Cardiology

Overview

Our cardiology physicians are experts in diagnosing and treating heart conditions. We use the most sophisticated tools to diagnose heart and vascular disease in people who may be at high risk, such as those with a family history of heart disease, high blood pressure, high cholesterol or those nearing middle age and worried about a lifestyle that may have affected the heart.

Screening consists of laboratory tests to measure the amount of fats and cholesterol in the blood and a combination of non-surgical imaging technologies that provide physicians a window into the heart.

Conditions

Our cardiology physicians and practitioners specialize in the diagnosis and treatment of many cardiovascular conditions, including: (click on plus sign to view description beneath)

Arrhythmias

An arrhythmia is an abnormal heart rhythm. Some arrhythmias can cause problems with contractions of the heart chambers by:
  • Not allowing the ventricles (lower chambers) to fill with an adequate amount of blood because an abnormal electrical signal is causing the heart to pump too fast or too slow.
  • Not allowing a sufficient amount of blood to be pumped out to the body because an abnormal electrical signal is causing the heart to pump too slowly or too irregularly.
  • Not allowing the top chambers to work properly.

Coronary Heart Disease

Coronary heart disease - the most common type of heart disease - is the number one killer of both men and women in the United States. Coronary heart disease is a disease in which a waxy substance called plaque builds up on the inner walls of the coronary arteries.

Heart failure

Heart failure, also called congestive heart failure, is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the heart's diminished capacity to pump reflects a progressive, underlying condition.

Heart Valve Disorders

Heart valve disorders can arise from two main types of malfunctions:

Regurgitation (or leakage of the valve). The valve(s) does not close completely, causing the blood to flow backward through the valve. The heart is forced to pump more blood on the next beat, making it work harder.

Stenosis (or narrowing of the valve). The valve(s) opening becomes narrowed, limiting the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force in order to move blood through the narrowed or stiff (stenotic) valve(s).

Heart valves can develop both malfunctions at the same time (regurgitation and stenosis). Also, more than one heart valve can be affected at the same time. When heart valves fail to open and close properly, the implications for the heart can be serious, possibly hampering the heart's ability to pump blood adequately through the body. Heart valve problems are one cause of heart failure.

Hypertension

Hypertension or high blood pressure is a serious condition that can lead to coronary heart disease, heart failure, stroke, kidney failure and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.

Lipid Disorders (Cholesterol)

Lipid disorders are the broad term for abnormalities of cholesterol and triglycerides. Lipid abnormalities are associated with an increased risk for vascular disease - especially heart attacks and strokes. Abnormalities in lipid disorders are a combination of genetic predisposition as well as diet. Many lipid disorders are associated with being overweight.

There’s accumulating evidence that management of cholesterol and triglyceride disorders is associated with the reduced risk for heart attacks and strokes.

Vascular Diseases

Vascular disease is a form of cardiovascular disease primarily affecting the blood vessels. Some conditions, such as angina and myocardial ischemia, can be considered both vascular diseases and heart diseases.

Our Services

Cardiovascular Consultations

Individual consultations cover general cardiology conditions and concerns, including chest pain, coronary artery disease, valvular heart disease, hypertension, hypercholesterolemia, preventative cardiology, as well as surgical clearance.

Pacemaker and Heart Device Follow-up

Cardiac devices such as pacemakers or implantable defibrillators require routine, detailed follow-up to assure proper function.

Stress Test

Stress testing provides information about how an individual’s heart works during physical stress. Some heart problems are easier to diagnose when the heart is working hard and beating fast. During stress testing, patients exercise by walking or running on a treadmill or pedal a stationary bike.

Pharmacologic Stress Testing

This noninvasive diagnostic procedure is usually performed on those who are unable to walk on a treadmill. It combines nuclear imaging with a drug that increases demand on the heart to match exercise-type level.

Holter Monitor

The small, portable, battery-powered ECG machine is worn by a person to record heartbeats on tape over a period of 24 to 48 hours during normal activities. At the end of the time period, the monitor is returned to the doctor's office so the tape can be read and evaluated.

Cardiac Catheterization

In cardiac catheterization - also called cardiac cath - a very small hollow tube, or catheter, is guided through the large artery in the groin or arm through the aorta into the heart. Once the catheter is in place, several diagnostic techniques may be used. The tip of the catheter can be placed into various parts of the heart to measure the pressures within the chambers. This test shows narrowings in the arteries, heart chamber size, pumping ability of the heart and ability of the valves to open and close, as well as a measurement of the pressures within the heart chambers and arteries. The catheter can be advanced into the coronary arteries and a contrast dye injected into the arteries.

Electrocardiogram (EKG)

This test records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and can sometimes detect heart muscle damage.

Echocardiogram (also known as echo)

This noninvasive test uses sound waves to evaluate the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound probe is passed over the heart.

Magnetic Resonance Imaging (MRI) of the Heart

This diagnostic procedure uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. MRI of the heart may be used to evaluate the heart valves and major vessels, detect coronary artery disease and the extent of damage it has caused, evaluate congenital defects, and detect the presence of tumors or other abnormalities. The cardiac MRI may be used prior to other cardiac procedures such as angioplasty or stenting of the coronary arteries and cardiac or vascular surgery.

Cardiac CT Scan

This imaging procedure uses an X-ray machine and a computer to create 3-dimensional pictures of the heart. Sometimes a dye is injected into the vein so that the heart arteries can be seen as well.

Interventional Procedures

An interventional procedure is a non-surgical treatment used to open narrowed coronary arteries to improve blood flow to the heart. This procedure can be performed during a diagnostic cardiac catheterization when a blockage is identified, or it may be scheduled after a catheterization has confirmed the presence of coronary artery disease.

Once the catheter is in place, an interventional procedure is performed to open the artery: balloon angioplasty, stent placement, rotablation or cutting balloon.

Angioplasty

Angioplasty is used to open narrow or blocked coronary (heart) arteries to restore blood flow to the heart muscle.

Stenting

A stent is a small mesh tube that's used to treat narrow or weak arteries. It’s inserted in the clogged artery with a balloon catheter. The balloon is inflated and the stent expands and locks in place. This allows the artery to open and allows blood to flow more freely. Doctors also may place stents in weak arteries to improve blood flow and help prevent the arteries from bursting.

Rotablation

A special catheter, with an acorn-shaped, diamond-coated tip, is guided to the point of narrowing in the coronary artery. The tip spins around at a high speed and grinds away the plaque on the arterial walls. This process is repeated as needed to treat the blockage and improve blood flow. The microscopic particles are washed safely away in the blood stream and filtered out by the liver and spleen.

Cutting Balloon

The cutting balloon catheter has a balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, then, the balloon compresses the fatty matter into the arterial wall. This type of balloon may be used to treat the build of plaque within a previously placed stent (restenosis) or other types of blockages.

Genetic Counseling

Testing

Screenings

Ultrasound

Physicians

Locations

Videos

MHC-TV Episode 1 - Heart Health

Heart Health - Episode 1 of the Medical Health Center TV show and how the community is connected through the Medical Health Center in Middletown, its ...

MHC-TV Episode 4 - Heart Health 2

In this episode of Medical Health Center TV, host Dr. Joseph Clemente, interviews Dr. A.J. Shah, a Non Invasive Cardiologist, about Cardiac MRI and 3D ...

Mark Zucker, MD: Heart Failure Treatment and Transplant

Dr. Joseph Clemente, host of MHC-TV, interviews Mark J. Zucker, M.D., J.D., Director, Heart Failure Treatment and Transplant Program at Newark Beth ...

Dr. Dobrescu is interviewed about Heart Disease

Delia Dobrescu, M.D., is interviewed by host, Dr. Joseph Clemente, about symptoms of heart disease, the testing available, as well as info on ...

Medical Minute RN -- Heart Health/Women

Registered Nurse, Meghan, describes the usual protocol at the Medical Health Center in Middletown, NJ if a woman were to come in with chest pain. ...

Healthy Eating: Tilapia with Rice and Peppers

This 600 calorie meal is demonstrated by host Dr. Joseph Clemente, it's his recipe and it¹s outstanding as well as simple to make, 25-30 minutes. ...

Healthy Eating - Zucchini Pasta with Sauteed Cheese

Host Dr. Joe, cooks up his delicious Zucchini Pasta with Sauteed Cheese. His taste tester, Gus, is standing by, see if Joe get's a high five from Gus. ...