Central Maine Healthcare

Where You are the Center

Services

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

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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

Read more about Diagnostic Tests

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 American Style
Delicious Heart Healthy Latino Recipes

National Heart, Lung and Blood Institute
DASH Recipes
Recipe Analysis
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

View more Central Maine Healthcare Awards and Accreditations

Contact Us: Cardiovascular Services

Central Maine Heart and Vascular Institute

Central Maine Heart Associates
(207) 753-3900 | Practice Website

Central Maine Cardiovascular Surgery
(207) 795-8260 | Practice Website

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

Testing Center services:

Wound Center
(207) 795-8260 | Practice Website

CMMC Single Stay Unit (SSU)
(207) 753-3907
60 High Street, Young Wing 3
Lewiston, Maine 04240

The 16-bed Single-Stay Unit allows patients to be cared for in the same room from recovery through discharge. The Single-Stay Unit’s (SSU) patient rooms are designed to meet the needs of patients and their families. Each room provides comfortable space and thoughtful amenities so loved ones can stay with the patient through the recovery process. The room design and the layout of the SSU create a very patient- and family-friendly atmosphere.

The SSU is an essential part of a seamless, comprehensive system that creates a beneficial relationship between patients, families and care providers. Such relationships can assist the healing process.

CMHVI Mailing Address:
Central Maine Heart and Vascular Institute
300 Main Street
Lewiston, ME 04240

In addition to seeing patients at the main offices in Lewiston, CMHVI’s cardiologists care for patients at the following regional cardiology clinics:

Central Maine Heart Associates, Bridgton Hospital, Bridgton – (207) 753-3900

Central Maine Heart Associates, Rumford Hospital, Rumford – (207) 369-1130

Topsham Care Center, Topsham Fair Mall Road, Topsham – (207) 798-6300

For patients who are receiving care from CMHVI—we encourage you to call our care providers and support staff at Central Maine Heart Associates and Central Maine Cardiovascular Surgery if you have any questions.