Issue link: https://viewer.e-digitaledition.com/i/644379
W hen t he prog ra m wa s conceived, pat ient s i n severe ca rdiac distress were sent to la rger centers, which were thought to be better equipped to dea l with such ca ses. The time-consuming patient tra nsfer via emergency ser vices required for severe ca rdiac distress costs precious time a nd increases the risk of fur ther da mage to patients' hea lth. "At the time our ca rdiac inter ventiona l prog ra m wa s established, hospita ls were severely lim ited in what they were a llowed to do to help patients in a n acute sit uation w it hout a n on-site open-hea r t surger y prog ra m," says La rr y A ltschul, MD, FACC, Chief of Ca rdiolog y for Good Sa ma rita n Hospita l. "I beca me chief of the depa r tment in 2000, before the ca rdiac inter ventiona l prog ra m wa s established. Toget her w it h col lea g ues f rom a round t he state, we spea rheaded a ca mpa ig n to a llow locations like Good Sa ma rita n Hospita l — which at the time did not have a n adva nced ca rdiac surger y prog ra m — to i m mediately i nter vene w it h patient s presenti ng w it h a n a cut e myoca rd ia l i n fa rc t ion by qu ick ly A Clear Picture TO TRE AT COMPLE X cardiac conditions, physicians need to obtain a clear picture of what is happening inside the veins, arteries, muscles and organs of the cardiovascular system. Diagnostic and imaging studies can be used alone or in conjunction to create a detailed rendering of function, blood flow and potential blockages, ultimately guiding the use of advanced cardiovascular intervention. In the cardiac catheterization laboratory, intravascular ultrasound is used to assess the well-being of blood vessels. A minuscule ultrasound device is attached to a catheter and threaded through the arteries toward the heart, collecting images of potentially troublesome areas of narrowing, collapse or blockage. This same catheter system can then be used to deliver therapy to the area in a rapid intervention. Utilizing a similar theory as ultrasound, optical coherence tomography (OTC) imaging uses light waves instead of sound, bouncing them off of tissue to capture real-time, detailed images of the interior of blood vessels. OTC is positioned using catheters and captures detailed information about the function of tissue found inside blood vessels, such as whether or not neointimal scar tissue has developed in an artery after stenting or other interventional procedures. In a non-emergency situation, positron emission tomography (PET) technology can be used to assess heart function. To collect images, traceable radioactive material is inserted into the vein. Clinicians follow the progress of the isotope to identify damage to the heart muscle by precisely targeting what portions of the heart are functioning properly and which are not. "Using PET technology to perform a nuclear stress test requires very specific equipment, but the results are extremely helpful," says Larry Altschul, MD, FACC, Chief of Cardiology for Good Samaritan Hospital. "I have personally had five patients in the past year who had serious conditions revealed using PET technology. These conditions would have gone undiagnosed using less advanced modalities. Our commitment to leading-edge diagnostic technology is saving lives" PET technology, found at St. Francis Hospital – South Bay Cardiovascular in West Islip, can be used in conjunction with other modalities to gather information in multiple dimensions. It is used together with CT technology to perform myocardial perfusion imaging (MPI). MPI reveals how blood flows through the heart, and can be used to identify portions of the muscle that may not be receiving enough blood due to a blockage or valve failure. PET scans are considered a noninvasive diagnostic test, even with the introduction of a traceable marker to the blood. Noninvasive diagnostic cardiac tests available at Good Samaritan Hospital include: + Echocardiology + Electrocardiography + Electrophysiology + Holter monitor + Thallium stress testing + Stress testing + Tilt table testing When physicians require additional information about patients that cannot be collected with noninvasive methods, multiple invasive diagnostic tests are also available on-site, including: + Diagnostic cardiac catheterization + Pulmonary artery catheter pressure measurements + Transesophageal echocardiography Larry Altschul, MD, FACC, Chief of Cardiology for Good Samaritan Hospital, reviews the results of a cardiac catheterization performed at Good Samaritan. Medical cardiologists, such as Dr. Altschul, are at the forefront of diagnosing cardiac disease using a range of exams and procedures, including nuclear tests. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 016 0 7