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)
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
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
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