Specialties

Heart and Vasular Associates treats a variety of cardiovascular system conditions, including the heart, arteries, and veins.

Following are many of the Conditions we treat and the Procedures we perform.

Conditions Treated

Aneurysm

An aneurysm is a swelling or bulge, usually in a blood vessel. An aortic aneurysm is a swelling or bulge on your aorta that can grow and rupture if it’s not treated.

The aorta is largest artery in your body. It has the diameter of a garden hose. Your aorta exits from the left chamber of your heart, curves downward, and runs through your chest and into your abdominal area. There, it branches out into smaller blood vessels. These deliver oxygen-rich blood to the rest of your body.

The aorta is the main blood vessel for delivering oxygen to all parts of your body. Aortic aneurysms begin small, but they can become life-threatening if they’re not monitored. If you’re at high risk for an aneurysm, talk to us about having an aneurysm screening.

Angina and Acute Coronary Syndrome

Acute coronary syndrome is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart.

One condition under the umbrella of acute coronary syndrome is myocardial infarction (heart attack) — when cell death results in damaged or destroyed heart tissue. Even when acute coronary syndrome causes no cell death, the reduced blood flow alters heart function and indicates a high risk of heart attack.

Acute coronary syndrome often causes severe chest pain or discomfort. It is a medical emergency that requires prompt diagnosis and care. Treatment goals include improving blood flow, treating complications and preventing future problems.

Procedures Performed at Hospital setting

Cardioversion

An electrical cardioversion is a medical procedure during which the heart is given a brief electric shock to convert (change) an abnormal heart rhythm back to normal, sinus rhythm.

A cardioversion is normally performed electively for the treatment of abnormal heart rhythms; typically atrial fibrillation or atrial flutter. This procedure is normally performed in the hospital in an outpatient setting.

Transesophageal Echo (TEE)

A TEE is a procedure that uses ultrasound waves, however, unlike a standard echocardiogram, the transducer is performed from inside the espohagus which lies just behind the heart. This test is peformed in a hospital setting and is performed for the detection of possible blood clots or masses inside the heart, to detect possible infections in the heart, to assess a dissection (tear) in the heart, and additional conditions.

Diagnostics Performed at both Office and Hospital setting

Aortic Valve Disease

Aortic valve disease is a condition that occurs when your aorta (the main artery of your body) and left ventricle (the lower left chamber of your heart) malfunction. The aortic valve determines how blood flows from your left ventricle to your aorta.

There are two different types of aortic valve disease: aortic stenosis and aortic regurgitation. In the case of aortic stenosis, the opening of your aortic valve is narrower than it should be resulting in restricted blood flow to the aorta. In aortic regurgitation, some of the blood leaks back into your left ventricle because your aortic valve doesn’t close tightly enough.

Aortic Valve Regurgitation

Aortic valve regurgitation — or aortic regurgitation — is a condition that occurs when your heart's aortic valve doesn't close tightly. Aortic valve regurgitation allows some of the blood that was just pumped out of your heart's main pumping chamber (left ventricle) to leak back into it.

The leakage may prevent your heart from efficiently pumping blood to the rest of your body. As a result, you may feel fatigued and short of breath.

Aortic valve regurgitation can develop suddenly or over decades. Once aortic valve regurgitation becomes severe, surgery is often required to repair or replace the aortic valve.

Atrial Fibrillation/Atrial Flutter

Both Atrial Fibrillation and Atrial Flutter are an abnormal heart rhythm, or arrhythmia, that starts in the upper chambers of the heart and cause irregular, usually rapid beating of the heart. The difference is Atrial Fibrillation (Afib) beats in an irregular pattern, which Atrial Flutter (AFL) beats in a regular pattern.

Other symptoms of Afib or AFL include dizziness, fatigue, shortness of breath and chest discomfort. While Afib/AFL is usually not life threatening it can lead to other health problems such as stroke or heart failure. In most cases, these abnormal rhythms can be treated and/or controlled with treatment options and procedures.

Congenital Heart Defects/Disease

Congenital heart disease, or a congenital heart defect, is a heart abnormality present at birth. The problem can affect:

the heart walls
the heart valves
the blood vessels

There are numerous types of congenital heart defects. They can range from simple conditions that don’t cause symptoms to complex problems that cause severe, life-threatening symptoms.

According to the Centers for Disease Control and Prevention, there are currently 1 million adults and 1 million children in the United States living with congenital heart defects. Treatments and follow-up care for defects have improved drastically over the past few decades, so nearly all children with heart defects survive into adulthood. Some need continuous care for their heart defect throughout their lives. However, many go on to have active and productive lives despite their condition.

Nuclear Stress test

A nuclear stress test measures the blood flow to your heart while at rest and while your heart is working harder as a result of exercise or medication. This test provides radiological images which will show the physician areas of your heart with deceased blood flow or damage.

This test involves taking two sets of images of your heart for comparison. This test is ordered to assess for possible coronary artery disease.

Carotid Ultrasound

A carotid ultrasound is a non-invasive ultrasound used to create images of the carotid arteries in the neck. A transducer is a small device which picks up the reflected echo waves and sends them to a computer for recording. The physicians then interprets this information to assess the anatomy of the carotid arteries and any potential narrowing of the arteries.

A carotid ultrasound is ordered to assess various issues and symptoms including dizziness, visual disturbance, and/or history of TIA or strokes.

Coronary Artery Disease (CAD)

Coronary artery disease (CAD) is impaired blood flow in the arteries that supply blood to the heart. It is also called coronary heart disease (CHD), and it is the most common form of heart disease. According to the National Heart, Lung, and Blood Institute (NHLBI), it is the leading cause of death of both men and women in the United States. CAD can be treated both medically and with interventional procedures such as cardiac catheterization, coronary stent/angioplasty and coronary artery bypass surgery.

Heart Attack (Acute Myocardial Infarction)

Heart attacks (myocardial infarctions) are a very common occurrence in the United States. During a heart attack, the blood supply that normally nourishes the heart with oxygen is cut off and the heart muscle begins to die.

Some people who experience heart attacks have symptoms, while others show no signs. Many people who have a heart attack report they have chest pain, fatigue, and trouble breathing.

Heart Disease

Heart disease (also known as cardiovascular disease) is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC). This broad term encompasses a wide range of cardiovascular problems, including:

coronary artery disease
heart rhythm abnormalities (arrhythmia)
hardening of the arteries (atherosclerosis)
heart infections
congenital heart defects

Heart attacks, strokes, and other complications can arise when blood vessels become blocked or narrowed. While heart disease can be deadly, it’s also preventable in most people.

Mitral Valve Disease

Mitral valve disease refers to conditions of the mitral valve. Located between the left chambers of your heart, this valve works to keep blood flowing properly. It allows blood to pass from your left atrium to your left ventricle but prevents it from flowing backward.

When your mitral valve does not work properly, you can experience symptoms such as fatigue and shortness of breath because the defective valve is allowing blood to flow backwards into the left atrium. When this happens, your heart will not pump enough blood out of the left ventricular chamber to supply your body with oxygen-filled blood. Many people with mitral valve disease experience no symptoms, however.

Mitral valve disease can be serious. Left untreated, severe cases can lead to heart failure or irregular heartbeats (arrhythmias), which may be life threatening.

Mitral Valve Regurgitation

Mitral valve disease can be serious. Left untreated, severe cases can lead to heart failure or irregular heartbeats (arrhythmias), which may be life threatening.

Mitral Valve Stenosis

The mitral valve is located on the left side of your heart, between two chambers: the atrium (upper) and the ventricle (lower). Blood is pumped from the left atrium, through the mitral valve, and into the left ventricle on its way to the aorta. The healthy mitral valve allows blood to pass through, but prevents it from flowing back.

Mitral valve stenosis, also known as mitral stenosis, is when the mitral valve opening is narrowed. This means that not enough blood can flow through it. This can lead to a variety of issues, including fatigue, difficulty breathing, blood clots, and heart failure.

Septal Defect

A ventral septal defect, more commonly known as a ventricular septal defect (VSD), is a hole between your heart’s lower chambers, or ventricles. The defect can occur anywhere in the muscle that divides the two sides of the heart.

There are varying types of VSDs. Smaller defects may close without any treatment and will not cause any long-term effects. Defects that don’t close on their own can usually be repaired by surgery.

Tricuspid Valve Disease

Your heart is divided into four sections called “chambers.” The upper chambers are the left atrium and right atrium, and the lower chambers are the left ventricle and right ventricle. There is a wall of muscle called the “septum” that separates the right and left sides of the heart.

The upper (atria) and lower (ventricles) chambers are connected. There are openings called “valves” that regulate blood flow both in and out of the heart and between the chambers. The valves can be thought of like water faucets; they either open up and allow blood to flow freely, or close and stop the flow entirely.

Your tricuspid valve is the valve that separates your right atrium and right ventricle. Tricuspid regurgitation occurs when this valve doesn’t properly close, causing blood to flow back up into the right atrium when the right ventricle contracts. Over time, this condition can weaken your heart.

Tricuspid regurgitation is also known as “tricuspid valve insufficiency.”

Vascular Disease/Peripheral Artery Disease

Vascular disease and Peripheral Artery disease (PAD) are common circulatory problems in which narrowed arteries reduce blood flow to your extremities - usually the legs. These blockages can cause symptoms of claudication or pain. Without treatment PAD may result in damage such as ulcers in the feet or gangrene due to inadequate blood flow. In extreme cases, PAD can lead to amputation of toes, the foot, or part of the leg if left untreated.

Dr. Piotrowski performs cardiac and vascular procedures through the radial artery. This approach is safer and more comfortable for patients than traditional cardiac catheterization through the groin.

Vascular Duplex and ABI studies

These tests are commonly performed to diagnosis peripheral vascular disease and possible blockages or narrowing in the peripheral arteries in the extremities. A Vascular Duplex study is an ultrasound of the extremities to evaluate the blood flow in the blood vessel.

An Ankle Brachial Index (ABI) study compares the blood pressure in your ankle with the blood pressure in your arm. A special ultrasound device is used to evaluate the blood pressure and flow. The patient may walk on the treadmill and have the readings taken before and immediately after to capture the severity of the narrowed arteries during walking.

Echocardiogam

An Echocardiogram, or Echo, is a non-invasive ultrasound used to create images of the heart. A transducer is a small device which picks up the reflected echo waves and sends them to a computer for recording. The physicians then interprets this information to assess the size of the heart chambers, the individual valve function, and the heart pumping strength.

An echo is ordered to assess various issues and symptoms including valvular disease, cardiomyopathy, and to provide additional information on the functional capacity of the heart.