Cardiology

Cardiology Services

Our focus at UTMB is to provide you with the best possible care. We call the system academic cardiology–the dynamic integration of research, patient care, and education. We deliver the most appropriate care in each and every case. This means that we do not perform unnecessary tests or procedures and that when intervention is necessary due to progression of the condition, we are swift to assist you with skill, compassion and great expertise.

The services we provide can be categorized in four broad categories:

Non-Invasive Cardiology, including general cardiology, cardiac imaging, consultative and inpatient cardiology;
Invasive and Interventional Cardiology, offering the state of the art care for patients with coronary artery disease (CAD) and chest pain;
Heart Failure, Heart Transplant, and LVAD, offering comprehensive care for patients with weakened hearts; and
Heart Rhythm Center, offering a state-of-the-art electrophysiology lab and much more.

Below are additional services offered by the UTMB Health Division of Cardiology:

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Cardiac Imaging Service
- Transthoracic echocardiography
- Transesophageal echocardiography
- Three-dimensional echocardiography
- Stress echocardiography
- Dobutamine stress echocardiography
- Adenosine nuclear perfusion scan
- Cardiac CT angiography
- Cardiac MR imaging
General Cardiology Services
- Preventive cardiology
- Consultative cardiology
- Second opinion on complex cardiac diseases
- Inpatient cardiology
- Cardiac rehabilitation
- Electrocardiography
- Holter EKG
- Event monitoring
- Medical clearance prior to surgery
Heart Failure Service
- Aquapheresis
- Remote heart failure assessment
- Right heart catheterization
- Intraaortic balloon pump insertion
- Impella insertion
- Myocardial biopsy
- Heart transplantation
- Left ventricular assist device
Heart Rhythm Center Service
- Pacemaker implantation
- MRI-compatible (Revo) pacemaker implantation
- Internal cardioverter-defibrillator (ICD) implantation
- Remote pacemaker and ICD monitoring
- Cardiac resynchronization device (CRT) implantation
- Implantable loop recorder implantation
- Tilt-table test
- Electrophysiology test
- Cardioversion
- Supraventricular tachycardia ablation
- Atrial-flutter ablation
- Atrial-fibrillation ablation
- Ventricular tachycardia ablation
Invasive and Interventional Cardiology Service
- Right heart catheterization
- Intraaortic balloon pump insertion
- Impella insertion
- LifeBridge extra-corporeal membrane oxygenator (ECMO) insertion
- Intravascular ultrasound
- Optical coherent tomography (OCT) of the coronary artery
- Fractional flow reserve measurement
- Balloon angioplasty
- Stent implantation
- Intervention of chronic total occlusion (CTO)
- Intervention of in-stent restenosis (ISR)
- Rotational atherectomy
- Alcohol septal ablation
- Atrial septal defect closure
- Patent foramen ovale closure
- Trans-septal catheterization
- Foreign body removal
- Coil embolization of arteriovenous fistula
Pediatric Cardiology Services
- Pediatric Cardiology provides clinical services to children with suspected heart defects from birth to late adolescence
- We also have a fetal cardiology program in collaboration with Maternal and Fetal Medicine that provides fetal echo cardiography and counseling to expectant mothers with suspected congenital heart defects
- We continue to provide both inpatient and out-patient service to our patients at the UTMB campus as well as in League City
- We provide most of necessary cardiac testing in out-patient setting (EKG, Echo, cardiac monitors and stress testing, etc.)
- We provide telemedicine to referring physicians and hospitals
- We are committed to teaching and training of our medical students and pediatric residents
Peripheral Artery Disease Service
- Carotid stenting
- Peripheral artery intervention for intermittent claudication
- Orbital atherectomy
- Renal artery stenting
- Subclavian artery stenting

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Heart Conditions & how we treat them

Common Heart Conditions

Conditions / Procedures

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Arrhythmia
Overview:
Cardiac Arrhythmia is a condition in which electrical impulses in the heart don’t work properly and cause an irregular or abnormal heart rhythm.
Symptoms may include:
- a fluttering in the chest
- chest pain
- fainting
- dizziness
- there may be no symptoms
Treatment/procedure options:
Treatments vary for arrhythmia, but often can include prescription drugs, medical procedures, implantable devices, and surgery.
High blood pressure
Overview:
High blood pressure (also referred to as HBP, or hypertension) is when your blood pressure, the force of blood flowing through your blood vessels, is consistently too high.
When left untreated, the damage that high blood pressure does to your circulatory system is a significant contributing factor to heart attack, stroke and other health threats.
Symptoms may include:
- High blood pressure is a “silent killer” as most often there are no obvious symptoms.
Treatment/procedure options:
Treatments include Self-care (change of diet, exercising regularly, quitting smoking) and prescription medications to help lower blood pressure.
Rheumatic heart disease
Overview:
Rheumatic heart disease is a condition where the heart valves have been permanently damaged by rheumatic fever. Untreated or under-treated strep infections can increase the risk for rheumatic heart disease. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease.
Tests used to diagnose rheumatic heart disease vary, but most often are echocardiogram (echo), electrocardiogram (ECG), chest x-ray, cardiac MRI, or certain blood tests.
Symptoms may include:
- shortness of breath
- chest pain
- swelling
Treatment/procedure options:
Treatments may include surgery to replace or fix the badly damaged heart valve. The best treatment is to prevent rheumatic fever with antibiotics and anti-inflammatory medicines.

Early Heart Attack Care

Damage to the heart muscle, and even death, can be prevented with early detection of symptoms before a major heart event occurs.

The most important parts to early heart attack care are:

RECOGNITION AND RESPONSE

Recognition of early warning signs are key to saving a life
Responding by encouraging/calling for immediate medical care can prevent heart damage and avoid sudden death.
If you see a person collapse and they have no pulse, call 9 1 1, perform hands only CPR, and have help retrieve an AED (if available)

Heart Rhythm Program

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Atrial fibrillation

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications.

Symptoms may include: shortness of breath, palpitations, fatigue, or there may be no symptoms with this disease.
Cardiac ablation

Cardiac ablation (or catheter ablation) is a procedure that uses energy, either heat or extreme cold, to destroy or scar a small area of heart tissue that is causing rapid and irregular heartbeats.
Electrophysiology Study

An electrophysiology (EP) study test the electrical activity of your heart to find where an arrhythmia (abnormal heartbeat) is originating. These results can help you and your doctor decide whether you need medicine, a pacemaker, an implantable cardioverter defibrillator (ICD), cardiac ablation or surgery.
Holter monitoring

A Holter monitor is a type of electrocardiography device, a portable device for cardiac monitoring (the monitoring of the electrical activity of the cardiovascular system) for at least 24 to 48 hours (often for two weeks at a time).

The Holter's most common use is for monitoring heart activity (electrocardiography or ECG). Its extended recording period is sometimes useful for observing occasional cardiac arrhythmias which would be difficult to identify in a shorter period. For patients having more transient symptoms, a cardiac event monitor can be worn for a month or more.
Interventional cardiology

Interventional cardiology is the subspecialty of cardiology that deals specifically with the catheter- based treatment of heart diseases. The field includes the diagnosis and treatment of coronary artery disease, vascular disease and acquired structural heart disease.

Common procedures include angioplasty, aortic valve repair, cardiac ablation, electrophysiology studies, pacemaker insertion, monitoring devices and Watchman procedures.
Pacemakers

A cardiac pacemaker is a medical device that generates electrical impulses delivered by electrodes to cause the heart muscle chambers to contract and therefore pump blood; by doing so this device replaces and/or regulates the function of the electrical conduction system of the heart.

The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow a Cardiologist, particularly a Cardiac Electrophysiologist to select the optimal pacing modes for individual patients.
Watchman device

The Watchman device is a small implant placed in to the heart that can reduce the risk of stroke in patients with atrial fibrillation. Patients with atrial fibrillation are at increased risk of stroke, mainly due to clots that form in a small chamber in the top of the heart known as the left atrial appendage.

The Watchman implant is a minimally invasive, one-time procedure designed to reduce the risk of strokes that originate in the left atrial appendage.

Cardiothoracic Surgery

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Atrial Septal Defect (ASD)

A "hole" in the wall that separates the top two chambers of the heart. This defect allows oxygen-rich blood to leak into the oxygen-poor blood chambers in the heart. ASD is a defect in the septum between the heart's two upper chambers (atria). The septum is a wall that separates the heart's left and right sides.

If the opening is small, surgery or other treatments may not be needed. Most large atrial septal defects now can be closed either with open-heart surgery or during a cardiac catheterization using a device inserted into the opening to plug it. However, if the ASD is in an unusual position within the heart, or if there are other heart defects such as abnormal connections of the veins bringing blood from the lungs back to the heart (pulmonary veins), the ASD cannot be closed with the catheter technique. Then surgery is needed. Even when the defect is discovered in adulthood, patients benefit from closure of large defects.
Heart Failure Service
- Aquapheresis
- Remote heart failure assessment
- Right heart catheterization
- Intraaortic balloon pump insertion
- Impella insertion
- Myocardial biopsy
- Heart transplantation
- Left ventricular assist device

In the Health Blog

image of individual lying on ground while another person performs CPR

Cardiac Arrest - What you need to know

January 11, 2023 • 4:17 p.m. by Dr. Ashraf Aly and Houston Moms

In the wake of the cardiac arrest episode experienced by NFL player Damar Hamlin, UTMB pediatric cardiologist Dr. Ashraf Aly took some time out to visit with our friends at Houston Moms to answer some important questions surrounding the heart and how it works.

Living with Heart Failure

February 14, 2022 • 8:00 a.m.

While heart failure is a serious condition, it’s still possible to live a full and active life with the right medical treatment and lifestyle, and Heart Failure Awareness Week serves as a time to promote heart failure awareness, education and prevention.