It’s time for doctors who make time for you.
At Cardiovascular Associates, we believe it’s time for a more personal approach to heart care. So we treat our patients as people, not cases. We get to know you, which helps us to give you exactly the treatment you need. You’ll notice our personal touch from your first phone call. No referral necessary.
About Us:
Caring doctors give excellent care.
The physicians at Cardiovascular Associates don’t just share medical expertise of the circulatory system and its diseases. We share a common philosophy about how to provide the best cardiovascular care. We take the time to listen to our patients and get to know them. Because this personal touch facilitates good, clear communication and a caring atmosphere that are essential to accurate diagnoses and effective treatments.
Dedicated to the Northshore.
Cardiovascular Associates was founded on the Northshore by Dr. Barry Kusnick in 2001. All four of our physicians have lived and worked in the area for years. We serve St. Tammany, Washington, and Tangipahoa parish residents from offices in Covington, Franklinton, and soon in Hammond.
Our commitment to the community includes leading the region in new cardiovascular technology, techniques and innovations. In our Covington office, we have a Ventri Nuclear Camera System and a Vivid 7 Ultrasound, diagnostic technologies that are available at no other local practice. As an alternative to open heart surgery, we are also the only clinic on the Northshore to offer percutaneous closures of atrial septal defects and patent foramen ovales, which are holes in the heart that can cause migraines and strokes. Our physicians are board certified in internal medicine, cardiovascular diseases, interventional cardiovascular medicine, nuclear cardiology and Level III echocardiography.
At Cardiovascular Associates, we only order the tests and procedures that patients truly need, and the fact that we often get new referrals from existing patients and transfers from other cardiovascular providers points to the excellence of care that we provide. Through care, expertise, and innovation, we are setting the standard of exceptional cardiovascular treatment on the Northshore.
Procedures:
A healthy heart for a healthy life.
The heart is a muscle that pumps blood through your body’s arteries and veins, providing oxygen to every cell of your body. Problems with the cardiovascular system are unfortunately quite common. In fact, cardiovascular disease, which includes heart disease, heart attacks and strokes, is the leading cause of death in America for adults. Cardiovascular disease also causes disabilities. Some non-fatal conditions can reduce the flow of blood to your organs, muscles and limbs, impairing their function or killing healthy tissue.
So, having a healthy heart is vital for a long and a healthy life. Using our expertise and the latest methods and technology, we at Cardiovascular Associates know how to accurately diagnose and effectively treat cardiovascular disease. Sometimes your treatment may only involve medication and adjustments to diet, exercise, and lifestyle habits. Other conditions may require surgical tests or procedures. In all cases, we will only prescribe the treatments, tests, and procedures that you truly need.
Noninvasive tests and procedures
Noninvasive tests and procedures are conducted in our offices and don’t necessitate any surgical incisions or medical equipment entering your body.
Stress testing
A stress test tells us how hard your heart can safely work and helps us assess if any of your arteries are blocked. Because your heart works harder when you’re exercising, we will ask you to exercise on a treadmill in our offices while we monitor your cardiovascular system with an electrocardiogram (or EKG) and other devices.
If our analysis finds that an exercise stress test isn’t safe or appropriate for your condition, we can conduct the stress test with certain drugs that simulate the effects of exercise on your body. Alternatively, we can obtain a diagnosis with tests that uses our new, state-of-the-art nuclear camera, or with echocardiography. Our doctors will determine which stress test is best for you.
We will interpret your stress test on the same day you take it. If the results show any abnormalities or cause for concern, we will discuss the results with your referring physician as soon as possible and let you know best course of action.
Echocardiography
Similar to ultrasound tests used to view fetuses in pregnant women, echocardiography sends harmless sound waves into your chest cavity to create an image of your heart. We use echocardiography to check for any blockages, leaks or other problems with the heart’s valves and to see if your heart’s chambers are abnormally enlarged. As part of every echocardiogram, we also perform a Doppler study which provides us with additional information about the valves and pressures inside the heart.
At Cardiovascular Associates, we have a brand new digital GE echo machine which allows us to take the best images available today. Our reading station is updated as soon as your test is done, so we can review the results of your echocardiogram immediately.
Arterial ultrasound with Doppler
In addition to being useful for taking images of your heart, our new GE echocardiogram machine allows us to view the major blood vessels of your body. We can use ultrasound images to determine whether any of these vessels are blocked with plaque, which is a build-up of cholesterol, calcium and other substances. If this arterial ultrasound test uncovers a severe blockage, the next step is usually an angiogram in the hospital.
Ankle-brachial index (ABI)
An ankle-brachial index test compares the blood pressure in your arms to the blood pressure in your legs, allowing us to check if any of the arteries that supply blood to your legs and feet are blocked. Basically, we are screening for peripheral arterial disease (PAD), a condition in which not enough blood is making its way to your lower extremities.
The ABI test involves taking blood pressure measurements while you’re at rest and again after five minutes of exercise. We also perform an arterial ultrasound as part of this test.
EKG and Holter monitor
An electrocardiogram (EKG) allows us to measure your heart’s electrical system. We often use EKG readings as the first step in deciding when additional tests might be necessary.
If our doctors believe you have an abnormal heart rhythm and would like to get a more complete EKG reading than can be obtained during an office visit, we will supply you with a small device called a Holter monitor, which you wear continuously over several days. The Holter monitor has three leads, or electrodes, that attach to your body and will record data about your heart’s functioning. We will also ask you to keep an ongoing log of any symptoms you might have, so we can correlate them with the Holter monitor’s data after you return the device to our office.
Lab tests
Blood tests are needed for some cardiovascular disorders. Instead of requiring you to spend time visiting another facility, we draw blood in our offices at Cardiovascular Associates and then send it to an outside lab for analysis.
Lipid levels
One important test for cardiovascular health involves measuring your bloodstream’s level of lipids, which include cholesterol, triglycerides, lipoproteins and other substances. If your lipid levels are too high, you could be at risk for coronary artery disease, heart attack or stroke. We treat this problem with medications, but your lipid levels will require monitoring. We will ask you to come in regularly for tests so we can adjust your medication accordingly.
Coumadin levels
If you’re recovering from a heart attack, a heart valve replacement, a stroke or another event, your blood could be in danger of clotting in the blood vessels. For this disorder called thrombosis we prescribe Coumadin, an anticoagulant used to reduce the clotting risk. The medication is safe and widely used, but its effects on your body require frequent monitoring. Blood tests will be necessary to determine your international normalized ratio (INR), or Coumadin level. Cardiovascular Associates’ Coumadin Clinic will help you check and adjust your INR and educate you about the important steps you need to take. Appointments for the Coumadin Clinic are not necessary. Just come in during office hours when it’s convenient for you.
Invasive tests and procedures
Invasive tests and procedures are most often conducted in the hospital because they involve surgical incisions and the insertion of medical equipment into your body. All of the CVA physicians have advanced interventional cardiology training.
Coronary angiogram
If we need to get a better image of your heart than we can get through noninvasive testing and your medical history suggests it would the best course of action, we may order a coronary angiogram. The angiogram allows us to actually see the arteries of your heart and determine whether there are blockages that need to be treated.
An angiogram is a cardiac catheterization, a procedure during which a thin, plastic tube called a catheter is inserted into your body through an incision in your arm or groin. Using an X-ray, the catheter is guided to the arteries of your heart. During the procedure, the physician injects a special dye that shows up on the X-ray, giving your doctor invaluable information about any arterial blockages.
Normally, we schedule angiograms as an elective procedure at the hospital. You may be admitted the night before to receive IV fluids so your body can safely accept the special dye, but you will able to return home that day as long as no additional procedure is needed. If we’re concerned about your immediate welfare during your visit to Cardiovascular Associates, we may directly admit you to the hospital for an angiogram.
Percutaneous coronary intervention (PCI)
Percutaneous coronary intervention (PCI) is a medical technique to open clogged or blocked arteries in order to allow blood to flow freely again. Like a coronary angiogram, PCI procedures are cardiac catheterizations in which a catheter is inserted into your body through an incision in your arm or groin. The catheter is guided to the arteries of your heart using an X-ray.
Balloon angioplasty
Balloon angioplasty is a common PCI procedure. Once the catheter reaches its destination in your blood vessel, the surgeon inflates a small balloon that has been placed at its end. The expanded balloon compresses the material that’s been causing the blockage against your arterial walls and opens up the vessel. The balloon is then deflated and the catheter removed.
Coronary stenting
In another procedure known as coronary stenting, a mesh-like scaffold, or stent, is placed over a balloon and guided via catheter to a narrowed artery. When the surgeon inflates the balloon, the stent expands and props open the arterial walls. The deflated balloon and catheter are removed, but the stent stays in your artery permanently. For several months to a year, you will be prescribed a drug called Plavix which allows your body to safely accept the stent.
Atherectomy
When a hard plaque called atheroma is dangerously blocking your arteries, you will be admitted to the hospital for a peripheral atherectomy. During this procedure, a catheter with a blade attached is inserted into your body. A motor will activate the blade and shave off the plaque while safely storing the debris inside a small chamber. The chamber is emptied of debris when the catheter is removed, and then the catheter may be reinserted to chip off atheroma from another area.
Instead of a motorized blade, a coronary atherectomy uses a diamond-studded burr to drill through the atheroma. This version of the procedure is an older method and currently only used in select cases.
Intravascular ultrasound (IVUS)
To get information about potential trouble spots inside your heart and blood vessels, intravascular ultrasound (IVUS) is sometimes used to supplement a coronary angiogram. An angiogram offers only a two-dimensional image, does not give information about the vessel walls and has other limitations.
An IVUS catheter, which is guided into your blood vessels the same as other PCI procedures, has an ultrasound camera on its tip. It emits and reads reflected sound waves to create an image of the inside of your artery that is displayed in real time on a monitor for your doctors to analyze.
Angiojet thrombectomy
An angiojet thrombectomy is used to remove a thrombus, or blood clot, that is dangerously blocking an artery. It may be performed prior to other PCI procedures to make them safer.
During an angiojet thrombectomy, a catheter will be inserted into your body and guided to the clot. Then, a pump will expel a saline solution under high pressure to break it up. The jets also create a vacuum in the artery that further weakens the thrombus and safely sucks the clot pieces through the catheter and out of your body.
Transesophageal echocardiogram (TEE)
In some clinical situations, we need a better view of your heart than we can get in a normal echocardiogram taken through your chest wall. We then perform a transesophageal echocardiogram (TEE), which takes the ultrasound image from the inside your esophagus, or throat. A special camera is inserted through your mouth and down the esophagus, which rests directly behind your heart, to take the image. You’ll be admitted to the hospital the same day as the TEE and sent home a few hours after the procedure.
Pacemaker implantation
Pacemakers and implantable cardioverter-defibrillators (ICD) are devices surgically implanted in your body to treat abnormal heart rhythms. They deliver small shocks to stimulate your heart back into a normal state whenever they detect life-threatening rhythmic irregularities. Once a device is implanted, you will need it for the rest of your life, and you will be able to feel the device’s generator through your skin.
The procedure requires a minimum overnight stay in the hospital and then follow-up visits to the pacemaker/ICD clinic at Cardiovascular Associates. The device will also need its generator changed periodically, normally every five years or so, depending on your clinical situation.
Peripheral artery angiogram/intervention
Symptoms of leg or buttock pain when walking or high blood pressure that’s difficult to treat could mean that you have peripheral arterial disease (PAD). PAD is a condition where clogged arteries do not allow enough blood to make its way to your limbs, kidneys, or brain.
If peripheral arterial disease is suspected, we first conduct noninvasive procedures such as an ankle-brachial index test or an arterial ultrasound. If we detect abnormalities, we electively admit you to the hospital for a peripheral angiogram. Similar to a coronary angiogram, in this procedure we insert a catheter into your body and inject a dye to determine trouble spots.
PAD can be treated with balloon angioplasty, stenting, or an atherectomy.
Endovenous Laser Therapy (EVLT)
Endovenous Laser Therapy (EVLT) is a minimally invasive procedure for treating varicose veins that is performed in our offices rather than in a hospital setting. Aside from being unsightly, varicose veins can cause pain, fatigue, and heaviness in your legs.
EVLT is the most advanced and effective treatment for varicose veins available today. During the procedure, your physician inserts a thin, narrow fiber through a small puncture in your leg and guides it up the blood vessel using ultrasound imaging. Laser energy is delivered through the fiber as it is slowly withdrawn, closing up the vein. You only need local anesthesia for EVLT. It takes less than an hour, and you’re able to walk immediately once it’s through.
