Office Flow
All new patients see both a nurse practitioner and Dr. Goldberg at their first visit. Future visits will be scheduled with Dr. Goldberg, a nurse practitioner (NP) or a "Dual Visit". They may rotate visits as well one visit is with a nurse practitioner and next visit with Dr. Goldberg. The provider will decide how to schedule follow-up. Regardless of how it is scheduled Dr. Goldberg is always available if needed.
Electrocardiogram
An electrocardiogram is also known as an ECG or EKG and is a “snapshot” of the electrical activity traveling through the heart. The ECG is routinely used as a screening tool and is a simple test to obtain. Several electrodes (stickers) are applied to the chest while laying down on an exam table and the tracings are printed out over a few seconds. It is best to have clean skin without lotion and shaving may be required for placement of the electrodes.
Echocardiography
An echocardiogram is also called an “echo” and is an ultrasound of the heart. Echocardiography uses sound waves to make images of the heart chambers, valves and surrounding structures. This test is used to evaluate the size and function of the heart and determine how the muscle and heart valves are working. Many treatment decisions made by your providers are based on the results of an echocardiogram. There is no special preparation for this procedure which takes 30-45 minutes to complete while laying still on an exam table. Ultrasound gel is applied to the chest and a hand-held wand is placed on the chest and moved around to capture images. The test is then interpreted by Dr. Goldberg.
Carotid Ultrasound
Carotid ultrasound uses sound waves to produce pictures of the carotid arteries in the neck. This test is obtained to evaluate the structure of the carotid arteries, observe and measure blood flow. Carotid ultrasound is used to screen for blockage or narrowing of those arteries that may increase the risk of stroke. There is no special preparation for this test. This is a simple procedure which involves laying still while ultrasound gel is applied, and a hand-held wand is moved over the sides of the neck.
Abdominal Aorta Ultrasound
An abdominal aorta ultrasound uses sound waves to produce pictures of the aorta which is the main blood vessel leading away from the heart. This test is often obtained to screen or monitor an Abdominal Aortic Aneurysm (AAA) which is a condition in which the lining of this vessel is enlarged. This is a simple, brief procedure in which ultrasound gel is applied and hand-held wand is moved over the upper abdomen. There is no special preparation for this test.
Continuous Cardiac Monitor
Monitoring of heart rate and rhythm is often helpful in evaluating symptoms such as palpitations, dizziness, or fainting. It is used to look for issues with heart rate or conduction. A monitor can be worn for 72 hours up to 4 weeks. There are options on what type of monitoring device is used but most often it involves a small adhesive patch which is water resistant placed on chest. All normal activities can be performed while wearing the monitor. The staff will set up and explain everything for this test in the office.
Implanted Device Monitoring
There are multiple devices that are placed in the body to monitor and treat conditions that affect heart rate and/or function. Pacemakers are implanted for a heart rate that is too slow and defibrillators (ICD) are implanted for heart rhythms that are too fast. Cardiac Resynchronization Therapy (CRT) is a pacemaker to treat congestive heart failure and Loop Recorders are implanted to record heart rhythm disorders. All these devices require regular evaluation and monitoring. This can be completedin office and some devices can be monitored remotely via a device placed in the home.
Exercise Stress Test
A standard exercise stress test is also referred to as a treadmill test. It is a procedure that is used for screening purposes as well as evaluation of cardiac-related symptoms. A stress test observes how the heart responds to exercise or stress. Most often, this test is used to screen for coronary artery disease(CAD) that may be reducing blood flow to the heart. We place several electrodes (stickers) on the chest and the patient walks slowly on the treadmill. There is a gradual increase in speed and tilt in the treadmill to produce the effect of walking up a small hill. The treadmill is stopped once the patient has reached their personal maximum amount of exercise. The heart is monitored by an ECG and a provider is present during the test. To prepare for this test, wear appropriate walking shoes and a loose-fitting shirt that buttons in the front so staff can place the electrodes.
Remote Patient Monitoring
We have a program called remote patient monitoring (RPM) where we can monitor blood pressure and weight for patients with certain conditions. The device communicates directly with the office and is monitored daily. Staff will communicate with patients at least twice monthly. We also offer principal care management (PCM) where a patient is provided with additional care management and education on heart-healthy lifestyles and disease management. If it is recommended as part of your care, this may be covered by your insurance and staff will review this at your visit.
Nuclear Stress Test
A nuclear stress test is another test used to evaluate blood flow in the heart. This test is a more sensitive and diagnostic method of screening and evaluating for coronary artery disease. A nuclear stress test uses a radioactive tracer to produce pictures that show the blood flow in the heart at rest and during exercise/stress. This test involves a small IV being placed and the radioactive tracer is injected before and during exercise/stress. X-ray pictures are also obtained at rest and after exercise/stress. The exercise part of the test is performed on a treadmill or if the patient cannot walk safely on a treadmill, a “chemical stressor” will be used. This study takes 3 to 4 hours to complete and specific instructions on how to prepare will be provided by Camp Lowell Cardiology staff.