We are happy to announce the opening of our newest location in the Murabella section of World Golf Village, in Saint Johns County! We are part of the Flagler Health Plus specialty physicians. The new office is located at 70 Turin Terrace Suite 210 St. Augustine, FL 32092. Dr Ameeth Vedre will be seeing patients here. If this location is more convenient for you, please call 904-342-8300 and we will get you scheduled!
Dr. Ameeth Vedre, MD, FACC, FACP, FASE, FASNC is a Non-invasive Cardiologist and Cardiac Imaging Specialist. He is passionate about both general and preventive cardiology. He brings that passion, together with his extensive knowledge, to the patients of First Coast Heart & Vascular Center.
Cardiologist, Dr. Neil Sanghvi discusses Women and Heart Disease at the WJCT studio Lunch & Learn community heart education. The title of his talk was “What does your sex have to do with it? How to keep your heart ticking.”
Dr. Sanghvi discussed the facts, symptoms and treatment of irregular heart rhythms as well as the differences between women and men when it comes to heart care.
Did you know that heart failure is more common in women than men, yet women receive treatment two times less often than men.
Dr. Sanghvi was interviewed on First Coast Living and discussed the topics of Atrial Fibrillation, Pacemakers and Implantable Cardiac Devices. Dr. Sanghvi is an Electrophysiologist Cardiologist with First Coast Heart & Vascualr Center.
What is a pacemaker and why would someone need one? Pacemakers are devices that are about the size of a silver dollar. They are placed under the skin usually below the collar bone. They typically have anywhere from 1-3 wires that enter the heart via a blood vessel under the collar bone. These devices are usually placed in patients who suffer from a slow heart beat which results in a number of symptoms including fatigue, shortness of breath, inability to exercise, lightheadedness, or fainting to name a few.
What is a defibrillator, also known as an ICD, and why would someone need one of these devices? ICDs are implantable devices that are placed in similar fashion as a pacemaker. However, an ICD’s job is typically to treat fast and lethal irregular beats known as ventricular tachycardia (VT) or ventricular fibrillation (VF). Many people know that heart disease is the #1 killer in the US. What many do not know is that the reason most patients die is due to untreated VT or VF. Approximately 450,000 people die each year in the US from these arrhythmias. Patients at the highest risk include those who have had a prior heart attack, especially if this has resulted in a weakened heart muscle. Those with a weak heart muscle for other reasons are also at risk. Also, patients who may have had several episodes of passing out without an explanation should be evaluated since a small portion of these patients are likely suffering from VT and/or VF.
If a patient needs to have a device implanted, what type of device should be used? This is a decision that is typically made by the implanting surgeon. There are several manufacturers of devices in the US. Many of the devices have similar features. However, there are some distinct differences.
What happens if there is a problem with one of the wires or if one device type needs to be changed to another? Sometimes these devices may have a wire malfunction or one of the wires may be recalled due to a suspected risk of malfunction. Many surgeons often place a new wire in the heart and leave the old wire abandoned there since they are not capable of taking out the old wire. Unfortunately, this increases the risk of infections and for blood vessels to clot since there is more hardware in the body. Patients should seek out surgeons that specialize in lead extractions. Dr. Neil Sanghvi is able to utilize a laser to carefully and safely tease out the old lead that has scarred into the heart. The risk of a major complication is often less than 1-2% in many cases. The advantage is that it allows for less hardware to remain in the body which decreases the risks of infection and blood vessel clotting.
P.A.D. is short for Peripheral Arterial Disease. People have P.A.D. when the arteries in their legs become narrowed or clogged with fatty deposits, or plaque. The buildup of plaque causes the arteries to harden and narrow, which is called atherosclerosis . When leg arteries are hardened and clogged, blood flow to the legs and feet is reduced. Some people call this poor circulation.
P.A.D. occurs most often in the arteries in the legs, but it also can affect other arteries that carry blood outside the heart. This includes arteries that go to the aorta, the brain, the arms, the kidneys and the stomach. When arteries that supply the heart are hardened or narrowed, it is called coronary artery disease or cardiovascular disease.
The good news is that like other diseases related to the arteries, P.A.D. can be treated by making lifestyle changes, by taking medicines, or by undergoing leg artery angioplasty or vascular surgery, if needed. And you can live well with P.A.D.
Is P.A.D. serious?
P.A.D. is a serious disease commonly affecting Americans over the age of 50. The hardened arteries found in people with P.A.D. are a sign that they are likely to have hardened and narrowed arteries to the heart and the brain. That is why people with P.A.D. have a two- to six-times greater chance of death from a heart attack or a stroke.
When the blood flow to the legs is greatly (or severely) reduced, people with P.A.D. may have pain when walking. P.A.D. may cause other problems that can lead to amputation of a toe, foot or a leg. People with P.A.D. may become disabled and not be able to go to work. As time goes on, they may have a very poor quality of life.
Who is at risk for P.A.D.?
The chance of having P.A.D. increases as you get older. People over age 50 have a higher risk for P.A.D., but the risk
is increased if you:
Smoke, or used to smoke
Have diabetes
Have high blood pressure
Have abnormal blood cholesterol levels
Are of African American ethnicity
Have had heart disease, a heart attack or a stroke
Have a family history of P.A.D., heart attack or stroke.
What are the warning signs or symptoms of P.A.D.?
P.A.D. develops slowly over many years. In the early stages, most people with P.A.D. have no symptoms. Only about one out of four people with P.A.D. actually feel typical symptoms of P.A.D. in their leg muscles (known as “claudication”, defined below). By that time, their arteries may be so clogged or hardened that they are not getting enough oxygen to supply their leg muscles.
The most common signs of P.A.D. include one or more of these problems:
Cramps, tiredness or pain in your legs, thighs or buttocks that always happens when you walk but that goes away when you rest. This is called claudication.
Foot or toe pain at rest that often disturbs your sleep.
Skin wounds or ulcers on your feet or toes that are slow to heal, or that do not heal.
Sometimes, people ignore their leg pain and think it is just a sign that they are getting older. As a result, many people with P.A.D. do not know they have it and do not get treatment. It is important to discuss any leg or thigh pain you may be having with your health care provider since it may be a warning sign of a serious disease such as P.A.D.
How do I find out if I have P.A.D.?
If you think you have P.A.D., see your health care provider and talk about any symptoms you are having and go over your medical history and your risk factors for P.A.D. Your provider will examine the pulses in your feet and legs. If your provider finds those pulses are weak and thinks you may have P.A.D., your provider may order a test called the ABI, which stands for ankle-brachial index .
The ABI is the best test for finding out if you have P.A.D. It uses sound waves to find out if there is reduced blood flow in the arteries. It also compares the blood pressure in your ankles with the blood pressure in your arms. P.A.D. also can be diagnosed by other tests that measure blood pressures in the leg (segmental pressure), toe pressures (toe-brachial index or TBI) or artery blood flow (with ultrasound). Other more sophisticated tests can be performed such as PVR ( pulse volume recordings), CTA ( Cat scan) , magnetic resonance angiography (MRA) or catheterization or angiography.
How is P.A.D. treated?
P.A.D. can be treated with lifestyle changes, medicines and surgery, if needed. Since people with P.A.D. are at high risk for heart attacks and stroke, they must take charge of controlling their risk factors related to cardiovascular disease.
These life-saving steps will help to prevent and control P.A.D.:
Get help to quit smoking and set a quit date now.
Lower your blood pressure to less than 140/90 mmHg or less than 130/80 mmHg if you have diabetes or chronic kidney disease.
Lower your LDL (bad) cholesterol to less than 100 mg/dl or to less than 70 mg/dl if you are at very high risk for a heart attack or stroke (if you smoke, have diabetes or have chronic kidney disease).
Manage your blood glucose to reach an A1C level of less than 7 and practice proper foot care if you have diabetes.
Talk to your doctor about taking antiplatelet medicines such as aspirin or clopidogrel (Plavix) to prevent clotting.
Follow a healthy eating plan to control your blood pressure, cholesterol and blood glucose (for diabetes).
Get regular exercise such as walking for 30 minutes at least 3 or 4 times per week.
If you have pain or cramps in your legs, ask your health care provider about an exercise program that will help improve your symptoms. If possible, get a referral to a special P.A.D. exercise program.
For most people with P.A.D., these life-saving steps may be enough to slow down the disease and even improve any symptoms. If needed, your health care provider can refer you to a specialist for procedures or surgery to treat arteries that are severely blocked. These procedures often help people with P.A.D. to improve symptoms and to avoid losing a foot or leg.
Remember:
Finding and treating P.A.D. early can help keep your legs healthy, lower your risk for heart attack or stroke, and save your life and limbs.
Our board certified interventional cardiologists and vascular specialists have an extensive experience with interventions to treat simple to complex vascular blockages in any vascular bed or organ including carotids ( neck arteries), arms , kidney arteries, stomach or intestinal arteries, leg arteries as well as heart arteries. Our experts use simple balloon angioplasty, stents to more complex atherectomy devices, laser catheters, and clot buster catheters to remove clots or cholesterol plaques. If you wish to make an appointment with our doctors, please contact us at (904)-423-0010 or visit our web site (www.firstcoastheart.com) for our 8 locations or phone numbers in three counties.
