Expert cardiologists in southern New Hampshire
Our skilled cardiologists and heart surgeons specialize in diagnosing and treating a wide variety of heart conditions at Appledore Medical Group.
Cardiovascular disease care
At Appledore Medical Group, our expert cardiologists and heart surgeons are experienced in diagnosing and treating a range of heart conditions.
From common conditions like high cholesterol to more complex conditions such as coronary disease, our specialized heart teams provide advanced heart care to patients in Rockingham County.
Before visiting one of our locations that offers services for heart disease, please view our patient health forms.
Our heart specialists understand that learning about heart disease can be overwhelming. That's why we offer compassionate, comprehensive heart care in a patient-centered atmosphere, while communicating with patients to ensure all of their questions are answered.
Our experienced cardiologists are equipped to treat a variety of heart diseases, including:
- Atrial fibrillation
- Cardiac tumors
- Congenital heart disease
- Coronary artery disease
- Coronary heart disease
- Thoracic-aortic diseases
- Valve diseases
Heart disease treatment
Our cardiovascular specialists are equipped to provide a variety of services to treat heart disease.
Common treatments include:
- Lifestyle changes as directed by a doctor
- Medications for heart disease
- Heart and vascular surgery
Heart disease causes
Heart disease is usually caused when plaque builds up in the arteries or blood vessels that connect to the heart, however, the reason for this build-up can vary.
There are several knock risk factors that can increase the likelihood of heart disease, such as:
- Age (women 55 years old and older and men 45 years old and older are at a higher risk)
- High cholesterol
- Physical inactivity
- Poor diet
- Obesity and morbid obesity
- Smoking
Heart disease symptoms
Although symptoms may vary from person to person, some symptoms of heart disease may include:
- Chest pain or tightness
- Pain or numbness in the arms or legs
- Pain in the jaw, neck or throat
- Shortness of breath
It is important to note that some of these symptoms may also be a sign of a heart attack.
If you think someone is having a heart attack, call 911 immediately.
Diagnosing heart disease
Interventional cardiology is a minimally invasive approach to diagnose, evaluate, and treat cardiac, valve and vascular disease. Most procedures, ranging from heart function tests to the replacement of a diseased valve, are completed through a small, hollow tube called a catheter. This catheter is placed in an artery and expertly guided into the diseased area. Procedures performed by interventional cardiologists are usually short and require a minimal hospital stay.
We have a 24/7, highly-trained cardiac team to perform life-saving interventions for those experiencing heart attack or cardiac arrests. The interventional cardiologists performing procedures are among the most skilled in the region, using leading-edge treatments for heart and valve diseases, including: TAVR and TEER.
Extensive care for coronary artery disease (CAD)
Typically, CAD patients with one or more of the following risk factors fit this description:
- Diabetes
- Chronic kidney disease
- Increased age
- COPD
- Peripheral vascular disease
- Calcium buildup and thickening in the vessels
- Unable to tolerate coronary artery bypass graft (CABG)
Highly specialized treatments are available for patients with complex coronary artery disease, including atherectomy, left ventricular-assisted percutaneous coronary intervention (PCI), and intravascular lithotripsy (Shockwave IVL).
Treatment options for CAD
Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI)
A percutaneous coronary intervention for chronic total occlusion (CTO PCI) treats patients who have a 100% blockage in one of their coronary arteries. This severe plaque buildup occurs over time in a condition called atherosclerosis. About 10-15% of patients with coronary artery blockages have 100% blocked arteries. CTO PCI is a complex procedure that is performed by only 1-2% of interventional cardiologists in the US. Often patients are advised to undergo open heart bypass surgery or are treated with medications alone. Left untreated, the blockage may cause significant chest discomfort, shortness of breath, lower quality of life and potentially decrease heart function.
CTO PCI is a complex procedure that utilizes similar catheters through the wrist or groin artery. It differs from routine PCI in that, often, two catheters are placed in two different locations. In addition, specialized equipment is used to get through, or around your body’s small bypasses to get the blockage open. This procedure take an average of three-four hours and patients are typically monitored overnight in the hospital.
CTO PCI is an evolving field within Interventional Cardiology. In the United States, only a small number of centers have teams trained to perform the full spectrum of techniques to maximize success rate.
Atherectomy
An atherectomy is a procedure used to remove plaque from a coronary artery. It is a minimally invasive approach that uses a catheter inserted into one of the blood vessels. The catheter is fed to the heart and once it reaches the area of plaque blockage, a small laser or a tiny blade is used to cut away the plaque. This technique may be followed by an angioplasty or stent. Typically, patients will be kept overnight and may return home the following day.
LVAD High Risk PCI
When the heart needs additional support during angioplasty or stenting, a left ventricular assist device (LVAD) may also be used. This pump increases the heart’s ability to move blood.
LVAD High Risk Atherectomy
In this type of atherectomy, a left ventricular assist device (LVAD) is used. This allows greater cardiac output for those with a weaker heart and helps the heart pump blood better. It is typically used in high risk cases to provide enough time for the procedure to be completed.
Therapies to lower cardiovascular risk
Our multidisciplinary team of cardiovascular experts is dedicated to reducing your cardiovascular risk and enhancing your overall health. We offer personalized, comprehensive care for those looking to decrease their chances of developing or worsening cardiovascular disease.
Heart disease is the leading cause of death for both men and women worldwide. Early diagnosis and treatment can significantly lower your risk and prevent the progression of cardiovascular issues.
Cardiometabolic risk refers to the likelihood of experiencing a cardiovascular event, such as a heart attack or stroke, due to one or more cardiovascular risk factors. It also applies to individuals who established cardiovascular disease who continue to remain at risk.
Cardiometabolic Risk Factors
Several conditions can raise your risk for heart attack, stroke and death. Common risk factors that increase the likelihood of cardiovascular disease include:
- High blood pressure
- High cholesterol
- Diabetes
Other risk factors include:
- Obesity
- Inflammation
- Smoking
- Lack of physical activity
Personalized treatment plans
Many cardiometabolic risk factors are controllable and may even be reversible. Primary care providers, cardiologists and endocrinologists are skilled in managing these conditions.
Recommendations may include lifestyle changes as well as medications that can help lower your risk.
Cardiometabolic Medicine
Cardiometabolic medicine is a unique approach to the treatment of these conditions, combining their management into one program. It is typically multidisciplinary, including providers that are experts in cardiovascular risk reduction, diabetes and cholesterol management. When appropriate, we partner with other specialists to further reduce risk in patients. These may include (but do not replace your primary care provider):
- Endocrinologists
- Weight loss/bariatrics
- Exercise physiologists
- Nutritionists
- Sleep medicine
- Vascular surgeons
