The heart is evaluated at rest and during exercise using a small amount of radioisotope during the noninvasive procedure. A complex imaging technique, nuclear cardiology testing relies on the experience and training of both the physician and the technologist. Their interpretive and technical abilities determine the diagnostic accuracy of the examination. The Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL) has developed an accreditation program that evaluates the quality of these and other critical elements of a nuclear cardiology laboratory.

The Heart and Wellness Institute, Nuclear Medicine located in Grand Rapids, MI, was granted accreditation by the ICANL. The laboratory is one of a growing number of nuclear cardiology laboratories in the United States, Canada and Puerto Rico to be so recognized for its commitment to high quality patient care and its provision of quality diagnostic testing.

The ICANL was established with the support of the American Society of Nuclear Cardiology, the Society of Nuclear Medicine, the Society of Nuclear Medicine Technologist Section, the American College of Cardiology, the American College of Nuclear Medicine, the Academy of Molecular Imaging, and the American Society of Radiologic Technologists. The ICANL provides a peer review mechanism to encourage and recognize the provision of quality nuclear cardiology and nuclear medicine diagnostic evaluations by a process of voluntary accreditation. A non-profit organization, the ICANL is dedicated to ensuring high quality patient care and to promoting health care.

Participation in the accreditation process is voluntary. Accreditation status signifies that the facility has been reviewed by an independent agency that recognizes the laboratory’s commitment to quality testing for the diagnosis of heart disease.

For more information on the February 25th Go Red For Women event, please visit the Circle Of Red Website.

The Heart and Wellness Institute is recognized as the premier institute in West Michigan for delivering specialized care in Women’s Heart Disease and Prevention.

Did you know that over 100 million Americans are affected by abnormal cholesterol, and 12 million are on medication for it? That’s millions of people having unnecessary side effects. If you have abnormal cholesterol, just a few simple lifestyle modifications will help minimize your medications, or eliminate them. We can work with you and your healthcare provider to make conquering cholesterol a reality for you. This is a great place to start. Bookmark this site and check back often for helpful updates and advice for ways you can make lasting changes to your health and wellness.

Heart disease is the number one disease that affects us as women. In fact, it’s our number one killer. One out of two of us will die of heart disease. This means it could be you, your mom, your sister, or your best friend. Don’t let this be you or your loved ones. Heart disease is preventable, if you know what to look for. You may have typical symptoms of chest pain, neck pain, jaw discomfort, or arm pain, but many times women have atypical symptoms like nausea, vomiting, abdominal discomfort, or hot flashes. So if you have symptoms you cannot explain, talk to your healthcare provider and get an evaluation for heart disease. It could save your life.

Heart disease is the number one killer of us as Americans, but it doesn’t have to be. Heart disease is preventable. If you know what to look for, that’s the key. If you have symptoms of chest pain, neck pain, and jaw discomfort, these are signs of heart disease. Or if you have nausea, vomiting, heartburn, back discomfort, or other symptoms you cannot explain, contact your healthcare provider. These may be signs of heart disease. At the Heart + Wellness Institute, we can work with you and your healthcare provider to stop this number one killer.

Wednesday, March 17 at 7 PM

314 S. Hudson Road, Lowell, MI 49331
(the Lowell Community Wellness Center/Gilda’s Place)

When the left ventricle contracts, in addition to sending blood out the aorta, it sends oxygenated blood through the defect to the right ventricle. In the right ventricle, this oxygenated blood mixes with the normal unoxygenated blood coming back from the body and then it is all pumped to the lungs. The result is more blood than normal is pumped to the lungs and, in turn, more blood than normal returns from the lungs to the left atrium and left ventricle. If the hole is more than small, then this increase in blood returning to the left atrium and left ventricle causes these chambers to enlarge and work harder than normal. If the enlargement is significant, then the left ventricle may not function efficiently and blood can back up into the lungs. This may lead to signs of congestive heart failure. In addition, large ventricular septal defects can lead to increased blood pressure in the arteries in the lungs (called pulmonary hypertension) and may eventually lead to damage in the small arteries in the lungs.

What are the warning signs and symptoms of ventricular septal defect?
There are often no obvious signs or symptoms of a ventricular septal defect in a newborn infant. After several days or weeks, the following may appear and suggest the presence of a VSD:

• Abnormal heart murmur
• Labored breathing
• Poor feeding
• Poor growth

How is ventricular septal defect detected?
Often the first sign of a ventricular septal defect is the presence of an abnormal heart murmur. This often leads to the performance of an echocardiogram, which generally will show the precise anatomy of the defect as well as its size and effect on the heart function.

What are the treatment options for ventricular septal defect?
Ventricular septal defects are small and most of these will get even smaller or close by themselves. A medium-sized ventricular septal defect may need to be closed surgically but it is often possible to wait several years to see if the VSD will get smaller on its own. Small VSDs often never need treatment. If the VSD, however, is large enough to cause the left ventricle to be enlarged and there are no signs that the hole is getting any smaller, surgery is generally recommended. Large ventricular septal defects will require surgical closure, the timing of which depends on the degree of symptoms. Symptoms often can be improved by giving the infant medication such as:

• Diuretics, which decrease the amount of fluid retention in the body by increasing urine output
• Digoxin, which helps the heart pump more efficiently
• After-load reducing medicines, which improve the forward flow of blood from the left ventricle to the aorta

If, in spite of medication, the infant is still symptomatic, then surgery will be necessary. If the symptoms are improved but the hole is large, then a short period of observation is possible to see if there are any signs that the hole is getting smaller. Recently, some ventricular septal defects have been closed in the cardiac catheterization laboratory with devices that are undergoing research.  The vast majority still require surgical closure, however.

The above mentioned cardiac malformations are: ventricular septal defect, pulmonary stenosis, right ventricular hypertophy, and overriding aorta. For practical purposes, however, the signs and symptoms of tetralogy of fallot depend on the ventricular septal defect and the degree of pulmonary stenosis. The VSD is a large hole in the wall between the ventricles. Pulmonary stenosis is a narrowing in the outlet from the right ventricle to the pulmonary artery. With more severe degrees of pulmonary stenosis, the right ventricle delivers less and less blood to the arteries to the lungs for oxygenation. With increasing degrees of pulmonary stenosis, more and more of this blue blood (lacking oxygen) is directed away from the lungs, through the ventricle septal defect, and back to the left ventricle and out to the body. Thus, as the pulmonary stenosis becomes increasingly narrowed, the patient becomes more blue.

What are the warning signs and symptoms of tetralogy of fallot?
The most common warning signs and symptoms of tetralogy appear in a newborn or young infant and include bluish coloring around the mouth, lips, tongue, and fingertips (called cyanosis) and presence of a heart murmur.

Occasionally, early on, the degree of pulmonary stenosis will be very mild and the symptoms will be that of a ventricular septal defect, including labored breathing, poor feeding, and poor weight gain.

How is tetralogy of fallot detected?
Usually tetralogy patients are initially referred for evaluation because of a heart murmur or cyanosis. This leads to performing an echocardiogram and the diagnosis of tetralogy is documented. Occasionally, a cardiac catheterization with angiography is needed prior to surgery to obtain more detailed anatomical information.

What are the treatment options for tetralogy of fallot?
Patients with tetralogy of fallot generally undergo surgery in infancy. Most often a complete repair is performed with patch closure of the ventricular septal defect and widening of the outflow from the right ventricle to the pulmonary artery. Occasionally, it is too dangerous to perform open-heart surgery on a particular infant and a temporizing surgery is performed called a shunt, which allows more blood to flow to the lungs. The open-heart repair is then deferred until the patient gets bigger. Sometimes, infants will have periods of inconsolable crying accompanied by a severe increase in cyanosis (called “Tet Spells”) requiring immediate notification to the child’s physician.

A heart attack can damage heart tissue causing your heart to misbehave electrically. Abnormal and dangerously fast electrical signals, or arrhythmias, limit your heart’s ability to pump blood to the body and brain. This can also occur for no known reason.

Risk Factors
Most patients have no obvious symptoms of SCD so it is important to be familiar with the possible risk factors. Risk factors may include:

• Previous heart attack: A heart attack is a mechanical problem with the plumbing of your heart. A blockage in one of the arteries nourishing your heart prevents blood and oxygen from reaching your heart muscle, therefore part of your heart tissue dies.
• Impaired pumping function of the heart muscle: The pumping function of your heart or “ejection fraction” after a heart attack may be impaired. This is due to scarring of the tissue of your heart due to the heart attack.
• Rapid heart rhythms: You could experience a very brief period of short bursts of fast heartbeats called non-sustained ventricular tachycardia (VT). These rapid heartbeats may or may not be noticeable to you. Non-sustained VT is often the precursor to SCD.
• Family history of heart arrhythmias.

Early identification is key. If you are at risk it is important to talk to your doctor.

Diagnosis
If you have had a heart attack, your doctor may perform one or more of the tests below to make a diagnosis.

• Echocardiogram – The echocardiogram will determine your heart’s pumping function or “ejection fraction”. During this test, ultrasound waves are bounced off your heart muscle to provide a moving image. Based on the results of this test your doctor will determine if further testing is needed.
• Holter monitoring – A holter monitor is an external monitor that is worn on a 24-hour outpatient basis. The monitor records your heart’s electrical activity including any episodes of arrhythmia. Your doctor will analyze the recording to see if there are any abnormal rhythms, either rapid or slow or irregular.
• Electrophysiology (EP) testing – EP testing is commonly conducted in an electrophysiology lab. Wires will be threaded from your groin up into your heart. Then, an electrical stimulus will be delivered through the wires in an attempt to excite your heart into a fast rhythm. If your heart is stimulated into VT, medications will be administered intravenously to try and suppress the arrhythmia. While you are on the medications, the stimulus will be delivered again to see if your heart can still be induced into VT.

A stroke can be categorized in one of two ways: 1) ischemic stroke which is caused by the buildup of fatty deposits (plaque) in a brain artery or by a blood clot which blocks blood flow in a brain artery and 2) hemorrhagic stroke which is caused by a sudden rupture of an artery that leads to the brain. When blood flow to the brain ceases, the brain receives no oxygen. This can cause temporary or permanent brain damage, and with time, can result in death.

What are the warning signs and symptoms of a stroke?
A stroke can have several different symptoms. Do not ignore them- every second counts. When treated early, your chance of survival increases and the likelihood of permanent brain damage decrease.

Be aware of the following symptoms and signs of stroke:

• Difficulty feeling or moving on one side of the body
• Slurring or trouble speaking
• Brief episode of a weakness of an arm or leg
• Momentary loss of vision
• Darkening of the vision in one eye
• A shade or curtain coming down over one eye
• Dizziness or confusion
• Faint (syncope) or feeling faint

Do not ignore the warning signs of a stroke. If you or someone you know is experiencing any of the above symptoms, immediately call 9-1-1 to get to emergency hospital care as quickly as possible.

How is a stroke detected?
A stroke is usually detected too late.  That is, when a patient reaches the emergency room. However, if you experience early symptoms of a stroke, there are imaging tests that can determine if you are having a stroke or need treatment to prevent one.

Stroke is a progressive disease caused by several cardiovascular risk factors. These include family history of stroke, old age, diabetes, smoking, high blood pressure, high cholesterol, overweight, lack of exercise, and stress. We invite you to take a simple and free risk assessment to evaluate your own risk factors.

If you are at risk for stroke (e.g. have multiple risk factors), talk to your physician. He or she can perform imaging tests to detect cardiovascular disease early and prevent a stroke. These imaging studies include:

• Carotid Duplex Scan (ultrasound)
• Computed Topography (CT) Scan
• Magnetic Resonance Imaging (MRI)

What are the treatment options for a stroke?
The best medicine for treatment of stroke is prevention. This means making lifestyle changes to reduce your cardiovascular risk factors. A stroke occurs when fatty deposits (plaque) build up inside the arteries leading to your brain. This is called peripheral vascular disease, and is progressive–meaning the plaque accumulates over time. But if you modify your risk factors that contribute to peripheral vascular disease (and coronary artery disease as well), you can maintain, and in some cases, reverse the effects of the disease.

Should you or someone you know have a stroke, a treatment plan will be developed specific to the severity of your condition. Your doctor will monitor your health carefully to prevent further brain damage. Then your doctor may recommend therapy to deal with consequences of stroke. This may include physical, speech and occupational therapy.