever or cold or flu like symptoms.

    Chest discomfort after eating or lying in bed, typically is due to indigestion or heartburn. This is more a burning sensation that occurs behind the breastbone and may radiate up to the jaw. Gallbladder pain may also occur after eating, particularly a fatty meal. This pain is usually more right sided and may radiate to the shoulder blade. It is commonly associated with nausea. Chest pain immediately below the breastbone or to the left side of the upper abdomen that is resolved with eating is usually due to inflammation of the stomach or possibly an ulcer, Chest pain that is worse when one takes a deep breath or cough's is usually due to a lung cause of the pain. This could be due to inflammation of the outer sac of the lung. This condition is called pleurisy. This is most commonly caused by a viral infection. Finally, one could experience any type of superficial pain of the chest wall, either due to muscle, bone or nerve injury. In the case of females, the breasts can definitely produce chest pain in the location of the heart.

    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 to have one during an initial evaluation and any time there is a change in symptoms. It is also used to monitor effects of certain medications. The test is administered by a medical assistant or nurse in the office. It allows us to look at for irregularities in the electrical rhythm of your heart as well as give us clues to structural abnormalities of the heart.

    Heart failure is when heart is not able to pump efficiently to circulate oxygen rich blood to different organs of the body. Simply heart is not able to keep up with its workload.

    " Shortness of breath " Easy fatigability " Coughing especially lying down " Swelling in the ankles " Weight gain " Loss of appetite " Heart beating fast " Exercise intolerance

    Some of the common causes are: " Heart muscle weakness( Cardiomyopathy) " Stiffness of the heart " Valvular abnormalities like leaky valves or stenosis of the valves " Problems with the electrical system of the heart (Arrhythmias ) " Arterial blockages and heart attacks " High blood pressure problems " Congenital heart defects " Infections " Obesity " Nutritional deficiencies

    " Treatment depends on the cause and symptoms " Lifestyle changes help to decrease the signs and symptoms as well as some times to reverse the causes of heart failure " Medications like Ace inhibitors, beta blockers, angiotensin receptor blockers, diuretics or water pills, antiarrhythmic medications. " Implantation of devices like pacemakers, defibrillators in severe cases artificial heart(LVAD) may be an option " In severe and refractory cases heart transplant can be considered for selected patients

    " Taking medications regularly as prescribed. " Checking weight on the regular basis and watch for any unusual weight gain of more than 2 pounds in 24 hours. " Let physician know if there is any increase in shortness of breath, lower extremity edema, or significant weight gain " Follow low salt diet " Controlling blood pressure, blood sugars and treating underlying like sleep apnea

    " Dietary changes like following low salt diet. " Not to smoke, abuse alcohol and being physically active " Treating underlying conditions like high blood pressure, diabetes, sleep apnea, arrhythmias. " Controlling stress as it may increase blood pressure, increase his risk of heart attack

    " Highly variable depends on the etiology, risk factor modification, lifestyle changes and compliance with the medications " Without treatment or if underlying conditions are not correctable heart failure can become progressively worse and eventually fatal condition. Please discuss with your health care provider for specific treatment options.

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

    Implantation is very similar to pacemaker implantation. The ICD is typically implanted beneath the skin through a small incision below the collar bone. A lead is then threaded through a vein to the heart where it touches the lining of the heart. This lead allows the defibrillator to sense the heartbeat. If an electrical storm in the heart is detected, the defibrillator can charge up and shock the heart to reset it. It's almost like having a paramedic on standby. 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.

    There is usually only minimal pain after implantation and perhaps some mild swelling at the site. You will be given some pain medication to be used if needed. You will typically wear a sling for a few days. you should avoid lifting over 10 lb and keep the elbow below shoulder level for 3 weeks. Avoid extremely vigorous activity like a full golf swing for a couple of months more. You will typically be seen in the office within the next couple of weeks, but in the end, ICDs are followed usually in our device clinic between once and twice a year. Home monitoring is also available to augment office checks.

    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 to slowly, or because those electrical impulses don't make it reliably from the upper chambers, the atria, to the lower chambers, the ventricles.

    A pacemaker is typically implanted beneath the skin through a small incision below the collar bone. Pacemaker leads are then threaded through a vein to the heart where they touch the lining of the heart. 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.

    There is usually only minimal pain after implantation and perhaps some mild swelling at the site. You will be given some pain medication to be used if needed. You will typically wear a sling for a few days. you should avoid lifting over 10 lb and keep the elbow below shoulder level for 3 weeks. Avoid extremely vigorous activity like a full golf swing for a couple of months more. You will typically be seen in the office within the next couple of weeks, but in the end, pacemakers are followed usually in our device clinic between once and twice a year. Home monitoring is also available to augment office checks.

    The main pumping chamber of the heart is the left ventricle. But the effectiveness of that pump is compromised if the sides of the left ventricle don't squeeze at exactly the same time. This lack of synchronization not only affects the output of the heart, but can actually lead to progressive weakening and enlargement of the heart. When that lack of synchronization is because of a delay of 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.

    At the time of 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. It's a little more tricky to get that third wire in place, but is achievable in about 95% of cases. Otherwise, the rest of the procedures the same as standard pacemaker or defibrillator implantation. Please see descriptions of those procedures.

    Please see defibrillator or pacemaker implantation for details. However, unique to biventricular pacing, the left ventricular lead passes very close to a nerve that runs along surface of the heart from the spine all the way down to the diaphragm. This is called the phrenic nerve. If it is stimulated by the left ventricular leave, 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. It is because of the potential for phrenic nerve stimulation that we frequently watch people overnight.

    " Heart disease is the leading cause of death in United States, responsible for 1 and 4 female deaths " Same number of women and men die of heart disease each ear " Two thirds of women who die suddenly of heart disease have no previous symptoms. " About 6% of white women, 8% of African-American women, 6% of Mexican American women have coronary artery disease

    More women present with atypical symptoms, than men. Some women have no symptoms with heart disease. Common Heart attack symptoms in women can be pressure in the chest, shortness of breath, jaw pain, throat pain, pain in the upper abdomen or back. Pain can be sharp, dull, burning or indigestion like. These episodes can occur during rest or during 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 develop heart disease 10 years later than men. Microvascular disease, disease of small arteries in the heart is more common in women. Mitral valve prolapse is more common in women. Broken heart syndrome or Stress induced cardiomyopathy where extreme emotional stress can lead to heart muscle failure is more common in women. Palpitations are more common in women. Risk factor modification, lifestyle changes, medical treatment, surgical procedures can help women to lower the risk of heart disease mortality and improve symptoms like in men. So, early prevention, diagnosis and treatment are important to improve survival.

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