Dear Friends and Colleagues,
We at First Coast Heart & Vascular Center are delighted to welcome you to our new practice and sincerely appreciate the opportunity to care of you and your family’s heart and vascular needs.
We would like to remind you of the annual open enrollment season for Medicare participants. Many insurance carriers are offered and we take ALL of them with the exception of Humana Gold and Humana Gold Plus.
First Coast Heart & Vascular Center and all its providers are pleased to inform you of our continued participation with United HealthCare – Medicare AARP and we are in network.
We are growing and would love for you to be part of our family as our growth continues. First Coast Heart & Vascular Center is committed to providing quality ,efficient, compassionate and cost effective care. If you have further questions, please do not hesitate to contact our practice.
We appreciate your trust and confidence in our practice. We wish all of you a happy and safe holiday season.
Sincerely and respectfully,
First Coast Heart & Vascular Center
What is P.A.D.?
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.
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Dear Patients & Friends,
First Coast Heart & Vascular Center welcomes you to our Jacksonville Cardiology practice.
Dr. Vincent. Caracciolo, Dr. L. Van Crisco, Dr. David Grech, Dr. Kevin Hayes, Dr. Dinesh Pubbi, and Dr. Neil Sanghvi and their team of professionals would like to extend warm and sincere thanks for choosing our cardiology practice for your heart and vascular needs.
First Coast Heart & Vascular Center has made a sincere commitment to excellence that is second to none. We stand by core principles of: Quality, Integrity and Compassion. We will always put our patients first.
In our four main offices covering four counties (Duval, Clay, St. Johns and Flagler), First Coast Heart & Vascular Center provides a wide range of cardiac, vascular & electrophysiological diagnostic testing. We also have satellite offices in Duval County that are conveniently located to serve our patients.
Our physicians service all major hospitals in the Duval, Clay and St. Johns counties including:
- Memorial Hospital Jacksonville,
- Baptist Hospitals (downtown and South),
- St. Vincent Hospital South,
- Orange Park Hospital,
- Flagler Hospital in St. Augustine,
- Specialty Hospital
- Brooks Hospital.
We are on call 24/7 for our patients. If you are admitted to any of these hospitals, we will be happy to attend to your needs as long as you make it known and request that our doctors see you. We have access to your records from any of our offices or homes and that will ensure that there are no interruptions in your care. It will also cut down on your expenses, health care system expenses and will eliminate duplication and unnecessary testing.
Our main offices are equipped with the latest in Nuclear imaging machines, Echo or Vascular equipment as well as the latest in Electronic Medical Records (EMR) which facilitate getting all your records to your primary care or referring doctors in an expeditious manner and with high efficiency. EMR assures a full circle of care with your referring doctors and hospitals. Our board certified cardiologists offer a spectrum of services including, but not limited to: consultation, diagnostic stress testing (Nuclear), Echocardiography, vascular testing, pacemaker or defibrillator implantation & interrogation, diagnostic cardiac & vascular catheterization (Angiography) and intervention (Stents, Rotablators, Laser, Debulking with Atherectomy, Carotid Artery or Renal Artery Stenting, PFO Closure, etc.).
Dr. Dinesh Pubbi is a board certified electrophysiologist with much successful experience in atrial fibrillation treatment including Atrial Fibrillation Ablation.
Dr. L. Van Crisco welcomes both cardiac and vascular patients and especially complicated vascular patients with special attention to vein disease. He is a nationally recognized interventional cardiologist with a vast experience in both cardiac and vascular intervention as well as structural heart disease.
First Coast Heart and Vascular Center contracts with every major insurance company as well as Medicare, Tricare and Medicaid. We offer a wide range of financial plans for your piece of mind. We will work with you to make your care affordable. Please browse the patient portal where you may access us 24 hours a day or send a scheduling question, billing question, or a comment or suggestion. You will be contacted within ONE business day by knowledgeable professional staff ready to help you.
Our doctors welcome new patients, former patients and patients seeking a second opinion in all of our offices. Our doctors cross cover each other when one is caught up in an emergency or on vacation to make sure your care is not interrupted.
Please help us keep you informed of your care by pointing out which of our doctors you wish to see and which office location you prefer to visit.
We at First Coast Heart & Vascular Center also want you to know that we support our Veterans and our Local Law Enforcement communities; they are here for all of us so we will be here for them.
Thank you for choosing First Coast Heart & Vascular Center, PA and for putting your heart in our hands.
Respectfully,
The doctors and staff at First Coast Heart & Vascular Center
