Preventive Cardiology

Calcium score CT allows measurement of the amount of calcium in the coronary arteries to better assess a patient’s risk of cardiovascular disease.    

In this test, you will walk on a treadmill or ride a stationary bike while we monitor your heart rhythm, blood pressure and breathing. Wear comfortable clothing and walking shoes. You will wear sticky patches called electrodes on your chest, arms and legs to record your heart’s electrical signals and a cuff on your arm to monitor your blood pressure. You also may need to breathe into a tube to evaluate your oxygen levels. As you walk on the treadmill, the speed and incline of the treadmill will increase. Similarly, if you are pedaling a stationary bike, the resistance will increase. You will continue until you reach a target heart rate or you experience:

• Abnormal heartbeat
• Changes in your heart rhythm
• Chest pain
• High or low blood pressure
• Shortness of breath

When the test is over, you will be asked to rest until your heart rate and breathing return to normal. You can then return to your normal activities for the day. The appointment will take about an hour, but you will only be exercising for 10 to 15 minutes. Depending on the results of the test, additional testing, or a more advanced stress test, such as a nuclear stress test or stress echocardiogram, may be needed.

A nuclear stress test, also known as a thallium stress test, may be recommended in addition to an exercise stress test. It will take two to five hours and include taking images of your heart before and after exercise.  A very small amount of radioactive dye will be injected through an IV in your arm. Then we will take detailed pictures of the heart tissue with a special camera that detects the dye. These images can identify areas of the heart that have decreased blood flow.

After we take these images, you will proceed with the treadmill or bike stress test. Once that is over, another set of images will be taken. When the nuclear stress test is over, you should be able to return to your daily activities. You can help flush the dye out of your system by drinking extra water. The results of this test will help determine whether you need additional testing or treatment.

This type of stress test helps us better assess the structures of the heart by doing an echocardiogram before, during and after a treadmill or bike stress test. For the echocardiogram, or echo, a technician will stick patches called electrodes to your body so we can monitor your heartbeat. They will then rub gel on the area to be tested and will press a device called a transducer against your chest. The transducer creates sound waves and picks them up as they bounce back from your heart. These sound waves will create detailed images of your heart. After these images are taken, you will begin the treadmill or bike stress test. You may be stopped at one or more points to take additional echo images. One last image will be taken when you have finished exercising.

The appointment will take about an hour, but you will only be exercising for 10 to 15 minutes. When the stress echocardiogram is over, you should be able to return to your daily activities. The results of this test will help determine whether you need additional testing or treatment.

CT angiography can be utilized to visualize arteries throughout the body including cerebral arteries in the brain, carotid arteries in the neck, coronary arteries in the heart, pulmonary arteries in the lungs, arteries in the abdomen/pelvis, and peripheral arteries in the arms and legs.

An echocardiogram uses high-frequency sound waves, called ultrasound, to create images of your heart. These images are more detailed than a standard X-ray, and there is no radiation involved in the test.

The ankle-brachial index (ABI) is a simple, non-invasive test to check for peripheral artery disease (PAD). This test compares the blood pressure measured at the ankle with the blood pressure measured at the arm. A low ankle-brachial index number can indicate a blockage or narrowing of the arteries in the leg. Physicians recommend this test for people who have leg pain while walking or have risk factors for PAD, such as smoking and atherosclerosis in other parts of the body. 

The carotid arteries can be checked for the presence of plaque by using a duplex ultrasound test which combines a traditional ultrasound, which uses sound waves that bounce off blood vessels to create an image, and Doppler ultrasound, which records sound waves that bounce off moving objects, such as blood, to measure speed and flow.

A cardiopulmonary stress test, which is also called a cardiopulmonary exercise test (CPET) evaluates how the heart and lungs function during controlled exercise. The level of oxygen in the blood and how much air the lungs take in during the test are recorded. Physicians are then able to determine if the results are normal or abnormal and recommend follow-up treatment.

Based on you and your family’s medical history, diagnostic tests, and imaging, we prescribe medications to lower your cholesterol, lower your blood pressure, or improve your heart’s pumping ability. We also manage statin side effects or offer alternative medications for patients who do not tolerate these drugs to control high cholesterol.

Our nutritionists work with patients to reduce their cardiovascular risks by following healthy eating plans. 

We specialize in treating these patients who have uncontrolled hypertension (high blood pressure) which is a major risk factor for developing atherosclerotic cardiovascular disease, kidney disease, heart failure, arrhythmias, and sudden cardiac death.

We collaborate with patients to actively manage their cholesterol levels. Utilizing new and emerging markers of lipid related risk, we can determine the best medication regimens to treat patients diagnosed with dyslipidemias (abnormal levels of fat in the blood). Special attention is given to familial hypercholesterolemia which affects roughly 1 in 220 people and requires intensive lipid lowering therapy.

Diabetes, pre-diabetes, insulin resistance, hypertension, overweight/obesity, high cholesterol and/or high triglyceride levels often occur together and are all risk factors for cardiovascular disease. While each one of these conditions increases risk, the combined effect can result in early onset of severe cardiovascular disease and events such as heart attack or stroke. We collaborate with MedStar Health physician specialists and other health professionals to prevent the onset of cardiometabolic disease and aggressively treat existing disease.

MedStar Health's Cardiovascular Rehabilitation program is designed for patients recovering from heart disease or a cardiac event such as a heart attack or heart surgery. In addition, cardiac rehabilitation can help improve stamina in patients who have heart failure or a wide range of other cardiovascular conditions (e.g., chest pain, arrhythmia, cardiomyopathy, and others).

Cardiogenetics is a tool that can help us improve screening and detection of certain inherited heart conditions and intervene early to prevent future health problems. We offer genetic testing for people with hereditary cardiac conditions and their family members, and advancing research into the genetic factors of diseases, such as coronary artery disease. Our experts are working to identify the genetic risks that may predispose some people to such conditions.

People who do not get adequate sleep are at higher risk of cardiometabolic disorders. We refer these patients for sleep studies and treatment.

Smokers are two to four times more likely to have heart disease than non-smokers. When you stop smoking, your body begins to heal, and you will experience almost immediate decreases in blood pressure and heart rate. We refer patients to smoking cessation classes to address this important risk factor.

Excess weight can also put added strain on your heart, raising your blood pressure, cholesterol, and glucose (sugar) levels. Nutritionists address weight management and weight loss by developing healthy diets and eating plans. Select patients are referred to the bariatric surgery program.

Heart disease is the leading cause of death in American women, with 90% of women having at least one risk factor. The good news? It is largely preventable.

Preventive cardiology specialists can help women understand their unique risks and take steps to safeguard their heart health. Learn more about our Women’s Heart Health Program here.