Information for Physicians

Cardiovascular Surgery Information for Physicians

The Mat Gaberty Heart Center is the premier place in Macomb County where a patient can have a diagnostic procedure and go directly to surgery if needed. Services include:

• Coronary artery bypass graft surgery
• Valve replacement surgery
• AICDs in Cath Lab
• Permanent pacemakers  in Cath Lab

Briefly explain the appropriate procedure to your patient, so he or she knows what to expect before surgery, during surgery and after surgery. For example, tell patients that coronary artery bypass graft surgery involves:

• The removal of a blood vessel from the leg and the placement of the vessel on the heart to allow a new source of blood flow
• Medication for relaxation and to help induce sleep during the three to five hour operation
• Insertion of an arterial line into the wrist to monitor blood pressure and a heart catheter in the neck to monitor heart pressure
• An incision in the chest, breastbone and leg
• A stay in the ICCU following surgery
• Insertion of breathing, stomach, bladder, chest and IV tubes
• An EKG monitor
• Deep breathing exercises to prevent infection
• Cardiac rehabilitation
• New dietary guidelines and dealing with mood alterations
• A home care nurse to follow progress after discharge
• No driving, lifting, pushing or pulling for four or more weeks, exact length to be determined by physicians.

Invasive Cardiology Information for Physicians

The Mat Gaberty Heart Center is a state-of -the art facility, which includes three operational labs as well as nine prep and recovery bays.

The labs are staffed with registered nurses and cardiovascular techs. The advance practice nurses provide point-of-service pre-admission testing and education for patients who need an invasive procedure and/or heart surgery.

Some of the procedures we perform at the Mat Gaberty Heart Center include:

• Left heart catheterization
• Right heart catheterization
• Angioplasty
• Stent placement
• Intravascular ultrasound
• Wave Wire (Pressure Wire)
• Doppler Flow Wire
• Peripheral angiogram/Angioplasty
• Electrophysiological Studies
• Cardioversions
• Transesophageal echo
• Right ventricular biopsy

Invasive procedures require pre-procedure patient exams and non-invasive testing. Doctors should describe the test to the patient, explain expected results and mention the risks involved prior to the patient's arrival at the heart center.

Patients and their family members should arrive at the hospital an hour prior to pre-admission testing and staff will confirm the time of the procedure. Family members are expected to stay at the hospital until the procedure is completed and they have spoken with the doctor. The patient may or may not go home the same day depending on the outcome of the procedure and the doctor's recommendations.

Our courteous and helpful staff is available to schedule procedures by phone or fax. Phone mail is activated after hours for your convenience. Patients boarded after 1500 for the day following will be placed on the add-on list. The normal hours of operation to schedule cases are 0700-1700. We are available for emergency procedures seven days a week, 24 hours a day. Please call or fax at the following numbers:

• (586) 493-8048
• (586) 493-8734 Fax

Non-invasive Cardiology Information for Physicians

The many different procedures you need to assist you in making a diagnosis of heart disease are available at the Mat Gaberty Heart Center. These include:

• EKGs (Adult and pediatric)
• Myocardial Perfusion stress tests
• Pharmacologic Myocardial Perfusion stress tests
• MUGA studies
• Stress echos
• 2-D echocardiography with color doppler
• Pulse oximetry

You'll need to call ahead to schedule your patient for stress tests. Please call Non- Invasive Cardiology at (586) 493-8060. The following information is necessary to schedule a test:

• The correct spelling of the patient's full name
• Patient's date of birth
• Patient's home and work telephone number
• Patient's social security number
• Type of insurance the patient has. If the authorization number is necessary, please provide it
• Patient's height and weight
• Diagnosis as related to the test
• The name of the physician ordering the test
• Exact type of stress test the physician is ordering

An appointment is not necessary to schedule an EKG. Patients should come to the outpatient registration between 7 am and 6 pm A requisition from the physician office is necessary. We prefer that you fax it to us, but you may give it to the patient to bring with them.

Rehabilitation Information for Physicians

Cardiac Rehab

Stress the importance of rehabilitation in recovering from a cardiac illness to your patients. Make sure they understand how crucial cardiac or pulmonary rehab is in helping them return to a productive life. Tell them it can make them feel better faster, reduce stress and reduce the risk of future heart problems.

As you know, rehabilitation is particularly beneficial to patients with heart disease including:

• Angina or heart failure
• Heart attack victims
• Those who have had a coronary bypass or a balloon catheter

Rehab under the supervision of trained medical professionals at McLaren Macomb includes exercise, education and counseling in a series of steps:

• Phase I: Acute inpatient cardiac rehabilitation
• Phase II: Outpatient cardiac program
• Smoking cessation counseling
• Diabetes counseling and instruction (when necessary)
• Resistance training program for upper body rehabilitation

To enroll a patient in cardiac rehab, you must provide:

• A copy of a stress test performed within the past three months and performed after any heart procedure they have had. This test must include the 12 lead EKG at rest, during the test and during the period after the test.
• A copy of lab work done within the past three months. This should include cholesterol, LDL and HDL cholesterol, triglycerides and glucose. This test should be done when the patient has had nothing to eat for several hours before the test.
• A written referral from you to participate in the appropriate phase of cardiac rehab.

To enroll a patient in cardiac rehab, call (586) 493-3354.

Requirements for Patients Undergoing a Stress Test

To evaluate your cardiac status, your physician has ordered a stress test for you. The following are basic instructions you need in order to properly take the a stress test:

• Don't eat, drink or smoke after midnight prior to the day of the test
• Bring a current list of all the medications that you take
• Take your medication as directed with a small amount of water unless otherwise instructed by your doctor
• Wear comfortable clothes and walking shoes
• Make sure a requisition has been faxed by your doctor's office to the hospital to have the test done. If it was not faxed, bring it with you yourself on the day of the test.
• Know your medical history and the reason you need the test
• Arrive for the test at least 15 minutes early

For a Myocardial Perfusion stress test, follow the above instructions and be prepared for:

• An IV that will be inserted into your arm
• An injection of a small amount of radioactive substance, that is used to take scans of your heart
• Understand that you may have to return to the hospital for a second set of scans, depending on the type of radioactive substance that is used

For a Pharmacologic Myocardial Perfusion Adenoscan stress test, follow the stress test instructions in addition to these instructions:

• Do not have any caffeine 24 hours prior to the test
• Do not take any medications that contain Theophylline, Xanthine or oral Persantine

Follow any other specific instructions your doctor has given you as well. If you have any questions regarding your test, need to cancel your appointment or have any other questions, call the EKG Department at (586) 493-8060.