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Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a very common condition affecting 12-20 percent of Americans age 65 and older. PAD develops most commonly as a result of atherosclerosis, or “hardening of the arteries,” which occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries that narrows and clogs the arteries. This is a very serious condition. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking, and eventually gangrene and amputation.

Peripheral Arterial Disease Facts

Because atherosclerosis is a systemic disease, people with PAD are likely to have blocked arteries in other areas of the body. Thus, people with PAD are at increased risk for heart disease, aortic aneurysms and stroke. PAD is also a marker for diabetes, hypertension and other conditions. This is a major public health issue and the Society of Interventional Radiology recommends greater screening efforts through the use of the ankle brachial index (ABI) test. This simple, painless test compares the blood pressure in the legs to the blood pressure in the arms to determine how well the blood is flowing and if further tests are needed.

Symptoms of PAD Include Intermittent Leg Pain, Numbness and Tingling

The most common symptom of PAD is called claudication, which is leg pain that occurs when walking or exercising and disappears when the person stops the activity. Other symptoms of PAD include: numbness and tingling in the lower legs and feet, cold lower legs and feet, and ulcers or sores on the legs or feet that don’t heal.

Leg Pain: Don’t Assume It’s Just Old Age

Many people simply live with their pain, assuming it is a normal part of aging, rather than reporting it to their doctor.

Prevalence

• Peripheral Arterial Disease (PAD) is a disease of the arteries that affects 10 million Americans.
• PAD can happen to anyone, regardless of age, but it is most common in men and women over age 50.
• PAD affects 12-20 percent of Americans age 65 and older.

Women & Vascular Disease

Heart disease is the #1 killer of women in the United States. Like heart disease, peripheral arterial disease is under-recognized in women. Through early detection, the progression of vascular disease can be halted, saving women from future stroke, heart attack, and early death if PAD is detected early.

Risk Factors

Get tested if you:

• Are over age 50
• Have a family history of vascular disease, such as PAD, aneurysm, heart attack or stroke
• Have high cholesterol or high lipid blood test
• Have diabetes
• Have ever smoked or smoke now
• Are overweight
• Have an inactive lifestyle
• Have a personal history of high blood pressure, heart disease, or other vascular disease
• Have trouble walking that involves cramping or tiredness in the muscle with walking or exercising, which is relieved by resting
• Have pain in the legs or feet that awakens you at night

Peripheral Arterial Disease – Diagnosis

The ABI Test for PAD

The most common test for PAD is the ankle-brachial index (ABI), a painless exam in which a special stethoscope is used to compare the blood pressure in your feet and arms. Based on the results of your ABI, as well as your symptoms and risk factors for PAD, the physician can decide if further tests are needed. When the ABI indicates that an individual may have PAD, other imaging techniques may be used to confirm the diagnosis, including duplex ultrasound, magnetic resonance angiography (MRA) and computed tomography (CT) angiography.

The ABI is a simple, painless test to help your physician determine if you have PAD. The blood pressure in your arms and ankles is checked using a regular blood pressure cuff and a special ultrasound stethoscope called a Doppler. The pressure in your ankle is compared to the pressure in your arm to determine how well your blood is flowing and whether further tests are needed.

Peripheral Arterial Disease – Treatments

The best treatment for PAD depends on a number of factors, including your overall health and the seriousness of the disease. In some cases, lifestyle changes are enough to halt the progress of PAD and manage the disease. Sometimes, medications or procedures that open up clogged blood vessels are prescribed to treat PAD.

If decreased blood flow to the legs is causing injury to the feet and toes, a foot care program to prevent sores or infection may be prescribed. This may include referral to a podiatrist.

Lifestyle

Often PAD can be treated with lifestyle changes. Smoking cessation and a structured exercise program are often all that is needed to alleviate symptoms and prevent further progression of the disease. Like many patients with coronary artery disease caused by atherosclerosis, PAD patients frequently have elevated cholesterol levels that contribute to the disease. A low fat diet and other cholesterol-lowering strategies are often part of a treatment plan.

Medication

For many patients, lifestyle changes combined with medication can control the symptoms of PAD. Drugs that lower cholesterol or control high blood pressure may be prescribed. New medications that help prevent blood clots or the build up of plaque in the arteries, or that reduce the pain of PAD, also are appropriate for some patients.

Angioplasty and Stenting

Interventional radiologists are vascular specialists who pioneered angioplasty and stenting, which was first performed to treat peripheral arterial disease. Using imaging for guidance, the interventional cardiologist threads a catheter through the femoral artery in the groin, to the blocked artery in the legs. Then the interventional cardiologist inflates a balloon to open the blood vessel where it is narrowed or blocked. In some cases this is then held open with a stent, a tiny metal cylinder. This is a minimally invasive treatment that does not require surgery, just a nick in the skin the size of a pencil tip.

Balloon angioplasty and stenting has generally replaced invasive surgery as the first- line treatment for PAD. Early randomized trials have shown interventional therapy to be as effective as surgery for many arterial occlusions, and in the past five to seven years, a very large clinical experience in centers throughout the world has shown that stenting and angioplasty are preferred as a first-line treatment for more and more processes throughout the body.

The long-term clinical results of stent placement to treat PAD are comparable to those of aortofemoral artery bypass surgery, with a much lower risk of associated morbidity and mortality. Surgery should be reserved for the rare patient in whom stenting can’t be done or fails.

Of all the modern medical advancements pioneered by interventional cardiologists, perhaps the most significant has been peripheral angioplasty and stenting. Today, interventional treatments are the first-line standard for PAD and they preserve future treatment options.

This unique specialty offers multimodality state-of-the-art imaging and diagnostic expertise, coupled with an unparalleled clinical experience across specialties, and in-depth knowledge of the least invasive treatments. Interventional cardiologists are specialists in minimally invasive treatments, have a unique breadth of training and provide consults to every type of specialist.

These specialists have an in-depth foundation in diagnostic radiology with specialized training in procedures performed using imaging to guide them. When it comes to best practices for safely performing minimally invasive medicine, interventional cardiologists pioneered the standards for safety and quality.

The information provided on this website is provided for informational purposes only, and should not be used to diagnose or treat a health problem or disease. Such information is not intended as a substitute for professional medical care, and is not intended to provide complete medical information. Only your doctor can diagnose and treat medical problems. Consult your physician if you want more information on the procedures and tests that are described on this website.

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The Cardiac Rehabilitation Program at Bradenton Cardiology Center is designed to meet the needs of patients with heart disease. Each member of the team is a highly trained professional, dedicated to providing you with quality care after your hospitalization.

We look forward to having you as part of our “family” and are eager to assist you in reaching your goals. Should you have any questions, please feel free to contact us at (941) 748-2277.

WHAT IS CARDIAC REHABILITATION?

Cardiac rehabilitation is a program that helps heart patients recover after a heart attack, bypass surgery, or other heart problems. Our caring and skilled staff will assist you so that you can safely resume your usual activities. They will talk with you and answer any questions that you may have regarding coronary artery disease or the rehabilitation program. The staff will report any problems that you may have promptly to your physician.

The program includes:

• A program to increase awareness of risk factors
• A program to let you know what to expect as you recover
• A plan to promote a heart – healthy diet

Support

• from other patients
• from the staff

Who Should Consider Cardiac Rehabilitation ?

Anyone who has had:

• heart attack
• bypass surgery
• valve surgery
• transplant
• angina
• heart failure
• angioplasty

How Do I Get Started ?

After your physician has referred you for cardiac rehabilitation, please call the staff at (941) 748-2277 to schedule an admission interview.

Does Insurance Pay For The Program?

Medicare and other insurance’s may pay for part or all of the program. Our office will be glad to work with you to determine coverage.

What Does The Program Involve ?

The Phase II program is a 12 week course. Classes are held every Monday, Wednesday and Friday. Each class lasts approximately 1 hour to 1 hour and 15 minutes.

Class times are as follows:

• 7:45 am – 9:15 am
• 10:45am – 2:30pm

We will choose a time that fits into your daily schedule. We continually monitor your progress by taking your pulse, blood pressure, and watching your ECG on our monitoring system.

How Will I Benefit ?

• You will feel more confident and less afraid.
• You will learn what activities and levels are safe for you.
• You will become stronger and be able to return to your normal activities.

Our EDUCATIONAL program includes information on:

• Stress management, techniques
• Medication guidelines
• Risk factor modification
• Maintaining lifestyle changes
• Emergency planning
• Dietary counseling: low-fat, high fiber fast foods, dining out and label reading
• Normal feelings, coping
• Home program guidelines
• Sexual considerations

What Other Participants Have Said…

• Superb !
• Most beneficial as well as enjoyable.
• Exactly what a heart patient needs !
• A 10, on a scale of 1 to 10.
• A very good way to eat right, lose weight, and exercise.
• This program is the best thing that I could do; it has helped very much.
• The program reassured and gave me a confidence to know what my body can and cannot do.
• I liked sharing the experiences.

The information provided on this website is provided for informational purposes only, and should not be used to diagnose or treat a health problem or disease. Such information is not intended as a substitute for professional medical care, and is not intended to provide complete medical information. Only your doctor can diagnose and treat medical problems. Consult your physician if you want more information on the procedures and tests that are described on this website.

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The Consultative Cardiology Program at The Bradenton Cardiology Center provides an integrative approach to the diagnostic evaluation of the cardiovascular system and to the formulation of short- and long-term therapeutic strategies for cardiac patients.

Our cardiologists and their support staff base their evaluation of patients’ needs on the most up-to-date clinical information and can adjust medications or suggest alternative therapeutic approaches when indicated. They also routinely confer not only with patients and their families but also those patients’ primary-care physicians and cardiologists, in order to coordinate an optimal and seamless approach to care.

We see patients will all types of cardiovascular disease and suspected cardiovascular disease, such as:

• hypertension
• angina
• heart failure
• valvular disease
• palpitations
• coronary artery disease
• arrhythmia and PAD

Patients can be seen by a consultative cardiologist and may subsequently be referred to a sub-specialist, such as an electrophysiologist or heart failure specialist.

The Bradenton Cardiology Center routinely accepts referrals of patients from other medical centers to its cardiology team for consultation and assessment. The Bradenton Cardiology Center welcomes patients seeking second opinions or who have questions about diagnosis or treatment plans prescribed by their current physicians experiencing difficulties or failing to improve as hoped.

The information provided on this website is provided for informational purposes only, and should not be used to diagnose or treat a health problem or disease. Such information is not intended as a substitute for professional medical care, and is not intended to provide complete medical information. Only your doctor can diagnose and treat medical problems. Consult your physician if you want more information on the procedures and tests that are described on this website.

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Nuclear Cardiology Test

Nuclear cardiology studies produce images of the heart at work (during exercise) and at rest. During a test, you are given an injection of a small dose of a harmless radioactive tracer. Then you spend time exercising on a treadmill or stationary bicycle and then resting. A specialized camera (called a “gamma camera”) detects the tracer as it passes through the chambers of your heart, creating the pictures. The pictures may reveal problems in heart muscle and blood vessels, especially when the images of the heart at work and at rest are compared.

The information provided on this website is provided for informational purposes only, and should not be used to diagnose or treat a health problem or disease. Such information is not intended as a substitute for professional medical care, and is not intended to provide complete medical information. Only your doctor can diagnose and treat medical problems. Consult your physician if you want more information on the procedures and tests that are described on this website.

The pacemaker clinic duties include:

• Adminsitering diagnostic tests.
• Checking pacemakers for regular evaluations and reprogramming.
• Scheduling follow-up appointments, and telephonic checks.
• Holter Scanning.
• Wound site evaluations for new implant.
• Keeping an updated patient file system in the pacemaker art computer and pacemaker patients charts in file cabinets.

Pacemakers

An arrhythmia is any disorder of your heart rate or rhythm. It means that your heart beats too quickly, too slowly or with an irregular pattern. Most arrhythmias result from problems in the electrical system of the heart. If your arrhythmia is serious, you may need one of two devices implanted under your skin: a cardiac pacemaker or an implantable cardioverter defibrillator (ICD).

A pacemaker monitors the electrical impulses in the heart. When needed, it delivers electrical pulses to make the heart beat in a more normal rhythm. A pacemaker may be helpful when the heart beats too slowly or has other abnormal rhythms. An ICD is a device that monitors heart rhythms. If it senses dangerous rhythms, it delivers shocks. Many ICDs record the heart’s electrical patterns when there is an abnormal heartbeat. This can help the doctor plan future treatment.

Comparison of an Implantable Cardioverter Defibrillator and a Pacemaker

The illustration compares an implantable cardioverter defibrillator and a pacemaker. Figure A shows the location and general size of an implantable cardiac defibrillator in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest. Figure B shows the location and general size of a double-electrode pacemaker in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest.

What Is a Pacemaker?

A pacemaker is a small device that’s placed under the skin of your chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate.

Pacemakers are used to treat heart rhythms that are too slow, fast, or irregular. These abnormal heart rhythms are called arrhythmias (ah-RITH-me-ahs). Pacemakers can relieve some symptoms related to arrhythmias, such as fatigue (tiredness) and fainting. A pacemaker can help a person who has an abnormal heart rhythm resume a more active lifestyle.

Faulty electrical signaling in the heart causes arrhythmias. A pacemaker uses low-energy electrical pulses to correct faulty electrical signaling.

Pacemakers can:

• Speed up a slow heartbeat
• Help end an abnormal and fast rhythm (only in implantable cardioverter defibrillator/pacemaker combination devices)
• Make sure the ventricles contract normally if the atria are quivering instead of beating in a normal rhythm (a condition called atrial fibrillation)
• Coordinate the electrical signaling between the upper and lower chambers of the heart
• Coordinate the electrical signaling between the ventricles (cardiac resynchronization therapy used in heart failure)

Pacemakers also can monitor and record your heart’s electrical activity and the rhythm of your heartbeat. Newer pacemakers can monitor your blood temperature, breathing rate, and other factors and adjust your heart rate to changes in your activity.

Pacemakers can be temporary or permanent. Temporary pacemakers are used to treat temporary heartbeat problems, such as a slow heartbeat due to heart attack, heart surgery, or an overdose of medicine. Temporary pacemakers are used in emergencies until a permanent pacemaker can be implanted or until the temporary condition goes away. A person with a temporary pacemaker will stay in the hospital as long as the pacemaker is in place.

The information provided on this website is provided for informational purposes only, and should not be used to diagnose or treat a health problem or disease. Such information is not intended as a substitute for professional medical care, and is not intended to provide complete medical information. Only your doctor can diagnose and treat medical problems. Consult your physician if you want more information on the procedures and tests that are described on this website.

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Bradenton Cardiology Center is among the first in Bradenton, Florida approved to offer the newly available Transcatheter Aortic Valve Replacement (TAVR) procedure to patients with severe aortic stenosis.
The new TAVR procedure (sometimes referred to as TAVI – Transcatheter Aortic Valve Implant) is an alternative to traditional open-heart surgery and enables a collapsible aortic heart valve to be placed by entering the femoral artery in the thigh and going through the body via a catheter-based delivery system.

TAVR not only offers an improved quality of life for the patient, but it is also an alternative for high-risk patients with severe aortic stenosis, who may otherwise not be a candidate for open aortic valve replacement.

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