CardioHealth













CardioHealth

 As a cardiology practice our goal is to improve and maintain your overall health and to empower you with an understanding of your condition and treatment plan.  We specializing in Hypertension, Congestive Heart Failure, Atrial Fibrillation, and Valvular Heart Disease.

Welcome

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CardioHealth is a patient-centered cardiovascular practice located in Jacksonville, Florida. Led by board-certified cardiologist Ramon Castello MD, FACC, FASE, CardioHealth is staffed by a caring, team of certified nurse practitioners, medical assistants, and a cardiac sonographer. Together, they’re committed to providing the highest quality cardiovascular care and service to patients in the Jacksonville metropolitan area.


Dr. Castello is one of the very few cardiologists in Jacksonville who speaks Spanish, and he is eager to bring exceptional cardiovascular care to the growing Spanish-speaking population. All medical assistants at CardioHealth are also bilingual.

Services

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Clinical Services:

*Cardiology Consultations

*Pre-operative evaluations

*Walk-in cardiology visits

*Workers compensation- clinical services 

In Office Procedures:

*Electrocardiogram

*Holter monitoring

*Event monitoring

*Echocardiography

*Contrast Echocardiography

*Strain Imaging

*EKG treadmill stress testing

*Stress echocardiography 

*Carotid ultrasound

*Renal ultrasound

*Arterial ultrasound

*Venous ultrasound

*Resting and stress ABI (ankle brachial index)

*Autonomic nervous system evaluation (ANSAR) 

Hospital Procedures:

*Transesophageal Echocardiography

*Cardiac catheterization

*Coronary intervention (PCI and stents)

*Carotid angiography and stenting

*Peripheral arterial disease angiography and stenting

*Structural heart disease procedures including:

Watchman procedure

TAVR (transcutaneous aortic valve replacement) 

Mitra clip

Radiography Procedures: 

*Coronary calcium score

Coronary CT angiogram

We are here for you

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CardioHealth offers a full scope of cardiovascular services. Every noninvasive cardiovascular test is provided at the office. Others are provided in partnership with other cardiology groups, Memorial Hospital, and an outpatient radiology center. 

Dr. Castello and his team specialize in diagnosing and treating a complete range of acute and chronic cardiovascular conditions, including coronary and peripheral vascular disease, valvular and structural heart disease, hypertension, cholesterol disorders, heart arrhythmias, syncope, stroke, and congestive heart failure. 

To get familiarized with cardiovascular conditions, tests or medications visit Cardiosmart.orga website full of all the information you need provided by the American College of Cardiology. 

In Office Procedures

Stress Test/ Stress Echocardiogram

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Some cardiovascular problems, such as coronary heart disease, are much easier to diagnose when your heart is working harder than normal, and when your heart rate is elevated.


See below for further explanation. 

Echocardiogram

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An echocardiogram may be used to diagnose: Abnormal heart valves, Abnormal heart rhythms,  Inflammation or infection, Atherosclerosis, Coronary heart disease, Congestive heart failure


See below for further explanation. 

Vascular Ultrasounds

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  • Carotid Ultrasound
  • Venous Ultrasound
  • Arterial Ultrasound





See below for further explanation. 

ANSAR

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The Ansar Test is a relatively new non-invasive testing of your nervous system. It usually can be completed within 15 minutes, and requires minimal effort from the patient. Used to evalute patients with palpitations, dizziness, high blood pressure. 


See below for further explanation. 

Holter/Telemetry

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A Holter monitor is a battery-operated portable device that measures and records your heart's activity (ECG) continuously for 24 to 48 hours or longer depending on the type of monitoring used. Used for patients with palpitations or abnormal EKGs that require further monitoring.


See below for further explanation. 

Stress ABI

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An arterial ultrasound is indicated if you are experiencing 

  • Leg pain when walking 
  • Resting leg pain, leg heaviness 
  • Foot, ankle, heel or toe ulcers
  • Skin discoloration



See below for further explanation. 

In Office Procedures

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Stress Test/ Stress Echocardiogram

During a standard stress test, you walk on a treadmill to make your heart work harder.The electrodes will be placed on your chest and are connected to an electrocardiograph (EKG) monitor that registers your heart’s electrical activity over the course of the exam. Heart rate, rhythm, and blood pressure are continuously monitored throughout the entire exam.

If you have a medical condition that prevents you to walk vigorously, you may undergo a stress test where exercising is replaced with a medication.This type of test is known as a pharmacological stress test.

A stress echocardiogram is designed to capture ultrasound images of your heart at rest and at peak exercise. This test is typically used to evaluate chest pain, shortness of breath and valvular disease

How do I prepare for a Stress Test or Stress Echo?

If you’re scheduled to undergo a stress test or stress echocardiogram, you will need to fast for at least 3 hrs. before your appointment. You should take your medications as scheduled with small sips of water, unless otherwise specified. You will also be required to wear closed- toe shoes. We advise you to wear comfortable clothing or working-out attire.

If you are having a stress test, one of the nurse practitioners; Erin, Marta or Nicole will be with you while you are on the treadmill. If you are having a stress echo, Courtney will first do an echo (ultrasound of the heart) then one of the nurse practitioners will come in take your blood pressure and stay with you for the treadmill portion of the test. Courtney will do an echo after the treadmill portion is completed. 

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Echocardiogram

A cardiac ultrasound exam, or echocardiogram, is a painless diagnostic test that uses sound waves to create moving pictures of your heart. 

Echocardiography is a key test for your heart evaluation. It allows to evaluate the size and strength of the heart. It also provides images of the heart valves, both for narrowed and leaking valves. It can also provide calculations of the pressures inside your heart, which will help to guide your treatment. In summary, it is the best initial test to evaluate if your heart is healthy or not

What happens during an echocardiogram?  

There is no preparation required on your part to have an echocardiogram.  Courtney, the sonographer at CardioHealth, will place three small, sticky patches called electrodes on your chest. After you lie down on your left side, Courtney will place an instrument called an ultrasound transducer on various areas of your chest. The tip of the wand is coated with gel to help facilitate clearer pictures.  You may be asked to change positions a few times during the exam to help Courtney get a complete range of images.You will also hear sounds that correspond to your blood passing through different areas of your heart and valves. Aside from the slight pressure you may feel from the transducer, an echocardiogram is a very comfortable procedure. The exam will take approximately 30 to 45 minutes

Vascular Ultrasounds

  • Carotid Ultrasound
  • Venous Ultrasound
  • Arterial Ultrasound

Carotid Ultrasound

Carotid ultrasonography is an ultrasound-based test to reveal structural details of the carotid arteries, narrowing due to fat buildup and other blood flow problems. Your two carotid arteries are located on each side of your neck. They deliver blood from your heart to your brain. Carotid ultrasound tests for blocked or narrowed carotid arteries, which can increase the risk of stroke. Dr Castello will use the results to determine if you need medical treatment or and intervention such as surgery or stent is required. The exam will take approximately 15 to 30 minutes.

Venous Ultrasound

Venous ultrasound uses sound waves to produce images of the veins in the body. It is commonly used to search for blood clots, especially in the veins of the legs; a condition often referred to as deep vein thrombosis. You will be lying on the exam table on your back with your hands at your sides. Courtney, the sonographer at CardioHealth will evaluate for clots in different areas of your legs. No preparation is needed for this procedure. The exam will take approximately 15 to 30 minutes.

Arterial Ultrasound

An arterial duplex ultrasound uses sound waves to create images of the arteries in your legs to identify narrowing of your vessels. There is no preparation needed for this procedure. Your procedure will be performed with you lying on the examination table on your back with your hands at your sides or on your stomach. Courtney, the sonographer at CardioHealth will apply the gel-covered transducer over various areas on your legs. You will not feel any pain; however, you will feel mild pressure from the transducer. A television monitor shows images of your arteries, and velocities of your blood as it passes through the different leg arteries. You will hear unusual sounds as Courtney views and records images of the blood flowing through the arteries.

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ANSAR

This test is utilized to evaluate your autonomic nervous system. The autonomic nervous system (ANS) controls all your involuntary processes, such as blood pressure, heart rate, body temperature, digestion, metabolism, fluid and electrolyte balance, sweating, urination, and other processes. This test is conducted with a computer that analyzes your heart rate variability, respiratory activity and blood pressure. The computer provides the status of the balance of the 2 components of the autonomic nervous system: the sympathetic and parasympathetic systems. The sympathetic system is responsible for the “alert” functions and the parasympathetic is responsible for the “resting” functions. A balance between the 2 systems is essential for good body functions.

Patient with neuropathy normally have abnormal ansar results. The test is commonly utilized on anyone who has problems of diabetes, congestive heart failure, dizziness, syncope (passing out), and lightheadedness.

The Ansar Test is usually completed within 15 minutes, and requires minimal effort from the patient. It measures your heart rate variability, respiratory activity, and blood pressure readings during 4 different stages: resting, deep breathing, Valsalva (belly pushing) and standing.  Analysis of this data gives information that is not obtainable in any other way. 

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Holter/Telemetry

A Holter monitor is a portable device that records your heart's rhythm (ECG) continuously for 24 to 48 hours.The device is the size of a small camera. It has wires with silver dollar-sized electrodes that  are attached to your skin. Dr. Castello uses information captured on the Holter monitor to figure out if you have a heart rhythm problem. It is used in patients who have palpitations, irregular heart beat or known arrhythmias. If a 24 hour Holter monitor doesn't capture your irregular heartbeat, you may need a wireless telemetry monitor, which can be worn for weeks.

One of our medical assistants will attach the electrodes to your chest and  will help you put the Holter monitor on and explains how to take care of it.  They will instruct you how to record your symptoms on a diary while wearing it. Do your usual activities while you wear the monitor with these exceptions: Don’t bathe, shower or swim while wearing the monitor. Stay away from high-voltage areas, metal detectors or large magnets.If you feel symptoms such as chest pain, shortness of breath, uneven heartbeats or dizziness, note in your diary the time of day they began 

and what you were doing. Your diary entries will be compared to the changes in your ECG recorded by the Holter monitor.

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Stress ABI

An ankle-brachial index (ABI) test is a simple way for Dr. Castello to check if you have blockages in the arteries of your legs also known as peripheral artery disease (PAD).  The ankle brachial index compares the blood pressure in the upper and lower limbs, obtained by placing blood pressure cuffs in your arm and ankle.  Blood flow is also obtained with a small Doppler device that measures the velocity of the blood. You will hear unusual sounds. There is a resting component and an exercise component. The resting pressures and Doppler velocities are first obtained at rest. Then, you will be asked to walk on a treadmill for a few minutes to complete the exercise component. If you are unable to walk, you will be asked to raise your toes, to complete the exercise part.Generally, you won't need to follow any special preparation before your appointment to have an stress ABI test performed. You may want to wear loose, comfortable clothing that allows Courtney to easily place a blood pressure cuff on your ankle and upper arm.

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Insurances Accepted

  • Aetna
  • AvMed
  • Blue Cross Blue Shield/Florida Blues
  • Cigna
  • Florida Blue: Blue Cross Blue Shield 
  • Cigna
  • Florida Blue: Blue Cross Blue Shield of Florida
  • GEHA
  • Humana
  • Medicaid/Sunshine/Ambetter
  • Medicare
  • Medicare AARP Complete (UHC)
  • Medicare Florida
  • Medicare Railroad
  • Medicare Railroad
  • MULTIPLAN/HPCS
  • Tricare Standard/For Life
  • United Healthcare
  • United Healthcare Multi-Plan: Charter
  • United Healthcare Multi-Plan: Charter Balanced
  • United Healthcare Multi-Plan: Charter HMO
  • United Healthcare Multi-Plan: Charter PLUS
  • United Healthcare Multi-Plan: Choice
  • United Healthcare Multi-Plan: Choice HMO
  • United Healthcare Multi-Plan: Choice Plus
  • United Healthcare Multi-Plan: Choice Plus HMO
  • United Healthcare Multi-Plan: Choice Plus with Harvard Pilgrim
  • United Healthcare Multi-Plan: HMO
  • United Healthcare Multi-Plan: Medica Choice with United-Healthcare Choice Plus
  • United Healthcare Multi-Plan: Options PPO
  • United Healthcare Multi-Plan: Passport Connect Choice
  • United Healthcare Multi-Plan: Passport Connect Options PPO
  • United Healthcare Multi-Plan: Plus
  • United Healthcare Multi-Plan: Select
  • United Healthcare Multi-Plan: Select Plus
  • WELLCARE/STAYWELL