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Heart and Vascular Institute

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Pikeville Medical Center’s Heart Institute offers comprehensive cardiac care to the people of Eastern Kentucky. Services include interventional and invasive cardiology, electrophysiology, open heart surgery and a 2 stage cardiac rehab program. PMC strives to be your #1 choice when it comes to your heart.

In an effort to better meet the needs of our patients, Pikeville Medical Center (PMC) has invested in some of the most advanced cardiac equipment and technologies available.

As the region’s leader in health care, PMC offers comprehensive care for your heart. Making huge strides for this area, PMC’s Heart Institute excels in prevention, early detection, patient care and education.

The Heart Institute is located on the first floor of the Elliott Building. Offices for our cardiothoracic and vascular surgeons are located in the Pam May Clinic Building.

Aneurysm Repair – Repairs an enlarged and weakened section of the artery. This is done through a small incision in the femoral artery (located in a large muscle in the thigh and groin area).

Angioplasty – Widens a narrowed or obstructed blood vessel and may require using a patch of the artery. This can be accomplished through surgery, or a balloon and stent procedure.

Ankle-Brachial Index (ABI) – A measurement used to evaluate one’s circulation in the legs and arms. Stress Testing – A physical or chemical test used to check for significant blockages in arteries.

Atrial Fibrillation – Occurs when the heart’s two small upper chambers beat irregularly.

Atrial Fibrillation Management – Treatment of the most common cardiac arrhythmia.

Automatic Implantable Cardioverter Defibrillator (AICD) – Regulates the rhythm of the heart to a normal pattern. This may be done by pacing the heart, or by delivering a small shock to the heart muscle. This device is like a pacemaker, with wires in the vein leading to the heart to increase function.

Biventricular Defibrillators & Pacemakers – Electrical devices, surgically implanted under the skin, with wires leading to the heart. These devices regulate the heart’s rhythm by sending pulses into both pumping chambers (ventricles), and helps when the heart muscle is weak.

Cardiac Ablation – A non-invasive cardiac procedure that disrupts abnormal rhythms in the heart and restores a normal heartbeat.

Cardiac Arrhythmia Evaluation – A number of studies and tests, including Electrophysiology Studies, that are used as tools to diagnose heart rhythm disturbances.

Cardiac Computed Tomography Angiography – Uses a CT scanner to look at the structure of the heart’s blood vessels.

Cardiac Electrophysiology – The study of the electrical system of the heart.

Carotid Ultrasound – A painless test used to determine the amount of plaque built up in the carotid arteries, located on each side of the neck. This aids in the detection of Carotid Artery Disease.

Coronary Stents & Angioplasty – A procedure used to open clogged arteries, improve symptoms of blocked arteries and prevent damage to the heart during a heart attack.

Cryoablation Therapy – Treats patients with Paroxysmal Atrial Fibrillation.

Defibrillator Implantation – The installation of a device that detects arrhythmias and delivers electrical therapy as necessary.

Diagnostic Arteriography – Allows doctors to view arteries in nearly every part of the body.

Diagnostic Cardiac Catherization – An invasive imaging test that determines how well the heart is working.

Echocardiography – Uses an echocardiogram to take a sonogram (picture) of the heart. This procedure can create 2-D, 3-D, or 4-D real-time images.

  1. Transthoracic – Known as the “standard echo,” this echocardiogram is very simple and painless to perform
  2. Transesophageal – Conducted by placing a probe in the patient’s esophagus
  3. Stress – Combines the simple transthoracic echocardiogram with an exercise, or chemical stress test to show what the heart looks like when it is working harder

Endovascular Aneurysm Repair – Consists of a stent graft being placed in an enlarged, aneurysm-affected blood vessel.

Event Monitoring – A portable, heart-monitoring device that patients may plug into a telephone line to transmit data back and forth to the reviewing cardiologist.

Fainting Disorder Treatments – Treatment for a number of cardiac issues that cause fainting.

Follow-up for Pacemaker and Defibrillator Implantation – The monitoring and adjustment of pacemakers or ICDs after they have been installed. This includes remote (from home) testing.

Heart Failure Pacemakers and ICDs – The use of specialized devices to treat patients with congestive heart failure.

Heart Valve Surgery – Repairs or replaces the heart’s valves.

Holter Monitoring – Monitors the electrical activity of the heart with portable units worn for more than 24 hours.

Impedance Cardiography – Uses electrical signals to determine the blood flow properties through the aorta.

Implantable Cardiovascular Defibrillator (ICD) Check – Checking ICDs to insure they are working properly. ICDs aid in the correction of life-threatening heart rhythm problems; can also work as a pacemaker.

Lung Cancer Surgery (Thoracotomy) – Used to remove all or part of the lung affected by cancer.

Pacemaker – Regulates a patient’s heartbeat with small electrical pulses.

Pacemaker Implantation – The installation of a device that regulates the heart’s rate and rhythm.

Peripheral Artery Disease – Refers to the development of blocked arteries outside the heart. This can be detected by conducting a simple screening known as an Ankle-Brachial Index (ABI) Test.

Peripheral Artery Disease (PAD) – Blockage of the arteries leading to the leg, causing pain and poor circulation. This is considered the most common form of Peripheral Vascular Disease (PVD).

Peripheral Bypass Grafting – Treats Peripheral Vascular Disease (PVD) by creating a bypass around a section of a blocked artery.

Radio Frequency Catheter Ablation for Arrhythmia – A treatment used to destroy tissues that cause arrhythmias.

Renal Dialysis Access Ports – Conducted by installing ports into the arms or legs, allowing blood to be sent from a dialyzer to the body; leads to a quicker and more efficient dialysis.

Stage 2 Cardiac Rehab – An outpatient, monitored, supervised exercise program for patients.

Stage 3 Cardiac Rehab – An unmonitored, mildly supervised exercise program for patients who want to continue rehabilitation, after stage 2 rehab, with minimal support.

Stress Testing – A physical or chemical test used to check for significant blockages in arteries.

  1. General Stress Testing – Performed by using either medication or physical exercise to check the heart’s function
  2. Nuclear Cardiac Stress Testing – Requires an injection of radioactive medication into the bloodstream only seen by special equipment. This allows physicians to monitor and study theheart’s blood flow

Stent – A permanent device used to hold the artery open, improve blood flow to the heart muscle and relieve chest pain symptoms.

Surgical Approach to Esophageal Disease – Surgery performed to narrow the esophagus or treat esophageal cancer. This is accomplished through an incision in the abdomen and chest.

Tilt Table Testing – A testing to evaluate fainting and dizzy spells.

Video-Assisted Thoracoscopy – A minimally invasive surgical technique used to diagnose and treat problems in the chest. This is performed by making a small incision in the chest and inserting a small camera called a “thorascope.”

PMC receives Atrial Fibrillation Certification

PIKEVILLE – Pikeville Medical Center (PMC) has received full Atrial Fibrillation Certification status from the Society of Cardiovascular Patient Care.

PMC Cardiologist and Electrophysiologist Dr. Michael Antimisiaris said, “We join a select group of hospitals that are Atrial Fibrillation Certified, showing our commitment to state-of-the-art heart care.”

Atrial fibrillation is the most common cardiac arrhythmia and has become recognized as a health concern that in some cases can lead to stroke and possible death.

Nearly 3 million patients in the United States have atrial fibrillation and the numbers are rapidly increasing as the population ages. Atrial fibrillation patients use more healthcare services and have much higher healthcare costs than those without the disease.

The Society of Cardiovascular Patient Care’s (SCPC) goal is to help facilities evaluate and manage atrial fibrillation patients more effectively and improve patient outcomes.

PMC has demonstrated its commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and undergoing a comprehensive review by an accreditation review specialist from the SCPC.

PMC’s protocol-driven and systematic approach to patient evaluation and management allows physicians to reduce time from diagnosis to treatment and perform risk assessments on patients to decrease their length of stay in the Emergency Department and the hospital. Key areas in which a facility with Atrial Fibrillation Certification must demonstrate expertise include the following:

•Emergency Department integration with Emergency Medical Services

•Emergency assessment of patients with atrial fibrillation

•Risk assessment of patients with atrial fibrillation

•Treatment for patients presenting to the Emergency Department in atrial fibrillation

•Atrial fibrillation discharge criteria from the Emergency Department, Observation Services or Inpatient Unit

•Atrial fibrillation patient education in the Emergency Department, Observation Services and Inpatient Unit

•Personnel competencies and training

•Process improvement

•Organizational structure and commitment

•Atrial fibrillation community outreach.

For more information about PMC’s Heart & Vascular Institute, call 606-218-3500. To schedule a physician appointment, call 606-218-2201.

Level IV Chest Pain Center Accreditation

After a detailed review and on-site survey, Pikeville Medical Center was awarded a Level IV Accreditation as a Chest Pain Center with PCI by the Society of Chest Pain Centers. This highly-acclaimed distinction made PMC one of the first five in the nation, and the first hospital in Kentucky to earn this accreditation.

PCI (percutaneous coronary intervention) refers to a variety of procedures used to treat patients with diseased arteries of the heart caused by a build-up of fats, cholesterol, and other substances from the blood (referred to as plaque) that can reduce blood flow and lead to chest pain or a heart attack.

Pikeville Medical Center’s Heart Institute features the region’s most experienced cardiology professionals. The group, comprised of interventional cardiologists, cardiothoracic surgeons, vascular surgeon, cardiologists and an electrophysiologist, the Heart Institute uses the state-of-the-art diagnostic tools to provide world-class quality care.

Pikeville Medical Center’s accreditation means the hospital can provide the whole continuum of care, from diagnostics to heart surgery procedures, on site.

To earn Chest Pain Center accreditation, a facility must successfully meet the Society’s eight criteria. Integration of the emergency department with the Emergency Medical System

  • Timely diagnosis and treatment of patients with ACS (Acute Coronary Syndrome)
  • Assessment of patients with low to moderate risk of ACS
  • Functional facility design
  • Organizational structure
  • Process improvement orientation
  • Community outreach, and personnel Competencies and training

PMC’s Chest Pain Center strives to quickly diagnose cardiac patients, begin treatment within minutes and significantly improve the chance of a positive outcome. Studies show that Chest Pain Centers reduce mortality rates by 37 percent. More than five million Americans visit hospitals each year with chest pain, but only ten to fifteen percent of the patients are diagnosed with an acute myocardial infarction, or heart attack. We achieve success with early intervention and rapid initiation of therapy.

Pikeville Medical Center worked with local emergency service providers to equip ambulances with EKG monitors capable of relaying test results during transport. This allows members of PMC’s Chest Pain Center to implement a plan of action while the patient is en route to our emergency department.

According to the American Heart Association (AHA), Coronary Heart Disease is the No. 1 killer in the United States. Statistics show that about 7.9 million people (age 20 and older) have survived a heart attack. This year, the AHA predicts that 1.2 million Americans will suffer their first heart attack. Warning signs often include tightness or pressure in the chest and may also spread to the shoulders, neck and arms.

  • EHAC (Early Heart Attack Care)

    DID YOU KNOW HEART ATTACKS HAVE BEGINNINGS?

    THESE “BEGINNINGS” OCCUR IN OVER 50% OF PATIENTS.

    Most importantly, if recognized in time, these “beginnings” can be treated before the heart is damaged!

    ALARMING STATISTICS:

    Heart disease caused approximately 1 of every 6 deaths in the United States in 2006.

    In 2011, an estimated 785,000 Americans had first-time heart attacks, and an estimated 470,000 had repeat heart attacks.

    Every 25 seconds, an American will have a coronary event, and every minute, someone will die of one.

    BY WORKING TOGETHER, WE CAN CHANGE THESE SOBERING STATISTICS!

    What Is Early Heart Attack Care (EHAC)?

    “EHAC is really two things. First, it is a common sense movement which recognizes that early symptoms of a heart attack occur in 50 percent of all heart attack patients and that these early clues allow time for preventive measures to take place,” states Raymond D. Bahr, M.D., the physician who declared war on the heart attack problem in the U.S. and initiated the EHAC movement. “Second, it is an education process that is designed to change behavior and attitudes. It teaches that heart attacks can be prevented.”

    Public Awareness
    The primary goal of EHAC is to promote public awareness that heart attacks have “beginnings” that can occur weeks before the actual attack. EHAC centers on intervention during these beginnings to help prevent acute myocardial infarction (MI) and cardiac arrest.

    EHAC focuses on prevention through the recognition of early symptoms of heart attack. Early symptoms, such as mild chest pain or stuttering chest pain, are identified as major risk factors for heart attack. Adults too frequently ignore these warnings and put themselves at risk for significant damage to the heart muscle or even death.

    Evaluation and Treatment
    The second goal of EHAC is to teach the public that individuals with heart attack symptoms should be evaluated and treated in an emergency department (ED) or chest pain center (CPC), typically located within the emergency department. The ED and/or CPC is supported by diagnostic services that allow for rapid evaluation of patients, bringing together ED physicians, nurses, cardiologists, and technicians who work as a team to establish a comprehensive management plan for patients with chest pain.

    So What Are The Symptoms?

    Man having Heart AttackEarly Heart Attack Symptoms
    Not every heart attack displays the same symptoms as those we may see on the many medical TV shows we are exposed to daily. In fact, many people ignore the early signs of a heart attack, simply dismissing the more subtle symptoms because they expect the drama associated with a Hollywood episode. Unfortunately, when these early signs are ignored, we miss a “window of opportunity” to prevent the attack before any heart damage can occur. The following signs and symptoms are ones to be aware of in yourself or in your family members:

    • Shortness of Breath without Exertion
      Although most of us experience shortness of breath when we are exercising or expending energy outside of what we do normally, difficulty breathing when performing normal activities is an early sign that should be investigated.
    • Heartburn
      The sensation of heartburn or a burning in the chest can be mapped to spicy food and quickly discarded. This sensation can also be an early sign of a heart attack, especially if the condition becomes chronic. If you find yourself taking over-the-counter antacids on a regular basis, the underlying cause of your trouble needs to be discussed with your doctor.
    • Discomfort or Pain
      Although we think of heart pain as pain occurring in the area of the heart, for some individuals this is not the case. People who have suffered a heart attack have described their early symptoms everywhere from crushing to squeezing to pressure occurring in the chest and even other areas of the body. Shoulders, neck, and jaw are areas reportedly affected prior to a heart attack. Always seek immediate attention if you are experiencing this type of pain, even if the symptoms disappear or are only intermittent.
    • A Feeling of Impending Doom
      Some patients describe a feeling of anxiety and fear prior to the occurrence of a heart attack. Although not usually thought of as an early symptom, and certainly attributable to other matters, this “feeling” can still be an early indicator, especially when combined with any of the other symptoms listed above.

    Remember, people may or may not experience any or all of these symptoms.

    ALSO
    People may experience mild chest symptoms, such as pressure, burning, aching or tightness.These symptoms may come and go until finally becoming constant and severe.

    So What Should We Do?

    COMMIT to these three steps:

    1. LEARN THE EARLY SIGNS AND SYMPTOMS OF A HEART ATTACK

    2. SHARE EHAC WITH OTHERS

    3. TAKE THE OATH (see below)

    Take the EHAC Oath

    I understand that heart attacks have beginnings that may include chest discomfort, shortness of breath, shoulder and/or arm pain, and weakness.

    These may occur hours or weeks before the actual heart attack.

    I solemnly swear that if it happens to me or anyone I know, I will call 9-1-1 or activate our Emergency Medical Services.

  • Heart Healthy Eating

    Shop for foods that do not have a lot of added ingredients, such as salt, fats, or sugar. Learn your goals for fat, calories, and sodium. Then use food labels to help you make choices that keep you on target. For example:

    • If you are on an eating plan that limits sodium, choose foods with less than 300 mg of sodium per serving.
    • Choose foods with very little or no saturated fat or trans fat.

    Remember: Not everything that is advertised or labeled as healthy is really good for you!

    Fruits and Vegetables

    Start with fresh fruits and vegetables. These do not have added fats, sugar, or sodium.

    When you buy frozen or canned produce, read labels:

    • Look for types that do not have anything added to the fruits or vegetables, such as sauces, gravies, or seasonings.
    • Canned vegetables may be high in sodium. However, you can enjoy many lower-sodium or salt-free varieties.

    Breads, Cereals, and Grains

    Choose breads and cereals that are made from whole grains and high in fiber:

    • Look for products with whole grains (such as whole wheat, rye, or oats) as the first ingredient.
    • Breads with at least 2 grams (g) of fiber per serving are good choices.
    • Select cereals that contain at least 5g fiber per serving.
    • Limit cereals that list added sugars on the label.
    • Check the label for the amount of sodium if you are on a reduced-sodium plan.

    Milk and Dairy

    When choosing milk or dairy products, pick nonfat or low-fat types:

    • Choose nonfat (skim), ½%-fat, or 1%-fat milk.
    • Look for tasty cheeses that are low in saturated fat and sodium. Choose them more often than regular cheese.

    Meats and Other Protein Foods

    You can get protein from poultry, fish, beef, pork, dried beans, soy products, and other vegetable proteins.

    • When choosing chicken or other poultry, look for breast or white meat without the skin
    • When choosing beef and veal, pick cuts without much marbling (fat). Healthy types include round steak, tenderloin, and sirloin tips.
    • Lean center cuts are the best cuts of pork and lamb.
    • You can buy any type of fresh fish that you enjoy. Do not always choose the same kind because some types may contain mercury or other contaminants that you don’t want to eat in large amounts.
    • Canned fish (such as tuna) can be high in sodium. Choose low-sodium brands.
    • Add vegetarian entrees and vegetable protein foods, like beans, veggie burgers, or tofu. Look for products that are low in saturated fat and sodium and high in fiber.

    Other Foods

    • Convenience foods, such as canned soups, pasta sauces, and prepackaged or frozen dinner entrees and side dishes can be high in sodium and/or fat. Read labels and choose carefully.
    • There are many snack foods that you can enjoy:
      • Nuts, seeds, and pretzels make good snacks. Avoid those with added salt.
      • Keep your sodium and saturated fat limits in mind while you shop.
      • Look for snacks that are free of trans fat. If the ingredients include hydrogenated oil, then the food has trans fat
    • It’s okay to have desserts once in a while if you choose wisely:
      • Fresh fruit and nonfat or low-fat frozen yogurt are good choices.
      • There are many kinds of reduced-fat and fat-free candies, cakes, cookies, pastries, and frozen desserts. They may fit within your limits for fat and sodium. However, many fat-free or low-fat desserts are high in calories and low in healthy nutrients. Have them only occasionally.

  • Living Well with Heart Disease

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For patients who are diagnosed with some form of heart disease or who have undergone heart surgery, PMC’s Cardiac Rehabilitation program offers lifestyle monitoring and fitness programs to help restore the patient’s heart to maximum efficiency. Cardiac rehab programs are designed to help heart patients incorporate changes into their daily routines such as exercising, taking medications and eating a heart healthy diet. PMC’s Stage II & Stage III Cardiac Rehab gives patients, who have suffered from heart disease, the tools they need to return to an active lifestyle.

treadmillWhat are the Benefits of Attending Cardiac Rehab?

  • Reduce the risk of another heart attack or death
  • Alleviate or lessen activity related symptoms
  • Limit or reverse the progression of atherosclerosis (hardening of the arteries)
  • Reduce blood pressure
  • Receive close nurse supervision
  • Positive motivation through support groups
  • Smoking cessation counseling
  • Decrease body weight and fat stores
  • Improve physical fitness
  • Modify lipid (cholesterol) levels
  • Improve vessel function
  • Psychological, vocational or occupational counseling
  • Nutritional counseling
  • Stress management

Success in Cardiac Rehab is based on the level of patient participation. People who attend regularly and actively participate have a better quality of life and a better long term outcome. The heart is a muscle, and like all muscles in the body, it must be exercised to keep it in shape.

606-218-4925

The Heart Institute
Pikeville Medical Center
911 Bypass Road
Pikeville, KY 41501
606-218-2201

Specialty Clinic at Grundy
1520 Slate Creek Rd.
Suite 205
Grundy, VA 24614
606-218-2201
Fax: 276-935-0688

Specialty Clinic at Prestonsburg
311 N. Arnold Ave.
Prestonsburg, KY 41653
606-218-2201
Fax: 606-886-1986

Specialty Clinic at Whitesburg
255 Main Street
Whitesburg, KY 41858
606-218-2201
Fax: 606-633-6325




Call 606-218-2201 for an appointment

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