Brigham and Women’s Cardiovascular Associates at Care New England provides innovative, personalized, and compassionate care of the highest quality for the entire array of cardiovascular diseases and conditions.
From more common cardiovascular conditions, such as coronary artery disease, vascular disease, and heart rhythm disorders, to lesser-known diseases, we have the expertise and advanced technologies necessary to provide the best health care to patients.
The staff at Brigham and Women’s Cardiovascular Associates at Care New England are among the most renowned. We offer highly integrated and comprehensive care with specialists in cardiovascular medicine, cardiac surgery, and vascular surgery, working together to provide a collaborative and personal experience.
The specialized procedures consist of a variety of preventative, interventional, and non-invasive methods of care. These may require tests, clinical evaluation, advanced imaging, devices, or advanced cardiac care nursing support.
Some tests may include:
We have consultative cardiology coverage 24 hours a day, seven days a week, 365 days a year. Our team of Care New England Cardiology providers also offers inpatient evaluations, outpatient evaluations at one of our convenient sites, preoperative assessment, diagnostic testing review, and second opinions for complex cases.
We offer an array of advanced imaging modalities, including:
This service, led by Bruce Koplan, MD, provides a full range of consultative and procedural services focused on the heart's electrical system, including:
This service provides Percutaneous Coronary Intervention (PCI), which includes angioplasty and stenting. This non-surgical procedure involves opening up blood vessels narrowed by plaque accumulation using a thin tube.
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From diagnosis and treatment to surgery and ongoing care, we offer comprehensive care for individuals with congenital heart disease.
If you are an adult with congenital heart disease, getting the proper care is vital to your well-being. You can receive a consultation, a meeting, or treatment with Brigham and Women’s Cardiovascular Associates at Care New England, no matter your condition, with the team led by Fred Wu, MD.
What is Adult Congenital Heart Disease?
Congenital heart defects occur during fetal development. For the heart to develop properly, a series of genetically and environmentally determined steps have to take place. If one of these steps doesn’t happen, a defect develops. The results can intensify over someone’s lifetime.
Congenital heart disease is the most common birth defect. According to the American Heart Association, about 1% of people born in the United States has a congenital heart defect.
Someone should consider care for congenital heart disease if they:
There are many types of congenital heart disease, varying in severity and consequence. For many congenital heart defects, there are few or no symptoms. Severe defects, however, often cause symptoms at any age. These symptoms may include:
Severe defects may be diagnosed before or soon after birth, but some may not be diagnosed until much later in life or are never detected.
Along with a careful physical examination and evaluation, a cardiologist may order one or more of the following tests or procedures:
Minimally Invasive Catheter Procedures
Surgery may be recommended for the following reasons:
Cardiac surgeons offer a variety of surgical techniques, which include:
Brigham and Women’s Cardiovascular Associates at Care New England offers expert care for any condition affecting your heart’s valves or chambers. We use the latest treatments, including minimally invasive techniques and procedures.
The Care New England Advanced Valvular and Structural Heart Disease Clinic at Kent Hospital features a local heart care team lead by Cardiologist Alice Kim, MD, and Cardiothoracic Surgeon Tsuyoshi Kaneko, MD, who are both affiliated with Kent Hospital and Brigham and Women's Hospital. Dr. Kim and Dr. Kaneko evaluate and manage patients who have advanced valvular disease and structural heart disease with the opportunity to have expert care for these complex conditions in a setting close to home.
Office visits, imaging studies, and diagnostic testing are performed locally in Rhode Island. Patients who require valve interventions such as transcatheter therapies or minimally invasive or traditional cardiac surgery at Brigham and Women’s Hospital will have the convenience of receiving pre and post-procedure care locally.
This unique link between the cardiologists at CareNew England and the team at the Heart and Vascular Center at Brigham and Women’s Hospital has widely advanced the options available for patients in Rhode Island who need cardiac care.
We believe in the practice of patient-focused and evidence-based care delivered by a regional heart team of general cardiologists, cardiothoracic surgeons, interventional cardiologists, cardiac imaging specialists, and cardiac anesthesiologists. We work together with the patient and their families in shared decision-making for optimal patient care, safety, and outcomes.
What is heart valve disease?
Heart valve disease involves two main types of conditions: regurgitation and stenosis.
Heart valves can develop in both conditions at the same time. The consequences for the heart can be severe. Blood will not pump properly through the body.
What are the types of replacement valves?
What are the repair or replacement procedures?
Minimally Invasive Surgery Procedures
What is Amyloid Heart Disease?
Amyloidosis refers to a group of diseases caused by deposits of abnormal proteins, known as amyloid, in one or more organs of the body. Deposition of amyloid in the heart is known as cardiac amyloidosis or amyloid heart disease. When this occurs, the heart becomes stiff, causing fluid build-up in the lungs that leads to breathlessness and fluid buildup in soft tissues, which, in turn, leads to leg and abdominal swelling.
If you or a loved one have an aortic aneurysm or another condition affecting your aorta, the boy’s largest blood vessel, it’s important to get timely treatment to prevent life-threatening complications.
What is an aneurysm?
An aneurysm may be found in many areas of the body, such as:
The most common type of aneurysm is in the aorta. The aorta carries oxygenated blood from the heart to the rest the body.
What causes an aneurysm?
An aneurysm may be caused by factors that result in the breakdown of the artery wall. Atherosclerosis (hardening of the arteries) may be a cause.
Other causes of aneurysms are related to where they occur. Examples may include:
Aneurysms may have no symptoms. If there are symptoms, they will depend on the location of the aneurysm in the body.
Other alternatives include:
What is atrial fibrillation?
Atrial fibrillation, or AFib, is the most common type of abnormal heart rhythm, or arrhythmia. A group of cells signals the heart to begin a heartbeat. This signal originates in the right atrium, which is the upper right chamber of the heart. It travels through the heart to the upper-left chamber or the left atrium and then to the pumping chambers. The heart contracts and blood is moved.
During atrial fibrillation, the signals are not regular and not organized. The blood is not being provided to the body, and blood can also pool and cause clots to form. These clots are usually found in the left atrium because of an area in the chamber where several lobes are located. These clots can be pumped to the brain and cause a stroke.
Atrial fibrillation is normally classified into three types:
There are many causes, but some include:
What is atherosclerosis?
Atherosclerosis is a buildup of plaque (mainly cholesterol deposits) within the arteries. This thickening of the artery walls decreases the flow of blood and oxygen to vital body organs and extremities, which can lead to severe cardiovascular diseases, such as:
Coronary heart disease (CHD) occurs when plaque builds up in the lining of the coronary arteries. The resulting narrowing of the arteries prevents blood and oxygen from flowing easily to the heart muscle, which may cause angina (pain, discomfort, or pressure in the chest). If blood flow is completely blocked by plaque or by a blood clot that forms inside the narrowed coronary artery, a heart attack may occur.
Cardiovascular specialists at Brigham and Women’s Cardiovascular Associates at Care New England offer comprehensive, compassionate, and innovative inpatient and outpatient services to adults with conditions related to atherosclerosis. We offer a broad range of diagnostics and cutting-edge medical, interventional, and surgical therapies.
Significant advances in cancer treatment have helped us to more effectively control cancer and markedly extend the lives of patients. However, some of these advanced therapies can also produce serious cardiovascular side effects.
Many cancer patients develop some type of heart complication as a result of cancer therapy. Potential complications include heart failure and cardiomyopathy, arrhythmia, and hypertension.
Brigham and Women’s Cardiovascular Associates at Care New England brings together expert cardiovascular specialists and oncologists to provide optimal care for cancer patients during and after cancer treatment.
We care for cancer patients who have pre-existing heart conditions and those who develop cardiac side-effects to cancer treatment. Working together as a team, we help minimize cardiotoxicity during cancer treatment and cardiovascular risks during cancer survival. Specialized surgical care is also available for patients who have non-cancerous tumors of the heart or atrial myxoma.
With Brigham and Women’s Cardiovascular Associates at Care New England, a multidisciplinary team of specialists collaborates to provide the most appropriate and effective care for patients with cardiac sarcoidosis and inflammatory heart disease.
What is sarcoidosis?
Sarcoidosis is a rare inflammatory disease of adults that can occur in almost any organ. It affects the lungs (pulmonary sarcoidosis) in most patients. Sarcoidosis can affect the heart in about 20 percent of patients and is called cardiac sarcoidosis.
The cause of sarcoidosis remains unknown.
Sarcoidosis can be difficult to diagnose because symptoms often do not appear in the early stages and when they do, they can mimic other diseases. When sarcoidosis appears in the heart (cardiac sarcoidosis), patients may experience:
Cardiac sarcoidosis can be challenging to diagnose because symptoms can often mimic those of other diseases.
To effectively diagnose sarcoidosis, your physicians will review any results from tests you have already had done and may recommend others (see services below). These can include imaging studies and biopsies, among other tests.
If your symptoms are not severe, treatment may not be necessary and the disease may resolve on its own. If it does not resolve, the multidisciplinary medical team will recommend an individualized treatment plan which may include:
Additionally, if your cardiac sarcoidosis has caused heart rhythm issues (arrhythmias), we may recommend one or more of the following:
Brigham and Women’s Cardiovascular Associates offers comprehensive evaluation, diagnosis, and management for those who are at risk for or have an inherited cardiac disorder. Genetic testing can be used to create a diagnostic and treatment plan for each patient and their family members who also may be at risk.
Screening should be done for patients whose blood relatives have certain cardiovascular diseases. Some of these conditions include:
Tests to evaluate patients may include:
Treatment varies on a variety of factors, including age, health, family and medical history, and severity of a disease. Some treatment options can include:
What is carotid artery disease?
Also called carotid artery stenosis, is a narrowing of the carotid arteries. It is related to the build0up of plaque in the artery, or atherosclerosis. A stroke can occur is blood flow is obstructed to the brain.
Atherosclerosis is the main cause of the disease, and other factors may include:
Computed tomographic scanning and magnetic resonance imaging are used for evaluation. Some of these procedures may include:
The treatment for carotid artery disease varies on a variety of factors, but a specialist may prescribe:
Cerebrovascular disease includes to conditions and diseases that impact blood flow to the brain, which can lead to a stroke. These include:
It is caused by a lack of blood flowing through the vessels, which can result in:
If you have advanced heart failure, you can manage it with world-class care from Brigham and Women’s Cardiovascular Associates at Care New England. From congestive heart failure to pulmonary hypertension, our comprehensive program treats every heart failure condition. Here’s what you can expect from our team, led by Garrick Stewart, MD:
From medication and lifestyle management to surgery and heart transplant, Care New England offers every type of treatment you need to manage your heart failure. Our care offerings include:
What is congestive heart failure and cardiomyopathy?
Congestive heart failure is when the heart fails to sufficiently pump oxygenated blood. The heart continues to pump, but not as efficiently as a healthy heart.
Cardiomyopathy, which describes any disorder that affects the heart muscle, also can be a contributing cause of heart failure.
Three forms of cardiomyopathy are:
After an evaluation from a physician, a cardiologist may order one of these tests or procedures:
What is coronary artery disease?
The heart is a muscle that needs oxygen in order to function and pump blood, and it receives the oxygen it needs from coronary arteries. Blood flows easily through the artery when it is healthy, but blockages inside the arteries can cause damage. These blockages include plaque, which can be caused by issues like cholesterol buildup, high blood pressure, and high blood sugar.
The arteries are narrowed, which, when the body is under stress, such as when exercising, can cause pressure, tightness, pain in the chest or in other parts of the body.
A blocked artery occurs when plaque breaks off inside the artery, or a blood clot forms, and blocks the passageway, which causes the blood flow to stop. This is the reason why a heart attack occurs.
Coronary artery disease, or coronary heart disease, is the most common type of heart disease.
What is deep vein thrombosis and a pulmonary embolism?
Deep vein thrombosis occurs when there are blood clots in the deep leg veins if the lower extremities. Pulmonary embolism occurs when a clot breaks off from the walls of a vein and then travels to the heart. This condition is very serious and can lead to a patient’s death.
There are various risk factors that include:
During a pulmonary embolism some symptoms can include:
Treatment can involve:
What is endocarditis?
Endocarditis is an infection of heart valves or possibly the inner lining of the heart chambers. These infections can be caused by bacteria or a fungus.
Patients who have had heart valve replacement or have damaged valves are at the greatest risk, but there are a number of factors:
When a heart attack assaults the body, every second counts. Care New England is a regional leader in cardiac care and can provide the rapid and advanced response needed to provide life-saving care to those suffering from a heart attack.
If you or a loved one is experiencing symptoms of a heart attack, call 911 immediately.
What Causes a Heart Attack?
A heart attack occurs when the flow of blood to a portion of the heart is blocked suddenly. With coronary artery disease, a buildup of a fatty substance, which is called plaque, within artery walls leads to the development of atherosclerosis, or the stiffening and narrowing of the arteries. When a piece of plaque breaks or splits off, a blood clot forms inside the artery. That stops blood flow to that portion of the heart.
A heart attack can occur at any age but the risk increases over time.
Not all heart attacks come on abruptly. Symptoms may be different for some individuals, including involving indigestion.
How is a heart attack treated?
You may also need other procedures to restore blood flow to the heart. These may include:
Percutaneous coronary intervention or coronary angioplasty
This procedure opens up a blocked or narrowed coronary artery by using a small balloon inserted with a catheter and then inflated inside the blocked artery, which helps open the blocked area. The blockage can also be cut out or destroyed using other methods. A special tube called a stent may also be placed inside the artery to help it open.
Coronary artery bypass graft
This surgery is also called bypass surgery. It is often done in people who have chest pain (angina) and severe coronary artery disease that can't be treated with percutaneous coronary intervention.
During the surgery, the surgeon makes a bypass to let blood flow around the blockage. This is done by grafting a piece of a vein from the aorta to the coronary artery beyond the blocked part of the artery. A healthy blood vessel is used for the graft and usually is taken from:
For personalized, comprehensive care of your irregular heartbeat (called an arrhythmia), the cardiac physicians of Brigham and Women’s Cardiovascular Associates at Care New England will develop a treatment plan that’s right for you.
From offering dedicated care for atrial fibrillation to the monitoring of your device, we combine deep clinical experience with expertise in the latest technologies.
Our experts are adept at providing exceptional care to patients with irregular heart rhythms, heart palpitations, and rapid heartbeats.
What is a heart rhythm disorder?
Heart rhythm disorders (arrhythmias) are atypical heartbeats that cause the heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly, which is caused by a problem with the heart’s electrical system.
After an evaluation from a physician, a cardiologist may order one or some of the following tests or procedures:
Blood pressure is the force of blood traveling through an artery. With each heartbeat, blood is pumped from the heart and into the blood vessels. Every time the heart beats, pressure is created inside arteries as the heart contracts and relaxes.
High blood pressure occurs when the force inside the arteries is too high during the contraction or relaxation.
Complications of high blood pressure include:
Very high blood pressure may exhibit:
Check blood pressure
Systolic pressure – top number is the pressure inside the artery when the heart contracts
Diastolic pressure- the bottom number is the pressure inside the artery when the heart is at rest
There are four ratings of blood pressure:
Normal – 120/80 or less
Elevated – Systolic 120-129 and diastolic less than 80
Stage 1 high blood pressure – Systolic is 130-139 or diastolic is 80-89
Stage 2 high blood pressure – Systolic is 140 or higher or diastolic is 90 or higher
High fiber foods
Limit calories and fat in food
Limit salt (sodium) in food
Limit serving sizes in food
Reduce alcohol consumption
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor blockers
Calcium channel blockers
What is pericardial disease?
Pericardial disease, or pericarditis, is inflammation of the thin membrane that surrounds the heart. The inflammation can cause the fluid that is present to increase and disrupt the heart to be able to fill and function properly.
What is peripheral artery disease?
It is a circulation disorder that affects the arteries in the arms and legs. It is closely associated with the narrowing and blocking of arteries in atherosclerosis, and it found often in patients with coronary artery disease.
Lifestyle changes may be necessary, including exercise, diet, and quitting smoking, but a provider may prescribe other treatments:
Pregnancy can have an impact on the heart. Changes to the heart and circulatory system during pregnancy include:
Combining clinical and research expertise in cardiovascular disease and high-risk obstetrics, Brigham and Women’s Cardiovascular Associates at Care New England work with medical teams at Kent Hospital and Women and Infants Hospital to provide care to women looking to get pregnant or have high-risk pregnancies.
Our specialists use a multidisciplinary approach to diagnose and treat women with arrhythmia, cardiomyopathy, coronary artery disease, structural heart disease, vascular disease, and other serious cardiovascular conditions. This includes care for women with pre-existing heart and vascular disease or for women who develop cardiovascular conditions during pregnancy.
This service, led by Fred Wu, MD, provides consultation for patients with pulmonary hypertension and symptoms that might require advanced medical or interventional management. This clinic also serves adult patients with a history of congenital heart disease requiring local follow-up.
Brigham and Women’s Cardiovascular Associates at Care New England brings together pulmonary and critical care medicine physicians, cardiothoracic surgeons, interventional cardiologists, and cardiovascular medicine clinicians who have extensive experience in the diagnosis of implementation of treatment for all forms of pulmonary vascular disease and hypertension.
What is pulmonary hypertension?
Pulmonary hypertension is high blood pressure in the blood vessels of the lungs. It occurs when the blood vessels that go through the lungs become thicker, constrictor becomes blocked. This leads to increased pressure in those vessels, which causes the heart to work harder to pump blood through the lungs. This weakens and enlarges the heart and its proper functions.
While the exact cause of pulmonary hypertension is unknown, there are a number of factors that may contribute, including:
Other common symptoms include:
Pulmonary hypertension is rarely discovered during a routine medical examination, and it can be confused with other conditions that affect the heart and lungs.
Diagnosis typically is a process of exclusion. Diagnostic procedures may include:
What is renal artery stenosis?
Renal artery stenosis is a blockage of an artery to the kidneys. This can be caused by atherosclerosis, or a build-up of plaque in the arteries, or by a condition such as fibromuscular dysplasia and Takayasu’s arteritis.
When blood flow is prohibited from traveling to the brain, a stroke can occur when a blockage occurs in one of the blood vessels or when a blood vessel bursts. Treating cardiovascular disease and managing cardiovascular conditions are vital to stroke prevention.
What is thoracic outlet syndrome?
Thoracic outlet syndrome is characterized by conditions involving compression or tightening of arteries, nerves, or veins in the area between the spin, collarbone, and top rib. The condition can result in pain in the shoulders and neck as well as weakness, but it can also lead to blood clots.
There are different forms of thoracic outlet syndrome:
What is ventricular tachycardia?
Ventricular tachycardia is a fast, abnormal heart rate. It starts in your heart’s lower chambers, called the ventricles. It is defined as a heartbeat that is three or more heartbeats in a row, at a rate of more than 120 beats per minute.
It can become life-threatening if it is sustained for more than 30 seconds. The rapid heartbeat doesn't give the heart enough time to fill with blood before it contracts again. This can affect blood flow to the rest of the body.
Ventricular tachycardia is caused in two ways:
At Brigham and Women’s Cardiovascular Associates at Care New England, treatment is provided by some of the world's most experienced physicians in cardiac electrophysiology (the study of heart’s electrical system).
To diagnose ventricular tachycardia, the heart rhythm has to be recorded. That requires an electrocardiogram, or heart activity can be monitored using a Holter monitor or diagnosed from a stress test.