According to the Center for Disease Control, heart disease is the leading cause of death in the United States, killing more than 600,000 people each year.
The physicians at the Florida Hospital Cardiovascular Institute are expertly trained in the diagnosis and treatment of all kinds of arterial and venous conditions. Our experts treat more than 1,600 vascular patients a year, more than any other hospital in the nation.
Listen in as Amit Nanavati, MD discusses your options if you've been diagnosed with a Vascular Disease.
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Management of Vascular Disease
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He received his medical degree from Texas A & M College of Medicine and completed an interventional cardiology fellowship at the University of Florida in Jacksonville.
Learn more about Dr. Amit Nanavati
Amit Nanavati, MD
Interventional cardiologist Dr. Amit Nanavati has joined the Florida Hospital HealthCare Partners medical staff at Florida Hospital Flagler. As an interventional cardiologist, Nanavati performs minimally invasive procedures in the heart, such as angioplasties to open blocked arteries or implanting coronary stents to hold open blocked arteries. Nanavati is board certified in interventional cardiology, cardiovascular diseases and internal medicine.He received his medical degree from Texas A & M College of Medicine and completed an interventional cardiology fellowship at the University of Florida in Jacksonville.
Learn more about Dr. Amit Nanavati
Transcription:
Management of Vascular Disease
Melanie Cole (Host): According to the Centers for Disease Control, heart disease is the leading cause of death in the United States, killing more than 600,000 people each year. My guest today is Dr. Amit Nanavati. He's an interventional cardiologist with Florida Hospital. Welcome to the show, Dr. Nanavati. What conditions constitute vascular disease? What are we talking about here?
Dr. Amit Nanavati (Guest): Sure. First, for vascular disease, also known as “PAD”, peripheral arterial disease, is a very serious disease. It runs a wide spectrum of different conditions. It can range from having pain in the legs from a blockage in the arteries that go to the leg, all the way to having wounds that do not heal because they don't get enough blood flow and enough nourishment for healing. So, peripheral arterial disease ranges that wide spectrum and it's important to catch this disease early before it leads to very serious complications such as wounds that do not heal.
Melanie: How would somebody know if they have peripheral vascular disease?
Dr. Nanavati: There are a number of symptoms. Usually, symptoms start with fatigue in the legs, pain with walking and usually occurs in the thighs or the calf. A lot of times, though, the symptoms are very non-specific, meaning very vague symptoms could be the first markers of peripheral arterial disease. Certainly, pain in the legs, or trouble sleeping, or having to get up at night to dangle one leg could all be symptoms of peripheral arterial disease.
Melanie: Are there certain people that are more at risk for PAD than others?
Dr. Nanavati: Certainly, patients who are over the age of 50 can be at increased risk for this disease. Traditional risk factors for heart disease also apply to peripheral arterial disease such as smoking, diabetes, and high blood pressure and it's important to realize that the same processes that affect the heart can also affect the arteries that go to the leg which is what peripheral arterial disease is--arterial disease in the peripheral arteries goes outside of the heart.
Melanie: So, people would notice this claudication, this leg pain when they're walking or climbing stair When would you tell them it's time to come to a doctor to see somebody to get this checked out, because we all get pains in our legs for one reason or another. It could be back pain. It could be just musculoskeletal. So, what do you tell people is that red flag?
Dr. Nanavati: Really, it's consistency with activities, whether it's walking a certain distance and having pain or just not being able to do what one used to be able to do. Certainly, pain in the calves or the thighs, or the lower back with walking upstairs, is definitely a marker for peripheral arterial disease. There are a lot of conditions that can mimic it, such as back pain from nerves, or arthritic pain; however, it's important to have it evaluated. The initial screening is very simple. It's simply what's called an “arterial brachial index” which is blood pressure cuffs being inflated at various levels to determine where or if the level of blockage--determine where the level of blockage is, if there is one. So, the screening is relatively simple, so I'd encourage anyone who thinks that they might have this condition to at least bring it to medical attention and at least get screened for it.
Melanie: And, then, what are some first-line defense treatments? If you do determine that someone has blockages in their periphery, in their legs, what do you do for them?
Dr. Nanavati: So, the first line treatment is getting on an exercise program. Exercise programs have been shown to help with the symptoms of this condition. So, once a diagnosis is made, that would be the first step. There are medications that are available that can help with the symptoms of this condition. If these things fail, then there are other interventions that can be done, such as balloons and stents to open up the arteries that go to the legs.
Melanie: Okay. So, once somebody gets that, is this something that is permanent? Can peripheral artery disease be reversed?
Dr. Nanavati: With careful attention to risk factors and careful attention to cholesterol and diet, it's definitely possible to stop the progression as much as possible of peripheral arterial disease.
Melanie: Does exercise help to reverse that? Because exercise can even be limiting, Dr. Nanavati, because if it hurts to walk or climb stairs, then that would seem to work against itself.
Dr. Nanavati: Graded exercise is really the key here. So, doing a little bit, up to the level of symptoms and each day, doing a little bit more. A graded exercise program can be very helpful in managing symptoms.
Melanie: And, what do you tell patients about dietary management? Is there any that will contribute or help prevent peripheral artery disease?
Dr. Nanavati: Certainly, the same diet and exercise advice doctors have been giving out for generations which is a low-fat, low-cholesterol diet, and a diet that avoids carbohydrates. It's really a common sense diet to living well, being healthy, but no specific diet just for peripheral arterial disease.
Melanie: So, if you put them on medication, is this something now that they will take for the rest of their lives?
Dr. Nanavati: It really depends on each individual case. In some cases, medications are only temporary until exercise tolerance can build up and the patient deals well without the medicines. The medicines are really to help with symptoms more so than anything else. So, if a patient can overcome the symptoms, then medications may not be permanent.
Melanie: So, give us a little horizon picture, Dr. Nanavati. What are you doing for peripheral artery disease? Where do you see the future going?
Dr. Nanavati: I think the first step really remains prevention and remains vigilance. So, it’s detecting peripheral arterial disease, prevention in terms of lifestyle management, as well as medication management, whether it be managing cholesterol well, having a good diet, managing high blood pressure. One of the key things is to help patients to stop smoking. I think that's very important and when all of these fail, then there are certainly interventions available. They are new and exciting interventions in terms of balloons and stents to open up these arteries. Recently, there was a drug-coated balloon which was developed, which is really helpful in this condition. So, there's really a broad spectrum of interventions available, both in terms of medications and lifestyle management, as well as, should it become necessary, in terms of procedures and angiograms and stents and balloons, that can help to open up blockages.
Melanie: Thank you so much and, Dr. Nanavati, in just the last few minutes, give your best advice for listeners about preventing peripheral artery disease or vascular diseases in general, and why they should come to Florida Hospital for their care.
Dr. Nanavati: I think the first step is really prevention. Keeping good control of blood pressure, keeping a good, healthy diet, exercise, and if one smokes, we can certainly help, and Florida Hospital Flagler has a lot of tools that can help patients stop smoking. That's the first step. If medications are needed, certainly, we're equipped to diagnose and treat. We have the latest in diagnostic equipment for peripheral arterial disease at Florida Hospital Flagler and also the latest in terms of intervention, should balloons and stents become necessary. All those procedures are performed right there and in many cases, patients can go home the same day as their procedure.
Melanie: Thank you so much for being with us today. It's great information. You're listening to Health Chats by Florida Hospital. For more information, you can go to www.hcpphysicians.org. That’s www.hcpphysicians.org. This is Melanie Cole. Thanks so much for listening.
Management of Vascular Disease
Melanie Cole (Host): According to the Centers for Disease Control, heart disease is the leading cause of death in the United States, killing more than 600,000 people each year. My guest today is Dr. Amit Nanavati. He's an interventional cardiologist with Florida Hospital. Welcome to the show, Dr. Nanavati. What conditions constitute vascular disease? What are we talking about here?
Dr. Amit Nanavati (Guest): Sure. First, for vascular disease, also known as “PAD”, peripheral arterial disease, is a very serious disease. It runs a wide spectrum of different conditions. It can range from having pain in the legs from a blockage in the arteries that go to the leg, all the way to having wounds that do not heal because they don't get enough blood flow and enough nourishment for healing. So, peripheral arterial disease ranges that wide spectrum and it's important to catch this disease early before it leads to very serious complications such as wounds that do not heal.
Melanie: How would somebody know if they have peripheral vascular disease?
Dr. Nanavati: There are a number of symptoms. Usually, symptoms start with fatigue in the legs, pain with walking and usually occurs in the thighs or the calf. A lot of times, though, the symptoms are very non-specific, meaning very vague symptoms could be the first markers of peripheral arterial disease. Certainly, pain in the legs, or trouble sleeping, or having to get up at night to dangle one leg could all be symptoms of peripheral arterial disease.
Melanie: Are there certain people that are more at risk for PAD than others?
Dr. Nanavati: Certainly, patients who are over the age of 50 can be at increased risk for this disease. Traditional risk factors for heart disease also apply to peripheral arterial disease such as smoking, diabetes, and high blood pressure and it's important to realize that the same processes that affect the heart can also affect the arteries that go to the leg which is what peripheral arterial disease is--arterial disease in the peripheral arteries goes outside of the heart.
Melanie: So, people would notice this claudication, this leg pain when they're walking or climbing stair When would you tell them it's time to come to a doctor to see somebody to get this checked out, because we all get pains in our legs for one reason or another. It could be back pain. It could be just musculoskeletal. So, what do you tell people is that red flag?
Dr. Nanavati: Really, it's consistency with activities, whether it's walking a certain distance and having pain or just not being able to do what one used to be able to do. Certainly, pain in the calves or the thighs, or the lower back with walking upstairs, is definitely a marker for peripheral arterial disease. There are a lot of conditions that can mimic it, such as back pain from nerves, or arthritic pain; however, it's important to have it evaluated. The initial screening is very simple. It's simply what's called an “arterial brachial index” which is blood pressure cuffs being inflated at various levels to determine where or if the level of blockage--determine where the level of blockage is, if there is one. So, the screening is relatively simple, so I'd encourage anyone who thinks that they might have this condition to at least bring it to medical attention and at least get screened for it.
Melanie: And, then, what are some first-line defense treatments? If you do determine that someone has blockages in their periphery, in their legs, what do you do for them?
Dr. Nanavati: So, the first line treatment is getting on an exercise program. Exercise programs have been shown to help with the symptoms of this condition. So, once a diagnosis is made, that would be the first step. There are medications that are available that can help with the symptoms of this condition. If these things fail, then there are other interventions that can be done, such as balloons and stents to open up the arteries that go to the legs.
Melanie: Okay. So, once somebody gets that, is this something that is permanent? Can peripheral artery disease be reversed?
Dr. Nanavati: With careful attention to risk factors and careful attention to cholesterol and diet, it's definitely possible to stop the progression as much as possible of peripheral arterial disease.
Melanie: Does exercise help to reverse that? Because exercise can even be limiting, Dr. Nanavati, because if it hurts to walk or climb stairs, then that would seem to work against itself.
Dr. Nanavati: Graded exercise is really the key here. So, doing a little bit, up to the level of symptoms and each day, doing a little bit more. A graded exercise program can be very helpful in managing symptoms.
Melanie: And, what do you tell patients about dietary management? Is there any that will contribute or help prevent peripheral artery disease?
Dr. Nanavati: Certainly, the same diet and exercise advice doctors have been giving out for generations which is a low-fat, low-cholesterol diet, and a diet that avoids carbohydrates. It's really a common sense diet to living well, being healthy, but no specific diet just for peripheral arterial disease.
Melanie: So, if you put them on medication, is this something now that they will take for the rest of their lives?
Dr. Nanavati: It really depends on each individual case. In some cases, medications are only temporary until exercise tolerance can build up and the patient deals well without the medicines. The medicines are really to help with symptoms more so than anything else. So, if a patient can overcome the symptoms, then medications may not be permanent.
Melanie: So, give us a little horizon picture, Dr. Nanavati. What are you doing for peripheral artery disease? Where do you see the future going?
Dr. Nanavati: I think the first step really remains prevention and remains vigilance. So, it’s detecting peripheral arterial disease, prevention in terms of lifestyle management, as well as medication management, whether it be managing cholesterol well, having a good diet, managing high blood pressure. One of the key things is to help patients to stop smoking. I think that's very important and when all of these fail, then there are certainly interventions available. They are new and exciting interventions in terms of balloons and stents to open up these arteries. Recently, there was a drug-coated balloon which was developed, which is really helpful in this condition. So, there's really a broad spectrum of interventions available, both in terms of medications and lifestyle management, as well as, should it become necessary, in terms of procedures and angiograms and stents and balloons, that can help to open up blockages.
Melanie: Thank you so much and, Dr. Nanavati, in just the last few minutes, give your best advice for listeners about preventing peripheral artery disease or vascular diseases in general, and why they should come to Florida Hospital for their care.
Dr. Nanavati: I think the first step is really prevention. Keeping good control of blood pressure, keeping a good, healthy diet, exercise, and if one smokes, we can certainly help, and Florida Hospital Flagler has a lot of tools that can help patients stop smoking. That's the first step. If medications are needed, certainly, we're equipped to diagnose and treat. We have the latest in diagnostic equipment for peripheral arterial disease at Florida Hospital Flagler and also the latest in terms of intervention, should balloons and stents become necessary. All those procedures are performed right there and in many cases, patients can go home the same day as their procedure.
Melanie: Thank you so much for being with us today. It's great information. You're listening to Health Chats by Florida Hospital. For more information, you can go to www.hcpphysicians.org. That’s www.hcpphysicians.org. This is Melanie Cole. Thanks so much for listening.