St. Johns
- Here for your heart

Patients and their families trust their hearts to UF Health St. Johns' Cardiology Care program. Here’s why.

• Community - Thousands of local residents trust UF Health St. Johns' Cardiology Care program for a full range of heart and vascular services -- located close to home. These services include emergency coronary interventions, pacemakers, defibrillators, and more.

• Experts - Patients can take comfort knowing they are in safe hands. Our experts include world-class physicians, trained cardiology nurses, electrophysiologists and support teams, cardiothoracic surgeons, interventional and diagnostic cardiologists, and cardiovascular technologists.

• Collaboration - We practice a team approach to health care. We join forces with local hospitalists, intensivists, advanced specialty medical providers, physicians, St. Johns County Fire Rescue EMTs, and many others. UF Health St. Johns' Cardiology Care program provides patients with our community’s most comprehensive heart health care services.

• Recognition - UF Health Flagler Hospital, and by extension, UF Health St. Johns Cardiovascular Care, has earned recognition as one of the nation’s Top Hospitals. Year after year we’ve been awarded the Leapfrog Safety “Grade A” rating for ensuring a safe and healing environment for patients and their families.

Common cardiovascular conditions

At UF Health St. Johns' Cardiology Care, patients trust our medical staff to treat a range of cardiovascular conditions.

• Aortic aneurysm
• Blood clots
• Carotid artery disease
• Congestive heart failure
• Fibro muscular dysplasia
• Peripheral artery disease
• Structural heart disease
• Venous disease

Advanced diagnostic tests

UF Health Flagler Hospital's cardiac care uses state-of-the-art advanced cardiovascular diagnostic tests to learn more about your heart’s health.

If you are experiencing chest pain, chest pressure, shortness of breath, heart palpitations, dizziness, or weakness, these symptoms may indicate heart or blood vessel issues.

Advanced diagnostic tests provide your care team with vital insights including important details about your heart’s chambers, valves, electrical activity, and how your heart’s muscle is functioning. We learn if there are tumors or abnormalities. When we study the results, we get a more complete picture about how to provide treatment.

Diagnostic tests we perform include:

• Coronary angiogram

• Echocardiogram

• Electrocardiogram (ECG or EKG)

• Holter monitor

• Stress test

• Tilt table test

• Nuclear stress test

• Magnetic resonance imaging (MRI)

How we treat cardiovascular conditions

Evaluation

Physicians evaluate the best course for treatment by utilizing a variety of medical evaluations and risk screenings including:

• Cardiovascular Disease Prevention - When you schedule an appointment with a cardiologist, you will be asked to share your personal and family health history and likely some specific diagnostic tests relevant to your needs. When the results of those tests are reviewed, the provider will work with you and recommend the best course of treatment for your heart condition. This approach may include preventive measures such as diet, exercise, smoking cessation, and/or weight loss to keep your heart healthy or prevent further complications.

• Health Management and Primary Prevention - Our doctors and nursing staff provide patients and their families with compassionate care by sharing tools to better manage your health. We believe health screening is an important first step in identifying risk factors that may be contributing adversely to your condition. Identifying these factors, such as lifestyle and genetics, enables us to work with you to design a health management course of action where you are an active participant. Your personalized health plan will reflect your goals and lifestyle preferences and help you live a healthier life.

• Smoking Cessation and Wellness Centers - At UF Health St. Johns, we encourage you to take an important first step and decide to quit smoking. We are here to support you in that decision and will help you to obtain the tools you need to succeed including classes and support groups. Read more about our smoking cessation program or enroll in a class. We also operate Wellness Centers where you can focus on mind, body, and spirit through exercise, the arts, and special events. To learn more about UF Health St. Johns Wellness Center in your community, click here.

• Sleep Apnea Evaluation - Sleep Apnea is a potentially serious disorder that can be easily evaluated at the UF Health St. Johns Sleep Disorders Center. The center is fully accredited by the American Academy of Sleep Medicine. To learn more about the Sleep Disorders Center and to schedule either a day or evening appointment, click here.

Non-surgical heart disease treatments

While some heart disease cases require surgery, there are alternative, less-invasive options.

• Ablation therapy/ Atrial fibrillation ablation - Ablation therapy uses small burns or freezes to cause some scarring on the inside of the heart that break up the electrical signals that cause irregular heartbeats, thus helping the heart maintain a normal rhythm. The procedure is usually performed using a catheter that is inserted into the arteries or veins. It is considered a low risk procedure.

• Atrial flutter ablation - Atrial flutter ablation is a procedure that blocks the electrical signals that cause a fluttering heartbeat, to treat the upper chambers of your heart that beat too quickly.

• Cardiac ablation - In many cases, medication is used to treat irregular heartbeats, or arrhythmia. Some patients, however, do not respond to medication, making cardiac ablation the most effective option. Your cardiologist will determine the best course for you based on the results of diagnostic tests.

• Cardiac catheterization - Cardiac catheterization (also referred to as cardiac cath or heart cath) is a procedure that is used to examine how well your heart is working. A thin, hollow tube, or catheter, is inserted into a large blood vessel that leads to your heart.

• Cardiac resynchronization therapy - Cardiac resynchronization therapy (CRT) is treatment to help your heart beat with the right rhythm. It uses a pacemaker to restore the normal timing pattern of the heartbeat. The CRT pacemaker coordinates timing of the upper heart chambers (atria) and the lower heart chambers (ventricles).

• Carotid angioplasty and stenting - Carotid angioplasty is a procedure that helps to improve the blood flow in an artery or vein. The carotid artery runs along each side of your neck. The procedure involves doctors placing a thin tube with a balloon at its tip to open up the artery to improve blood flow. It is a minimally invasive procedure and considered non-surgical. Stenting is when a small mesh tube is placed into a blocked artery. It is made of either stainless steel or cobalt chromium and is designed to improve blood flow, with the goal of reducing or eliminating symptoms of chest pain.

• Cardioversion - Cardioversion helps to return an abnormal heartbeat to a normal rhythm. It is used to prevent fainting, stroke, heart attack, or sudden cardiac arrest. A scheduled procedure that is performed in the hospital, it involves electrical shocks to the chest. Patients usually are able to return home the same day.

• Coronary angiogram - Coronary angiograms use X-ray imaging to view your heart’s blood vessels, to determine if there are any restrictions to blood flow to your heart.

• Coronary angioplasty and stents - Coronary angioplasty is similar to the carotid angioplasty (see above), in that it is used to improve blood flow to heart by opening blocked arteries through the use of a narrow tube with a balloon at the tip. It is a minimally invasive procedure.

• EP study - An EP (electrophysiology) study is performed to determine your heart’s electrical system or activity. It is used to diagnose abnormal heartbeats or arrhythmia. It is administered by inserting catheters and then wire electrodes which measure electrical activity through blood vessels that enter the heart.

• Implantable cardioverter-defibrillators (ICDs) - An implantable cardioverter-defibrillator, or ICD, is a small, battery-powered device. It is placed in your chest to detect and to stop irregular heartbeats (arrhythmias). The ICD device monitors your heartbeat. It delivers electric shocks, when needed, to restore your heart’s regular rhythm.

• Implantable loop monitor - An implantable loop monitor is a device that is implanted underneath the skin near the breastbone. For a period up to 3 years, it serves as a continuous monitor of your heart rhythm. If you have symptoms that are infrequent – several months out of the year or possibly yearly – this device will record your heart rhythm.

• Pacemaker - A cardiac pacemaker is an electronic device, implanted in your body that monitors heart rate and rhythm. It gives the heart electrical stimulation when it does not beat normally. It operates on batteries with long, thin wires that connect it to your heart. It is also referred to as an artificial pacemaker.

• Percutaneous valve procedures - Patients that undergo a percutaneous value procedure do so because they have a diseased heart valve that needs to be replaced. The procedure is minimally invasive. The diseased valve is replaced with a new valve, which may be mechanical.

• Supraventricular tachycardia (SVT) - SVT is when you experience an irregular, rapid heartbeat in the upper chambers of the heart. One method of correcting this irregularity in your heart is accomplished by threading thin, flexible tubes, or catheters, through your blood vessels and into your heart. These catheters use heat or cold to correct the targeted tissue.

• Transesophageal echocardiography - A transesophageal echocardiogram, abbreviated TEE, is performed by your doctor when there is a need to look more closely at your heart to determine if it could be producing blood clots. Similar to an echocardiogram, the TEE uses high frequency sound waves, or ultrasound, to examine the structures of your heart.

• Transcatheter aortic valve replacement (TAVR) - This procedure, also known as TAVR, replaces a diseased aortic valve with a man-made valve. It can also be performed with open-heart surgery, referred to as a surgical aortic valve replacement, or SAVR.

• Mitra clip - A mitra clip is a device used to treat the mitral valve regurgitation for patients who are not candidates for open-heart surgery. It is implanted via a transcatheter technique. The procedure involves suturing together the anterior and posterior mitral valve leaflets.

• Watchman procedure - The Watchman procedure is a one-time, minimally invasive procedure for patients with atrial fibrillation that is not caused by a heart value problem, also known as non-valvular AFib. AFib is one of the most common heart rhythm problems in the world and is the number one cause of strokes in patients over the age of 65. This very symptomatic disease can be alleviated by the Watchman procedure. Boston Scientific has designed a minimally invasive device, known as the “Watchman” device, which is permanently placed into the left upper chamber of the heart to help prevent strokes. The majority of blood clots tend to originate from an area of the heart known as the left atrial appendage which be described as a small pouch. This device plugs the pouch thereby preventing clots from forming and dislodging into the heart. Learn more about the Watchman procedure in this video from Dr. Neil Sanghvi, Director of Electrophysiology at UF Health St. Johns.

• ASD and PFO closure - There are two types of holes in the heart – atrial septal defect (ASD), and patent foramen ovale (PFO) - that form in the wall tissue between the left and right upper chambers of the heart, also known as the septum. Both ASD and PFO can be treated at UF Health Flagler Hospital using minimally invasive, catheter-based interventions.

Cardiac and vascular surgical interventions

When you or a family member is diagnosed with a cardiac artery and vascular disease, the cardiac team at UF Health St. Johns will work with you to develop a treatment plan so you can regain a healthy life. The following are several of our cardiac and vascular surgical interventions:

• Aortic root surgery - Aortic root surgery is a procedure that treats an enlarged section (aneurysm) of the aorta, the large blood vessel that carries blood from the heart to the body located near where the aorta and the heart connect.

• Aortic valve repair and aortic valve replacement - Four valves are found within the heart: mitral, tricuspid, aortic and pulmonic. The aortic valve is located between the left ventricle (lower heart pumping chamber) and the aorta, the largest artery in your body. Valves maintain one-way blood blow through the heart. When a cardiologist reviews your symptoms, he or she will also conduct an echocardiogram to visualize the heart valves to determine the severity of the disease and how to treat it. This may involve minimally invasive surgery to repair the valve, or a valve replacement. The surgeon will review the results of your diagnostic tests and recommend a course of action to treat your condition.

• Carotid endarterectomy - A carotid endarterectomy removes fat and cholesterol building up that has collected inside the carotid artery. It improves blood flow and can help to prevent another stroke, if a person has already had a stroke.

• Coronary bypass surgery/Heart valve surgery - The goal of coronary bypass surgery and heart valve surgery is to restore blood flow to the heart. This is accomplished by creating a bypass, or a detour, around a blocked artery or arteries. The surgeon uses a healthy blood vessel, or graft, taken from your chest, leg or arm. The graft enables a new pathway to carry blood to your heart.

• Mitral valve repair and mitral valve replacement - Your UF Health St. Johns affiliated cardiologist will determine if you are in need of mitral valve repair or mitral valve replacement based on a review of your condition and diagnostic tests. Surgery may be needed to correct your condition, which can cause shortness of breath, fatigue, or swelling in your abdomen, legs, and feet.

• Tricuspid valve repair and tricuspid valve replacement - Tricuspid valve repair and valve replacement is recommended when the valve is narrow and blood flow is restricted, causing the heart to pump harder in order to move blood throughout the body. Tricuspid valve repair requires open-heart surgery. The surgeon will repair and then reshape parts of the valve, depending on the condition of the valve.

• Valvuloplasty - Valvuloplasty is a procedure to open a stenotic (stiff) heart valve. During this procedure, your doctor inserts a very narrow, hollow tube, or catheter, into a blood vessel in the groin and advances it through the aorta into the heart. At the tip of the catheter is a balloon that pushes the valve open to enable blood to flow and to alleviate the stress on your heart so that your heart will not have to work as hard to pump blood.

• Impella – Ventricular assist device (VAD) - Ventricular assist devices like Impella, or VADs, treat heart failure. They are also referred to as heart pumps. VADs are mechanical pumping devices designed to help the heart pump more blood. They take the blood from the heart and pump it to the body, taking the burden off the heart.

• Video-assisted thoracoscopic surgery (VATS) - Video-assisted thoracic surgery, or VATS, is a minimally invasive thoracic surgery performed with a thoracoscope (a small videoscope). It uses small incisions and special instruments. During surgery, three small incisions are used. The thoracoscope transmits images of the operative area onto a computer monitor.

• Peripheral vascular procedures - Peripheral vascular procedures are used to open blocked arteries that are located in the neck, arms, legs and abdomen. This condition can cause strokes, leg pain, kidney problems, and high blood pressure.

Cardiac rehabilitation and wellness

Following a cardiac event or procedure, you’ll likely be eager to return to a productive and healthy lifestyle. We want to do everything we can to help you in that process and encourage you to participate in one of our available rehabilitation programs. We offer:

• Cardiac rehabilitation - When you register for a UF Health St. Johns cardiac rehabilitation program, you commit to helping to improve your heart’s future. Cardiac rehabilitation is a medically supervised program for patients who have experiences heart attack, heart failure, angioplasty, or heart surgery.

• Pulmonary rehabilitation - At UF Health St. Johns we offer a program for patients diagnosed with pulmonary diseases such as chronic obstructive pulmonary disease (COPD), asthma, emphysema and other breathing problems. Our focus is providing a safe level of education, support, and working with you to design a treatment plan to help you or a family member regain your quality of life.

• Smoking Cessation - At UF Health St. Johns, we encourage you or a family member to take an important first step and decide to quit smoking. We are here to support you in that decision and help you obtain the tools you need to succeed. We offer classes and support groups. To read more about our smoking cessation program, or to enroll in a class, click here.

• Sleep Apnea Treatment - At UF Health St. Johns, our care team considers sleep apnea a serious, potentially life-threatening condition affecting people of all ages.

For more information

For additional information contact heartcare@flaglerhealth.org