The diversity of the cardiology group makes UofL Physicians – Cardiovascular Medicine the practice of choice for the diagnosis and treatment of the region’s most challenging cases.
Heart Attack Emergency Care
Chest Pain Centers & Emergency Departments
In May 2021, UofL Health – Jewish Hospital received the American College of Cardiology’s NCDR Chest Pain ̶ MI Registry Gold Performance Achievement Award for 2021 and is one of only 60 hospitals in the nation to receive the honor. To receive the Chest Pain ̶ MI Registry Gold Performance Achievement Award, UofL Health – Jewish Hospital has demonstrated sustained achievement in the Chest Pain ̶ MI Registry for two consecutive years (2019 and 2020), and performed at the top level for specific performance measures. Full participation in the registry engages hospitals in a robust quality improvement process using data to drive improvements in adherence to guideline recommendations and overall quality of care provided to heart attack patients.
UofL Health – Jewish Hospital performs approximately 500 heart catheterizations related to heart attacks each year and has fewer deaths than the national average due to the higher standard of care.
In 2016, UofL Health – Jewish Hospital became the first hospital in Kentucky to receive a full Chest Pain Center with Primary PCI and Resuscitation Accreditation from the Society of Cardiovascular Patient Care (SCPC), an Institute of the American College of Cardiology.
CPC-accredited hospitals demonstrate better survival rates and lower readmission rates for heart attack and heart failure patients. An Accredited Chest Pain Center’s (CPC) evidence-based, protocol-driven and systematic approach to cardiac patient care allows clinicians to reduce time to treatment during the critical early stages of a heart attack. Accredited facilities better monitor patients when it is not initially clear whether or not a patient is having a coronary event. Such monitoring by our cardiologists ensures patients are neither sent home too early nor needlessly admitted.
UofL Health Emergency Rooms provide faster registration and shorter wait times, with a 30 minute or less door to doc commitment. Offering a faster bedside triage and faster provider assessment, diagnostics, and treatment. All of the UofL Health Emergency Rooms are able and equipped to provide Advanced Cardiac Care; visit one of these 7 locations below if you are experiencing any heart disease-related symptoms.
- Jewish Hospital – an Accredited Chest Pain Center (proven exceptional competency in treating patients with heart attack symptoms and have primary PCI available 24/7 every day of the year).
- Mary & Elizabeth Hospital
- Shelbyville Hospital
- UofL Hospital
- Medical Center East
- Medical Center South
- Medical Center Southwest
24 Hour STEMI coverage
STEMI is an acronym meaning “ST segment elevation myocardial infarction,” which is a type of severe heart attack. While all heart attacks are serious, those considered a STEMI – which involve a total artery blockage – require the quickest treatment. Because of the total blockage, STEMI heart attacks cause a rapid loss of heart muscle that cannot be regenerated. In these situations, time saved is muscle saved.
While a heart attack patient is still on the way to the emergency department, our physicians can get the vital data they need to make a diagnosis. If the heart attack requires intervention, we can activate our cardiac cath team immediately, allowing us to provide lifesaving care faster than ever before. It’s all possible because of the STEMI network created by UofL Health – Jewish Hospital and regional EMS providers.
Through our STEMI network, UofL Health emergency departments at Jewish Hospital receive EKG results transmitted wirelessly by regional EMS providers when they suspect that a patient is having a STEMI in the field. Once the emergency department receives the patient’s EKG, and a total blockage is suspected, the emergency physician will then activate the cardiac catheterization lab (cath lab) team. When EMS arrives at UofL Health, hospital staff will transport the patient directly to the cath lab, allowing physicians to clear the blockage sooner. It ensures the area’s quickest access to care that can stop a heart attack in progress.
So why trust your heart to anyone but UofL Health?
Specializing in diagnosing heart disease, cardiac catheterizations provide the clearest look at the arteries that supply the heart muscle. A physician inserts a thin plastic tube, or angiography catheters, into an artery or vein in the arm or leg.
Contrast media (sometimes called dye) is injected through the catheter while x-ray images, or angiograms, are taken. The dye causes areas where blood flows, including vessels and heart chambers, to temporarily become darker than the surrounding tissue. This enables the physician to see how effectively your heart is pumping, and to determine if there are any narrowed blood vessels.
Not only evaluating the pumping ability of the heart, the test also evaluates the functioning of heart valves and takes pressure measurements. It helps diagnose the location and severity of blockages, coronary artery disease, defective heart valves, congenital heart defects and disease of the heart muscle.
Additional procedures include:
- Cardiac mapping
- Cardiac resynchronization therapy
- Catheter ablation
- Coronary angiographies
- Drug-eluting stents
No matter what procedure is chosen to help diagnose your cardiovascular complications, UofL Health – Jewish Hospital will be there every step of the way, offering the best care possible.
The body relies on a natural electrical system to create heart muscle contractions, which cause blood to flow in and out of the heart. Normally, electricity flows throughout the heart in a regular pattern. But if a problem occurs along the electrical pathway, the heart rhythm (or beat) can become too slow, too fast, or irregular. More than 4 million Americans have an irregular heartbeat, also known as cardiac arrhythmia.
We offer a complete spectrum of consultative and diagnostic services to provide patients and their families with a treatment plan related to heart rhythm abnormalities. These tests may include an electrocardiogram (ECG), a Holter monitor or event monitor, an exercise stress test, a tilt table test, cardiac imaging with nuclear, echo, MRI, and CT scans, or a diagnostic electrophysiologic (EP) study.
Once a diagnosis and treatment plan has been reached, the therapeutic plan is discussed with the patient, their family, and their referring physician. We are committed to following you longitudinally for all of your arrhythmia concerns and continued patient education.
Our experts are equipped with a full complement of therapeutic options including:
- Electrical cardioversion
- Implantation of cardiac electrical devices including Cardiac Resynchronization Therapy
- Complex ablation of supraventricular tachycardia (SVT), ventricular tachycardia (VT), and atrial fibrillation (AF)
- Complex lead management and laser lead extraction
Assessment / TX for Atrial Fibrillation
Your heart has the capability of beating 60-100 times a minute for your entire life. In the majority of people, the heart rhythm stays regular. However, in some people, the heartbeat may become irregular and beat too fast or too slow.
Everyone has an irregular heartbeat occasionally. There are some people who have these episodes frequently and may have symptoms such as lightheadedness, dizziness, shortness of breath, chest discomfort, or fainting. Fortunately, these rhythms can be identified and treated. UofL Health – Jewish Hospital’s Heart Rhythm Care focuses specifically on just that – diagnosing types of arrhythmias through electrophysiology studies and determining the best treatment. At UofL Health – Jewish Hospital, the heart rhythm specialists are providing the most innovative procedures for patients who have any type of arrhythmia, including atrial fibrillation (AFib), which is the most common type of heart rhythm disorder.
A device is used to maintain heart rate by keeping it from going too fast or too slow.
Defibrillator (ICD) Implants
A device used to prevent sudden cardiac death in life-threatening arrhythmias. An ICD also has the capability to be a pacemaker in case the heart beats too slowly.
Bi-Ventricular Pacemaker or Defibrillator
A device used in cases in which the two bottom chambers of the heart do not sync, which can lead to heart failure.
This procedure removes heat from tissue to essentially “freeze” the affected area causing an arrhythmia to restore the heart’s normal electrical function.
A large catheter is inserted through the groin and into the heart to help support the workload of the heart during a complex ablation. It’s designed to pump blood to vital organs throughout the body and to keep blood pressure stable.
This device is an alternative to long-term blood thinners for patients with AFib. It is implanted into the heart to block potential stroke-causing blood clots from traveling to the brain. Learn more about the WATCHMAN procedure.
Heart disease is the leading cause of death in the United States. Each year, more than 10,000 people lose their lives to cardiovascular disease. But the pioneering health care professionals at UofL Physicians – Cardiovascular Medicine are working to reverse those trends and help you and your loved ones live longer healthier lives.
Our cardiology practice takes pride in being able to offer you the most advanced treatments available, with the widest range of procedures possible. Our cardiology doctors are dedicated to using their knowledge, skill, and experience to improve the quality of your health because we believe that technology is best when it can help you enjoy the simple pleasures in life.
A longtime leader in cardiology, UofL Physicians offers some of the most advanced heart care available. Many of the cardiologists within the practice are on the faculty of the University of Louisville School of Medicine, bringing to their patients innovative technology through the research conducted within the university.
Many of our physicians are also members of the Institute of Molecular Cardiology, which was formed by the University of Louisville in 2001 and has become a leading program in cardiovascular research both nationally and internationally. The Institute has made extraordinary contributions in many fields, particularly myocardial ischemia/reperfusion injury, cardioprotection, environmental cardiology, diabetes, heart failure, stem cells, and regenerative cardiology. Recently, the Institute has performed SCIPIO, the first study of cardiac stem cells in humans.
When to see a cardiologist
Heart disease is a broad term used to describe a range of diseases that affect your heart and blood vessels. The various diseases that fall under the umbrella of heart disease include diseases of your blood vessels, such as coronary artery disease, heart failure; heart rhythm problems (arrhythmias), heart valve problems (narrowing or leaks of the valves), heart infections, heart defects you’re born with (congenital heart defects), and heart tumors.
The term “heart disease” is often used interchangeably with “cardiovascular disease.” Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, (angina) or stroke. Other heart conditions, such as infections and conditions that affect your heart’s muscle, valves, or beating rhythm, also are considered forms of heart disease. UofL Physicians – Cardiovascular Medicine specializes in the diagnosis and treatment of all diseases that affect your heart.
Conditions we treat:
- Heart attack (coronary thrombosis, myocardial infarction): A heart attack occurs when the blood flow to the heart is blocked by a blood clot. If the clot blocks the flow to the heart completely, the artery will begin to die. Many people survive their first heart attack; however, many lifestyle changes will need to be made and medications could be prescribed. Common treatments other than medicine include coronary angioplasty and coronary artery bypass graft surgery.
- Coronary artery disease (CAD): A condition that develops when plaque builds up in the walls of the arteries (atherosclerosis). This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow and can potentially cause a heart attack or stroke.
- Angina: Chest pain
- Arrhythmia: Irregular heartbeat. There are different types of arrhythmia: the heart beating too fast, too slow or irregularly. Tachycardia refers to a heart rate that is over 100 beats per minute. Bradycardia refers to a heart rate that is less than 60 beats per minute. An irregular heartbeat may cause your body not to get the nourished blood that it needs. Common treatments for arrhythmia include medications and a pacemaker.
- Atherosclerosis: Narrowed and hardened blood vessels through plaque buildup.
- Atrial fibrillation: Fast and irregular heartbeat.
- Cardiomyopathy: A weak or enlarged heart muscle.
- Carotid artery disease: Atherosclerosis in the arteries that supply blood to the brain.
- Congenital or acquired structural heart diseases: A problem with the structure of the heart, usually present at birth. It can involve the walls or the valves of the heart, and the arteries and veins near the heart.
- Congestive heart failure: A decrease in the heart’s pumping ability. It is not pumping blood as well as it should to meet the body’s needs for blood and oxygen. Heart failure can occur if the heart cannot fill (diastolic) or pump (systolic) adequately. Heart failure does not mean that the heart stops beating, however, it can get a lot worse if left untreated.
- Endocarditis: Infection of the heart’s inner lining (endocardium) and valves.
- High blood pressure/hypertension: High blood pressure directly increases the risk of coronary heart disease (which leads to heart attack), stroke, heart failure, and kidney failure, especially when combined with other risk factors.
- Hypercholesterolemia/Hyperlipidemia: Chronic high levels of cholesterol in the blood, largely exacerbated by diet.
- Narrowed and leaky heart valves (valvular heart disease): When heart valves narrow and do not open enough to allow the blood to flow through, a condition called stenosis results. When the heart valves do not close properly and thus allow blood to leak through, it is called regurgitation. If the valve leaflets bulge or prolapse back into the upper chamber, it is a condition called prolapse. Common treatments for heart valve problems include medications and heart valve surgery. Includes mitral valve prolapse, aortic stenosis, mitral stenosis, and more.
- Peripheral artery disease (PAD): Occurs when arteries outside the heart and brain become blocked.
- Stroke: Affects the arteries leading to and within the brain. An ischemic stroke (the most common type of stroke), occurs when a blood vessel that feeds the brain gets blocked, usually from a blood clot. Brain cells will begin to die when this blood flow is cut off. This can result in a loss of functions that the brain controls including walking and talking. A hemorrhagic stroke occurs when a brain vessel in the brain bursts; this usually is related to hypertension (high blood pressure). If too many brain cells die from the stroke, the effects can be permanent, however, if the brain cells do not die, they have a chance to repair themselves and you can recover over time.
- Tobacco Dependency
- Ventricular Tachycardia: A condition in which the lower chambers of the heart (ventricles) beat very quickly, usually caused by a problem with the heart’s electrical impulses.
The signs and symptoms that relate to heart disease vary widely and can include:
- Chest pain, tightness, pressure, and discomfort
- Shortness of breath
- Pain, numbness, weakness, or coldness in your arms or legs
- Pain in the neck, jaw, throat, upper abdomen, or back
Common symptoms are chest pain and shortness of breath. However, some people have no signs or symptoms. This is called silent Coronary Artery Disease (CAD). It may not be diagnosed until a person shows signs and symptoms of a heart attack, heart failure, or arrhythmia. Know your risks and talk to your health care provider about CAD. Taking action to control your risk factors can help prevent or delay CAD.
Take Action and Lower Your Risk
- Eat a healthy diet low in saturated fat, trans fat, cholesterol, and sodium.
- Keep your weight under control.
- Be physically active for at least 30 minutes on most or all days of the week.
- Control your blood pressure and cholesterol levels.
- Manage your blood sugar if you have diabetes.
- Get regular medical check-ups.
- Talk to your doctor about a prevention plan and medicines that may be right for you.
- Do not smoke and avoid exposure to secondhand smoke.
- Fast action can save lives. Call 911 or visit the nearest ER if you think you or someone else is having a heart attack.
Heart Valve Center of Excellence
The nationally recognized UofL Health – Jewish Hospital – Valve Center of Excellence is comprised of a multidisciplinary team of cardiovascular specialists dedicated to delivering advanced, minimally invasive treatments for heart valve disease. Our team consists of interventional cardiologists, cardiovascular surgeons, cardiologists, anesthesiologists, a program coordinator, and a nurse navigator that work together to determine the best treatments for each patient.
Since the beginning of our program in 2011, we have accurately diagnosed and treated over 1000 patients with innovative treatments to include transcatheter aortic valve replacement (TAVR). Our heart valve team has performed over 7500 heart surgeries and performs over 650 heart bypass and valve procedures annually. As an academic medical health system, our team of expert physicians and nurses often provide education, mentoring, and professional consultation to providers and hospitals nationwide.
Accurately diagnosing valvular heart disease is the key to obtaining superior results for our patients so they can return to their normal activities while improving their quality of life. At UofL Health – Jewish Hospital, patients have access to state-of-the-art diagnostic testing to include echocardiography, three-dimensional computerized tomography scan, and cardiac magnetic imaging.
Two cutting-edge treatments being provided by the Heart Valve Team are transcatheter aortic valve replacement (TAVR) and mitral valve repair through the use of a device called MitraClip.
TAVR – Transcatheter Aortic Valve Replacement
A TAVR is a minimally invasive procedure where a new valve is inserted into the heart without removing the old, damaged valve. The new valve is placed inside the diseased valve.
The UofL Health – Jewish Hospital Heart Valve Team has developed a very successful transcatheter aortic valve replacement (TAVR) program and has performed more than any other hospital in the state and region. Most TAVR procedures are “awake” procedures that provide faster recovery times and less pain for patients with severe aortic stenosis. Regardless of your level of risk for standard valve replacement surgery, you might be a candidate for this minimally invasive procedure at UofL Health – Jewish Hospital.
Why choose UofL Health – Valve Center of Excellence for your TAVR?
- Our team is comprised of board-certified cardiothoracic surgeons, interventional cardiologists, anesthesiologists, a program coordinator, and a nurse navigator all working to make sure you receive the best treatment option available.
- Many of our providers are also academic professors at the University of Louisville and regularly conduct innovative research and perform clinical trials to ensure we lead the way in establishing best care practices.
- Patients benefit from minimal sedation during their procedure, which allows for a reduced recovery time and promotes next-day discharge.
- We are organized and efficient, ensuring appointment to treatment time is prompt and reliable when time matters most.
Mitral valve repair – MitraClip
Mitral regurgitation occurs when the mitral valve of the heart does not close tightly, resulting in the leakage of blood backward from the heart’s left ventricle into the left atrium.
MitraClip was the world’s first transcatheter mitral valve repair therapy, providing an option for select patients with mitral regurgitation. The MitraClip Delivery System consists of implant catheters and the MitraClip device. The device is a permanent implant that attaches to the mitral valve leaflets. This procedure results in a double opening of the mitral valve that improves closure and reduces the leakiness of the valve.
Open heart surgery
The UofL Health – Rudd Heart & Lung Center is one of the leading centers in the U.S. for comprehensive cardiovascular care. Our surgeons and professional staff have been working as a team for more than 40 years.
UofL Health – Jewish Hospital was the site of the world’s first and second AbioCor® Implantable Replacement Heart, as well as the world’s first successful heart transplant following the use of a Thoratec ventricular assist device. In Kentucky alone, Jewish Hospital was the first to perform open-heart surgery, heart transplant, first implantation of the HeartMate II ventricular assist device, and much more.
For patients with end-stage heart failure, UofL Health offers many alternatives to heart transplantation, including the use of Ventricular Assist Devices (VAD), so if the heart can recover on its own, it can heal without the need of a transplant. Heart surgery remains an effective treatment for many conditions of the heart that cannot be corrected by medication or lifestyle changes to manage heart attack risks.
Open heart surgery is any surgery where the chest is opened and surgery is performed on the heart muscle, valves, arteries, or other heart structures. The term “open” refers to the chest, not the heart itself. The heart may or may not be opened, depending on the type of surgery.
Because the heart is constantly beating, heart surgery has challenges that no other type of surgery has. Not only does it move, but it also cannot be stopped for more than a few minutes without causing brain damage.
A heart-lung machine, or a cardiopulmonary bypass machine, is usually used during conventional open-heart surgery to help provide oxygen-rich blood to the brain and other vital organs while the heart is stopped. Body cooling techniques are also used to slow the need for oxygen to the heart and allow more time for surgery without causing brain damage. This in turn enables surgeons to work on the heart for two to four hours without damaging the heart tissue.
In the instance where a heart cannot continue beating without assistance, ventricular assist devices are used as bridges to heart transplants, myocardial recovery, rescue surgeries, and destination therapy, or permanent use of the device for patients that are not transplant-eligible.
Averaging more than 1,500 open-heart surgeries annually, UofL Health – Jewish Hospital offers the most technologically advanced, complete open-heart surgery care in the region. Why would you choose anywhere else?
Complex Surgery of Aorta
The aorta is the main artery of the body, supplying oxygen-rich blood to the body. It starts from the left ventricle of the heart and runs down in front of the backbone. There are many conditions and diseases that can cause the aorta to dilate or tear, increasing your risk for potentially life-threatening situations. A primary cause for surgery of the aorta is when the aorta weakens and the wall abnormally bulges. The bulging is called an aortic aneurysm and can be very serious. Complex aortic procedures treat patients with aneurysms that need replacement of the aorta from the aortic valve down to the aortic bifurcation.
Advanced Heart Failure Clinic
The Advanced Heart Failure Clinic at UofL Health – Jewish Hospital diagnoses heart failure (HF) and determines the best treatment path for each patient based on their individual case. The clinic approaches patient care comprehensively, meaning we have experts in many different areas who come together to help make the process as effective and simple as possible. Team members include physicians, coordinators, nurses, pharmacists, dietitians, and social workers.
A ventricular assist device (VAD) is a blood pump for those with advanced heart failure that helps the heart send blood to the rest of the body. Surgery is required to implant the VAD, which can be placed inside or outside the body.
UofL Health – Advanced Heart Failure Therapies uses VADs as:
- A bridge for patients while they wait for their heart transplant
- Permanent support for those who are not candidates for a heart transplant
- Temporary support to see if the heart will recover or heal itself before a transplant is considered
To hear about a VAD life-saving story, please watch the video below.
UofL Physicians – Vascular Surgery Associates provides specialized treatments for vein, artery and circulation issues. Our expert team performs a full range of surgical and nonsurgical treatments, and their expertise can make a difference in your vascular care.
People with vascular disease may or may not exhibit symptoms. For example, aneurysms rarely cause symptoms. However, there are other symptoms that should lead you to schedule an evaluation with our team. For instance, if you are experiencing pain, cramping, or tiredness in your leg while exercising or walking stairs, you might have a peripheral artery disease. Identifying a vascular disease is the first step to treatment.
Common Vascular Conditions
Our vascular specialists treat a wide range of conditions including:
- Aneurysms – abnormal widening of a portion of an artery due to weakness in the blood vessel
- Peripheral artery disease (PAD) – narrowing or blockage of the vessels that supply blood to the legs
- Carotid artery disease (CAD) – narrowing or blockage of the vessels that supply blood to the brain
- Messenteric ischemia – narrowing or blockage of the vessels that supply blood to the intestines
- Renovascular conditions – narrowing or blockage of the vessels that supply blood to the kidneys
- Deep vein thrombosis (DVT) – a blood clot that forms in a deep vein
Included in the vascular care provided at UofL Health – Jewish Hospital are treatments for the aorta, the main artery in the human body that distributes oxygen-filled blood to all parts of the body and can require state-of-the-art treatment techniques.
Peripheral Arterial Disease (PAD) is one of several terms used to describe partial or complete blockage in one or more arteries outside of the heart. It is estimated that more than 8 million Americans have some form of PAD. It is being increasingly recognized as a major risk factor for the presence of concomitant CAD that can be fatal if unrecognized. PAD might manifest as a stroke if it involves the carotid or cerebral arteries or as leg pains if present in the lower extremities.
We at UofL Physicians are well-trained in the diagnosis and management of PAD. We have all the imaging tools, including CT scan, MRI, ultrasound, and angiography to diagnose the condition and treat it by angioplasty, atherectomy, or stents. We collaborate closely with our vascular surgery and radiology colleagues to reach a well-thought-out plan in the treatment of this complex group of patients.
Early Detection is Important
Our commitment to “improved circulation” begins before any treatments, procedures, or therapies. In an effort to prevent vascular events, like aneurysms or strokes, from occurring, UofL Health offers diagnostic vascular screenings at multiple facilities for just $50. Since vascular conditions do not always present with symptoms, a screening could help detect a problem before it occurs. To schedule an appointment call 502-587-4327.
Pulmonary hypertension is high blood pressure in the heart-to-lung system that delivers oxygenated blood to the heart while returning used (oxygen-depleted) blood back to the lungs.
Pulmonary blood pressure reflects the pressure the heart exerts to pump blood from the heart through the arteries of the lungs. In other words, it focuses on the pressure of the blood flow in your lungs.
Pulmonary blood pressure is normally a lot lower than systemic blood pressure. Normal pulmonary artery pressure is 8-20 mm Hg at rest. If the pressure in the pulmonary artery is greater than 25 mm Hg at rest or 30 mmHg during physical activity, it is abnormally high and is called pulmonary hypertension.
Similar to how systemic high blood pressure can cause the heart to work harder to deliver blood to the body, pulmonary hypertension can occur when the arteries in the lungs narrow and thicken, slowing the flow of blood through the pulmonary arteries to the lungs. As a result, the pressure in your arteries rises as your heart works harder to try to force the blood through. Heart failure occurs when the heart becomes too weak to pump enough blood to the lungs.
Early symptoms of PHT include:
- Chest pain
- Racing heartbeat
- Shortness of breath
- Pain in the upper right side of the abdomen
- Lack of appetite
Later symptoms of PHT include:
- Feeling light-headed, especially during physical activity
- Swelling in the ankles or legs
- Bluish lips or skin
Pulmonary hypertension can develop slowly, without early signs and symptoms. When symptoms do occur, they may be attributed to asthma or other lung or heart conditions. To diagnose pulmonary hypertension, your doctor may ask about your symptoms and risk factors, including other medical conditions and family history. Having a family member with pulmonary hypertension increases your risk of developing the disease.