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What Does Electrocardiography Mean For You?

Heart disease affects many Americans and is currently the leading cause of death in this country. In many cases, a heart attack is the first symptom of this condition. Preventive cardiology can help lower your risk of developing heart disease or prevent the condition from getting worse. One of the important aspects of preventive cardiology is know what's going on with the heart. To that end, a vein doctor like Ken Stevens, MD, of Premier Heart and Vein Care, uses several electrocardiography techniques.

How The Heart Works

The heart runs on electricity. An electrical impulse begins in a spot inside the heart called the SA node. The impulse travels through the heart and the muscle responds by squeezing to pump blood through the heart and out into the body. The blood goes first to the lungs, where it takes on oxygen, then returns to the heart and is sent out through the arteries. After delivering oxygen to the body cells, the blood returns to the heart for another round. The electrical impulse can by measured to determine if it is fast, slow or irregular.

Electrocardiography

An electrocardiogram (usually called an EKG) is one of the most common ways to measure electrical activity in the heart. Completely non-invasive, this test translates the information it receives into a pattern that can be viewed on a screen or printed on special paper. The doctor then measures important aspects of the tracing for size and frequency and looks at the overall pattern to determine what's going on in the heart. The procedure is performed in a doctor's office, is not painful and has no side effects.

Holter Monitor

An EKG can give you a one-time picture of the heart's activity. A Holter monitor is an EKG that is meant to be worn as you go about your activities during the day and while sleeping. Sometimes your heart rate and rhythm change significantly with activity or during the night; the Holter monitor will record all of those changes. In most cases, patients are asked to wear the Holter monitor for 24 to 48 hours, but occasionally it may be longer. In all other respects, a Holter monitor is just like a regular EKG.

Other Tests

In addition to an EKG or Holter monitor, your doctor might want to check how much blood is flowing through the chest and how hard the heart has to work to pump the blood. In that case, a procedure known as impedance cardiography will be used. An echocardiogram is an ultrasound of the heart. This test can create images from sound waves that show the internal structure of the heart in real time. It is used to look for physical heart abnormalities.

In order to make recommendations for care, doctors need information about the heart. Electrocardiography provides that information. If you have questions about electrocardiography or the tests listed above or want to schedule an appointment, please contact us at Premier Heart and Vein Care.

 

Uses of an Electrocardiography Test

Known as an EKG or ECG, an electrocardiography records your heart’s electrical activity through the use of electrodes placed on your skin. It is a very common test performed by your general physician, cardiologist, and vein doctor.

The EKG detects the slightest electrical changes on your skin that come about from each and every heartbeat in order for your doctor to learn more about the function and structure of your heat. The test is non-invasive, painless, and takes just seconds after the leads are attached.

Attaching the leads are the longest part of the test, and can take upwards of 10 minutes. The technician or nurse may have to shave small areas of hair to ensure the electrodes are secured appropriately to the skin.

Medical Uses for an EKG

There are many indications for a physician to use an EKG. Some reasons you might be advised to get an electrocardiography test include:

  • Cardiac stress testing
  • Suspected pulmonary embolism
  • Fainting spells
  • Dizzy spells
  • Circulation concerns
  • Vein problems
  • Seizures
  • Heart murmur
  • Suspect heart attack
  • Heart valve problems
  • Heart arrhythmia
  • Coronary heart disease
  • Monitor the effectiveness of a pacemaker
  • Breathing difficulties
  • Feeling weak or fatigued
  • Feeling that your heat if racing, pounding, or fluttering
  • Feeling pains in your chest

Abnormal results from an ECG can indicate an heart condition, and additional testing is necessary. The results may indicate that your heart is beating erratically, beating too fast, or beating too slow. It can indicate that you are having a heart attack, or have had one previously. An EKG can provide clues that you have an enlarged heart, have blocked articles, or have problems with blood flow. It can also indicate that you might have heart valve problems or coronary heart disease.

Other EKG Considerations

There are very few risks associated with having an EKG, aside from possible irritations or rash from the electrodes placements.

There is no real preparation for having an ECG. However, patients are advised to refrain from exercising or drinking cold water before getting this test. Exercising can elevate your heart rate and drinking cold water can alter the electrical patterns, and may alter the test results.

Your San Luis Obispo vein doctor will interpret the results of your EKG to determine if any treatment is warranted to improve your condition.

 

Why Endocarditis Patients Need a Cardiovascular Center

Endocarditis is a disorder that is fortunately rare in individuals who have healthy hearts.  However, it can develop suddenly or slowly.  Those with symptoms of this condition need excellent medical care at a the state-of-the art cardiovascular center.  Understanding the basics of this condition helps patients form realistic expectations about their care.

Overview of Endocarditis

This condition is an inflammation of the heart.  Most often the result of a bacterial infection, it is occasionally caused by fungal activity.  MedlinePlus notes that sometimes doctors are unable to find the cause. The inflammation affects the endocardium, the inner lining of the heart’s chambers and valves.

The most likely ways germs get into the blood and move to a patient’s heart include:

  • Through a central venous line
  • From unsterile needles used to inject drugs
  • After dental surgery
  • Following certain major or minor procedures, such as those performed on the urinary tract

According to research reported at PLOS ONE, a number of studies have estimated the incidence of this condition at 4 cases per 100,000 individuals.  More recent research suggests it might be higher.

The Mayo Clinic indicates that endocarditis has many potential symptoms.  Among the most common are these:

  • Chills and fever
  • New heart murmur
  • Aches in muscles and joints
  • A persistent cough
  • Weight loss
  • Abdominal or limb swelling
  • Spleen tenderness
  • Blood in the urine

The most important possible complications of the disorder include:

  • Strokes and damage to organs
  • Infections that strike areas outside the heart
  • Actual heart failure

Treatment at a Cardiovascular Center

Based on a patient’s medical history and a physical exam, a cardiovascular specialist might suspect endocarditis.  Since in its earliest stages the illness can mimic other disorders, physicians often order these tests to make a diagnosis:

  • Blood tests to look for bacteria and anemia
  • Electrocardiogram to assess the electrical phases of the patient’s heartbeat
  • Transesophageal echocardiogram to examine the heart valves
  • Chest X-rays to evaluate the heart and the lungs
  • CT or MRI scan to determine if an infection has moved to areas outside the heart

Physicians are able to choose the appropriate antibiotic or combination to treat endocarditis based on results of blood cultures.  Patients sometimes need to receive intravenous antibiotics while in a hospital and continue them at home for a total of four to six weeks of treatment.

When endocarditis damages a patient’s heart valves, symptoms can persist and complications might develop years after antibiotics.  In some cases, surgery is the recommendation for infections that linger, for replacement of damaged valves, or to treat endocarditis linked to a fungal cause.

Surgery could mean either repairing a damaged heart valve or replacing it.  Replacement valves might consist of man-made material or come from an animal.

Sometimes cardiovascular specialists recommend preventive antibiotics before medical or dental procedures the might allow bacteria into the bloodstream.

 

4 Reasons Your Vein Doctor Might Perform Electrocardiography

if you are having heart pain or other heart problems, one of the first tests your vein doctor or surgeon might perform is an electrocardiogram. Electrocardiography is a non-invasive test that measures the electrical activity of the heart. Also known as an EKG or ECG, the test is often the first part of the diagnosing process for heart disease. There are a number of reasons why a doctor might perform or order an EKG.

Common Reasons for Electrocardiography

If You Have Heart Palpitations

Heart palpitations occur when it feels as though your heart is racing or pounding. It might feel is if your heart is fluttering in your chest, like the wings of a butterfly.  One thing that an EKG measures is heart rate. Along with measuring your heart rate, performing an EKG allows your doctor to determine if the heart rhythm is regular or unsteady.

It can be a useful tool for diagnosing heart palpitations, since the doctor can see when the heart rate increases. Performing the test can help doctors narrow down the list of potential causes of the palpitations as well. After the test, your doctor might ask you a number of questions to shed further light on the cause of the palpitations.

If You Have Chest Pain

Another common reason for performing an EKG is if a patient is experiencing chest pain or pressure in the heart. There are a number of reasons why you might have chest pain, ranging from a heart attack to pericarditis, which is inflammation in the sac around your heart. An EKG can be performed to diagnose chest pain caused by angina.

If You Have a Pacemaker

Some patients have a Pacemaker implanted in their hearts. The device uses electrical pulses to help the heart beat at a normal rate and rhythm. For a Pacemaker to be effective, it needs to properly maintain the heart's rhythm. A doctor might perform an electrocardiogram to confirm that the Pacemaker is working properly.

Before You Have Surgery

Surgery usually has a number of risks, particularly for patients who aren't in the best of health. If you are considering an elective surgery, meaning you don't need the surgery for medical reasons, your doctor might order an EKG first, to make sure your heart is healthy enough to handle the stresses of surgery.

Usually, an EKG is only performed if there's thought to be a problem with the heart or to rule out any issues before going forward with another procedure. You most likely won't need to have one as part of your annual exam, unless you have a history of heart disease.

If your doctor recommends having an EKG, it's best to schedule the test as soon as possible. For more details about the test and to schedule an appointment, contact Premier Heart and Vein Center today.

Pros and Cons of Spider Vein Removal

If you have spider veins, you're not alone. Millions of people in the US have some sort of vein problem, including spider veins. In 2015, 314,629 women and 7,541 men had spider vein treatment in the US, according to the American Society for Aesthetic Plastic Surgery.

Spider vein removal at a vein clinic has many benefits, among them getting rid of those unwanted veins. Another benefit is a boost in your confidence. But before you rush out to schedule your treatment, it helps to look at the procedures available from all angles and to really understand the positives and negatives involved.

Spider Vein Removal: The Good and the Bad

Pro: Say Good-Bye to Unsightly Veins

One of the main reasons to consider spider vein treatment is that the procedures, such as sclerotherapy, usually work very well and effectively eliminate the unwanted veins. In the case of sclerotherapy, the vein doctor injects the veins with a special chemical solution. The solution destroys the veins, so that they collapse and disappear from view.

Con: You Might Need Multiple Treatments

A drawback of sclerotherapy and other spider vein removal treatments is that occasionally, you need more than one treatment to get the results you want. Often, the treatments are spaced a few weeks to a month apart.

Pro: There's No Downtime

Although you might need multiple spider vein treatments to get the full results, you won't have to really disrupt your life between or after treatments. Usually, no recovery or downtime is needed after treatment. You'll be able to get back to work or your regular activities immediately afterwards. You might have to wait a week or so before you start working out again, though.

Additionally, preparation before the treatment is minimal and the process is usually very quick, so its overall impact on your schedule should be minimal.

Con: Hello, Compression Stockings

While you don't have to set aside time off from work following a spider vein treatment, your doctor will most likely advise you to wear compression stockings for a few days or weeks afterwards. Wearing the stockings helps improve your results. They put pressure on the treated area, so that the veins fade away and collapse more easily. The downside is that compression stockings can seriously cramp your style. It's best to think of them as a temporary setback on the road to looking better and feeling more confident. You can always cover them up with a pair of pants or a long skirt.

For many patients, the pros of spider vein removal far outweigh the cons. If you have more questions about your treatment options or would like to learn more about sclerotherapy, talk to Dr. Ken Stevens at Premier Heart and Vein Care today. Call 1-805-979-4777 to schedule an appointment.

Who is a Good Candidate for Sclerotherapy?

Fortunately, spider veins are seldom serious medical problems.  However, for some individuals, they steal self-confidence.  The so-called gold standard of spider vein treatment is sclerotherapy.  Learning about these vessels and this procedure helps patients understand whether they are good candidates for this treatment.

Overview of Spider Veins

These abnormal blood vessels get their name from their appearance, which resembles a spider’s web.  They develop when a small group of veins near the skin’s surface enlarge.  The University of Chicago Medicine says they are typically red or purple and most frequently develop on a patient’s legs or face, more frequently in females than in males.

While these spidery veins are similar to varicose veins, they usually form closer to the surface of the skin.  They also tend to be much smaller than varicose vessels.

How Sclerotherapy Works

The use of this outpatient procedure in the United States dates to the 1930s, according to the Cleveland Clinic.  In one session, a vascular specialist is usually able to get rid of between 50 and 80 percent of unwanted vessels.

More than 90 percent of sclerotherapy patients respond to the treatment.  However, since no procedure to eliminate a spider vein problem prevents new vessels from forming, some individuals return from time to time for additional sessions.

Sclerotherapy utilizes injections into targeted veins.  It is sometimes also useful for small varicose veins.  Many physicians combine ultrasound with sclerotherapy for the most precise results.

The physician inserts a very fine needle into each targeted vein to inject a special substance called a sclerosant.  The sclerosant irritates the vein, causing it to collapse and eventually disappear.  Normal veins nearby pick up its circulatory duties.

While MedicineNet reports that some sclerosants are more painful than others, most patients report very little discomfort beyond a mild burning sensation.  Sessions usually last an hour or less.

Who is a Good Candidate for Sclerotherapy?

The path to eliminating a spider vein problem begins at a consultation with a physician who specializes in vascular issues.  After taking a medical history and conducting a physical exam, the doctor will determine whether a patient is a likely candidate for the procedure.

Acceptable candidates usually have these attributes:

  • They have realistic expectations of the treatment and results.
  • They are not pregnant or breastfeeding and have not been pregnant for a minimum of three months.
  • They are between 30 and 60 years old.
  • They are able to follow the detailed instructions issued before and after sclerotherapy.
  • They acknowledge that the treatment will not stop the formation of future veins.

According to the Cleveland Clinic, these criteria preclude becoming a candidate:

  • Desired vessels could be used for a future bypass
  • Individual has a history of clots or has clotting issues requiring individual analysis
  • Patient is bedridden.

What to Expect When a Cardiovascular Doctor Orders a Holter Monitor

When a cardiovascular doctor recommends Holter monitoring, many patients are unfamiliar with the test.  Understanding what to expect can greatly reduce patient anxiety about this procedure.

What Exactly is a Holter Monitor?

A Holter monitor is a device patients wear to track heart rhythm.  Test results are important tools in helping cardiologists make diagnoses.  According to the Mayo Clinic, the test is noninvasive and painless.

This portable device is a type of electrocardiogram (ECG).  The American Heart Association indicates that it is roughly the size of a small camera and records heart activity for 24 or more hours.

Changes in an ECG can signal various cardiac conditions.  A Holter monitor records electrical impulses that coordinate heart contractions.  The information it collects shows:

  • How fast a heart is beating
  • A steady or an irregular beat rhythm
  • Timing and strength of impulses as they travel through the heart

Why Cardiologists Order It

A standard ECG in a doctor’s office only records heart activity at a single point in time.  Holter monitoring allows cardiologists to evaluate heartbeats over an extended period.

The data collected provides physicians with information such as:

  • Whether current medications are effective
  • Why a patient experiences symptoms like dizziness, feeling faint, or sensing a skipped heartbeat or a racing heart
  • Whether the heart is getting a sufficient supply of oxygen

Doctors order this test when symptoms such as low blood pressure, dizziness, fainting, fatigue, and heart palpitations persist, but a resting ECG cannot detect a precise reason, Johns Hopkins Medicine reports.  Other common reasons include evaluating chest pain not duplicated with exercise testing, assessing the risk of future cardiac issues, monitoring heart rate after a heart attack, and determining whether an implanted pacemaker is effective.

The Monitoring Process

At a patient's appointment, a staff member will ask that jewelry and any other objects that could interfere with the test be removed.  The patient removes clothing from the waist up and changes into a gown so that a technician can affix electrodes to the chest.

It is sometimes necessary to shave to clip hair so that the electrodes will adhere properly.  The technician also attaches electrodes to the abdomen.  Wires connect them to the Holter device, which patients wear over the shoulder, around the waist, or clipped to a pocket or belt.  Since the device operates on batteries, it is important that patients carry extra batteries and know how to change them.  Patients cannot swim, shower, or bathe while wearing the monitor.

After getting instructions, a patient returns to normal activities unless the physician advises otherwise.  Monitoring requires keeping a patient diary of activities and symptoms noted that will be matched to the data collected.  At the end of the test, the individual returns to the practice to have electrodes removed.

 

5 Types of Venous Disease

Your veins do something amazing. Everyday, they fight against gravity, pumping blood up to your heart. Given the forces working against their veins, it shouldn't be much of a surprise that many people develop some form of venous disease or another. Vein disease develops when your veins have difficulty pumping the blood back to the heart. The walls of the veins might be weak or the valves damaged. Get to know a few types of common vein problems.

Examples of Vein Disease

Varicose Veins or Spider Veins

When you think of vein problems, spider veins or varicose veins are probably what comes to mind first. That shouldn't be much of a surprise, since about half of the population has or will have varicose or spider veins, according to the Office on Women's Health. Varicose veins form when the valves in the veins don't work as they should. Blood is allowed to flow backwards down the legs, causing the veins to bulge and twist.

Spider veins form when there is a backup of blood in the tiny vessels near the skin. Usually, spider veins are much smaller than varicose veins. They can also develop on the face and can form as a result of sun exposure.

Superficial Venous Reflux

Another common problem in the veins is superficial venous reflux. It's also known as venous insufficiency. When a person has venous reflux, the blood doesn't make its way up the legs to the heart. Instead, it pools in the veins, causing swelling, darkening of the skin and a feeling of pain or pressure in the legs. Venous insufficiency is often connected to varicose veins, but usually the symptoms it causes are much worse.

Deep Vein Thrombosis

Deep vein thrombosis, or DVT, develops when a blood clot forms deep in a person's veins, usually in the legs. Several things can put a person at an increased risk for developing DVT, including an inherited blood clotting disorder, hormonal birth control and sitting still for long periods of time, such as on a flight.

Some people with DVT don't have any symptoms. Others might have pain or swelling in the affected leg. The major concern with DVT is that the clot will come loose and travel to the lung, causing a pulmonary embolism, a potentially life threatening problem. For that reason, treating the clot early is usually the best course of action. A doctor might prescribe blood thinners or other medications to reduce the clot or compression stockings to help with swelling.

At Premier Heart and Vein Care, Dr. Ken Stevens offers patients with vein disease a variety of treatment options. To learn more about vein problems and the options for treatment, call 1-805-979-4777 to schedule a consultation today.

 

Spider Vein Treatment Options

For most individuals considering treatment, spider veins are a cosmetic rather than a medical issue.  Understanding the basics of this vascular disorder and the spider vein treatment options available can help reduce patient stress.

Overview of Spider Veins

Spider veins are visible signs of venous insufficiency.  According to the American College of Phlebology, patients with this underlying vascular disorder are likely to experience:

  • Feelings of heaviness in a leg
  • Pain or discomfort
  • Swollen legs
  • Leg cramping
  • Leg fatigue
  • Itching

Spider veins get their name from their web-like appearance.  These small vessels are usually red, blue, or purple and typically develop on a patient’s legs or face.  They are similar to varicose veins but are smaller and usually closer to the surface of the skin.

These vessels form when veins previously too tiny to be seen stretch because of defective valves that allow blood to leak backward and pool.  As the veins expand, they become visible as streaks or clusters. 

Physicians recognize quite a few causes of spider veins, the Cleveland Clinic reports.  The most common include:

  • Family history
  • Growing older
  • Being obese or overweight
  • Hormonal shifts
  • Prolonged standing or sitting
  • Vein injury

Choices for Spider Vein Treatment

Treatment for spider veins is available on an outpatient basis from a physician who specializes in vascular problems.  The goal of some treatments is preventing the condition from worsening or lessening the chances that new spider veins will develop.  Other therapies eliminate existing veins.  Depending on the severity of each case, a patient might undergo a mixture of treatment options. 

The three categories of treatment include:

  • Conservative measures often require lifestyle modifications like losing weight, avoiding tight clothing and shoes, wearing compression stockings, getting more exercise, elevating the legs whenever possible, following good skin hygiene, and not crossing the legs.
  • Sclerotherapy is the most common method of eliminating spider veins.  Doctors sometimes also use it to treat small varicose veins.  Many doctors combine the technique with ultrasound for precision.  Using a small needle, the physician injects a substance called a sclerosant into each targeted vessel.  The sclerosant irritates the walls of the vein, causing them to become sticky and the vein to close and eventually disappear.  Healthy vessels assume the workload of the destroyed vein.  The number of sessions required depends on the size, number, and location of the vessels targeted for elimination.  With the exception of strenuous activities, patients are usually able to resume their normal routines the following day.
  • Laser and light therapy use heat to shrink and eliminate spider veins.  Several sessions might be required for laser treatment.  Pulse-light therapy relies on sending out a spectrum of light and is useful for selectively shrinking spider veins, vascular birthmarks, and certain small varicose veins.

No treatment to eliminate veins can prevent new ones from developing.  For this reason, some patients return for periodic treatment.

 

 

Choosing the Right Type of Vein Treatment

Upload: October 1, 2015

Many different types of vein treatment are available. Depending on the nature of your condition, some forms of treatment may be more effective than others. Below is a guide to help you choose the right type of vein treatment for your condition.

Treatments for Spider Veins

Spider veins are small dilated blood vessels that can be located anywhere on the body. Because they are close to the surface of the skin, they are usually visible. Because spider veins can be embarrassing, many people seek treatment.

If your spider veins are not too large, widespread or serious, you may be able to improve the condition through conservative treatments, such as losing weight, elevating your legs, wearing special socks and avoiding long periods of standing. However, in many cases, spider veins must be treated with sclerotherapy. When you undergo sclerotherapy, the doctor will inject a medication under your skin that causes spider veins to collapse. Depending on the severity of the case, sclerotherapy may be performed with or without ultrasound guidance.

Treatments for Varicose Veins

A varicose vein is a vein located near the surface of the skin that has become enlarged and twisted. These veins are easily visible, and they may also be painful. As with spider veins, many people seek treatment in order to eliminate embarrassment and discomfort.

Conservative treatments, such as special socks, walking and weight loss, may be effective in the treatment of mild cases of varicose veins. However, this condition often requires more invasive treatments. Options for treating varicose veins include:

  • Ambulatory microphlebectomy
  • Endovenous laser therapy
  • Non-thermal vein ablation

Both ambulatory microphlebectomy are minimally invasive surgical treatment options. Ambulatory microphlebectomy involves the surgical removal of unsightly varicose veins, while endovenous laser therapy involves the use of a laser to reroute blood out of abnormal veins.

For patients that want to treat their varicose veins without surgery, non-thermal vein ablation may be the best choice. During this procedure, the physician uses ultrasound guidance to feed a catheter into problematic veins. He or she then uses the catheter to inject medication into the vein that causes it to collapse.

Choosing the Right Treatment

If you are suffering from spider veins and/or varicose veins, skilled vascular surgeons can help you choose the vein treatment that's best for your situation. For treatment advice, contact the  vein doctors at the Premier Vein Institute today.

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