Cardiology Department

2750 Broadway Ave., Boulder, CO  80304

303-440-3057

Technological advances have made the evaluation of cardiovascular disease safer, faster, and more reliable. The Boulder Medical Center is able to offer a comprehensive range of diagnostic and therapeutic procedures for the heart patient.

Providers

• Hilary Clark, PA
• Matthew Holland, MD

Diagnostic Procedures

Electrocardiography

The electrocardiogram (ECG) is a simple test used in the diagnosis and therapy of many cardiac conditions and provides essential information about a patient's condition and progress. The ECG is a graphical representation of the electrical activity of the heart. As such, it can tell us such information as where an electrical impulse originated, if a rhythm is regular, and if damage to the heart muscle exists.

Echocardiography

Echocardiography is one of the most important non-invasive techniques for the assessment of cardiovascular disease. It is quick, safe for the patient and provides reliable clinical information. Cardiac ultrasound uses high frequency sound waves to create images of both cardiac valve structure and wall motion while the heart is beating. Information gleaned can pinpoint specific abnormalities and furnish direction for further diagnostic studies and treatment. A state-of-the-art cardiac ultrasound machine, providing 2-D and M-Mode imaging as well as pulsed wave, continuous wave and color flow Doppler imaging is utilized. Reports are faxed to referring physicians on the same day of the procedure.

Exercise Tolerance Testing

A variety of exercise tolerance tests are administered at the Boulder Medical Center to evaluate the heart's response to exercise. Exercise increases the oxygen demand on the heart by making it pump faster and move vigorously. Cardiovascular abnormalities not present at rest, such as ECG abnormalities, blood pressure alterations or rhythm disturbances are often elicited following exercise. Also, the amount of blood flow through the coronary arteries and muscular responses to exercise can be assessed by this technique. Stress echocardiograms determine the adequacy of blood flow to the heart muscle under rest and exercise conditions. Furthermore the function of the heart chambers, valves and muscle during exercise can also be ascertained by exercise tolerance testing.

Nuclear Cardiology

Nuclear Imaging utilizes low dose radioactive tracers for the detection and assessment of coronary heart disease. Nuclear exercise tests using thallium or technetium sestamibi tracers provide greater diagnostic accuracy than standard exercise tolerance tests by more accurately assessing the adequacy of the blood supply to the heart muscle. The exposure associated with a radioactive tracer study is very low level and approximates the exposure of a person living one mile above sea level (e.g. Denver) over a 5-year period.

Cardiac Catheterization

Cardiac Catheterization is an invasive procedure allowing the cardiologist to accurately and precisely evaluate the location and extent of blockages in the coronary arteries and to determine any cardiac muscle abnormalities or changes in valve function. Diagnostic catheterization studies are performed under local anesthetic and people usually go home the same day.

Treatment Procedures

Precutaneous Transluminal Coronary Angioplasty

Also known as PTCA or angioplasty, this is a non surgical procedure performed in the cardiac catheterization laboratory under local anesthetic. A balloon catheter is inserted into the narrowed or blocked coronary artery. Once in place, the balloon is inflated several times to compress the plaque against the artery wall. The larger opening allows for improved blood flow to the heart and relief of symptoms such as chest pain or pressure and shortness of breath.

Directional Coronary Atherectomy

Directional Coronary Atherectomy, or DCA, involves a cup-shaped rotating blade housed in a rigid cylinder. The device is guided to the narrowed coronary artery similar to the balloon in a PTCA. Once in place, the cutting blade is rotated and plaque is shaved from the artery wall and removed. This procedure is done in the cardiac catheterization laboratory under local anesthetic.

Coronary Stents

A stent is a wire support, much like a tubular screen, that is permanently implanted at a narrowing in a coronary artery to keep the vessel open. This procedure provides a lower incidence of recurrent narrowing in the months following the procedure as compared to PTCA. This procedure is done in the cardiac catheterization laboratory under local anesthetic.

Pacemaker Implantation

Done in the cardiac catheterization laboratory, pacemaker implantation is a rapid and relatively uncomplicated procedure. With the advent of programmability, dual chamber and rate-responsive systems, pacemakers are capable of taking over impulse generation and cardiac conduction when the conduction system of the heart fails.