Medical School University of New England College of Osteopathic Medicine, Biddeford, ME Residency Internal medicine, Baystate Medical Center, Springfield, MA Undergraduate University of New England, Biddeford, ME
Cardiovascular magnetic resonance imaging, or Cardiac MRI is a state-of-the-art technique for taking pictures of the heart. It is an imaging modality that can be used to supplement other imaging modalities such as echocardiography and Cardiac CT, but with better accuracy and more detail.
The study is done by asking a patient to lie flat in a strong magnet. One of the more significant patient benefits is that no radiation is used in the study. The magnet emits radio frequency pulses. Based upon the interaction of the impulses, the molecules in the heart and the magnetic field, images are acquired of the heart and displayed on a computer. Using special software, those images are manipulated to provide information about the patient's heart. Most patients are given a contrast agent through an IV which enhances the image quality and helps increase diagnostic yield. Tissue characteristics of Cardiac MRI are excellent and, as a result, the heart muscle can be closely evaluated for abnormal thickness or cardiac anatomy.
Cardiac MRI can also be used to measure the extent of damage, or scar, within the heart muscle that may result from a heart attack. Inflammation of the heart muscle such as myocarditis or pericarditis can be seen in Cardiac MRI as well.
The Central Maine Heart and Vascular Institute's Vascular Lab uses non-invasive vascular measures to diagnose conditions and abnormalities of the circulatory system, including blood vessel blockages and aneurysms.
The Vascular Lab is accredited by the Intersocietal Commission for the Accreditation of Vascular Laboratories. The lab's sonographers are nationally certified.
Recording someone's blood pressure over a 24-hour period may be done to help diagnose patients experiencing borderline high blood pressure, uncontrollable blood pressure, blood pressure problems caused by medications, pregnancy accompanied by high blood pressure, or fainting spells.
A 24-hour blood pressure monitor is a small digital device that records blood pressure readings while an individual is at home, work or participating in day-to-day activities. This information shows how environmental factors impact an individual's cardiovascular system, including "white-coat hypertension" experienced by those who only have high blood pressure at the doctor's office.
Patients are asked to keep a diary of their activities, so the doctor will know when patients were active and when they were resting.
An abdominal ultrasound is a painless test that provides information about internal organs and blood vessels within the abdomen.
Sound waves are used to produce images. The ultrasound may be prescribed for patients with kidney, liver, gallbladder, appendix, pancreatic, spleen or arterial issues.
The exam may take up to an hour. Patients recline while the technician uses a wand and gel to transmit soundwaves, which are then recorded as images.
Ankle-brachial index (ABI) testing measures blood pressure in the arms and legs for comparative analysis. The ratio of the two measurements can indicate if there is a blood flow problem in the legs.
ABI testing is a non-invasive flow study (NIFS) used to diagnose claudication, experienced as pain while walking, may be caused by peripheral arterial disease (PAD). PAD, a form of atherosclerosis, causes arteries to narrow and leg muscles to receive less blood, and therefore less oxygen.
Diagnosing this condition is important, as it may precede cardiovascular issues, including heart attack or stroke.
The test takes 45 minutes to an hour. No special preparation is needed.
An arterial duplex ultrasound is used to evaluate issues involving arteries and/or veins of the arms and/or legs.
This painless, non-invasive procedure uses sound waves to gather information. Blood flow is measured and images of the blood vessels are taken. The technician transmits sound waves with the use of a wand that is gently passed over the areas being studied. The procedure takes about an hour.
Carotid duplex ultrasound is a simple and painless procedure that allows doctors to evaluate the carotid arteries in the neck. These major arteries supply blood to the brain. When blood flow to the brain is insufficient, a stroke and/or death are possible.
The ultrasound may reveal blood clots (thrombosis), narrowing of the arteries (stenosis), or other blockages. The ultrasound uses sound waves to produce images of the blood vessels so blood flow can be evaluated.
xSegmental pressure testing is similar to ankle-brachial index (ABI) testing, but involves two or three additional blood pressure cuffs. These are placed just below the knee, just above the knee, and at the upper thigh. Blood pressure at each point is recorded. Significant drops between body segments may suggest blockages or narrowing in the arteries.
Segmental pressure testing is a non-invasive flow study (NIFS) used to diagnose claudication, experienced as pain while walking, may be caused by peripheral arterial disease (PAD). PAD, a form of atherosclerosis, causes arteries to narrow and leg muscles to receive less blood, and therefore less oxygen.
Diagnosing this condition is important, as it may precede cardiovascular issues, including heart attack or stroke.
The test takes 45 minutes to an hour. No special preparation is needed.
Venous Ultrasound Imaging capture real-time images of the inside of the body. Venous ultrasound, in particular, looks at blood flow through veins in the arms or legs.
Ultrasound is easy-to-use, less expensive than other imaging methods, and does not emit any ionizing radiation. For standard diagnostic ultrasound there are no known harmful effects on humans.
Venous ultrasound studies are used to evaluate varicose veins; assist in the placement of a needle or catheter into a vein; evaluate veins in the leg or arm for potential use for bypassing a narrowed or blocked blood vessel (graft); and examine a blood vessel graft.
Venous ultrasound is used to search for blood clots, especially in leg veins. Often called deep vein thrombosis, or DVT, these clots can cause a dangerous condition called pulmonary embolism if they move to the lungs. However, if a blood clot in the leg is detected early enough, proper treatment can prevent it from passing to the lung.
A doctor specifically trained to supervise and interpret imaging examinations (radiologist) analyzes the ultrasound results and sends a report to the patient's primary care provider and/or to the physician who referred the patient for the exam.
Central Maine Medical Center has received the American Heart Association/American Stroke Association's Get With The Guidelines ® Target: Stroke Honor Roll Gold Plus Quality Achievement Award. The award recognizes the hospital's commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.
It was the second straight year that CMMC earned the award by meeting specific quality achievement measures for diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines, with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.
“CMMC is dedicated to improving the quality of care for our stroke patients by implementing this stroke initiative,” said Dr. David Tupponce, president of the hospital and executive vice president of Central Maine Healthcare. “The tools and resources provided by the American Heart Association help us track and measure our success in meeting clinical guidelines and improving patient outcomes.”
Last year, CMMC won accreditation from the Joint Commission for advanced primary stroke care.
In addition to the Get With the Guidelines honor, CMMC also received the association's Target: Stroke SM Honor Roll award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient's arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA , the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke .
“We are pleased to recognize Central Maine Medical Center for their commitment to stroke care,” said Lee. H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services at Massachusetts General Hospital. “Research has shown that hospitals adhering to clinical measures lower mortality rates.”
According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.
