Central Maine Healthcare

Where You are the Center

Conditions We Treat

Vein Disorders

Although you may think of varicose veins only as a cosmetic problem—and sometimes, that’s all they are—they can sometimes lead to serious issues such as leg pain, leg swelling and the development of serious blood clots.

At the CMHVI, we offer a full range of vein treatments for people whose vein disorders are a health risk. Most insurance plans cover varicose vein treatment if self-help management has failed to alleviate symptoms.

Varicose Veins Can Be More than a Visual Concern

Your arteries carry blood from your heart to the rest of the body and your veins deliver blood back to the heart. In healthy veins, valves help prevent blood from flowing backwards. In patients with a condition known as venous insufficiency, the valves are damaged and no longer work properly. Venous insufficiency causes leg veins to enlarge, twist and appear blue or purple, a condition called varicose veins.

Varicose veins are not necessarily a serious health risk, but they can be painful and cause leg ulcers that are resistant to healing. In addition to swelling, they can raise your risk for serious blood clots known as deep vein thrombosis (DVT).

Get a Non-invasive Diagnosis

CMHVI’s Vascular Lab uses non-invasive ultrasound to diagnose conditions and abnormalities of the circulatory system, including vein disorders. The Vascular Lab is accredited by the Intersocietal Accreditation Commission, which accredits vascular laboratories. Our sonographers are nationally certified. Some of the diagnostic testing we use for vein disorders includes:

  • Arterial Duplex Ultrasound: This test is used to evaluate issues involving arteries and/or veins of the arms and/or legs. It is a painless, non-invasive procedure that uses sound waves to measure blood flow and measure blood vessel size. 
  • Venous Ultrasound Imaging: This test uses sound waves to capture real-time images of the flow of blood through veins in the arms and legs. It is used to evaluate varicose veins and to search for DVT blood clots, especially in leg veins. These clots can cause a dangerous condition called pulmonary embolism if they move to the lungs. However, if a blood clot in the leg is detected early enough, proper treatment can prevent it from passing to the lung.

Receive Treatments Specific to Your Disorder

Our vascular and endovascular surgeons can treat varicose veins and other vascular conditions using some of the following procedures:

  • Microphlebectomy: A diseased vein is removed through a series of very small incisions. Recovery is fast, but the procedure doesn’t fix the underlying problem of leaky valves.
  • Sclerotherapy: Using a small needle, a provider injects spider veins and small varicose veins with a solution that seals the veins. The treated veins fade after a few weeks, but the same veins may require more than one treatment. This treatment may not be covered by your health insurance.
  • Stripping and Ligation: Along section of vein is tied off, usually at the groin, then removed along the length of the thigh. This conventional treatment for varicose veins has been largely replaced by minimally invasive venous ablation.
  • Venous Ablation: The provider inserts a catheter into the enlarged vein and uses ultrasound imaging to guide the catheter to the saphenous vein, a major blood vessel in the thigh. The catheter emits radiofrequency energy that closes the vein. This sealing of the saphenous vein typically causes decompression of downstream varicose veins resulting in symptomatic relief and improved appearance. Blood is naturally rerouted into healthy veins and is carried back to the heart more efficiently. This procedure causes less post-operative pain and bruising than vein stripping and promotes faster recovery.

Valve Disease

Structural heart disease is any type of abnormality of the heart’s muscle, valves, arteries or other supporting structures. The most common type of structural heart disease is aortic stenosis, which affects about 1.5 million Americans.

In the past, open heart surgery offered the only option for repairing structural heart conditions. But now, minimally invasive surgery offers you or your loved one a far less complex way to correct some structural heart and valve problems. Our heart providers have expertise in all types of heart valve surgeries, including minimally invasive aortic valve and mitral valve surgery. We offer valve repair as well as both aortic valve replacement (AVR) and transcatheter aortic valve replacement (TAVR)] a revolutionary, minimally invasive alternative to open heart surgery.

What is Structural Heart and Valve Disease?

Aortic stenosis is a condition that affects the aorta, which is the main artery through which blood flows from the heart to the rest of your body. The aortic valve must open fully to allow blood to flow and then close to prevent blood from flowing back into the heart. When your aortic valve doesn’t function properly, blood flow from the heart is decreased and the heart must work harder to pump blood, which can cause thickening of the heart as well as chest pain. Over time, blood can back up into your lungs.

Although aortic stenosis can develop before birth (congenital aortic stenosis), it is more likely to occur later in life, because of a buildup of calcium deposits on the aortic valve. Aortic stenosis afflicts about 2 percent of people over age 65. It’s important to diagnose and replace faulty heart valves, because if you have severe aortic stenosis and don’t have the valve replaced, the chance of dying in two to three years increases by roughly 50 percent.

Another common type of structural heart disease is mitral valve stenosis. The mitral valve is located between the left atrium and the left ventricle of the heart and controls blood to flow from the left atrium into the left ventricle. Problems with this valve can make it harder for your heart to pump blood properly.

Recognize Valve Disorder Symptoms

Valve disorders can cause the following symptoms:

  • Chest pain or discomfort that may worsen with activity
  • A feeling of pressure or squeezing in the chest that can extend into the arm, jaw or neck
  • Cough, sometimes bloody
  • Trouble breathing during activity
  • Fatigue
  • Heart palpitations
  • Fainting
  • Weakness, lightheadedness or dizziness, particularly with activity
  • Swelling of the feet or legs

How Do You Determine Structural Heart Disease?

To diagnose structural heart disease, your cardiologist starts by giving you a physical exam and talking with you about your symptoms and health history. You may also receive one or more of the following diagnostic tests:

  • Electrocardiogram (ECG): This test uses small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart. 
  • Echocardiogram: In this noninvasive test, sound waves are used to produce a video image of your heart in motion. 
  • Chest X-ray: This test can show whether your heart is enlarged and whether you have enlarged blood vessels or calcium buildup in your heart. 
  • Cardiac stress test (also known as a treadmill test or exercise EKG or ECG): This test measures how your heart performs in response to exercise or stress by monitoring blood flow and oxygen levels as your heart beats faster and works harder.
  • Cardiac computerized tomography (CT) scan. This test uses a series of X-rays to look at the size and condition of your heart and heart valves.
  • Catheterization and angiogram: During this test, a cardiologist guides a catheter (a thin plastic tube) through an artery in the arm or leg into coronary arteries. Dye is injected through the catheter, to make images that can be captured in an X-ray. This test allows your providers to look at your heart and heart valves. 
  • Cardiac MRI: This test uses magnets and radio waves to create images of your heart as it beats. It can give your providers a better idea of whether your heart or valves are damaged. 

Peripheral Artery Disease

Just as the arteries in your heart can become narrowed and blocked by atherosclerosis, so too can the arteries that bring blood to your legs, stomach, head and arms. When these arteries in the outer regions of the body become blocked, the resulting condition is known as peripheral artery disease (PAD). PAD can cause severe pain; without intervention, PAD can cause gangrene that can require amputation.

Luckily, treatment can help. If you have PAD, you can trust the board-certified vascular and endovascular surgeons at CMHVI to provide you with the care you need.

PAD: Learn When It’s More than Leg Pain

PAD is caused by a build-up of plaque in the arteries (most often, of the legs) that restricts blood flow. If you have PAD, you may suffer muscle pain while walking, a condition known as claudication. In severe cases, PAD can cause severe foot pain or gangrene.

Symptoms of PAD may include:

  • Leg pain while exercising that does not go away when you stop moving
  • Foot or toe wounds that do not heal or that heal slowly
  • Coldness in your lower leg or foot 
  • Reduced growth of toenails or leg hair
  • Erectile dysfunction, particularly in men with diabetes

Get a Thorough Diagnosis with a Range of Diagnostic Tests

Our vascular specialists have a range of diagnostic tests they can use to determine whether you have PAD. They include:

  • Ankle Brachial Indexes:  This test measures blood pressure in your arms and legs for comparative analysis. The ratio of the two measurements can indicate if there is a blood flow problem in the legs.
  • Segmental Pressures Test: Like ankle-brachial index testing, this uses two or three additional blood pressure cuffs placed just below the knee, just above the knee and at the upper thigh. Significant drops between body segments may suggest blockages or narrowing in the arteries. 
  • Arterial Duplex Ultrasound:  This painless, non-invasive procedure uses sound waves to gather information and evaluate issues involving the arteries and/or veins of the arms and/or legs. 
  • Computed Tomographic Angiography (CT): This non-invasive test creates images of the arteries in your legs, abdomen or pelvis.  
  • Magnetic Resonance Angiography (MRA): This non-invasive test is like a CT but creates images without the use of X-Rays. 
  • Peripheral angiogram: This is a test that uses dye X-rays to determine whether arteries that bring blood to your legs are narrowed or blocked.

What Are Your Options for Treatment?

Depending on how serious it is, your PAD may be treated in the following ways:

  • Diet modification: Many people with PAD have unhealthy cholesterol levels. Your provider may suggest eating a diet low in saturated fat and trans fats to help lower your cholesterol levels. If you’re overweight, your provider may recommend weight loss. 
  • Exercise: Regular activity can be a very effective treatment for PAD and its symptoms. Your provider may recommend that you participate in our Cardiopulmonary Rehabilitation Program. Cardiac rehabilitation is a medically supervised program to help heart failure patients recover by following an individualized plan that provides evaluation and instruction on physical activity, nutrition, stress management and other health-related areas as needed. Other activities that may benefit you include walking outdoors, treadmill walking and leg exercises designed specifically for people with PAD. 
  • Smoking Cessation: If you smoke, your provider can help you find a program to help you quit. Smoking makes PAD worse. 
  • Managing diabetes: Because diabetes raises the risk of PAD, taking steps to keep your blood sugar under control can help manage PAD. 
  • Medication: Various medications can help people with PAD. For example, your provider may prescribe medication for cholesterol, blood pressure or to prevent the formation of blood clots.  
  • Balloon angioplasty with a stent: A stent is a tiny mesh tube that our providers implant in an artery to prevent plaque from blocking the blood vessel. After clearing a blockage in an artery with a balloon angioplasty, your provider uses a catheter to place the stent in the newly opened artery. The stent helps hold the artery open and reduces the chance that plaque will block the artery again. 
  • Bypass surgery: This procedure uses an implanted blood vessel from elsewhere in your body to create a new path for blood flow around a blocked artery. 

Arrhythmia/Atrial Fibrillation

A healthy heart beats smoothly, with a steady rhythm. If your heart beats too quickly, too slowly or irregularly, you may be experiencing arrhythmia. In that case, it’s important to be diagnosed and treated to reduce your chances of more serious problems such as stroke. In fact, your risk of stroke is about five times higher if you have atrial fibrillation (AFib), the most common form of arrhythmia.

Trust the board-certified cardiologists at CMHVI to provide you with the arrhythmia care you need. Our cardiac electrophysiology heart specialist will use the resources available in our Electrophysiology Lab to diagnose and treat any condition affecting your heart’s electrical system. We offer a range of treatments that can help you feel better and help prevent the health problems that can result from this condition.

When Your Beat is Off: About Arrhythmia

Arrhythmias affect millions of Americans, including about nine percent of people over the age of 65. They are related to the complex system in your heart that manages your heartbeat. Certain cells in your heart create electrical signals that cause your heart to beat and pump blood. When you have AFib or other type of arrhythmia, the electrical impulses that control your heartbeats occur unevenly, rather than at a steady, measured pace. People with AFib sometimes describe it as making their heart feel as if it’s quivering like a bowl of gelatin.

In addition to AFib, there are several kinds of arrhythmias, including:

  • Bradycardia (slow heart rate)
  • Tachycardia (very fast heart rate)
  • Conduction disorders (abnormal heartbeat)
  • Premature contraction (early heartbeat)

It’s important to diagnose and treat AFib and other heart rhythm disorders as early as possible, because they can interfere with normal blood flow. Over time, this can damage your lungs, brain and other organs. They may even lead to stroke or heart failure.

Know the Symptoms of Arrhythmia

If you experience any of the following symptoms, you may have AFib or some other heart rhythm abnormality.

  • A fast, slow or irregular heartbeat
  • A feeling that your heart is skipping beats
  • Lightheadedness or dizziness
  • Chest pain
  • Shortness of breath 
  • Sweating 
  • Getting tired more easily when you exercise
  • Fainting
  • Chronic fatigue

How Will You Be Diagnosed?

When you visit our state-of-the-art Electrophysiology Lab, our cardiac electrophysiology heart specialists will take your medical history and perform a physical exam. They’ll also perform one or more of the following diagnostic tests to learn more about your heartbeat.

  • Electrocardiogram (ECG): This test uses small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart. 
  • Echocardiogram: In this noninvasive test, sound waves are used to produce a video image of your heart in motion.
  • Holter monitor: This portable ECG device is carried in your pocket or worn on a belt or shoulder strap. It records your heart’s rhythms for 24 hours or longer, giving your provider a prolonged look at any problems.
  • Transtelephonic monitor: For infrequent arrhythmias or arrhythmias that come and go, this monitor attaches to your arms, wrists or fingers for a month or two. It records and stores information about your heart’s electrical system, which can be transmitted to your provider. 
  • Treadmill testing: Also known as a stress test or exercise test, a treadmill test can check for arrhythmias that occur with activity. 
  • Blood tests: These help your provider rule out thyroid problems or other substances in your blood that may lead to AFib.
  • Chest X-ray: These images help your provider see the condition of your lungs and heart and may help diagnose conditions other than AFib that may explain your signs and symptoms.

Understand Your Treatment Options

If our tests show that you have AFib or another form of arrhythmia, you and your provider discuss the best approach to managing your symptoms and reducing your risk of complications. Your provider may recommend one or more of the following treatments for arrhythmia:

  • Medication: Drugs used to treat arrhythmias include anti-arrhythmia drugs, drugs that control heart rate and blood thinners.
  • Pacemaker and Implantable Cardioverter-Defibrillator (ICD): An ICD is a tiny device implanted through a small incision under the collarbone during a minimally invasive surgery. The system includes a palm-sized device with electrical leads that connects to your heart to restore a normal rhythm. Recovery is quick, though some patients may stay overnight. 
  • Cardioversion: Cardioversion is a medical procedure for treating an abnormally fast or irregular heartbeat. Most commonly used for AFib, atrial flutter or ventricular tachycardia, cardioversion sends an electrical impulse to your heart muscle, restoring normal heart rhythm. Cardioversion is usually performed as a scheduled treatment and may be repeated if the arrhythmia returns. 
  • Radiofrequency Ablation: During an ablation procedure, small areas of your heart muscle are purposely destroyed to create scars (called lesions) that improve your heart’s function by correcting a faulty electrical process. 
  • Catheter Ablation: This procedure uses intense cold or high-frequency electrical energy to disrupt an abnormal heart rhythm. Ablation is performed surgically or with a thin, flexible tube (catheter) that is inserted into a blood vessel in the groin or neck and guided into the heart. Your provider uses the catheter for the ablation, which is done either with intense cold (cryo-ablation) or with high-frequency energy (radio-frequency ablation). Some patients require a pacemaker after an ablation is performed. 
  • This procedure can be done with cryo-ablation, radio-frequency ablation, microwave ablation, ultrasound energy or laser energy. There are two types of surgical ablation, minimally invasive via small chest incisions or during open-heart surgery. 

Heart Failure

Your heart has a big job: To pump enough blood to every part of your body. A healthy heart has no trouble doing this, but in people with heart failure, which is also known as congestive heart failure, the heart can’t pump enough blood to meet the body’s needs. The name “heart failure” is a little misleading. If you have heart failure your heart is still working; it simply isn’t working as well as it should.

Our cardiac specialists can provide you with the full range of care you need for heart failure. Our team of cardiologists, specially trained nurses and other care providers work closely with you to create a fully personalized treatment plan to treat your condition.

Although there is no cure for heart failure, medications, treatments and smart lifestyle choices can help you feel more comfortable and live a longer, more active life.

Give Your Heart a Break: Learn about Heart Failure

If you are one of the 5.7 million Americans living with heart failure, you understand that how hard your heart works. And if you suffer with diabetes, lung disease, coronary artery disease , arrhythmia, high blood pressure and other heart conditions, the impact is even greater.

If your heart weakens, it can cause fluid buildup in the lungs and other parts of the body. This fluid buildup can contribute to the most common signs and symptoms of heart failure, which include:

  • Shortness of breath
  • Trouble breathing
  • Fatigue 
  • Swelling in the ankles, feet, legs or abdomen
  • Swelling in the veins of the neck

What to Expect During Diagnosis

There is no single test used to diagnose heart failure. In addition to giving you a physical exam and talking with you about your medical history, your provider may administer one or more of the following diagnostic tests:

  • Electrocardiogram (ECG):  This test uses small sensors (electrodes) attached to your chest and arms to record electrical signals as they travel through your heart. 
  • Echocardiogram: In this noninvasive test, sound waves are used to produce a video image of your heart in motion. 
  • Cardiac stress test (also known as a treadmill test or exercise EKG or ECG): This test measures how your heart performs in response to exercise or stress by monitoring blood flow and oxygen levels as your heart beats faster and works harder.
  • Holter monitor:  Worn for one or two days, the Holter monitor is a small appliance that can be attached to a belt or a shoulder strap. Several electrodes placed on the chest connect to the monitor, which records heart rhythms. 
  • Chest X-ray: This test can show whether your heart is enlarged and whether you have fluid in your lungs. 
  • BNP blood test:This test measures the amount of a hormone in your blood known as BNP, which increases in people with heart failure.
  • Doppler ultrasound: This is a test that uses sound waves to learn more about how your blood is flowing through your heart and to your lungs. 
  • Nuclear heart scan: During this test, you receive an injection of a safe radioactive substance known as a tracer. Using special scanners, your provider can see images of your heart and learn more about how well blood is flowing through your heart. 
  • Catheterization and angiogram: During this test, a cardiologist guides a catheter (a thin plastic tube) through an artery in the arm or leg into coronary arteries. Dye is injected through the catheter, to make images that can be captured in an X-ray. This test can measure blood pressure and blood oxygen levels and detects blockages that may have to be repaired.
  • Cardiac MRI: This test uses magnets and radio waves to create images of your heart as it beats. It can show damage whether heart failure has caused damage to your heart. 

Work with a Specialist to Find the Right Treatment

Your treatment options for heart failure depend on the type and severity of heart failure you have and how early heart failure is diagnosed. Treatment strategies include:

  • Diagnosing and treating the causes of heart failure: For example, if your heart failure is caused by coronary artery disease, arrhythmia or high blood pressure, you’ll receive treatment or medication for those conditions. 
  • Improving symptoms: Treating symptoms such as excessive swelling can help you feel better. For example, medications can help lower your blood volume and make it easier for your heart to move blood throughout your body and diuretics can reduce fluid buildup in your lungs and swelling in your legs, ankles and feet. 
  • Making healthy lifestyle changes: Quitting smoking, improving your diet, being more active and losing weight may help relieve symptoms of heart failure and improve your outcome. 
  • Pacemaker:This small device, which is implanted near your heart, sends signals to your heart to help it beat at the correct pace. 
  • Implantable cardioverter defibrillator: This device, which is implanted near your heart, produces electrical pulses that can correct irregular heart rhythm and reduce the risk of sudden cardiac arrest. 
  • Mechanical heart pump: This device, which is surgically implanted in your chest, helps your heart pump blood. 
  • Heart transplant: This surgery, which is reserved for end-stage heart failure as a life-saving intervention, replaces your heart with a healthy heart from a deceased donor. 

Improve Quality of Life with Cardiac Rehabilitation

If you have heart failure or any other heart conditions, CMHVI offers cardiac rehabilitation as part of its Cardiopulmonary Rehabilitation Program. Our cardiac rehabilitation is a medically supervised program that helps heart patients recover with an individualized plan that provides evaluation and instruction on physical activity, nutrition, stress management and other health-related areas as needed. Cardiac rehabilitation can make a significant difference in the lives of heart patients.

  • Coronary artery disease
  • Angina
  • Coronary artery angioplasty or stents
  • Open heart surgery such as coronary bypass or valve surgery
  • Heart failure
  • Heart transplantation

We also invite you to join Mended Hearts™, a patient-run support group affiliated with the American Heart Association that offers support and encouragement through its visiting program, monthly meetings and educational forums. To learn more, call 207-795-8230.

Heart Attack

If you think you or a loved one is experiencing a heart attack, call 911 immediately. Do not attempt to drive to the hospital.

Each year, about 800,000 Americans have a heart attack, which happens when the blood supply to your heart is cut off. Having a heart attack is a frightening experience, but the good news is about 85 percent of people survive if treated quickly.

The best cure is prevention: as part of our commitment to cardiac and vascular health, we sponsor wellness and prevention programs throughout the region.

Around 85 percent of heart damage occurs within the first two hours of a heart attack, so be sure to call 911 right away if you or someone you’re with shows symptoms of a heart attack.

Certified for Rapid Response: CMMC’s Chest Pain Center

We are proud of the fact that our CMMC Chest Pain Center, which is part of our Emergency Department in Lewiston, is certified for its rapid-response care. If you come in with chest pain, the emergency professionals in our Chest Pain Center provide the immediate care you need. We treat all patients with chest pain as potential cardiac patients until we determine a definite diagnosis.

If you arrive at our Emergency Department with chest pain or other heart attack symptoms, you will be immediately connected to a cardiac monitor, receive oxygen and started on intravenous lines so that life-saving drugs can be administered quickly if needed. Our experienced emergency professionals conduct diagnostic testing to determine what’s causing your symptoms and once your condition is stable, we connect you with one or more cardiologists for possible follow-up care.

Know the Warning Signs of Heart Attack

It’s important to be aware of the signs of heart attack so that if you or someone you’re with is having a heart attack, you can get emergency care as rapidly as possible. Warning signs include:

  • Chest pain or discomfort that occurs in the center or left side of the chest; it may last for a few minutes or more or it may come and go
  • Pressure or a feeling of squeezing or fullness in the chest
  • Pain or discomfort in one or both arms or your back, neck, stomach or jaw
  • Shortness of breath
  • Cold sweat
  • Nausea (with or without vomiting)
  • Light-headedness or fainting

The signs of heart attack may look different in men than in women. Although men and women may both feel chest pain or pressure, women often don’t have chest pain with a heart attack. Instead, they may have other symptoms, such as shortness of breath or dizziness, that are less commonly associated with heart attack.

Keep in mind that your chance of having a heart attack goes up if you have risk factors such as high blood pressure, high cholesterol or diabetes or if you smoke or have had a previous heart attack or stroke.

Learn How We Provide Diagnosis

To determine whether you’re having a heart attack, our chest pain specialists may conduct one or more of the following tests:

  • Blood tests: These tests measure certain enzymes in your blood. For example, high levels of an enzyme known as troponin in the blood can indicate a heart attack has taken place.
  • Electrocardiogram (ECG or EKG): A test that measures heart rate, monitors the heart’s electrical system and provides images of the heart’s structures, assessing heart and valve health and blood flow.
  • Chest X-ray: X-rays may show whether the heart muscle has been damaged.
  • Echocardiogram: An ultrasound test that uses sound waves and the echoes they produce to obtain highly detailed images of the walls and chambers of the heart.
  • Cardiac stress test (also known as a treadmill test or exercise EKG or ECG): A test that measures how your heart performs in response to exercise or stress. This test monitors blood flow and oxygen levels as your heart beats faster and works harder.
  • Nuclear stress test: A test that assesses the blood flow to your heart by taking two sets of pictures of your heart: one set while you’re at rest and the second while your heart is being stressed by exercise, medication or a combination of both. Radioactive material is injected into your vein to highlight healthy and damaged tissue in the pictures.

Get Access to a Range of Treatments

Heart attack treatment varies based on several factors, including the type and severity of the attack and other health considerations. After we determine that you’re having a heart attack, we may provide one or more of the following treatments:

  • Medications: Depending on the type and extent of your heart attack, as well as any other health conditions you have, your provider may prescribe drugs such as anticoagulants, ACE inhibitors, beta blockers, calcium channel blockers, cholesterol-lowering medications, diuretics or vasodilators.
  • Thrombolysis: A procedure in which a clot-dissolving agent is injected to restore blood flow in a coronary artery.
  • Catheterization and balloon angioplasty: A test in which an inflatable balloon-type tool is used to compress plaque against artery walls, allowing increased blood flow. Balloon angioplasty is performed during a catheterization.
  • Percutaneous Coronary Intervention (PCI): Also known as angioplasty and stent treatment, PCI implants a tiny mesh tube in an artery to prevent plaque from blocking the blood vessel. After clearing blockage in an artery, your provider uses a catheter to place the stent in the newly opened artery. The stent helps hold the artery open and reduces the chance that plaque will block the artery again.
  • Coronary artery bypass grafts (CABG): Also known as heart bypass surgery, this procedure is open-heart surgery requiring general anesthesia. During bypass surgery the surgeon removes a piece of a healthy blood vessel from your leg, arm or chest wall to use as a graft to create a new path for blood flow around a blocked artery. One end of the healthy graft is sewn to the blood vessel just below the blocked artery. The other end of the graft is sewn above the blocked artery. Blood can then flow around the blocked area. After bypass surgery, blood moves more freely through the coronary arteries, lowering the risk of heart attack.

Recover with Cardiac Rehabilitation

If you have a heart attack or any other heart conditions, we offer cardiac rehabilitation as part of our Cardiopulmonary Rehabilitation Program. Our cardiac rehabilitation is a medically supervised program that helps you recover with an individualized plan that provides evaluation and instruction on physical activity, nutrition, stress management and other health-related areas as needed. Cardiac rehabilitation can make a significant difference in your quality of life after a heart attack.

  • Coronary artery disease
  • Angina
  • Coronary artery angioplasty or stents
  • Open heart surgery such as coronary bypass or valve surgery
  • Heart failure
  • Heart transplantation

As a heart attack survivor, you will also be invited to join Mended Hearts™, a patient-run support group affiliated with the American Heart Association that offers support and encouragement through its visiting program, monthly meetings and educational forums. To learn more, call: (207) 795-8230.

Coronary Artery Disease

In a healthy heart, blood flows smoothly and easily through clear arteries and the heart gets all the oxygen it needs. But if you are diagnosed with coronary artery disease (CAD), the arteries that bring blood to your heart become hardened and narrowed by plaque buildup, reducing the amount of oxygenated blood delivered to your heart.

As the leading cause of heart attacks and death in the United States, it’s important to take a CAD diagnosis seriously. Our board-certified cardiovascular providers can help ease your concerns and improve your outlook by providing a full range of state-of-the-art cardiac care. In our Cardiac Catheterization Laboratory, known as our Cath Lab, we perform a range of diagnostic and interventional cardiac procedures, including heart catheterization to assess and diagnose CAD, and treat with angioplasty and stent placement.

CAD: The Most Common Type of Heart Disease

If you have CAD, you’re not alone. It’s the most common type of heart disease in the United States. CAD occurs when cholesterol and other materials build up on the insides of your arteries. This buildup, known as atherosclerosis, starves your heart muscle of oxygen and may create pain, which is known as angina. If plaque breaks up, a blood clot can form and cut off blood supply to your heart, causing a heart attack. CAD can also lead to other heart conditions, such as arrhythmia or heart failure.

Although you may never experience symptoms from CAD, especially in the early stages, if you have any of these symptoms, talk to one of our specialists to determine if you have the disease.

  • Chest pain or discomfort, especially with activity or emotion
  • Heaviness or pressure on your chest, under your breast bone or in your neck, upper back, stomach or arms
  • Shortness of breath
  • Fatigue
  • A general feeling of weakness

Determining Your Diagnosis

We offer a full range of tests to diagnose CAD and other cardiac conditions. Our diagnostic tests, many of which are non-invasive, offer safe, painless ways to check your cardiac function and determine the extent to which plaque may be blocking your arteries. Our specialists use the latest tests and tools to diagnose CAD, including:

  • Electrocardiogram (ECG or EKG): A test that measures heart rate, monitors the heart’s electrical system and provides images of the heart’s structures, assessing heart and valve health and blood flow. 
  • Cardiac stress test (also known as a treadmill test or exercise EKG or ECG): A test that measures how your heart performs in response to exercise or stress. This test monitors blood flow and oxygen levels as your heart beats faster and works harder.
  • Pharmacological (medication-induced) stress echocardiogram: A stress test that uses medication to stimulate exercise for patients who are unable to exercise safely.
  • Metabolic stress testing: A test that measures the performance of the heart and lungs while under physical stress. Like an exercise stress test, it includes an analysis of your respiratory system.
  • Nuclear stress test: A test that assesses the blood flow to your heart by taking two sets of pictures of your heart: one set while you’re at rest and the second while your heart is being stressed by exercise, medication or a combination of both. Radioactive material is injected into your vein to highlight healthy and damaged tissue in the pictures. 
  • Coronary arteriogram (or angiogram): With this procedure, X-rays are taken to locate the narrowing, occlusions and other abnormalities of specific arteries.
  • Echocardiogram (Echo): An ultrasound test that uses sound waves and the echoes they produce to obtain highly detailed images of the walls and chambers of the heart.
  • Transesophageal echocardiogram (TEE): This test is like an echocardiogram but is for patients who have conditions such as serious lung disease, immobility or excess weight that may interfere with the creation of high-quality images with a standard echocardiogram. Instead of using an external ultrasound transducer, this test passes the transducer into the esophagus or stomach through a thin swallowing tube. 
  • Catheterization (Cath) and angiogram: This test, which is used both for CAD diagnosis and treatment, creates images that can be captured in an X-ray of artery blockages that may require repair. During the catheterization, a thin flexible tube called a catheter is inserted through a blood vessel in your groin (or sometimes in your arm) and guided toward the blocked vessel. Dye injected through the catheter allows images of your blood vessels to appear on a monitor for analysis.
  • Diagnostic peripheral arterial catheterization: This test is used to diagnose artery disease and blockage that occurs outside the heart, such as in the legs. 

Treatment Options Available to You

Once we have a full understanding of your condition, as well as your health history and your risk factors, we work with you to develop a treatment plan that best meets your needs. We provide a wide range of CAD treatments, including:

  • Catheterization and balloon angioplasty: A test in which an inflatable balloon-type tool is used to compress plaque against artery walls, allowing increased blood flow. Balloon angioplasty is performed during a catheterization. 
  • Angioplasty and coronary stent replacement: A stent is a tiny mesh tube that our providers implant in an artery to prevent plaque from blocking the blood vessel. Stents may be implanted in arteries in your heart (coronary arteries), neck (carotid arteries) or liver. After clearing blockage in an artery, your provider uses a catheter to place the stent in the newly opened artery. The stent helps hold the artery open and reduces the chance that plaque will block the artery again. 
  • Coronary artery bypass grafts (CABG): Also known as heart bypass surgery, this procedure isopen-heart surgery requiring general anesthesia. During bypass surgery the surgeon removes a piece of a healthy blood vessel from your leg, arm or chest wall to use as a graft to create a new path for blood flow around a blocked artery. One end of the healthy graft is sewn to the blood vessel just below the blocked artery. The other end of the graft is sewn above the blocked artery. Blood can then flow around the blocked area. After bypass surgery, blood moves more freely through the coronary arteries, lowering the risk of heart attack. 

Cardiac Rehab for a Smooth Recovery

We help our CAD patients get back on track with a comprehensive cardiac rehabilitation program. Our Cardiopulmonary Rehabilitation Program ensures exceptional care for all our patients. Our team guides you and your loved ones to achieve a good quality of life after surgery or other cardiac treatment. The program is held on the first floor of the Young wing in the Cardiopulmonary Rehabilitation Department.

Cardiac rehabilitation is a medically supervised program to help you recover by following an individualized plan that provides evaluation and instruction on physical activity, nutrition, stress management and other health-related areas as needed. Cardiac rehabilitation will help you achieve greater quality of life when recovering from CAD and other heart conditions such as:

  • Heart attack
  • Angina
  • Coronary artery angioplasty or stents
  • Open heart surgery such as coronary bypass or valve surgery
  • Heart failure
  • Heart transplantation

You will need to obtain a referral from your provider to enter our cardiopulmonary program; however, we encourage you to call us for more information (207) 795-8225 for assistance in accessing our services or to answer any questions you may have about our program.

Conditions We Treat: Cardiovascular Services

Find the Beat Again with Arrhythmia Care

If your heart beats too quickly, too slowly or irregularly, you may be experiencing an arrhythmia. Our heart rhythm specialists (electrophysiologists, or EPs), diagnose and treat arrhythmias such as atrial fibrillation and other problems with the heart’s electrical system. Treatments include implanting medical devices to regulate your heart and minimally invasive procedures that use either heat (radiofrequency) or cold energy (cryoablation) to modify abnormal heart tissue and restore a healthy rhythm.

Clear Up Coronary Artery Disease

Being diagnosed with coronary artery disease (CAD) means the arteries that bring blood to your heart have hardened and narrowed by a buildup of plaque on their inner walls, reducing the flow of oxygenated blood to the heart. Our board-certified cardiologists offer answers through a full range of state-of-the-art CAD care. In our cardiac catheterization lab, we provide diagnostic and interventional cardiac procedures, including heart catheterization, angioplasty, trans-catheter aortic valve replacement (TAVR) and stent placement.

Nationally Recognized Heart Attack Care

Heart attacks strike 800,000 Americans each year. You’re most likely to survive a heart attack if you receive emergency treatment as quickly as possible. Our nationally certified Chest Pain Center, part of our Emergency Department in Lewiston, is ready around the clock to provide rapid-response care. If you or a loved one report chest pain, we will treat you as a potential cardiac patient until we determine a definite diagnosis. If you suffer a heart attack, we also offer personalized rehabilitation to help restore your quality of life and reduce your chances of having another episode.

Get Your Life Back after Heart Failure

When you suffer heart failure, your heart can’t pump enough blood to meet your body’s needs. Our cardiac specialists can provide you with the full range of care you need for heart failure. You’ll also have access to our comprehensive cardiac rehabilitation program to help regain the highest possible quality of life.

Relieve Pain from Peripheral Artery Disease

Just as the arteries in your heart can become narrowed and blocked by atherosclerosis, so too can the arteries that bring blood elsewhere in your body, such as your legs, causing severe pain and other potential problems. This condition is known asperipheral artery disease (PAD). Our board-certified vascular/endovascular providers can provide you with the care you need to feel better and to prevent future problems, such as medication and information about lifestyle interventions.

Find the Right Solution for Structural Heart Disease

If you are one of the millions of Americans who suffer with structural heart diseases such as aortic stenosis, the heart surgeons at CMHVI can help. We offer expertise in all types of structural heart procedures, including valve repair and replacement. In addition to open heart surgery, we offer aortic valve replacement (AVR) and transcatheter aortic valve replacement (TAVR)—a revolutionary, minimally invasive alternative to open heart surgery.

Get Relief from Vein Disorders

If you experience leg pain or leg swelling, you may suffer from vein disorders that can result in serious, potentially life-threatening blood clots. CMH Heart & Vascular Care offers a full range of vein treatments to help repair or manage your vein disorders, reducing associated health risks.