Office-Based Services


Consultation

  • Cardiac evaluation for signs and symptoms of heart disease
  • Preventive cardiology (risk factor management for hypertension, elevated cholesterol, strong family history of heart disease)
  • Preoperative cardiac evaluation
    • For a new patient consultation, expect to be in the office for approximately one hour
    • If you are not an established patient in our office (not previously seen for testing or doctor visits), the Patient History and Information Forms can be printed and completed prior to the visit. Alternatively, you should arrive at least 15 minutes prior to the scheduled visit to allow time to complete these forms
    • Please bring a complete, up to date list of all of your medications for all visits with the doctor

Ongoing management of chronic heart disease

  • Congestive heart failure
  • Coronary artery disease
  • Cardiac arrhythmia/atrial fibrillation
  • Hypertension
  • Hyperlipidemia

Stress testing and Nuclear Cardiology

  • Evaluation for presence of significant coronary artery disease (chest pain, shortness of breath, screening of high risk patients)
  • IAC certified
  • Treadmill exercise (without nuclear imaging)
    • For standard (non-nuclear) exercise treadmill tests expect to be in the office approximately 45 minutes
    • If you are not an established patient in our office (not previously seen for testing or doctor visits), the Patient History and Information Forms can be printed and completed prior to the visit. Alternatively, you should arrive at least 15 minutes prior to the scheduled visit to allow time to complete these forms
    • You may drive yourself to and from the office for this appointment
    • Do take your morning medications unless otherwise instructed
    • You may eat lightly prior to the test
    • Wear a short-sleeved shirt and pants (no skirts or dresses)
    • Wear comfortable walking shoes (no high heels or sandals)
    • Women should wear a bra
  • Nuclear Stress Testing (treadmill or pharmacologic for patient unable to exercise)

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Echocardiography (Transthoracic echo)

  • Non-invasive ultrasound study of heart structure and function (evaluate cardiac chamber size, pumping function of the heart, cardiac valve function)
    • Expect to be in the office for 30-45 minutes
    • If you are not an established patient in our office (not previously seen for testing or doctor visits), the Patient Information Form can be printed and completed prior to the visit. Alternatively, you should arrive at least 15 minutes prior to the scheduled visit to allow time to complete these forms
    • There are no dietary restrictions prior to this test
    • This is a non-invasive test (no IV required)
    • You may drive yourself to and from the office for this appointment
    • Do not apply cream or lotion to the chest area on the day of your test

Carotid artery ultrasound

  • Non-invasive evaluation and screening for carotid artery disease (important assessment of stroke risk)
    • Expect to be in the office for 30-45 minutes
    • If you are not an established patient in our office (not previously seen for testing or doctor visits), the Patient Information Form can be printed and completed prior to the visit. Alternatively, you should arrive at least 15 minutes prior to the scheduled visit to allow time to complete these forms
    • There are no dietary restrictions prior to this test
    • This is a non-invasive test (no IV required)
    • You may drive yourself to and from the office for this appointment
    • Do not apply cream or lotion to the neck area on the day of your test

24-hour (“Holter”) monitor and long term cardiac monitoring

  • Portable ECG recorder used to detect intermittent rhythm problems (evaluate for palpitations, dizziness, passing out episodes)
  • Monitor can be worn for periods between 24 hours and 30 days as recommended by ordering physician
    • Expect to be in the office for 15-30 minutes
    • If you are not an established patient in our office (not previously seen for testing or doctor visits), the Patient Information Form can be printed and completed prior to the visit. Alternatively, you should arrive at least 15 minutes prior to the scheduled visit to allow time to complete these forms
    • Do not apply cream or lotion to the chest area on the day of your appointment
    • Perform normal activities while wearing the monitor
    • Your technician will provide instructions on returning the monitor

Pacemaker and defibrillator services

  • Ongoing management of cardiac pacemaker and defibrillator device function
  • Home monitoring over telephone

Coumadin/warfarin management

  • In office monitoring of anticoagulation (blood thinner) drug therapy
  • Point of service testing by fingerstick

Hospital-Based Services


Inpatient consultation and management

  • New and established patients seen
  • 24 hour coverage

Cardiac catheterization and coronary intervention

  • Full range of services for diagnosis and treatment of coronary artery disease includes balloon angioplasty, coronary artery stenting
  • Procedures performed by our physicians who are University of Maryland trained, Board Certified in Interventional Cardiology
  • Baltimore Washington Medical Center, University of Maryland, Union Memorial Hospital, Sinai Hospital

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Transesophageal echo (TEE)

  • Cardiac ultrasound performed under sedation utilizing endoscopy to provide detailed cardiac imaging when transthoracic echo alone is not sufficient
  • Baltimore Washington Medical Center

Electrical cardioversion

  • Electrical procedure used to restore normal heart rhythm in patients with atrial fibrillation or flutter, performed under IV sedation
    • Expect to be in the hospital for approximately 3 hours
    • Do not eat or drink anything after midnight the night before your procedure
    • You should take your usual morning medications on the day of the procedure unless otherwise instructed
    • You will need someone to drive you to and from the hospital
    • IV sedation will be administered by an anesthesiologist; we recommend that you do not drive or perform any strenuous activity for the remainder of the day following the procedure

Permanent pacemaker and Internal Cardioverter Defibrillator (ICD) therapy

  • Pacemaker device implantation performed to treat abnormally slow heart rate
  • ICD implantation to prevent sudden death associated with life threatening, abnormally fast rhythm (ventricular tachycardia/ventricular fibrillation)

Before your pacemaker or ICD implantation surgery:

  • Do not eat or drink anything after midnight the night before your procedure
  • If you take medications for diabetes or diuretics (“fluid pills”), hold these on the morning of the procedure, unless otherwise instructed. Type I diabetics should discuss insulin dosing with their physician
  • If you take warfarin (Coumadin), Pradaxa, or Xarelto, hold these medications as instructed by your physician
  • If you take aspirin, Plavix, Effient, or Brilinta, hold these medications as instructed by your physician
  • Otherwise, take all your regular medications with a small sip of water on the day of the procedure
  • Please have pre-procedure blood work performed as instructed
  • When you arrive at the hospital, please check in at the admitting office. The procedure will be performed in the cardiac catheterization lab on the second floor. Family members can wait in the waiting room
  • The procedure will take one to four hours. Usually, you will stay one night in the hospital

After your pacemaker or ICD implantation surgery:

  • Please keep the surgical site clean and dry
  • No full showers, but sponge baths are allowed
  • Keep the sling on, if you were given one
  • Keep your upper body at 60 degrees when resting
  • Take medications as directed on the discharge instructions
  • Please keep appointments for bandage change, device interrogation and analysis, and surgical staple removal
  • If bleeding, drainage, fever, dizziness or significant pain, please call or return to the hospital