Services

The Heart & Wellness Center is a full-service cardiology practice. We offer the following services:

Rhythm Monitoring and Management

We offer the standard EKG and extended day monitoring required for the detection and management of cardiac dysrhythmias. We also provide convenient extended day monitors that are wireless, simple to use, and can be used for as long as a month, if necessary. We also accommodate patients that require surveillance for more than a month, such as for patients with syncope (spontaneous passing out), whereby we perform a simple, 5-minute procedure to place an implantable loop recorder (ILR) to monitor your heart rhythm for over 2 years.

ILR device placed under the skin on the left side of the chest.

Echocardiography

Echocardiography is a simple, non-invasive procedure that uses ultrasound to view the size and function of the heart and it’s valves. The procedure is relatively quick (less than 30 minutes) and allows us to diagnose and surveil issues related to the heart (cardiomyopathy), it’s valves, as well as any chamber enlargements. Chamber enlargements seen on an echocardiograph are usually indicative of an increased risk heart attack or stroke.

An electrocardiograph image of a normal heart.

Nuclear Stress Testing

To help assess a patient’s heart fitness, the Heart & Wellness Center offers Treadmill and Nuclear Stress testing. These services are the gold-standard for diagnosing Coronary Artery Disease (CAD), which is the number one cause of heart attacks, heart failure and death in the US and throughout the world (CDC, September 2024).

Stress testing is performed by using a treadmill or stationary bike and incrementally increasing the pace or incline level of activity, and thus, raising the heart’s workload. While exercising, we use an EKG to monitor the heart for any strains, which may indicate a potential blockage of blood flow (CAD). Stress testing is also used by physicians to assess a patient’s risk for an upcoming surgery.

A nuclear stress test is a stress test that’s coupled with specialized imaging of the heart based on how well it takes up a nuclear isotope, and this information allows us to very accurately detect blockages in the coronary arteries. Blockages in the coronary arteries are one of the precursors to having a heart attack (myocardial infarction, or MI ). The nuclear stress test takes about 20-25 minutes to perform, and considering the facts surrounding death rates, is one of the most important diagnostic tests in healthcare.

Vascular Testing

The Heart & Wellness Center specializes in treating both venous and arterial vascular disorders. To diagnose vascular disorders, ultrasound testing is used in combination observing symptoms that are typically present. Our practice offers comprehensive vascular testing for the abdominal aorta, carotid arteries, renal arteries and the lower extremities.

Peripheral arterial disease (PAD) is marked by arterial blockages in the legs or arms, which we can visualize using an ultrasound. PAD is usually accompanied by symptoms of pain with ambulation called “claudication” and is usually confirmed with ultrasound (Arterial Doppler pictured here). Since vascular disease is a Systemic disorder, finding PAD in any vascular area, places the patient at higher risk for Cardiovascular Events. Conversely, a patient identified as having Coronary Artery Disease (CAD) ie “heart disease” is more than 40% more likely to have PAD of significance.

Luckily, most Atherosclerosis (hardening of the arteries, plaque build up) whether it be in the extremities or in the heart is amendable to the treatment philosophy and modalities advocated by the Heart and Wellness Center!

Electrocardiogram (EKG)

An EKG is a simple, non-invasive test that measures the electrical activity of the heart to evaluate heart health and detect abnormalities. The procedure provides critical information about the heart’s rhythm, rate, and overall function. This test is often performed as part of routine check-ups, pre-surgical assessments, or when heart disease is suspected. The EKG provides important insights and aids in the early detection and management of heart conditions. The test is quick taking no more than 5-10 minutes.

An EKG machine will create a graph showing the timing and strength of the electrical signals as they travel through the heart. This graph helps healthcare providers assess the heart’s rhythm and detect conditions such as arrhythmias, heart attacks, or other heart-related issues.

The Vein Clinique

The Heart & Wellness Center offers complete vein clinic services. Vein disease affects millions of people worldwide, and although it is often considered a minor issue, if left untreated, vein disease can become very debilitating. Symptoms of vein disorders can be as mild as small varicose veins (reticular veins), but over time, the valves veins continue to degenerate and cause larger varicosities. This leads to swelling, aching, discomfort, discoloration, and eventually, venous stasis ulcers.

Patients who experience symptoms of swelling, pain and discoloration may request an ultrasound from their provider, or at our office, to definitively diagnose vein disease and identify the poorly functioning veins (or insufficient veins). The mainstay treatment for early vein disease are weight loss, leg elevation and graduated compression therapy (stockings). If after treatment with first-line therapy is unsuccessful, then a minimally-invasive procedure called “venous ablation” is the next best treatment option.

The procedure typically takes 25-30 minutes and is relatively painless. Furthermore, patients can usually go back to normal activities a day or so after their procedure. Some patients may require sclerotherapy following a venous ablation procedure, which utilizes medications injected into the remaining smaller veins to close them and prevent their recurrence. The procedure is safe and effective requiring little-to-no downtime.

Dr. Makki has been treating vein disease for over 10 years utilizing venous ablation. Having performed this treatment successfully on thousands of patients, Dr. Makki is highly regarded among his peers as one of the fields leaders. If you’re suffering from vein disease and would like to consider your options, call our office or schedule an appointment online. Check out these short videos showcasing the procedure and how its done.

Varicose Veins: Pathophysiology

Exercise Assessment and Enhancement Program

We encourage all of our patients to participate in our Exercise Assessment and Enhancement Program, which is designed to help guide your health and fitness goals.