Cardiology

A comprehensive approach to "heart health"

At Lawrence Memorial Hospital (LMH) and Melrose-Wakefield Hospital (MWH) cardiac services feature the latest diagnostic technology, advanced treatment options and ongoing rehabilitation support to help you achieve optimum "heart health." Our board-certified physicians, many trained at renowned teaching hospitals, provide the most advanced and personalized cardiac care and emergency treatments in the north suburban area.

How we do it

  • Emergency angioplasty services at MWH, the first hospital in the area to offer the life-saving, state-of-the-art service of balloon angioplasty to open blocked arteries. Studies show that getting treatment within two hours of cardiac distress reduces damage to the heart and saves lives. MWH is able to perform emergency angioplasty in less than 90 minutes.

  • State-of-the-art cardiac catheterization laboratory with the most advanced film-less, digital imaging system to view blockages of the arteries and insert stents and implant pacemakers. Cardiologists at LMH and MWH currently perform over 350 cardiac catheterizations per year.

  • Pacemaker implants-cardiologists implant more than 100 pacemakers per year.

  • Advanced diagnostic cardiac testing including EKG (electrocardiogram) exercise stress tests, nuclear stress tests, echocardiography and holter monitoring.

  • The latest in diagnostic radiology including CCTA (coronary computed tomography), SPECT imaging, stress adn non-stress nuclear medicine exams. Our physicians practice under the principle that a full evaluation is a key component to an accurate diagnosis and successful treatment plan. 

  • Emergency care at LMH and MWH includes cardiologists who coordinate care for heart attack patients or those with other acute cardiac emergencies. Emergency catheterization and angioplasty are performed at MWH.

  • Advanced treatment and ongoing research using the most advanced heart medications including ACE inhibitors, beta blockers, and lipid-lowering agents to manage the care of patients after a heart attack or patients with heart failure.The largest enroller for clinical cardiology trials north of Boston, LMH and MWH are currently involved in several studies exploring new treatments for congestive heart failure.
  • Cardiac rehabilitation assists patients with angina and those recovering from a cardiac event. Our programs promote a healthy lifestyle through monitored exercise, nutritional counseling and educational classes, including control of weight and lipid levels (fat in the blood), stress management, risk factors, medication management and personal time management.
  • Nutrition-counseling program helps each patient achieve and maintain the desirable body weight to achieve good cardiac health.
  • Comprehensive diabetes management and counseling - Hallmark Health System is affiliated with the Joslin Diabetes Center, the world's preeminent diabetes research and clinical care organization. The management and counseling services available at The Joslin Diabetes Center Affiliate at Hallmark Health hepls patients control their diabetes and live a healthy, normal life through diet, exercise and education. Heart disease is the number one killer of diabetics and diabetes is a major risk factor for heart disease.

Primary Angioplasty

Angioplasty is the most effective procedure to save lives and reduce damage to the heart muscle when patients are suffering a heart attack. Performing emergency angioplasty within 90 minutes of the onset of a heart attack has proven to minimize heart damage in 95 percent of all cases. Melrose-Wakefield Hospital (MWH) is now the first hospital in the 16 cities and towns it serves to offer this procedure in their state-of-the-art cardiac catheterization lab.

Minimizing heart damage and restoring blood flow

When a patient meets a specific clinical criteria the emergency angioplasty team performs a cardiac catheterization to locate the blockage. Then, the team inserts another catheter with a balloon on the end and guides it to the blockage. The doctor performs the angioplasty by inflating the balloon. Blood flow is restored to the artery and in most cases a stent is inserted to keep the artery open.

Primary angioplasty restores blood flow to a blocked coronary artery in a timely manner. Studies have shown that emergency angioplasty works better than clot-busting medications. Quickly performing angioplasty reduces damage to the heart muscle.

Partnering with leading tertiary hospitals in Boston

Melrose-Wakefield Hospital's efforts to offer the most advanced cardiac care available at a community hospital, will save more lives. The angioplasty team includes interventional cardiologists: Co-director of Cardiac and Endovascular Services, Carl Turissini, MD, Laurence Conway, MD, David Criss, MD, and Khether Raby, MD, as well as a team of highly-trained nurses and technologists.

Melrose-Wakefield Hospital's cardiac catheterization lab is a state-of-the-art center where angioplasty is performed. The hospital invested in cutting-edge diagnostic equipment including the installation of advanced, film-less, digital imaging equipment.


 

 

 

Salil Midha, MD
Chief of Cardiology, Melrose-Wakefield Hospital
David Pladziewicz, MD
Chief of Cardiology, Lawrence Memorial Hospital
Laurence Conway, MD
David Pladziewicz, MD
David Samenuk, MD
John Carroll, MD


Erica Brooks, MD

Lawrence Moschitto, MD
Farouk Pirzada, MD
Carl Turissini, MD

David Criss, MD

Bruce Watrous, MD

 


 

Innovations: Echocardiography gives cardiologists a powerful diagnostic advantage

Sound waves provide unparalleled pictures of heart disease

A man in his thirties collapses in the Emergency Department at Lawrence Memorial Hospital. With the help of echocardiography - a safe, non-invasive, portable imaging system for taking detailed pictures of the heart - the patient is quickly diagnosed with a potentially fatal blood clot in his lungs. Life-saving, clot-busting drugs are immediately administered.

This real-life scenario is just one dramatic example of the benefits of echocardiography, says cardiologist David Samenuk, MD. Also called cardiac ultrasound, the imaging system uses high-frequency sound waves to create comprehensive images of the outside and inside of the heart and the major connecting blood vessels.

Diagnosing palpitations, chest pains, heart murmurs and more

As a board-certified specialist in echocardiography, Dr. Samenuk is confident that Hallmark Health's investment in state-of-the-art equipment and highly trained staff ensures quality of service, second to none.

Patients are referred for echocardiography for investigation of a number of common symptoms that can signal underlying heart disease, says Dr. Samenuk. These include unexplained shortness of breath, dizziness, palpitations, chest pains and heart murmurs.

Most exams take about 40 minutes and are done by placing a transducer - a probe that emits the high-frequency sound waves - on the chest wall. Sound-wave echoes are translated into images on a monitor for the sonographer and physician to evaluate.

Discovering clots and creating maps for surgery

Of the 40 or so patients that Dr. Samenuk and his team test each week, two or three undergo transesophageal echo (TEE) imaging. For this test, a thin flexible probe with a transducer at the tip is passed down the esophagus directly behind the heart, while the patient is under conscious sedation and feels nothing.

TEE imaging produces "unbelievably superb" pictures, says Dr. Samenuk. It is used in specialized cases, for example to look for clots inside the hearts of stroke patients and to provide detailed maps of the heart in patients about to undergo surgery.

Echocardiography has been used on patients since the late 1960s, but Dr. Samenuk says the technology has "really blossomed" in the last five years.

He is, naturally, an enthusiastic advocate of this safe, noninvasive, painless procedure that can be easily performed in many settings and provides "more information about the heart than any other test."


Women and Heart Disease

Heart disease causes more deaths among women than all cancers combined. Nearly 500,000 women will die of heart disease this year. And unfortunately most women think breast cancer is their biggest health threat. Cardiovascular research specific to women has generated important information to help in the fight against heart disease. And doctors are hoping that women are listening.

Cardiologist Lawrence Moschitto, MD, said, "Every year we learn more about what causes heart disease and the difference in the way men and women are affected. Women were excluded from the research for a long time because heart disease was considered a 'man's disease.' The more women know about their risk for heart disease, the better able they are to prevent and manage it."

Women fare worse than men-why?

Although more men than women have heart attacks each year, outcomes are significantly worse for women. Of the approximately 1 million people who will have a mild heart attack this year, 24 percent of men and 42 percent of women will die within one year.

"Women don't always have the same symptoms as men. Although some men present with atypical symptoms, generally it's women who don't know that indigestion, nausea and jaw discomfort can often be signs of a heart attack," Dr. Moschitto said. "Eighty-five percent of men will have classic symptoms of chest pain, shortness-of-breath, and sweating, while only a fraction of women will have these symptoms."

Most women have fewer chest symptoms, but other symptoms include stomach or abdominal pain, nausea or dizziness, unexplained anxiety and nervousness, weakness or overwhelming tiredness, cold, sweaty skin, and paleness, and swelling of the ankles and/or lower legs.

"As we learn more, we see that women may have a different response to pain and delay seeking treatment, resulting in more severe damage. They also have smaller arteries, which become blocked more quickly," Dr. Moschitto said.

Managing the risk

"We used to view heart disease as a condition that a person 'has' or 'does not have,'" stated Dr. Moschitto. "Now we know that everyone is at risk. A clear definition of where you are on the continuum of risk-low to high-allows you to develop a more specific plan to decrease your risk."

Significant information about the effects of long-term hormone replacement therapy (HRT) was generated from the Women's Health Initiative, a major 15-year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women - cardiovascular disease, cancer, and osteoporosis.

"The study produced evidence that long-term HRT increases the risk of heart disease and stroke," Dr. Moschitto said. "Knowing this, every woman and her doctor should discuss the risks and benefits of HRT as well as the other options available to reduce osteoporosis risk and decrease the symptoms of menopause."

Early diagnosis-the key to saving lives

Other differences between women and men involve the effectiveness of standard diagnostic tools. With men, standard treadmill stress tests adequately test a man's heart but other imaging tests such as echocardiograms often are more conclusive when testing women.

"Some of the tests used to diagnose heart disease are less accurate for women," Dr. Moschitto said. "It is very important to be an active participant in your care, pay attention when you 'don't feel right,' and establish a relationship with a physician who really listens."

Heart-healthy habits reap long-term benefits

Many studies have validated that exercise successfully decreases heart disease risk for women. The American Heart Association (AHA) recommends 30 minutes of moderate physical activity most or all days of the week.

"The benefits of exercise are indisputable, yet many of us find it hard to fit it into an already hectic schedule," Dr. Moschitto said. "Small changes to your routine, such as taking the stairs instead of the elevator, parking further away and walking briskly to your destination, or putting more energy into regular household tasks is a good way to start."

"Women today are 'doing it all' and therefore should be even more careful about taking care of themselves whether single, married, a mother, a caregiver, a career woman or all of the above," Dr. Moschitto concluded. "By taking care of themselves with heart-healthy habits, they are setting a good example and will be better able to take care of themselves and their loved ones in the long run."

 


Congestive Heart Failure

Congestive heart failure is also known as CHF. Your heart is a pump and it pumps blood rich in oxygen and nutrients to all parts of your body and helps remove the waste products. In CHF, your heart doesn't pump as well as it should and the blood backs up in the veins. A backup in the veins of the lungs causes shortness of breath, while a backup in the veins of the legs causes swelling or edema. This is a manageable condition, which you can control with proper medications and life style changes. Weight gain is one of the first signs that you may have; other symptoms will follow if you do not monitor your weight.

Download the helpful information below to learn more:

Patient Guide

Fact Sheet

Self-Management Program


 

  • Angina: chest pain usually caused by a lack of oxygen from restricted blood flow to the heart.
  • Angioplasty: a procedure for the treatment of narrowed arteries. A balloon-tipped catheter is inserted into an artery, most commonly the coronary arteries, to press plaque back against the vessel wall widening and unblocking the artery to restore blood flow.
  • Artherosclerosis: a disease in which the arteries are hardened and narrowed, due to the gradual build-up of plaque on the inner walls.
  • Arrhythmia: an abnormal heartbeat resulting from a change, deviation or malfunction of the heart’s electrical system. An arrhythmia may be abnormally fast (tachycardia) or abnormally slow (bradycardia).
  • Atrial Fibrillation: a rapid, irregular heart rhythm caused by abnormal electrical impulses that begin in the upper chambers of the heart. As a result, the heart’s lower chambers beat rapidly and irregulary.
  • Cardiac Arrest: the abrupt, immediate stopping of the heart. Without treatment with a defibrillator, sudden cardiac death in unavoidable.
  • Congestive heart failure: a chronic condition where at least one chamber of the heart is not pumping well enough to meet the body’s needs. This leads to congestion in the lungs or pulmonary fluid backup or swelling in the lungs, legs and ankles.
  • Coronary artery disease: a chronic disease in which there is a hardening of the arteries.
  • Echocardiogram: a test that uses sound waves to produce a moving image of the patient’s beating heart on a video screen. Used to study the heart’s thickness, size and function, as well as the motion pattern and structure of the four heart valves.
  • EKG (electrocardiogram): a test that records the hearts electrical activity as a graph.
  • Exercise stress tests: an EKG test that monitors cardiac activity while elevating the heart rate to certain levels through controlled treadmill exercise. Helps to detect heart irregularities, disease and damage.
  • Heart attack: (also known as an MI or myocardial infarction). Scarring or death of heart muscle due to lack of oxygen. Oxygen-rich blood is blocked by a blood clot in a coronary artery, usually due to plaque-related narrowing of the artery.
  • Holter monitoring: a temporarily attached EKG that records the heart’s electrical activity as patients go about their daily routines for 24-hours.
  • Mitral valve prolapse: a condition in which the flaps of the mitral valve are too large and cannot close properly causing blood to leak back through the valve (regurgitation) when it should only flow forward.
  • Nuclear cardiology (nuclear stress tests): imaging tests that introduce tiny amounts of radionuclide substance into the body to emit energy used by cameras to take very clear pictures of the heart.
  • Pacemaker: implanted in the chest, an artificial pacemaker is a battery-powered device that monitors and if necessary, corrects an abnormal heart rhythm by sending electrical charges to the heart.
  • Ventricular fibrillation: a condition where the heart no longer beats but "quivers" very rapidly. A person must receive defibrillation within minutes to survive.

 

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