December 6, 2011
Cardiology Services now available in Yerington & Mammoth Lakes
Mammoth Cardiology is a branch of Carson Tahoe Cardiology (shown above)
On December 8, 2011, in collaboration with Mammoth Hospital, Mammoth Cardiology will hold its first cardiology clinic at Mammoth Hospital’s SPORT Center. Mammoth Cardiology is a branch of the Carson Tahoe Heart Institute and is accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACCVPR). Mammoth Cardiology offers bimonthly clinic visits as well as some diagnostic echo cardiography and physician consultation. “I am excited that the cardiologists from Carson Tahoe Regional Healthcare have decided to provide care at the clinics of Mammoth Hospital,” says Gary Boyd, Mammoth Hospital CEO. “They are outstanding physicians and I am sure they will serve the community well.” If further cardiac care is needed, the Carson Tahoe Heart Institute is ready with advanced technology for cardiac diagnostics, treatment, open heart surgery and rehabilitation.
Additionally, CTC holds bimonthly cardiology clinics in Yerington at South Lyon Medical Center. Yerington will also offer bimonthly clinic visits as well as some diagnostic echo cardiography and physician consultation.
Board Certified Cardiologists serving in Yerington and Mammoth Lakes include Stephen Tann, MD, focusing on peripheral vascular interventional cardiology procedures; Nathan Ho, DO, focusing on cardiac catheterization and coronary interventional procedures; and David Baker, MD, focusing on coronary artery disease, vascular heart disease, general cardiology, cardiomyopathies, and non-invasive imaging.
For more information or to make an appointment at either location, please call the main CTC line at 775.445.7650.
Patients will be seen at the following locations:
Yerington
South Lyon Medical Center
213 S. Whitacre Street
Yerington, NV 89447
(775) 445-7650
Mammoth Lakes
Mammoth SPORT Center
85 Sierra Park Road
Mammoth Lakes, CA 93547
(775) 445-7650.
July 5, 2011
Two New Interventional Cardiologists Join Carson Tahoe Cardiology
Please join Carson Tahoe Regional Healthcare and Carson Tahoe Cardiology (CTC) in welcoming Dr. Stephen Tann and Dr. Nathan Ho to our acclaimed healthcare team. Both board certified doctors are joining the CTC office located in Eagle Medical Center – 2874 N. Carson Street, Suite 102.
Interventional Cardiologist, Dr. Nathan Ho
We are proud to welcome Interventional Cardiologist Dr. Nathan Ho to Carson Tahoe Cardiology. Dr. Ho specializes in Cardiac Catheterization and Coronary Interventional Procedures. He graduated from Midwestern University College of Osteopathic Medicine in Glendale, AZ; completed his residency at Pacific Hospital of Long Beach in Long Beach, CA and did his cardiology and interventional cardiology fellowships at Oklahoma State University Medical Center in Tulsa, OK.
In his spare time, Dr. Ho enjoys trail running, basketball and skiing. However, most of his free time is spent chasing around his two toddlers, “It’s just a terrific joy to see them get excited over little things. Makes you appreciate and in turn find renewed enjoyment in the important things.”
Interventional Cardiologist, Dr. Stephen Tann
We are also welcoming Interventional Cardiologist Dr. Stephen Tann back to Northern Nevada. He is returning after receiving advanced fellowship training in Interventional Cardiology and minimally invasive catheter based treatments.
Dr. Tann graduated from The Ohio State University College of Medicine, and completed his residency at Vanderbilt University. He did his cardiology fellowship training at Medical University of South Carolina, endovascular medicine and interventions fellowship at El Camino Hospital in Mountain View, CA and interventional cardiology fellowship at Banner Good Samaritan Medical Center in Phoenix, AZ.
In his spare time, Dr. Tann likes to play guitar, ski and surf. He also enjoys music production and independent film.
For more information on either doctor, click here; to schedule an appointment please call 775.841.6700
March 4, 2011
Exercise Regularly – Your Heart, Body and Soul will Thank you
While there are numerous benefits to exercise and physical activity, one of the most important benefits is heart health. A sedentary lifestyle is one of the top risk factors for heart disease and stroke. People who don’t exercise have higher rates of heart disease and death compared to people who perform even mild to moderate amounts of physical activity. Even activities like gardening, walking or golfing can lower your risk of heart disease.
Cardiovascular disease (CVD) is the No.1 killer in America, affecting more than 13 million Americans. CVD encompasses a variety of disorders and conditions that can affect the heart and blood vessels in the body. The most common type of heart disease is coronary heart disease (CHD). CHD is a process in which cholesterol plaque builds up in the arteries of both the heart and body. This plaque restricts blood flow to vital organs including the heart. Reduced blood flow to the heart and organs can result in a heart attack or stroke. Exercise and a proper diet can help reduce the formation of this detrimental plaque. Even a moderate exercise program can help people reduce the “risk” factors that lead to CVD.
Taking the following steps can normally reduce a person’s risk for CVD:
• Quit smoking
• Improve cholesterol levels
• Control high blood pressure even if medication is needed
• Exercise to maintain muscle mass and flexibility
• Eat nutritious, low fat foods
• Maintain a healthy weight
• Control diabetes
Regular exercise improves cholesterol levels by lowering LDL (bad), raising HDL (good) and by reducing triglyceride levels. Exercise is very effective in lowering blood pressure as well. Blood pressure is the tension in the walls of your arteries as the heart pumps blood with each beat. If the pressure is elevated above normal and remains high for a period of time, this can be damaging to the organs of the body including the heart, vessels, brain and kidneys. Over 50 million people in the U.S. have high blood pressure, making it the most common heart disease risk factor. Additionally, people who are physically active have a lower risk of getting high blood pressure than people who are not active.
Exercise also helps in maintaining a healthy weight and in retaining muscle strength. Excess weight puts significant strain on your heart and worsens several other heart disease risk factors, such as diabetes.
Research has shown that obesity itself increases heart disease risk. By eating properly and exercising, you can maintain a healthy weight and reduce your risk of heart disease and diabetes.
Developing a steady exercise program is an easy way to make an impact on your cardiovascular health; however, it’s important to talk to your doctor before starting a new exercise plan.
In general, to achieve maximum benefits, you should gradually work up to an aerobic session lasting 20 to 30 minutes, at least four times a week. Examples of aerobic exercise include walking, jogging, bicycling and swimming. Yoga and Pilates are also excellent sources of exercise and strength. If you choose an activity you enjoy, it’s more likely you’ll stick with it.
Remember, it’s important to warm-up before starting your aerobic exercise and to cool-down upon completion of your session. Start with shorter time sessions and gradually build up to optimize time frames.
While exercising, you are effectively improving your cholesterol levels, lowering your blood pressure, getting active, maintaining a healthy weight and overall, reducing your risk of heart disease. Exercise presents so many wonderful benefits, but heart health is by far one of the most important.
Dr. Rachel Chaney is a cardiologist at Carson Tahoe Cardiology, on staff with Carson Tahoe Regional Healthcare.
With Heart Attacks, the Quicker the Angioplasty, the Better the Outcome
Carl Juneau, MD, Cardiologist, Carson Tahoe Cardiology
Heart attack is the No. 1 killer of both men and women in the United States. More than a million people will suffer a heart attack, also called a myocardial infarction, this year. Statistics show 58 percent of these attacks will be fatal. What happens to the other 42 percent?
That depends, to a large extent, on how fast they get treatment. Heart attacks result in the death of muscle tissue. That death occurs when blood flow is severely restricted or stopped due to a blockage. Remove the blockage, and the blood flow is restored. The faster the blood flow is restored, the less damage occurs.
Fortunately, there are two ways that doctors can help to remove the blockage: Coronary angioplasty, and clot-dissolving drugs. Sometimes we use both. Because the clot-dissolving drugs have the side effect of bleeding elsewhere in the body, and because they’ve been found to be a bit less effective, for most patients, the first choice is PTCA, commonly known as angioplasty.
Studies show that angioplasty has an 85-95 percent success rate in opening up blocked arteries. The doctor inserts a catheter into the patient’s artery, usually the femoral artery near the groin or the radial artery in the wrist, feeds it up to where the blockage is in the heart, and inflates a very small balloon, just for a second, to squish the blockage against the wall of the artery. This provides an open tunnel for the blood flow to resume. You’re awake the whole time.
Stents, which are tiny stainless steel mesh cylinders that look like miniature Slinkys, can be inserted into the artery to keep it open. This procedure can restore blood flow rapidly, thus saving the distal muscle.
And the best part is, you can usually go home in a day or two.
Studies show that if your heart blockage can be opened within 90 minutes, your chances of survival are raised dramatically. Of those, 25 percent of people who present with an evolving heart attack and receive angioplasty experience no permanent muscle damage at all. The other 75 percent can have much better outcomes.
So what’s the catch? Time is of the essence, and not all hospitals are equipped to perform angioplasties. If you’re taken to a hospital that isn’t equipped, you’ll need to be transported again. That takes time, which, as you know, can cost you heart muscle.
Here there is only one hospital equipped and staffed to perform angioplasties and that’s Carson Tahoe Regional Medical Center. Smaller clinics and hospitals may be OK for some things, but if you think you’re experiencing a heart attack, get yourself to CTRMC.
Be proactive: Know the signs, get help immediately, and know where you want to go. It could save your heart.
To learn more about angioplasties, go to www.americanheart.org.
Dr. Juneau is a board certified cardiologist at Carson Tahoe Cardiology.
Is it a Heart Attack? Symptoms Differ Between Men and Women
David Baker, MD, Cardiologist, Carson Tahoe Cardiology
Approximately one million Americans suffer a heart attack each year, killing roughly 400,000 people annually, making heart attack the leading cause of death in the United States. Fortunately, treatments are available that can save lives and prevent disabilities; however, recognizing heart attack symptoms and getting help quickly is the best thing you can do to save you or a loved one.
Simply speaking, a heart attack occurs when blood flow to the heart is blocked. The blockage is usually caused by the buildup of plaque inside the coronary arteries which supply blood and oxygen to the heart. Eventually, an area of plaque can rupture, thus forming an open wound within the artery wall and causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can block the flow of oxygen-rich blood to the heart resulting in a heart attack. If the flow of blood isn’t restored quickly, heart muscle suffers permanent damage and begins to die.
The most commonly reported symptom of a heart attack is chest pain. Many people describe the pain as a crushing or squeezing feeling. Sometimes it can be mild, sometimes extremely strong. It might last for a long time, yet it may go away and then come back. The pain may spread from the chest to the left arm, back, jaw or neck.
This chest pain, when coupled with one or more of the following symptoms, usually results in a heart attack:
- Sweating
- Nausea and vomiting
- Trouble breathing
- Fatigue
- Shortness of breath
- Dizziness or lightheadedness
- A fast or irregular heartbeat
- Pain or pressure in one or both arms, back, neck, jaw or even stomach
Presently there is a misconception that heart disease and heart attacks primarily affect men — but heart disease doesn’t discriminate. It is also the number one killer of women. Fueling this misconception is the fact that men and women suffer different symptoms and warning signs during a heart attack.
Research conducted by the National Institute of Health showed that 95 percent of women surveyed often experience new or abnormal physical symptoms as early as a month prior to suffering a heart attack. The most common symptoms reported were unusual fatigue, sleep disturbance and shortness of breath. Shockingly, fewer than 30 percent of the women said they had chest pain, and 43 percent reported they had no chest pain at all. As more research data comes in, it’s becoming increasingly clear that women’s symptoms are not as predictable as men’s.
Women most often experience the following symptoms up to a month prior to a heart attack:
- Unusual fatigue
- Sleep disturbance
- Shortness of breath
- Indigestion and nausea
- Anxiety
Symptoms during the heart attack may include:
- Shortness of breath
- Heart flutter or racing
- Heartburn
- Weakness
- Unusual fatigue
- Cold sweat
- Dizziness
- Pain in the back, between the shoulder blades
- Coughing
There are many possible reasons for the disparity in symptoms. If you look at it from a scientific perspective, women’s hearts are physiologically different from men’s. While this area of study is relatively new, it is certain that women tend to have smaller hearts and smaller arteries. Researchers believe that women also have a faster heart beat, due to a different intrinsic rhythmicity to the pacemaker of their heart, and that it may take their heart longer to relax after each beat.
Perceived pain also is a differentiating factor when looking at heart attacks in women vs men. There are various ways the brain interprets the discomfort signals sent out by the heart. What women perceive as pain is very different from what men perceive as pain. Women tend to ignore the signals while men are more likely to recognize their symptoms as being related to their heart.
According to a survey taken by the American Heart Association, women are more likely to fail to recognize that they are having a heart attack and then they seem to wait longer to seek help. The survey reported that 78 percent of women would call 911 to save someone else, but less than half said they’d call 911 if they were experiencing the same symptoms. Instead they’d “wait it out.” Due to these enlightening facts, the U.S. Department of Health and Human Services has launched a new national campaign urging women to learn the signs of a heart attack and to call 911 immediately upon experiencing the symptoms.
If you are experiencing symptoms of a heart attack, act fast. Quick treatment could save your life.
1. Call 911 or other emergency services right away. Describe your symptoms, and say that you may be having a heart attack.
2. Stay on the phone. They emergency operator will tell you what to do.
3. After calling for help, chew 2 adult-strength aspirin or 3 to 4 low-dose aspirin. Aspirin helps keep blood from clotting, so it may help you survive a heart attack.
If you can’t reach emergency services, or an ambulance is not readily available, have someone drive you to the emergency room as soon as possible. Do not drive yourself.
And if you find yourself in an ambulance or emergency room, don’t be afraid to say, “I think I’m having a heart attack.” If the thought crosses your mind that you may be having a heart attack, you need to speak up. Remember that getting treatment quickly can save your life, so don’t wait. Even if you’re not sure it is a heart attack, you still should have it checked out.
If you have any questions or concerns regarding heart disease, please contact your doctor. When in doubt, check it out.
Dr. Baker is a Board Certified Cardiologist at Carson Tahoe Cardiology.
February 4, 2011
Cholesterol: The Good, The Bad and The Ugly
Carl Juneau, MD, Cardiologist, Carson Tahoe Cardiology
Cholesterol is found among the fats of the bloodstream and in cells in every part of our bodies. It helps the body build new cells, insulate nerves and produce hormones. The liver creates all the cholesterol we need. So where’s the problem? In addition to what the body produces naturally, cholesterol is also in the foods we eat. When we have too much cholesterol in our bloodstream, that’s when the trouble begins.
Too much cholesterol in the bloodstream can build up on the walls of the arteries and form plaque. This plaque narrows the lumen of the arteries, decreasing the space for blood to flow. Over time, this can lead to high blood pressure or can even block blood flow completely, resulting in a heart attack or stroke.
Cholesterol and fats don’t dissolve in the bloodstream. They are taken care of by the liver. Here’s what you need to know: there are two lipoproteins that are involved in transporting cholesterol to and from the cells. These are the levels that your doctor will test for, kind of an indirect method of measuring your cholesterol.
LDL, Low-Density Lipoprotein, is sometimes referred to as the “bad cholesterol”, because it forms plaque. You can remember that it’s the bad one by thinking L for lousy. Lower LDL levels reflect a lower risk of heart attack. HDL, High-Density Lipoprotein, is referred to as the “good cholesterol”. Think H for happy. These lipoproteins carry cholesterol away from the arteries and back to the liver, where it’s excreted from the body. Higher HDL levels lower your risk of heart attack.
The goal is a low LDL and a high HDL. How do we accomplish this? There are three ways: a low cholesterol diet, exercise, and, if that’s not enough, your doctor can prescribe medications. Modifying your diet is the first and easiest step on the road toward a healthy heart.
The American Heart Association offers the following recommendations:
- Eat a diet rich in vegetables and fruit
- Choose whole-grain, high-fiber foods such as peas and beans
- Eat fish at least twice a week
- Avoid partially hydrogenated oils and saturated and trans fats. Oils and fats that are solid at room temperature aren’t good for you.
- Choose lean meats and poultry and don’t eat the skin of poultry.
- Select fat free or low fat dairy products
- Switch to egg whites rather than whole eggs
- Minimize salt intake
- Cut back on sugary drinks
The second step on the path toward heart health is an exercise regime. It doesn’t have to be much, just any kind of physical activity at least four times a week. It can be a walk after dinner, a hike up a mountain, a bike ride, whatever feels good. Remember, if it’s not fun, you likely won’t keep it up. And, exercise has the added benefits of helping to control weight, diabetes and high blood pressure.
Medications are the third step. Several types of medications are available that help lower your cholesterol. Among these are Niacin, Fibrates and Fish Oil. Your doctor may prescribe statins, a kind of medication that helps lower LDL. These require monitoring of liver enzymes as well as cholesterol levels and will necessitate consistent follow up visits to your care provider. And, of course, the fourth thing, need it even be mentioned? STOP SMOKING!
Cigarettes raise your risk of heart disease, lung disease, emphysema, stroke, high blood pressure and a multitude of cancers. They are just plain bad for you.
So there’s your overview of what cholesterol is, how it’s measured and how we can lower our levels. It’s easy really. Eat healthy, exercise often, stop smoking, and take your meds as prescribed. Do it for yourself, to feel better, and do it for the people that love you. They’ll feel better too.
Dr. Juneau is a Board Certified Cardiologist at Carson Tahoe Cardiology.
November 22, 2010
Introducing Carson Tahoe Cardiology
Carson Tahoe Cardiology
David Baker, MD; Carmella Downing, PA-C; Basil Chryssos, MD; Joe Chavez, MD; Jennifer McCord, PA-C and Susan O’Leary, MD – formerly Sierra Nevada Cardiology Associates – feel right at home with Carson Tahoe.
Now associated with Carson Tahoe Cardiology, this exceptional healthcare team is right here in our community, continuing to provide outstanding cardiac care. With convenient access to the entire Carson Tahoe Healthcare system, their practice has grown even stronger thanks to the added resources, specialty services, and dedicated network of healthcare professionals.
Carson Tahoe Cardiology has two locations to best serve Carson City, Douglas County, Lyon County and Lake Tahoe:
1470 Medical Parkway, Suite 160 in Carson City
925 Ironwood Drive, Suite 2107 in Minden
Please call 775.445.7650 with questions or to make and appointment.
Here's to Your Health 