Services

Gynecology

We use the latest technologies to bring you high-quality diagnostics and minimally invasive surgeries. Then we combine that with the expert and compassionate care from our providers and nurses for a friendly, supportive healthcare experience. Whether you just need a well-woman checkup or you’re struggling with something more serious like urinary incontinence, we’re here to help. No matter your age or health issue, we’ve got a team ready to assist.

Conditions We Treat

Gynecologic conditions can be a frustrating experience for anyone, which is why we at Central Maine Healthcare work hard to get you feeling healthy again quickly. Our gynecology specialists offer treatments for several issues, and we prioritize using less invasive treatments whenever possible. If necessary for full recovery, we offer surgical treatments that are based on the newest research evidence paired with the latest technology. We always offer techniques that are the most minimally invasive, which offer benefits such as less pain, fewer complications, and a quicker recovery time. We want to get you back on the road to health as quickly as possible with the highest level of satisfaction.

Endometriosis

At Central Maine Healthcare, we understand how frustrating it is to deal with the effects of endometriosis. Our caring gynecologists want to help you get back on the road to feeling healthy and pain-free once again. That’s why we offer the latest in diagnostic and surgical technology, as well as prioritize treatments that are minimally invasive. It’s our goal to do everything we can to ensure your endometriosis is significantly lessened so you can get back to living well.

If you’ve been having pelvic pain, you might be wondering if it’s endometriosis. This frustrating condition occurs when the tissue that typically grows on the inside of the uterus migrates to the outside of the uterus and grows there. The typical cycle for endometrial tissue follows the path of your menstrual cycle, expanding, contracting, then expelling tissue with your period. But when this happens on the exterior of your uterus, it’s not effective and can instead be very painful.

Diagnosing Endometriosis: Your gynecologist will decide what diagnostic tool is the best based on your symptoms. These techniques for diagnosing might include:

Pelvic exam: A simple exam to see if the provider can feel the endometrial tissue growing outside of the uterus in the form of cysts or scar tissue and where it might be attached.
Ultrasound: Either an external or internal ultrasound to create a visual of where the endometrial tissue might be in your pelvic cavity.
Magnetic Resonance Imaging (MRI): An MRI will help get a clearer picture of how endometriosis is affecting you and how extensive it is.
Laparoscopy: Typically done by a surgeon, a laparoscopy involves a tiny incision during general anesthesia. An instrument is inserted that allows the provider to see inside your abdomen. In some cases, the endometriosis can be surgically corrected that day.

Treatment for Endometriosis: At CMH, we want you to feel your best and achieve your fertility goals. Your provider will discuss the various treatment options with you and together, you’ll investigate the extent of your endometriosis and start with minimally invasive options to see how your body responds. In many cases, a combination of treatments will help achieve a pain-free experience and other fertility improvements. Treatments might include:

Pain medication: Typically, this will include over-the-counter pain relief such as NSAIDS (Advil) or naproxen sodium (Aleve). If these don’t help, other options will be explored.
Hormone therapy: This treatment varies and can include options such as taking birth control pills, progestin therapy, or treatments that block certain hormones.
Surgery: For those wanting to conceive or reduce surgical effects, laparoscopy is a type of surgery that removes the endometrial tissue areas while keeping all reproductive organs intact. For severe cases, it might be necessary to remove some or all reproductive organs, though we only use this treatment in the rarest situations.
Fertility treatments: If you are trying to conceive, it might be a good idea to also work with a fertility specialist that can help you achieve a pregnancy and carry it to full term. This treatment would be a great pairing with traditional gynecological care.

Fibroids

The diagnosis of fibroids can feel like a scary experience, which is why Central Maine Healthcare is committed to ensuring you’re supported throughout the entire process. Whether your provider discovered a fibroid during a routine pelvic exam or you’ve got many of the symptoms, we’ll help to get the right diagnosis and work with you to design the best treatment. We offer excellent care combined with the latest technology, ensuring that you’ll get the best results possible. Our gynecologists are highly skilled, compassionate caregivers that will guide you through the process and help you get back to healthy, pain-free living.

Fibroids 101: Fibroids are small to large non-cancerous tumors that grow in the tissue of the uterus. They can grow inside or outside the uterus, or in its walls. About 20-50% of women in the US have at least one, making them relatively common. Not every fibroid is diagnosed and sometimes they don’t cause problems. Only about a third of these fibroids are large enough that they are discovered.

Fibroids aren’t associated with a higher risk of uterine cancer. There is the very rare case in which they are cancerous. So, it’s a good idea to see a provider about yours to make sure you are cared for correctly. Researchers aren’t quite certain what causes fibroids but believe the high levels of estrogen are the reason they grow so quickly.

Risk and Protective Factors: Certain women are at higher risk for fibroids. Those entering or going through menopause have elevated levels of estrogen, which makes them more likely to get fibroids. Other risk factors include obesity. Giving birth to children seems to have a protective effect on women or at least is correlated to a decreased chance of fibroids. If you’ve got at least 2 children that you’ve given birth to, your risk for fibroids is cut in half.

Symptoms of Fibroids: Often, women with fibroids won’t have symptoms. Many others will have a variety of symptoms, with no two women having the exact same experience of how the fibroids make them feel. Some of the most commonly reported symptoms are:

Extra heavy periods
Periods that last 7 or more days
Unusual bleeding between periods
Pain in your pelvis
Needing to urinate often

Pain in your lower back
Painful intercourse
A mass that can be felt by your provider Anemia caused by the heavy bleeding

Diagnosis of Fibroids: Typically, women discover that they have a fibroid when they go for their routine health exam. A provider can feel the mass through the abdomen, which will require testing for a true diagnosis:

X-ray: This will help to create an image of your pelvis to see if the fibroid is detectable.
Transvaginal ultrasound: This ultrasound is done through the vagina and creates a more detailed picture of the fibroid inside the pelvis.
Magnetic Resonance Imaging (MRI): For harder-to-see fibroids, an MRI can produce a finely detailed picture of the pelvic area, including details about the location and size.
Hysterosalpingography: This is a special x-ray where we use dye to check for any blockages in your fallopian tubes.
Hysteroscopy: An instrument is inserted into the vagina that allows the provider to look around in the uterus to visually check for fibroids.
Endometrial biopsy: This test involves a sample of the lining of the uterus to test for abnormal cells that could indicate fibroids.
Blood test: Your provider may request a blood sample to check for anemia, fibroids and whether you need help for your overall health.

Treatment of Fibroids: The great news is that many fibroids tend to stop growing and even shrink when a woman gets closer to menopause. So, sometimes you may not need to do anything about your fibroids if they aren’t causing you physical pain or any other issues. For those fibroids that are causing problems, there are a variety of possibilities for treatment:

Pain medicine: Over-the-counter painkillers (Advil, Aleve) can provide significant relief, and if you need more pain relief your provider can help you find additional options.
Surgery: For those who would like to conceive or prefer a more conservative surgical approach, your provider can carefully remove the fibroids from the uterus tissue. In cases where this isn’t enough, a hysterectomy might be the best course of action.
Hormone-blocking therapy: Since certain hormones can encourage the fibroids to grow, this medicine helps to reduce those hormones and stop the fibroid in its tracks.
Uterine artery embolization: This newer treatment option finds the arteries that are providing blood to the fibroid, then they block that artery, so the fibroid can’t receive nutrients or oxygen. This causes it to stop growing and even shrink.

Infertility

When you long to start a family, one of the hardest things to experience is infertility. CMH provides sensitive, compassionate care for those couples who are struggling to conceive. Whether you need help with conception or to ensure that the pregnancy goes to full term, our specialist providers are there to offer support and exceptional skills. We’ve got the best in fertility technology and have the most supportive care providers on our team. Our goal is to help you bring home a new bundle of joy, whether it’s your first or your fourth.

Infertility 101: Infertility is when a couple has unsuccessfully tried to conceive for 12 months or longer. If you’ve been trying to get pregnant and are starting to wonder if something is wrong, we’ll help you determine what the issue is and find the right treatment options.

Symptoms of Infertility: While the most obvious symptom is the inability to get pregnant, you can get checked long before you want to get pregnant. Other issues with women’s or men’s reproductive health can be signs of a problem that could cause infertility:

Being 35 or older: As women age, their egg count decreases. There is also a higher chance of eggs being deformed or issues that could cause a problem with conception.
Menstrual periods that aren’t regular: Regular cycles fall between 21 and 35 days apart. When a woman bleeds too often or not often enough, it could be a major sign that ovulation isn’t happening or isn’t happening at predictable times.
Fibroids or polyps on the endometrium: The endometrium is the lining of the uterus where a fertilized egg attaches and grows. If fibroids or polyps are making the endometrium act unusual or dysfunctional, a fertilized egg can’t attach easily or at all.
Issues with pelvic infections or STIs: Infections in the female reproductive organs can cause scarring to the fallopian tubes. This makes those tubes close, blocking the way for sperm to get to the eggs for fertilization.
Semen abnormalities: If a male partner has had his semen checked or has had infertility issues in the past, ineffective or dysfunctional semen could be a cause of infertility.

Diagnosis of Infertility: Our providers will take a thorough medical history of you and your partner. This will help them understand your menstrual cycle, previous pregnancies, red flags for hormonal issues and any previous health problems that might impact fertility. They’ll also do a physical examination to see if there are any obvious physical clues. They might continue with other types of diagnosis and testing, if needed:

Laboratory testing: Your provider might order blood tests that look at levels of certain hormones. Some hormones are critical for pregnancy or some could inhibit conception.
Transvaginal ultrasound: This ultrasound picture is taken by way of the vagina, where it can capture a detailed view of what’s going on inside your uterus and fallopian tubes. This can help your provider determine if you might have cysts, fibroids, or polyps that could be causing problems or blocking critical areas for conception.
Hysterosalpingogram (HSG): This is a special type of x-ray that can detect issues in the fallopian tubes and determine if they might be blocked.
Semen analysis: Your provider can look for various issues with your partner’s semen to discover if that might be the cause of the infertility. This includes semen volume, the concentration of sperm to fluid, the sperms’ ability to move correctly, and if the shape and structure of the sperm looks healthy.

Treatment of Infertility: There are many ways we can help you overcome infertility. At CMH, we offer the best in fertility treatments and a supportive environment and team, partnering with local specialists to ensure you have a full range of options:

Medications to increase ovulation
Intrauterine Insemination (IUI)
In Vitro Fertilization (IVF)

Sperm, egg, or embryo donation support
Surrogacy support
Surgery to correct physical abnormalities

Menopause

Menopause is a natural part of aging for women and at CMH we want to support you through this process as best we can. While most women will naturally go through menopause at the biologically right time and without many issues, there are challenges that can pop up for some women. It can be helpful to have a provider who can help you get the diagnostic testing and treatments needed so you can always feel your best, no matter your age.

Menopause 101: Typically, you’re considered to be in menopause when you haven’t had a menstrual period in 12 months or longer. The process of your menstrual cycles ending is a natural part of life and usually occurs during your 40s or 50s. While it is a natural process, it can be uncomfortable for some women.

Symptoms of Menopause: The major sign that you are entering menopause is that your periods have become very irregular or have stopped completely. Other significant symptoms:

Hot flashes and chills: Suddenly needing to put on a sweater and then a while later pulling it off because you’re very hot.
Vaginal dryness: Especially if this is new, usually due to rapid changes in hormones.
Thinning hair and dry skin: Losing hair in the shower or when brushing or having to apply far more lotion than typical.
Weight gain: Suddenly exercise and healthy diet aren’t maintaining your typical weight.
Loss of breast density: Change in breast tissue due to no longer needing to breastfeed.
Night sweats: Feeling too hot in the night, regardless of room temperature.
Sleep issues: Insomnia, being unable to fall back to sleep, or not sleeping soundly.
Mood changes: Feeling happy at one moment and sad or upset at another.

Conditions that Can Accompany Menopause: The drastic changes in hormone balance and the aging process can contribute to other conditions. Always attend your regular wellness checkups and screening exams so that your provider can catch and treat an issue early:

Osteoporosis: Women who have gone through menopause tend to lose bone density and are at risk for osteoporosis, it is a risk. If you develop this condition, your bones will be thin and brittle, making falls dangerous. Make sure to get screened regularly.
Cardiovascular disease: After menopause, your estrogen decreases, causing your cardiovascular system to be more at risk of issues like heart disease. Make sure to eat healthy, exercise and check in with your provider if something is concerning.
Urinary incontinence: With aging comes a loss of elasticity in your pelvic tissues. You might not be able to control your bladder as easily, and find that sneezing or jumping causes a strong urge to urinate. This can be strengthened through physical therapy, pelvic floor exercises and hormone solutions prescribed by your provider.
Weight gain: Menopause is often a significant cause of weight gain, as your metabolism starts to slow down. Be sure to exercise, eat healthy, and talk with your provider about strategies that might help if you have concerns about weight gain.
Sexual dysfunction: Vaginal dryness can make intercourse uncomfortable or painful. Decrease in certain hormones can also lead to a loss of libido. Talk with your provider if you experience these issues, as there are some remedies and treatments that can help.

Osteoporosis

Just because you’re aging doesn’t mean that your quality of life should decline. At Central Maine Healthcare, we want to help you stay active and healthy throughout your lifespan no matter your age. Osteoporosis is a condition that some people experience when they are 65 or older, and we offer a full range of treatments to help keep you strong.

Osteoporosis 101: While it seems like bone is totally solid, it is actually living tissue that is constantly broken down and then rebuilt back up again by your cells. As we age, this process slows down and for some people stops working correctly. Osteoporosis is when the bone isn’t built back up again. This makes bones weak and brittle, causing many symptoms, especially the heightened possibility for fractures to happen.

Risks for Osteoporosis: Since osteoporosis is all about how dense or thick your bones are, some people are more at risk than others. Women tend to get it more often than men, simply because their body frames are smaller and there is less bone tissue to work with. After menopause, hormone changes also cause bone breakdown at faster rates then pre-menopause, making women ages 65 and older more at risk. Smaller boned women, especially those who are white or Asian, tend to get osteoporosis at higher rates.

Symptoms of Osteoporosis: Osteoporosis starts long before you notice symptoms. The foundation for future osteoporosis depends significantly on lifestyle. As we age, bone density issues accelerate and become a real problem once we are over 65 years old.

Height loss: Caused by a general loss of bone tissue, vertebrae compress causing a loss of inches.
Stooped posture: Osteoporosis tends to affect the spine the most, causing a loss of structure and support. Those with osteoporosis can start to get a “hunched back” that causes them to stoop over while sitting and walking.
Back pain: The loss of support in the spine and the stooped posture can contribute to back pain. It’s also possible to have a fractured vertebra caused by osteoporosis that could make the back hurt.
Easy bone breakage: If a fall easily causes a bone to break or if an everyday task causes a bone fracture, it’s likely connected to osteoporosis.

Diagnosis and Treatment for Osteoporosis: We recommend women 65 years and up come for a bone density scan. This state-of-the art screening is painless and takes less than 15 minutes. The osteoporosis specialist will take low dose X-rays of the lower back and one hip. The scans will be reviewed and sent to your primary care provider who will discuss the findings and help you decide which treatment option is best. This may include medication and changes in diet and lifestyle. CMH has physical therapists who have specialized training in treating osteoporosis who help patients treat issues such as back pain and postural changes.

Prevention of Osteoporosis: While osteoporosis is related to old age, there are things you can do to reduce your risk significantly while you’re younger. Here are a few things to consider doing to keep your bones fit and healthy throughout your life.

Exercise: Bone density is directly impacted by exercise, especially exercises that build muscle strength (weight training), high impact (walking, running and skiing), and encourage balance (such as yoga and tai chi).
Reduce sedentarism: Sit less and move more. Exercise is important, and so is activity. Get out and do fun things you enjoy. Start hobbies that involve physical activity, such as hiking, walking outside or sports.
Get enough calcium and vitamin D: Calcium and vitamin D are both very important nutrients for your bones. Not getting enough of these can be a big issue in osteoporosis.
Eat enough protein: Protein is the building block of our bodies and our bones, so it’s important to always get enough through your diet.
Check your medications: Some medications can cause a loss of bone density, so check with your provider to see what risks you might have.
Ask about other medical conditions: Other types of medical conditions, such as cancer and celiac disease, are associated with an increased risk of osteoporosis. Check with your provider to see what your risk is and how you can reduce it.
Reduce alcohol consumption and quit smoking: Excessive amounts of alcohol can impair bone regeneration, so make sure to drink moderately throughout your lifespan. Tobacco has also been associated with osteoporosis, so it’s a great idea to quit smoking if you can. Talk with your provider to get help setting yourself up for lifelong health.

Pelvic Pain

At CMH, our patients’ comfort and quality of life is our top priority. If you’re dealing with pelvic discomfort or pain, we’re here to help you find the cause and get the treatment that you need. Our board-certified providers use the latest medical technology and the most up-to-date research to assist women, so they can get back to a pain-free lifestyle.

Pelvic Pain 101: Pelvic pain can be acute or chronic. Acute pain is sudden (perhaps sharp) pain that won’t go away. If it’s more of a constant (maybe dull) pain that lasts for weeks, months, or even years, your pain would be considered chronic. The pelvis holds many organs connected to various organ systems. Your pain might be related to reproductive health, but it could also be connected to your digestive health or elimination system. It could also have something to do with your tendons or ligaments, or other types of issues.

If you have acute pain, make sure to get in to see a provider as soon as possible. If it’s a sharp pain or a sudden pain that really hurts, head to the emergency room to make sure it’s not something dangerous. For chronic pain, schedule an appointment with your provider so you can work together to find the source of the pain.

Types of Pelvic Pain: Pelvic pain can often be related to issues with the reproductive health system including the ovaries, uterus, and vagina.

Reproductive health causes could include:

Ectopic pregnancy
Miscarriage
Ovulation
Menstrual cramps

Ovarian cysts
Uterine cancer
Cervical cancer
Endometriosis

Fibroids
Pelvic Inflammatory Disease (PID)
Pelvic adhesions (scar tissue)
Adenomyosis

Non-reproductive health causes could include:

Pelvis disorder
Broken pelvis
Fibromyalgia
Nerve conditions
Bladder disorder

Appendicitis
Kidney infection
Kidney stones
Hernia

Inflammatory Bowel Disease
Irritable Bowel Syndrome (IBS)
Urinary Tract Infection (UTI)
Sexually Transmitted Infections (STIs)

Diagnosis of Pelvic Pain: Your provider will do an initial consult with you to find out more about your symptoms. Some conditions will be simple to diagnose whereas others might take several tests. You’ll discuss your medical history and family history of certain health conditions. You might need to do blood or urine tests, or x-ray, ultrasound or MRI to get a visual of the inside of your pelvis. Once your symptoms and a screening reveal what is causing the pain, your provider will help you decide what treatment options are best.

Treatment of Pelvic Pain: Treatment for pelvic pain comes in all shapes and sizes, depending on what is causing your pain. You might take medicine, see a physical therapist, have diet or lifestyle changes or need surgery. Our providers offer supportive care and minimally invasive techniques to help you get back to feeling healthy and pain-free again.

Stress Urinary Incontinence

Another struggle that some patients have is stress urinary incontinence. We offer a supportive environment and the most effective methods of handling this kind of incontinence. We would love to meet with you to discuss your symptoms and discuss treatment options. Feel free to reach out to us if we can help you answer questions and give support.

What is SUI? Incontinence is a condition of involuntary urinary leakage. Stress Urinary Incontinence (SUI) occurs if there is pressure on the bladder because of physical movement such as coughing, laughing or sneezing. SUI is a common medical condition that an estimated one of three women experience. It is not the same condition as Overactive Bladder, also known as Urge Incontinence. With OAB, there is a sudden urge to urinate without movement.

What are the Symptoms of SUI? The main symptom of SUI is leaking urine. You may leak just a few drops, or you might leak more. There are varying degrees of SUI. In mild cases, leakage may occur when you are exercising or engaged in rigorous activities such as lifting an object. It may also occur after coughing, sneezing, or laughing. Women with more severe SUI may experience leakage with less intense physical movements, such as with standing or walking.

Who is Likely to Experience SUI? Women of any age may experience this condition, but it is more common among older women. Common risk factors are:

Obesity
Smoking
Chronic cough
Pelvic surgery

Caucasian and Hispanic women
Nerve injuries to the lower back
Pregnancy and childbirth

Generally, anything that weakens the pelvic floor muscles can lead to SUI.

How Does SUI Impact My Life? Women with SUI may feel self-conscious, leading them to reduce social activities, physical activities or sex. If you’re avoiding activities that have been an important part of your life, it may be time to talk to your healthcare provider.
Helpful tip: Keep a diary noting when you experience SUI. This may give the provider clues on how to manage the condition.

How is SUI Treated? Your provider may be able to help you, or they may refer you to a urologist. Treatment options will vary for each person. For example, if you are overweight, your provider might recommend weight loss and smokers would be advised to quit smoking. Other treatment options include:

Pelvic floor muscle training. Your healthcare provider can show you daily exercises to strengthen the muscles of the pelvic floor, which can help reduce SUI.
Urinary control devices are another possibility. They help reduce pressure inside the pelvis. Your healthcare provider will explain the different options.
Some women may opt to wear sanitary or incontinence pads. These are a simple solution that may not bother some women.

Is Surgery an Option? Surgery is an option. Procedures are available that can even be done as a same day procedure! Your provider will discuss surgical procedures with you at your appointment.

Are there Medications for SUI? Unfortunately, no. At this time, there are no medications approved for use for SUI. That is because the leakage is happening from the weakness in your pelvic structure.

Urinary Incontinence

At Central Maine Healthcare, we offer compassionate and skillful care for those suffering from bladder issues and urinary incontinence. This condition can be embarrassing and confusing, and we’re here to help guide you through diagnosis and treatment so you can get back to a carefree lifestyle. Our team of friendly providers and nurses are here to assist you with your every need.

Urinary Incontinence 101: Bladder control problems are more common among Americans than Alzheimer’s disease or osteoporosis, and women are twice as likely as men to experience this problem. Even though it’s a common complaint, many people are reluctant to seek help because of embarrassment, and they may also not know that effective treatment is available. As a result, people with bladder control problems may be afraid to socialize because they fear venturing too far from a bathroom. Others are forced to limit physical activities. People lose sleep or experience unpleasant, sometimes painful symptoms:

Stress urinary incontinence: leakage of urine with exercise, laughter, sneezing, coughing
Urgency/urge incontinence: hurrying to the bathroom after feeling the urge to urinate
Chronic urinary tract infections
Post-prostatectomy incontinence
Urinary retention (the inability to urinate)
Difficulty urinating
Painful urination
Frequent urination during the daytime (going more than seven times per day)
Frequent nighttime urination
The inability to start the stream of urination
Straining to urinate

Women with and without urinary dysfunction may have pelvic anatomical problems:

Cystocele: When the bladder drops into the vaginal canal
Rectocele: When the rectum drops into the vaginal canal
Enterocele: When the small bowel drops into the vaginal canal
Uterine prolapse: When the uterus drops into the vaginal canal
Vaginal vault prolapse: When the uterus has been removed and the cuff of the vagina drops into the vaginal canal

Diagnosing Urinary Incontinence: Our providers will work with you to identify symptoms, collect medical history, and provide screening tests:

Exam: Physical and neurologic examination of the pelvic area
Cystoscopy: Procedure performed by a urologist or urogynecologist, allowing the provider to look directly inside the urethra and bladder. This takes a few minutes and once complete, the provider will chat with you about results and offer recommendations.
Urethroscopy: Looking inside the urine channel (urethra)
Bladder scanning: Non-invasive and painless procedure measures post-urination residual (urine remaining in the bladder after urination). Patients with higher than normal post-urination residuals include females with pelvic organ prolapse, males with prostate enlargement and patients with urinary retention or overflow incontinence.
Urodynamic testing: Series of tests that measure how the bladder fills and empties
Bladder instillations: Used to help in diagnosing interstitial cystitis.

Treatment for Urinary Incontinence: You will work with your provider to design a treatment plan that will get you back to a healthy state and comfortable life:

Biofeedback
Collagen injections
Pubovaginal slings/TVT/TOT
Neuromodulation

Physical therapy
Pelvic reconstructive procedures to correct prolapse and other anatomical defects

We can teach self-straight catheterization, when needed. Occasionally, patients need to catheterize themselves regularly in order to urinate. Our nurses are available by appointment to provide step-by-step instruction, and have you demonstrate to ensure it is done correctly. You will get written instructions, and our nurses will check in on you within 48 hours to make sure you’re doing well and to answer questions.

Gynecologic Surgery

Sometimes when you have severe gynecological issues, it’s best to have a specific surgery to speed up your healing. CMH offers the latest procedures and an array of options for every gynecological issue. Our providers and nurses are ready to help you make the best choices for your body and life, and gently help you heal. Many of our procedures are available as a day-surgery option.

Gynecological Surgery 101: When you and your provider have worked to find the cause of your issue, and surgery is needed, you can rest easy knowing we offer a wide array of possibilities. We offer minimally invasive surgeries, which are typically quick, require short healing times and allow you to return to your life faster. Since every gynecological problem is different and everyone has a unique body, we customize our treatment plans and surgeries to your needs. Check with your provider for specifics about your upcoming surgery.

Types of Gynecological Surgeries We Offer: We want to help you feel better quickly and offer the best procedures with the best outcomes. Our providers and nurses are here for you!

Endometrial ablations
Hysterectomies
Laparoscopic tubal ligation
Ovarian cyst removal

Uterine polyps and fibroids removal
Incontinence minimally invasive surgery
And more – chat with your provider for options!

Pelvic Floor Rehabilitation

CMH knows that one of the best ways to solve incontinence and prolapse is through pelvic floor rehabilitation. Our treatment team includes board-certified physical therapists who work to strengthen your pelvic floor muscles. You’ll be back to independence in no time!

Pelvic Floor Rehab 101: Pelvic Floor Rehabilitation is a treatment option for patients with urinary incontinence. This includes stress, urge or mixed incontinence, as well as prolapse. It can also help patients that are dealing with constipation or pelvic pain. The muscle groups in the pelvis can become stretched or weak from lack of use or experiences such as childbirth. This makes it hard to keep the pelvic organs in place and causes them to become out of balance. Through pelvic floor strengthening, you’ll learn to retrain these muscles, so they can do their job again. Your organs will function better as a result, including your bladder.

What Pelvic Floor Rehab Looks Like: A physical therapist will assess your unique needs, and you will be taught specific therapeutic exercises, including pelvic floor muscle strengthening. This will teach you correct muscle isolation and contraction. The program includes biofeedback and surface EMG to measure results. Once you have the exercises down, you can practice them at home for even better results. You’ll return to the rehab clinic every week for about six weeks to practice with your physical therapist and measure your results. We offer a flexible schedule of appointments to meet your needs.

Other Things to Know: In addition to the pelvic floor exercises, your provider and physical therapist will have you do a few more things to help speed up your healing:

Keeping a bladder diary. This will help your provider understand what your bladder and pelvic floor are doing throughout the day, so they can adjust your treatment as needed.
Following recommendations for your fluid intake. This will also help you reduce incontinence issues and potential embarrassment.
Following recommendations for your diet. You’ll be advised on potential bladder irritants, so you can work to avoid them to improve your continence.

Urogynecology

When you have issues with your pelvic floor, you’ll have the option to schedule a visit with one of our friendly urogynecologists. These specialized providers focus on both gynecology and urology, which means they understand the female reproductive system and how it relates to issues such as incontinence and prolapse. We offer the best treatment options for our patients, so you can get the specialized care that you deserve.

Urogynecology 101: Urogynecology is a specialized type of gynecology. Providers train in obstetrics and gynecology, then they train further in urology, or the study of the urinary system. This combination focuses specifically on the issues that women often have when the pelvic floor isn’t functioning correctly. These problems typically lead to:

Urinary incontinence: When a person can’t control their bladder easily.
Fecal incontinence: When a person can’t maintain control of their bowels.
Pelvic organ prolapse: When the bladder, vagina, uterus, or rectum “falls” from its proper place, causing it to malfunction and put pressure on other parts of the pelvis.

Symptoms of Pelvic Problems: You might have symptoms that you’d like to discuss with your provider. It’s a good idea to keep notes on the problems you’re facing, then bring that list to your provider appointment. Here are a few symptoms to keep an eye out for:

Difficulty urinating
Pain in your lower back
Irritable Bowel Syndrome (IBS)
Difficulty having a bowel movement
Sexual intercourse that is painful

Frequent and overwhelming urge to urinate
Acute (painful/sharp) or chronic (long-term) pain in your pelvis
Urge to have many bowel movements over a short period of time

How the Urogynecologist Can Help: The provider will ask about your and your family’s medical history. A physical exam will show if there are any obvious external signs of what is going on, and you might need to do blood or urine tests. After a diagnosis is made, your provider will help you craft a treatment plan that is right for you:

Diet and lifestyle changes
Physical therapy
Medication

Organ-supporting devices
Minimally invasive surgery
More complex surgery

Together you’ll find a path of healing, so you can feel great and get back to living an independent and carefree life once again.

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.

Treatment and Specialties

CMHVI heart and vascular experts offer a full spectrum of services and programs. We offer comprehensive cardiovascular care, from medical management of heart and vascular conditions and lifestyle guidance to diagnostic testing. We also perform procedures such as heart catheterizations, angioplasty or implanting a pacemaker as part of your personalized treatment plan. If necessary, our cardiac and vascular surgeons will provide advanced surgical treatment of your condition.

Our expert team of providers, nurses, technicians and therapists works together to improve heart and vascular health. From early prevention to advanced care and rehabilitation, you’ll find innovative technology and procedures, and a team who is there for you where and when you need us.

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.

Diagnosis: Cardiovascular Services

Cardiac Stress Test

A cardiac stress test measures how the heart performs in response to exercise or stress. The test monitors blood flow and oxygen levels as the heart beats faster and works harder. Stress tests are often performed to help determine the cause of chest pain or shortness-of-breath. A stress test can help diagnose coronary artery disease (CAD – narrowing of the heart’s blood vessels), which can cause chest pain and increases a patient’s risk for a heart attack. The test can also reveal irregular heart rhythms and determine if medical treatments have been effective.

Prior to the Treadmill Test, (also known as as an exercise stress test or an exercise ECG) patients are given an electrocardiograph (EKG or ECG) and an echocardiogram. The EKG measures heart rate, while the echocardiogram gives images of the heart’s structures. It assesses heart and valve health and blood flow. Both tests are painless and the patient’s heart rate, blood pressure and cardiac electrical system are monitored.

For the exercise test, electrodes are placed on the chest, arms and legs. A blood pressure cuff is worn on the arm and an oxygen monitor is placed on the finger. The patient exercises by walking on a treadmill or pedaling a bicycle until they develop symptoms or feels tired. The patient is given an EKG and echocardiogram afterward.

Metabolic stress testing – This test measures the performance of the heart and lungs while under physical stress. It is similar to an exercise stress test but includes an analysis of the patient’s respiratory system.

Pharmacological (medication-induced) stress echocardiogram – A stress echocardiogram integrates ultrasound imaging and exercise stress testing to measure how the heart functions while the patient walks on a treadmill or rides a stationary bicycle. Medication is be used to stimulate exercise for patients who are unable to exercise safely.

Nuclear stress test — Your provider may order a Nuclear Stress Test to assess the blood flow to your heart. This is done by taking two sets of pictures of your heart; one set of pictures shows the blood flow to your heart at rest, and the other set of pictures shows the blood flow to your heart at stress. Each set of pictures requires an intravenous injection of a radioactive material, which will not make you feel any different in any way. Your test may be scheduled with one set of pictures on different days, or it may be a one-day test. The stress test may be done on a treadmill, with medications, or a combination of both. For the pictures, you must lay very still on a table while a camera passes over your chest for about 15 minutes. While Nuclear Stress Testing is extremely safe, a provider will be at your side during stress testing.

Echocardiogram

A conventional or Transthoracic Echocardiogram (TTE) can be done in a resting state or during exercise (stress echo), the ultrasound source is outside the body, on top of the chest. A technician obtains views of the heart by moving a small instrument called a transducer to different locations on the chest or abdominal wall. A transducer, which resembles a microphone, sends sound waves into the chest and picks up echoes bouncing off the heart. A standard echo usually provides highly detailed images of the heart walls and chambers which can be analyzed by a cardiologist. There are no side effects from a TTE or recovery time needed.

Holter Monitor Applications and Interpretation

One tool that providers use to diagnose arrhythmia (an abnormal heart rhythm) is the Holter monitor. The Holter monitor, worn for one or two days, 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. The monitor records heart rhythms. Patients may also be asked to keep a record of cardiac symptoms experienced while wearing the monitor. Symptoms include chest pain, heart flutters, faintness or dizziness. It is also helpful for the patient to record when he/she takes medications, exercises or experiences emotional events. The Holter monitor will not interfere with most activities, other than bathing or water-based activities, as it must remain dry.

Transesophageal Echocardiogram

Echocardiograms use sound waves bounced off the structures of the heart to generate images of the heart in motion. In some cases, most often when patients have serious lung disease, or are immobile or overweight, ultrasound images of the heart are not clear. In these cases, cardiologists may request a transesophageal echocardiography (TEE)

Unlike the standard echocardiogram, in which the transducer is placed over the chest wall, in TEE the transducer is passed into the esophagus (the swallowing tube) and sometimes into the stomach. The esophagus, in particular, provides an ideal viewing of the heart, aorta and other great vessels and produces high-quality images of these structures.

TEE examinations are useful in helping providers diagnose and evaluate patients with embolisms (clots), valvular heart disease, bacterial infections, lesions, aortic abnormalities and injuries, and congenital heart disease. TEE is also used to evaluate critically ill patients and potential heart surgery candidates. A TEE carries more risk than the standard echocardiogram procedure (which is essentially risk-free) but is still very safe and under the right circumstances can be extremely useful.

Contact Information

CMHVI Diagnostic Testing Center
60 High Street, Y1
Lewiston, Maine 04240
(207) 795-8200

Services:

Cardiac Catheterization Lab
Cardiac Diagnostic
Cardiac MRI
Cardiopulmonary Rehab
Electrophysiology (EP) Lab
Vascular Lab
Vein Center
Wound Center – 795-8260

_________________________________

Lipid Clinic
60 High Street, ground floor
Central Maine Heart Associates
(207) 753-3900

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Single-Stay Unit (SSU)
60 High Street, Y3
Lewiston, Maine 04240
(207) 753-3907

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.

Cardiovascular Services Education and Support

We know you want to be healthy. Central Maine Heart and Vascular Institute offers a wide variety of services and treatments to support you.

Whether you are managing a chronic condition or preparing for an upcoming procedure, our tools will help you navigate your care plan and better understand how you can improve your health.

Your heart health matters, not just for you, but for the ones you care about and depend on you. When it comes to heart and vascular disease, the statistics don’t lie – but the most encouraging piece of news is that you don’t have to be a statistic. No matter what your age, you can make lifestyle choices that will lower your risk of heart and vascular disease and prevent heart attack and stroke.

Glossary of Heart & Vascular Terms

Ace Inhibitor: Medication used to treat high blood pressure.

Angina (Angina Pectoris): Pain or discomfort which occurs when the heart does not receive adequate blood flow – and thus oxygen — to the heart muscle. Angina may be experienced in the chest, neck, jaw, arms, shoulder or back. No permanent damage is done to the heart.

Angioplasty: A procedure performed by cardiac surgeons to open an obstruction or narrowing of a blood vessel, using a balloon that is inserted with a catheter. Also known as a Percutaneous Transluminal Coronary Angioplasty (PTCA).

Anticoagulant: A drug that slows or prevents the blood from clotting.

Aneurysm: An aneurysm is an abnormal widening of a blood vessel. Aneurysms can sometimes burst, causing a serious medical emergency. If not caught in time, they can be life-threatening.

Aorta: The main artery leaving the heart.

Arteries: Vessels that transport oxygen-rich blood from the heart to the rest of the body.

Atrial Fibrillation:A rapid and irregular rhythm that begins in the upper chambers of the heart (the atria). As a result, the lower chambers also beat irregularly. This condition requires diagnosis and treatment.

Arterial Line: A small plastic tube that is placed in an artery in your wrist in order to monitor arterial blood pressure. Blood samples can also be taken through this tube.

Arrhythmia: An abnormal rhythm of the heart, including rate, regularity, or site of impulse origin. Types of arrhythmias include tachycardias (fast heart rhythms) and bradycardias (slow heart rhythms).

Atherosclerosis:A disease process in which fatty substances (plaque), such as cholesterol, are deposited on the inner lining of blood vessels.

Arteriosclerosis:Arteriosclerosis is a general term for a condition that is characterized by the thickening, hardening and loss of elasticity of the walls of the arteries.

Beta Blocker: Medication used to treat high blood pressure, angina, myocardial infarction and other heart conditions, by controlling the heart rate.

Bradycardia: An abnormally slow heart rhythm.

Bypass Graft (Vein, Mammary Artery, Aorta-Coronary Bypass Graft): A surgical procedure where a piece of vein, taken from the leg, or a piece or artery, taken from the inside of the chest wall, replaces a diseased coronary artery. The graft helps get more blood to the heart muscle.

Calcium Channel Blocker: A drug used to treat high blood pressure and angina. It decreases the workload of the heart by blocking the influx of calcium ions into the smooth muscle cells, which reduces the oxygen demand on the heart.

Cardiac: Relating to the heart.

Cardiac Angiogram or Catheterization: An X-ray procedure which involves the injection of dye into the heart chambers and into the coronary arteries for diagnostic purposes. An X-ray reveals the exact site where the artery is narrowed or blocked and measures how well the heart is pumping.

Catheter: A hollow, flexible tube used to withdraw or inject fluid into the body.

Chest Tube: A tube or tubes in the chest which drain fluids from the area of the operation. The chest tubes remain in place for approximately two days.

Cholesterol: A waxy substance that circulates in the blood and plays a role in the formation of blockages. Cholesterol originates in foods that are rich in animal fats.

Congestive Heart Failure: The condition which results when the heart is unable to pump adequately. Congestive heart failure (CHF) can result from coronary heart disease.

Coronary Arteries: Special arteries which supply the heart muscle with blood.

Coronary Artery Disease: A condition in which the arteries supplying the heart muscle become blocked. The cause of this is unknown, but some known risk factors include: hypertension, family history, smoking, diabetes, obesity, diet and stress.

Diabetes: A disease that negatively affects the metabolism of glucose (sugar) and cause changes in blood vessels that, untreated, may lead to circulation issues, development of coronary artery disease, blindness and other health issues.

Dilation: The gradual opening of the narrowed coronary artery by cracking and compressing the narrowing or obstructing plaque.

Echocardiogram: An ultrasound of the heart.

Electrocardiogram (EKG/ ECG): A recording of the electrical activity of the heart. The EKG recording can be used to detect many abnormalities in the heart.

Endotrachael Tube (ETT): Breathing tube placed in the trachea during surgery or respiratory emergencies to assist with breathing. Removed when the patient is able to breathe on his/her own.

Fibrillation: A rapid and irregular heart rhythm caused by abnormal electrical impulses. This is a potentially serious condition.

Fibrillation, Atrial : See Atrial Fibrillation.
Heart Lung Machine (Bypass): This machine performs the function of the heart and lungs in surgery, when grafts are being attached to the heart.

Hypertension:High blood pressure, usually above 135/85.

Hypotension:Low blood pressure. The tolerance for low blood pressure varies greatly, but generally a systolic blood pressure less than 90 indicates hypotension..

Hypercholesterolemia: Hypercholesterolemia refers to levels of cholesterol in the blood that are higher than normal.

Incentive Spirometer: This machine lets you know if you are breathing deeply enough. Respiratory therapists teach patients how to use the spirometer.

Ischemia:Lack of or insufficient oxygen to the heart muscle. Ischemia is a reversible condition if normal blood flow is restored.

IV (Intravenous): Small tubes which are placed into the veins for the purpose of giving fluids and drugs, taking blood samples, and measuring pressures. These “lines” as they are called, will remain in place for several days after surgery.

Left Ventricle: The largest chamber of the heart. It is responsible for pumping blood throughout the body.

Local (Anesthetic): Numbing medicine which is used to decrease discomfort when intravenous lines are put into place.

Lungs: Sponge-like organs of the body which allow oxygen to enter the blood when you breathe.

Mammary Artery: An artery that runs down the inside of the chest wall and is sometimes used in coronary artery bypass graft surgery.

Murmur: A heart murmur is defined as the sound caused by turbulent blood flow through the heart, as heard by a provider through a stethoscope. Most heart murmurs are benign, but sometimes a murmur can indicate problems such as a malfunctioning heart valve.

Myocardial Infarction (M.I.):A “heart-attack”, with loss of part of the heart muscle due to a severe decrease in blood supply. Permanent damage to the heart occurs.

Myocarditis: An inflammatory disease of the heart muscle (myocardium) that can result from a variety of causes. While most cases are produced by a viral infection, an inflammation of the heart muscle may also be instigated by toxins, drugs, and hypersensitive immune reactions. Myocarditis is a rare but serious condition that affects both males and females of any age.

NG Tube (Nasogastric):A small tube placed through the nose and into the stomach to draw out secretions and lessen stomach upset immediately after surgery.

Pacemaker: Electronic device used to control the heart rate. Used after open heart surgery to maintain a steady heart rate for recovery, and, in emergencies, to stimulate the heart to bea

Pericarditis: Two thin membranes enclose the heart in a sac-like structure. If these membranes become irritated or inflamed, the condition is known as pericarditis. Pericarditis is fairly common, affecting about 1 in 1,000 people at some point in their lives. It can be caused by flu, polio, injury, or German measles. Other causes are rheumatoid arthritis or lupus. This condition sometimes follows a heart attack.

Pericardial Tamponade: Pericardial Tamponade is a dangerous form of pericarditis. The membranes enclosing the heart do not easily stretch, so if fluid accumulates between the membranes and the heart, pressure from it may prevent the heart from working as a pump. Pericardial tamponade usually is the result of trauma, such as an automobile accident, and must be treated immediately.

Percutaneous: Performed through a small opening in the skin.

Percutaneous Transluminal Coronary Angioplasty (PTCA).: See Angioplasty.

Plaque: The accumulated wax-like material that causes a blockage in a blood vessel. Also known as a lesion or stenosis.

Platelets: A substance in the blood that is involved in the formation of a clot.

Pressure monitors and pressure lines: Devices used to measure the internal pressures that the heart and lungs are emitting. Usually inserted through arteries in the neck, arm or leg.

Pulmonary Function Studies: A series of tests which are performed before surgery to evaluate the condition of your lungs.

Restenosis:A re-narrowing or blockage of an artery at the same site where angioplasty was previously done.

Saphenous Vein: The large vein in the leg, often used as the “bypass graft” in coronary artery bypass graft surgery.

Stenosis:A narrowing of any canal. Used to describe narrowed coronary arteries or a narrowed heart valve.

Stent: An expandable, slotted metal tube that is inserted into a vessel. A stent acts as a scaffold to provide structural support for a vessel.

Sternum: The breastbone.

Suctioning: A procedure performed on patients connected to a ventilator. A small tube placed down the throat draws out mucous, in order the keep the lungs clear.

Sutures (also called Stitches): The material used to close a surgical incision.

Tachycardia: An abnormally fast heart rate.

Transcatheter Aortic Valve Replacement (TAVR): Surgeons insert a replace

Telemetry Monitory: A specialized wireless monitor that allows patients to move freely in their rooms and the hall, but still enables team members to observe their EKG.

Thrombosis:A blockage caused by clumps of cells.

Triglycerides: Substances in the blood that are a component of the “bad” type of cholesterol.

Valves: The heart has 4 valves: the aortic, mitral, pulmonary and the tricuspid.

Aortic Valve: The valve that sits at the junction of the left ventricle and the aorta. When the valve is open it allows blood to flow from the left ventricle to the aorta, and when closed, prevents any backward flow.
Aortic Insufficiency: An incomplete closing of the aortic valve, causing blood to flow backward into the left ventricle.
Aortic Stenosis: A narrowing of the aortic valve, causing the left ventricle to work harder, but limiting the amount of blood that can be pumped forward into the aorta.
Mitral Valve:The valve that sits between the left atrium and the left ventricle.
Mitral Insufficiency:An incomplete closing of the mitral valve, causing blood to flow backward into the left atrium.
Mitral Stenosis:A narrowing of the mitral valve, causing blood to flow backward into the left atrium.
Pulmonary Valve: The valve that sits at the junction of the right ventricle and the pulmonary artery.
Tricuspid Valve: The valve that sits between the right atrium and the right ventricle.

Veins: Vessels that transport blood back to the heart after the oxygen has been used by the body.

Vein Graft: A piece of a vein taken from either a leg or arm that is used to bypass the damaged coronary artery and restore blood flow to the heart muscle.

Ventilator:A machine that helps patients breathe after surgery.

Ventricle: One of the two lower chambers of the heart.

Ventricular Fibrillation: A very rapid, uncoordinated, ineffective series of contractions throughout the lower chambers of the heart. Unless stopped, these chaotic impulses are fatal.

Recipes for a Healthier Lifestyle

For many newly diagnosed cardiac and diabetes patients, part of the road to wellness includes making nutritional changes and other lifestyle behaviors. (For example, the patient may need to stop smoking, and/or start exercising and/or reduce or eliminate alcohol.)

Try some new recipes today. Download a recipe or go to one of the websites under links to get started.

Keep the Beat Heart Healthy Recipes
Heart-Healthy Home Cooking African Ame rican Style
Delicious Heart Healthy Latino Recipes

National Heart, Lung and Blood Institute
DASH Recipes
Recipe Analysi s
Stay Young at Heart

Awards and Accreditations: Cardiovascular Services

Heart and Vascular Quality Care

The Central Maine Heart and Vascular Institute is a state-of-the-art facility that uses evidence-based clinical practice, sound research and tested care principles to support excellent clinical outcomes. CMHVI is committed to providing continuous quality care to the communities we serve, our patients and their families. The providers and team members remain proud of the values that have served as a foundation for the program since its inception.

C = Compassion M = Mastery H = Honesty V = Vision I = Integrity

CMHVI is proud of these achievements:

Get With The Guidelines® – Stroke GOLD PLUS Central Maine Medical Center has received the American Heart Association/American Stroke Association’s Get With The Guidelines^®-Stroke Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.
CMHVI Lifesaving Care from the American Heart Association
Cigna Center of Excellence for Cardiac Catheterization and Angioplasty
Cigna Center of Excellence for Heart Surgery
Named one of the Nation’s 50 top cardiovascular hospitals by IBM Watson Health
Accreditation for Quality Care in Advanced Primary Stroke by The Joint Commission
Chest Pain Center Accreditation – The American College of Cardiology

Women’s Choice Award® – America’s Best Hospitals Heart Care
Maine’s first Accredited Chest Pain Center
- PCI (Heart Attack Center) Accreditation
- National Society of Chest Pain and PCI Center Accreditation
Anthem Blue Cross Blue Shield – Blue Distinction Center for Cardiac Services
Aetna Institute of Quality® Cardiac Medical Intervention and Surgery Designation
Aetna Institute of Quality® Cardiac Surgery Designation

Intersocietal Commission for the Accreditation of Echocardiography Laboratories National (ICAEL)
- Accreditation in Echocardiography, Stress Echocardiography, and Transesophageal Echocardiography
Intersocietal Commission for the Accreditation of Vascular Laboratories National (ICAVL)
- Extracranial Cerebrovascular Testing, Peripheral Venous Testing, and Peripheral Arterial Testing
American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)
- Program Certification Cardiac Rehabilitation
Health Grades Quality Ratings
- 3 – Star Hospital Quality Rating for Carotid Artery Surgery and Peripheral Bypass Surgery
- 3- Star Hospital Quality Rating for Heart Attack, Heart Bypass surgery (CABG), and Valve Replacement Surgery
Rumford Hospital Cardiac & Pulmonary Rehab: 3-year certification from the Association of Cardiovascular and Pulmonary Rehabilitation

View more Central Maine Healthcare Awards and Accreditations

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Conditions We Treat

Endometriosis

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Infertility

Menopause

Osteoporosis

Pelvic Pain

Stress Urinary Incontinence

Urinary Incontinence

Gynecologic Surgery

Pelvic Floor Rehabilitation

Urogynecology

Varicose Veins Can Be More than a Visual Concern

Get a Non-invasive Diagnosis

Receive Treatments Specific to Your Disorder

What is Structural Heart and Valve Disease?

Recognize Valve Disorder Symptoms

How Do You Determine Structural Heart Disease?

PAD: Learn When It’s More than Leg Pain

Get a Thorough Diagnosis with a Range of Diagnostic Tests

What Are Your Options for Treatment?

Cardiac Stress Test

Echocardiogram

Holter Monitor Applications and Interpretation

Transesophageal Echocardiogram

Contact Information

When Your Beat is Off: About Arrhythmia

Know the Symptoms of Arrhythmia

How Will You Be Diagnosed?

Understand Your Treatment Options

Give Your Heart a Break: Learn about Heart Failure

What to Expect During Diagnosis

Work with a Specialist to Find the Right Treatment

Improve Quality of Life with Cardiac Rehabilitation

Glossary of Heart & Vascular Terms

Recipes for a Healthier Lifestyle

Heart and Vascular Quality Care