Tag: Transesophageal Echocardiogram

Heart Doctors in Houston

Marfan syndrome is a genetic disorder that affects the body’s connective tissue. Connective tissue holds all the body’s cells, organs and tissue together which plays an important role in helping the body grow and develop properly. It this tissue is damaged, many body systems are affected, including the heart, blood vessels, bones, tendons, cartilage, eyes, nervous system, skin and lungs.

People with Marfan syndrome are usually tall and thin with disproportionately long arms, legs, fingers and toes. The damage caused by Marfan syndrome can be mild or severe. If your heart or blood vessels are affected, the condition can become life-threatening.

How common is Marfan syndrome?

About 1 in 5,000 people have Marfan syndrome, including men and women of all races and ethnic groups. About 3 out of 4 people with Marfan syndrome inherit it. But some people with Marfan syndrome are the first in their family to have it; when this happens it is called a spontaneous mutation. There is a 50 percent chance that a person with Marfan syndrome will pass along the genetic mutation each time they have a child.

Causes of Marfan syndrome:

Marfan syndrome is caused by a defect in the gene that encodes the structure of fibrillin and the elastic fibers, a major component of connective tissue. This gene is called fibrillin-1 or FBN1.

In most cases, Marfan syndrome is inherited. The pattern is called “autosomal dominant,” meaning it occurs equally in men and women and can be inherited from just one parent with Marfan syndrome. People who have Marfan syndrome have a 50 percent chance of passing along the disorder to each of their children.

In 25 percent of cases, a new gene defect occurs due to an unknown cause. Marfan syndrome is also referred to as a “variable expression” genetic disorder, because not everyone with Marfan syndrome has the same symptoms to the same degree. Marfan syndrome is present at birth. However, it may not be diagnosed until adolescence or young adulthood.

Signs and Symptoms of Marfan syndrome:

Sometimes Marfan syndrome is so mild, few if any, symptoms occur. In most cases, the disease progresses with age and symptoms of Marfan syndrome become noticeable as changes in connective tissue occur. The symptoms of Marfan syndrome differ from one person to the next, depending on which body part is affected and to what degree. Symptoms may include:

  • Thin, long fingers and toes
  • Sunken or protruding chest
  • Long, narrow face, Scoliosis
  • Family history of the condition
  • Enlarged aorta, mitral valve prolapsed
  • Loose and flexible joints, often prone to dislocation
  • Proportionately small lower jaw and narrow, highly arched palate
  • Usually, tall lean stature with disproportionate long arms and legs
  • Visual problems, such as nearsightedness (myopia) or dislocation of the ocular lens

Diagnosis of Marfan syndrome:

Gene testing is not readily available, but can be organised for some families who meet the diagnostic criteria. A specific collection of major characteristic features must be present to establish the syndrome. A confirmed diagnosis requires coordinated evaluation by a cardiologist, ophthalmologist, orthopaedic surgeon and geneticist, all experienced with the Marfan syndrome. The condition is diagnosed using a number of tests, including:

  • Genetic data
  • Echocardiogram
  • Eye examination
  • Physical examination
  • Skeletal tests such as x-rays

Treatments for Marfan syndrome:

Treatment usually includes medications to keep your blood pressure low to reduce the strain on weakened blood vessels. Depending on the severity of your symptoms and the part of your body that’s affected, surgery may be necessary.

Marfan’s syndrome can’t be cured. Treatments typically focus on lessening the impact of various symptoms.

Seek counsel from our Heart Doctors in Houston if you suspect you are suffering from Marfan syndrome for the best treatment options for you.

Visit us at: www.Advancedcardiodr.com |Call on: +1 281-866-7701.


Ischemic Heart Disease – Advanced Cardio Vascularcare Center

Ischemic Heart Disease or coronary heart disease is a heart issue created by narrowing of the coronary arteries. This causes less blood and oxygen to achieve the heart. Being that the heart is a muscle, it relies on upon a consistent supply of oxygen and nutrients to course through the coronary arteries. At the point when the coronary arteries get to be stopped up by fat and cholesterol stores and can’t supply enough blood to the heart, the outcome is ischemic heart disease. There are real risk factors for adding to this sort of Ischemic heart disease.

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In any case, there are natural elements that you can dispose of to decrease your shots:

Age: Substantial rates of the individuals who kick the bucket of coronary heart disease are age 65 or more seasoned.

Sex: Typically men are at more serious danger of showing some kindness assault than ladies. They additionally have a tendency to have heart assaults prior in life than ladies.

Smoking: Smoking duplicates the danger of a heart assault versus a non-smoker.

High Blood Cholesterol: As blood cholesterol levels expand, so does the danger of coronary heart disease.

Hypertension: High blood pressure constrained the heart to overexert its muscles, which makes it extend and debilitate after some time.

Physical Inactivity: Regular, moderate movement is valuable for the best possible course of blood in the body.

Stoutness: An abundance measure of weight strains the heart and raises the blood pressure and blood cholesterol levels.

Diabetes: The vicinity of diabetes has an unfriendly influence on the heart in light of the fact that diabetes straightforwardly influences cholesterol and triglyceride levels. At the point when glucose levels are hoisted, the danger of heart disease is incredibly expanded.

Seek counsel from our Heart Specialist in Houston if you suspect you are suffering from Ischemic Heart Disease or coronary heart disease for the best treatment options for you.

Contact Advanced Cardio at www.advancedcardiodr.com and get the treatment with the best and advanced doctors.

Hypertrophic cardiomyopathy (HCM)

Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle (myocardium) becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood. Hypertrophic cardiomyopathy is very common and can affect people of any age. About one out of every 500 people has HCM. It affects men and women equally.

Other Names for Hypertrophic Cardiomyopathy

  • Asymmetric Septal Hypertrophy
  • Familial Hypertrophic Cardiomyopathy
  • Hypertrophic Obstructive Cardiomyopathy
  • Hypertrophic Non-obstructive Cardiomyopathy
  • Idiopathic Hypertrophic Sub-aortic Stenosis (IHSS)

Causes of Hypertrophic Cardiomyopathy:

HCM is a genetic condition caused by a change or mutation in one or more genes and is passed on through families. Each child of someone with HCM has a 50 per cent chance of inheriting the condition. HCM is a common cause of sudden cardiac arrest (SCA) in young people, including young athletes.

HCM also can affect the heart’s mitral valve, causing blood to leak backward through the valve. Sometimes, the thickened heart muscle doesn’t block blood flow out of the left ventricle. This is called non-obstructive hypertrophic cardiomyopathy. The entire ventricle may thicken, or the thickening may happen only at the bottom of the heart. The right ventricle also may be affected.


Symptoms of HCM:

Many people with HCM don’t experience any symptoms. However, the following symptoms may occur during physical activity:

You may find that you never have any serious problems related to your condition, and with treatment, your symptoms should be controlled. However some people may find that their symptoms worsen or become harder to control in later life.

The area of heart muscle that is affected by HCM and the amount of stiffening that occurs will determine how the symptoms affect you.

For some people, a number of other conditions can develop as a result of having HCM. These may include abnormal heart rhythms, or arrhythmias, including heart block and endocarditis.

Other symptoms that might occur, at any time, include:

  • Chest pain
  • Palpitations
  • Shortness of breath
  • High blood pressure
  • Light headedness and fainting


Diagnosis of Hypertrophic Cardiomyopathy:

The health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Signs may include abnormal heart sounds or a heart murmur. These sounds may change with different body positions, High blood pressure, the pulse in your arms and neck will also be checked. The doctor may feel an abnormal heartbeat in the chest.

Close family members of people who have been diagnosed with hypertrophic cardiomyopathy may be screened for the condition. Tests used to diagnose heart muscle thickness, problems with blood flow, or leaky heart valves (mitral valve regurgitation) may include:

  • Echocardiography, ECG
  • Cardiac catheterization
  • MRI of the heart, Chest X-ray
  • Transesophageal echocardiogram (TEE)
  • 24-hour Holter monitor (heart rhythm monitor)

Risk Factors include:

Any strenuous exercise that increases after load (i.e., heavy weight lifting/training) can theoretically increase the magnitude of LV hypertrophy over time and thus worsen obstruction in subjects with pre-existing HCM. Risk factors for the development of end-stage HCM (manifesting as LV systolic dysfunction and LV dilation) include younger age of onset/presentation of HCM, a family history of HCM, increased ventricular wall thickness, along with the presence of certain genetic mutations in certain individuals.

Treatment of HCM:

At present there is no cure for HCM, but treatments are available to help control your symptoms and prevent complications. Your treatment will depend on how your heart is affected and what symptoms you have. You may need:

  • A Pacemaker – to control your heart rate
  • Medicines – to help control your blood pressure, abnormal heart rhythms
  • An ICD – if you are at risk of having a life threatening abnormal heart rhythm

Seek counsel from our Houston Cardiologist if you suspect you are suffering from Hypertrophic Cardiomyopathy (HCM) for the best treatment options for you.

Visit us at: www.advancedcardiodr.com|Call: +1 281-866-7701.

Automatic Implantable Cardioverter-Defibrillator (AICD)

Automatic Implantable Cardioverter-Defibrillator (AICD) is a device that monitors a person’s heart rate. They are generally implanted into heart failure patients. AICD intended to convert life threatening rhythms of the heart which may cause sudden cardiac death also known as cardiac arrest, to a sinus (normal) rhythm. An abnormal heart beats are referred to as arrhythmias either one that beats too fast (Tachycardia), too slow (Brachycardia) or irregularly referred as Atrial Fibrillation.

Defibrillators treat arrhythmias in two ways: in the first instance the device tries to stop the abnormal rhythm with a burst of high speed pacing. If that fails, the device will deliver an electrical shock to the heart to reset its rhythm. Patients are usually not aware of cardioversion and nearly always aware of defibrillation. It is also capable of collecting and storing information about your heart’s electrical activity for your cardiologist to check. Cardiologist will program the defibrillator to deliver the best therapy for you.

The AICD gives your heart a shock if you suspect life threatening arrhythmias or an abnormally high heart rate. Some arrhythmias can cause the heart to completely stop beating. The shock given by the AICD can make the heart start beating normally again. An AICD can also make your heart beat faster if your heart is not beating fast enough.

The AICD System Consists of:

A small computer chip that tells the AICD when to deliver a shock

Batteries designed to last 4 to 5 years and deliver about 100 shocks

A pulse generator that can send an electrical impulse or shock to the heart

Electrodes that sense the rhythm of the heart and deliver a shock to the heart muscle

Doctor can also program the AICD to deliver a variety of sophisticated electrical therapies depending on the type of abnormal rhythm problem being treated.


An intravenous (IV) line will be started in your arm. Your doctor will inject a local anesthetic to numb the site where the device will be placed. Typically AICDs are implanted just under the collarbone, usually on the left side. Your doctor will make a small incision in the skin. From there, lead wires are passed through a vein to your heart and then tested to check their position in your heart. A little pocket is made under the skin for the pulse generator. It is about the size of a book of matches. The leads are connected to the pulse generator, and tested. Then your doctor will close the incision and program the device.

Potential Risks or Complications Associated with the Implantation:

The procedure is extremely safe, with a low risk of complication. Most complications are minor and easily treated, such as pain, bleeding and bruising at the implant site.

An infrequent complication is pneumothorax, a condition when the lung is accidentally punctured during the insertion of the lead. Air then leaks into the chest cavity, causing the lung to collapse. This condition can be treated with insertion of a chest tube to allow the air to escape and the lung to re-expand.

A rare but serious complication is infection of the implant site or the pulse generator/lead, requiring antibiotic therapy and even surgical removal of the entire AICD system if severe.

Factors that may Increase the Risk of Complications Include:


History of smoking

Use of certain medications

Chronic diseases such as diabetes

Bleeding or blood-clotting problems

History of excess alcohol consumption


Have chest pain or shortness of breath

Feel lightheaded and do not feel a shock

Call for medical help right away if you experience above life threatening symptoms. Seek counsel from our Heart Doctors in Houston for the best treatment options for you.

Visit us at: www.advancedcardiodr.com|Call: +1 281-866-7701


Advanced Cardiovascular Care Center

Advanced Cardiovascular Care Center Heart Clinic in Houston provides the highest standard of excellence in Cardiovascular Care while exemplifying our ideals of customized patient care. Our goal is that of achieving superior patient satisfaction in every aspect of services given. We perceive our organization as a team of cardiology doctors in Houston working towards one common goal, that of our patients’ good health and well being. To that end, we pledge our services.

Our Cardiac Care Center in Houston offers health services in a warm, comforting, relaxing atmosphere. The practice is committed to high quality patient care in an ever-changing health care environment.

Dr. Annie Varughese Cardiology Doctor in Houston attended the Medical College of Georgia, Augusta, Georgia and subsequently completed her residency in Internal Medicine as well as Fellowship in Cardiovascular Diseases at the University of Texas Medical School in Houston. Dr. Annie Varughese Houston Cardiologist pursued further training in Interventional Cardiology at The Texas Heart Institute/Baylor College of Medicine and now has been in private practice in the Northwest Houston and Woodlands area for the past 20 years.

The practice operates under the direction of Dr. Annie Varughese, Board-Certified one of Best Cardiologists in Houston and leading cardiology specialist providing treatment for heart attacks, angina, hypertension and all aspects of cardiology. We are well-trained staff of Heart Doctors in Houston offers a variety of comprehensive, state-of-the-art services to diagnose, treat and manage heart disease. Our Top Cardiologists in Houston improve the lives of thousands of patients every year using advanced surgical and non-surgical procedures.

Dr. Annie Varughese Heart Specialist in Houston is an avid speaker regarding issues in cardiology including that of Women & Heart Disease and holds the title of Clinical Assistant Professor of Medicine at the University of Texas Medical School in Houston.

Signs of Heart Disease :-

Most heart attacks are indirectly caused by coronary artery disease or Atherosclerosis, a condition in which fatty deposits (plaque) build up on the walls of an artery. This narrows the arteries and restricts blood flow to the muscle of the heart. A heart attack is usually triggered by a tear or rupture of the plaque, which leads to the formation of a blood clot that blocks the blood flow in the artery. Spasm of the artery can also contribute to the blockage. The symptoms of a heart attack may be far more subtle in women than in men. Chest pain or discomfort is typically the most common symptom in men and women, common symptoms include

  • Nausea and vomiting
  • Severe fatigue
  • Dizziness, fainting
  • Feelings of heartburn or indigestion in the upper abdomen
  • Pain that radiates into the arms (on the left side more than the right)
  • Pain high in the back, jaw, or neck
  • Heart palpitations
  • Profuse sweating
  • Shortness of breath
  • A fear of impending death

Nuclear Stress Test :-

Nuclear Stress Test used in medicine and cardiology to measure the heart’s ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or drug stimulation. Nuclear stress tests compare the coronary circulation while the patient is at rest with the same patient’s circulation observed during maximum physical exertion, showing any abnormal blood flow to the heart’s muscle tissue. The results can be interpreted as a reflection on the general physical condition of the test patient. This test can be used to diagnose ischemic heart disease, and for patient prognosis after a heart attack.

Transesophageal ECHO :-

This is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient’s esophagus. This allows image and Doppler evaluation which can be recorded. Transesophageal echocardiograms are most often utilized when transthoracic images are suboptimal and when a more clear and precise image is needed for assessment. This test is performed in the presence of a cardiologist, registered nurse, and ultrasound technician.

Cardiac Catheterization and Stenting :-

Cardiac Catheterization and Stenting is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. It is performed for both diagnostic and interventional (treatment) purposes. Cardiac catheterization is a visually interpreted test performed to recognize occlusion, stenosis, restenosis, thrombosis or aneurysmal enlargement of the coronary artery lumens; heart chamber size; heart muscle contraction performance; and some aspects of heart valve function. Important internal heart and lung blood pressures, not measurable from outside the body, can be accurately measured during the test.

PFO & ASD Closure :-

PFO & ASD Closure is a form of congenital heart defect that enables blood flow between the left and right atria via the interatrial septum. The interatrial septum is the tissue that divides the right and left atria. Without this septum, or if there is a defect in this septum, it is possible for blood to travel from the left side of the heart to the right side of the heart, or vice versa. This results in the mixing of arterial and venous blood, which may or may not be clinically significant.

Advance Lipid Test :-

Advanced lipid testing can identify additional risk factors of coronary heart disease that standard blood-cholesterol tests typically do not. Advanced Lipid Testing can diagnose early diabetes, insulin resistance if you have a tendency towards clotting or if you are genetically prone to having a heart attack. We analyze your blood test results in combination with your family history, lifestyle, medications and existing clinical factors.

EKG Echocardiogram :-

It is an important part of the initial evaluation of a patient who is suspected to have a heart related problem. Small sticky electrodes are applied to the patient’s chest, arms and legs. However, with some systems, the electrodes may be applied to the chest, shoulders and the sides of the lower chest, or hips. Wires are used to connect the patient to an EKG machine. You will be asked to remain very still while a nurse or technician records the EKG. The electrical activity created by the patient’s heart is processed by the EKG machine and then printed on a special graph paper. This is then interpreted by your physician. It takes a few minutes to apply the EKG electrodes, and one minute to make the actual recording.

Echocardiography :-

An echocardiogram is a fairly common test that allows doctors to use sound waves to see the inside of one’s heart and see how it’s beating and pumping blood. This procedure can help identify various abnormalities in the heart muscle and valves. A doctor may suggest an echocardiogram if he or she suspects problems with the valves or chambers of the heart or the heart’s ability to pump. An echocardiogram can also be used to detect congenital heart defects in unborn babies.

Echocardiogram :-

Echocardiogram is a sonogram of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart.

Stress Echo :-

The stress echo test is done with heart stimulation, either by exercise on a treadmill with the patient connected to an electrocardiogram. People who cannot use their legs may exercise with a bicycle-like crank that you can turn with your arms. The level of mechanical stress is progressively increased by adjusting the difficulty (steepness of the slope) and speed. The test administrator or attending physician examines the symptoms and blood pressure response.

Holter-Event Monitor:-

A cardiac event monitor is a device used to monitor patients with transient cardiac symptoms.

Tilt Table :-

A tilt table test, occasionally called upright tilt testing is a medical procedure often used to diagnose dysautonomia or syncope. Patients with symptoms of dizziness or lightheadedness, with or without a loss of consciousness, suspected to be associated with a drop in blood pressure. The procedure tests for causes of syncope by attempting to cause syncope by having the patient lie flat on a special table or bed while connected to ECG and blood pressure monitors. The table then creates a change in posture from lying to standing.

External Counterpulsation Therapy :-

Enhanced External counterpulsation therapy is a procedure performed on individuals with angina or heart failure or cardiomyopathy in order to diminish their symptoms ischemia, improve functional capacity and quality of life. In various studies, EECP has been shown to relieve angina, and decrease the degree of ischemia in a cardiac stress test.

Peripheral Angiography and Stenting :-

Angiography is also commonly performed to identify vessel narrowing in patients with leg claudicating or cramps, caused by reduced blood flow down the legs and to the feet; in patients with renal stenosis and can be used in the head to find and repair stroke.

Carotid Stenting :-

Carotid artery stenting is an endovascular, catheter-based procedure which unblocks narrowing of the carotid artery lumen to prevent a stroke. Carotid artery stenosis can present with no symptoms or with symptoms such as transient ischemic attacks (TIAs) or cerebrovascular accidents (CVAs, strokes).

Carotid Ultrasound :-

Carotid Ultrasound is an ultrasound-based diagnostic imaging technique to reveal structural details of the carotid arteries, so as to look for blood clots, atherosclerotic plaque buildup, and other blood flow problems.

Cardiac MRI/Coronary CTA :-

Cardiac MRI/Coronary CTA – Cardiovascular magnetic resonance imaging is a medical imaging technology for the non-invasive assessment of the function and structure of the cardiovascular system. It is derived from and based on the same basic principles as magnetic resonance imaging (MRI) but with optimization for use in the cardiovascular system.

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Logon to www.advancedcardiodr.com and request an appointment for the desired service.

Diagnostic Tests

In order to properly diagnosis an illness, an individual must undergo a series of tests. Some medical tests are simply a physical examination. Other tests require elaborate equipment used by medical technologists or the use of a sterile operating environment.
Specifically, a diagnostic test is a kind of medical test performed to aid in the diagnosis or detection of a disease.

For example, diagnostic tests can:

•    Diagnose diseases
•    measure the progress or recovery from disease
•    confirm that a person is free from disease

In the case of cardiologists, diagnostic tests are critical in detecting and monitoring illnesses of the heart and surrounding tissues.

For example, following are a few of the more common cardiology diagnostic tests:

•    Blood test
•    CAT Scans
•    Echocardiography
•    Electrocardiograms (EKG)
•    Exercise Stress Tests
•    MRIs
•    Cardiac catherization
•    Cardiac biopsy

Diagnostic tests are a safe way to look inside the heart and determine not only the ailment, but possibly the safest and most effective treatment option. Cardiologists rely on diagnostic testing to monitor a disease and watch its progression or improvement.

If preventative measures weren’t enough to keep you from falling victim to a heart or blood vessel disorder, in best case scenarios, diagnostic testing can quite possibly catch the ailment in an early stage where treatment is non-invasive and rapid.

If you fear you may suffer from a heart disorder, see your cardiologist immediately to gain an accurate diagnosis and an effective treatment plan.

logon to www.advancedcardiodr.com and know more about the dignostic tests provided by Advanced Cardiovascular Care Center.

Transesophageal Echo in Houston

Transesophageal Echocardiogram (TEE) is a way of performing an echocardiogram in which the echo transducer is placed in the esophagus or food pipe of the patient to get a much clearer image of the heart compared to the standard echo. Transesophageal Echo (TEE) gives clear images of the back structures of the heart, such as the left atrium, which may not be seen as well by a standard echo taken from the front of the heart.

Clearer images in the case of Transesophageal Echocardiography are possible because the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. This reduces the attenuation of the ultrasound signal, generating a stronger return signal, ultimately enhancing image and Doppler quality. All these structures, along with the increased distance the beam must travel, weaken the ultrasound signal thus degrading the image and Doppler quality.

Test Procedure details of Transesophageal Echocardiography (TEE):

Transesophageal Echo requires sedation to ease the discomfort and the throat is sprayed with an anesthetic to numb it. The ultrasound probe containing the echo transducer is then inserted into the patient’s mouth and the patient is asked to swallow. The tube goes down the esophagus the same way as swallowed food.

The transducer at the end of the tube is positioned in the esophagus, directly behind the heart. By rotating and moving the tip of the transducer, the physician can examine the heart from several different angles. The heart rate, blood pressure and breathing are monitored during the procedure. Oxygen is given as a preventive measure and suction is used, as needed.

Uses of Transesophageal Echocardiography:

  • Transesophageal Echo is used to evaluate and image the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries.
  • A Transesophageal Echo is extremely useful in detecting blood clots, masses and tumors that are located inside the heart.
  • Transesophageal Echo has a very high sensitivity for locating a blood clot inside the left atrium.
  • Transesophageal Echo is used to gauge the severity of certain valve problems and help detect infection of heart valves, certain congenital heart diseases and a tear of the aorta.
  • Transesophageal echocardiography is also beneficial where conditions such as closely positioned ribs, obesity and emphysema create technical difficulties in the use of Transesophageal Echo by limiting the transmission of the ultrasound beams to and from the heart.

An echocardiogram is a painless procedure that enables doctors to see how well the heart is functioning. The test utilizes sound waves to create moving images that are recorded and displayed on a system. Echocardiography enables physicians to see the size and shape of the heart. Echocardiography helps doctors to pinpoint heart muscles that aren’t working efficiently and detect blood clots or problems with major arteries.

Advanced Cardiovascular Care Center with a team of top cardiologists provides Transesophageal Echo Test Services in Houston at patient’s personal level.