Advanced ischemic heart disease, also called advanced coronary artery disease, includes conditions that reduce the blood flow to the heart, causing damage to the heart muscle. This in turn, causes conditions such as:
In many cases, patients with ischemic heart disease are told they have exhausted traditional treatment options.
The multi-disciplinary team of specialists in Cleveland Clinic's Advanced Ischemic Heart Disease Center are dedicated to diagnosing and treating patients with severe ischemic heart disease, especially when the best course of treatment is not obvious.
How do you know if you have advanced coronary disease?
- You have had at least one coronary artery bypass surgery (CABG) and require additional bypass surgeries.
- You have had multiple angioplasty procedures and stents for recurrent, persistent coronary disease.
- You are still having symptoms even though you have been receiving optimal treatment for coronary artery disease.
- You have been told that there are no more treatment options for your coronary artery disease.
- You have been told that you are at risk of developing heart failure (poor heart function) and arrhythmias.
If you have advanced ischemic heart disease, there are five steps to your care:
- Highly specified diagnostic testing to see if your heart has muscle that could be helped by procedures designed to improve blood flow to the heart muscle
- Procedures to improve blood flow to the heart muscle or improve the pumping ability of the heart. If you can benefit from these procedures, a team of highly skilled interventionalists or heart surgeons may be able to improve blood flow to your heart muscle using special catheters or surgical procedures. If you have heart failure, special devices and surgeries may improve your symptoms, quality of life and longevity.
- A medication plan that includes the best medicine and dosages to make sure your heart is pumping the best it can and to protect it from further damage
- A lifestyle plan designed specifically for your needs, including regular exercise and a nutritious diet to keep you healthy and strong
- Potential for enrollment in clinical trials looking at new ways to restore blood flow to the heart and/or repair or replace damaged heart muscle.
A multidisciplinary approach is usually needed to achieve optimal care, as outlined above. The Center for Advanced Ischemic Heart Disease is a collaborative effort among clinicians who specialize in treating advanced coronary disease. This team includes physicians and nurses who specialize in Interventional Cardiology, Thoracic and Cardiovascular Surgery, Cardiac Imaging, Electrophysiology and Pacing, Heart Failure, Preventive Cardiology and Rehabilitation, Pain Management, Stem Cell Therapy and Pharmacy.
Why choose Cleveland Clinic for your care?
Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.
The Advanced Ischemic Heart Disease Center is a collaborative effort among clinicians who specialize in treating advanced coronary disease, including physicians and nurses from Invasive & Interventional Cardiology, Cardiovascular and Thoracic Surgery, Cardiac Electrophysiology & Pacing, Cardiovascular Imaging, Heart Failure, Preventive Cardiology & Rehabilitation, along with specialists from Pain Management and Pharmacy. These medical professionals are dedicated to providing specialized treatment to improve your symptoms and increase your quality of life.
Our Medical Team
Cardiovascular Medicine, Section of Cardiovascular Imaging
This group of specialized physicians will evaluate you and begin to develop your plan of care. They are specialized to perform diagnostic testing and treat patients with advanced ischemic heart disease
Cardiovascular Medicine, Section of Interventional Cardiology
Interventional Cardiologists are experienced at providing specific diagnostic catheterization procedures and complicated interventional procedures. Interventionalists who are part of the Center for Advanced Ischemic Heart Disease have experience in treating difficult blockages such as bifurcation and calcified blockages, totally blocked coronary arteries and in-stent restenosis.
Cardiovascular Medicine, Section of Heart Failure
Heart failure does not mean your heart has "failed," but that it is pumping less effectively. Advanced ischemic heart disease is associated with damage to the heart muscle—or heart failure—and often requires a heart failure specialist to assist with the plan of care. A variety of medication, devices and surgical procedures are available to patients.
Cardiovascular Medicine, Section of Electrophysiology and Pacing
Patients with advanced ischemic heart disease, especially those with heart failure are prone to irregular heart rhythms. The Section of Electrophysiology and Pacing physicians manage arrhythmias through medications and special pacemaker and defibrillator devices designed to improve heart rate, rhythm and function. New implantable devices are also available to help physicians monitor volume changes in the heart for those with heart failure and provide ongoing monitoring for those with complex arrhythmias or devices.
Thoracic and Cardiovascular Surgery
Cleveland Clinic cardiothoracic surgeons are very experienced with treating high risk patients who have severe coronary artery disease, co-existing conditions, heart muscle damage, or prior bypass or other types of heart surgery.
Other specialties are often needed to assist in confirming a diagnosis or treating an underlying or associated condition. These medical professionals are experts in their field and have a particular specialty interest in the treatment of advanced ischemic conditions.
- Michael Militello, PharmD, RPh, BCPS
What to Expect
Whether you are coming from around the corner or around the world, you want to know what to expect before, during and after your visit with us. If you have any questions while reviewing this information, please contact us. We are happy to answer any questions you may have.
Before Your Appointment
If you are scheduled at least one week away, you will be asked to send in your records, including medical history, test results and films (such as echocardiogram, cardiac catheterization, chest x-ray, MRI or CT as applicable), prior surgery reports, prior intervention reports, device implantation report. All information should be sent in the same package (clearly marked with your name and address) via Airborne Express, Federal Express, or certified U.S. mail (make sure you have a tracking number) to the physician with which you have an appointment. The address is:
Advanced Ischemic Heart Disease Center
9500 Euclid Avenue – Desk J1 - 5
Cleveland, Ohio 44195
If you are scheduled less than one week out, please bring your records and films to your appointment.
Traveling to Cleveland Clinic
When you make your appointment, we would like to make traveling to Cleveland Clinic as easy as possible. Information on travel to the Miller Family Heart and Vascular Institute.
During Your Appointment
You will meet with a nurse who will collect your information, and begin the documentation process. The diagnosis and treatment of advanced ischemic heart disease involves:
- Thorough history and exam
- Diagnostic imaging studies
- Patient management and recommendations
You will then meet with your Center physician who will review your records and prior films, take a medical history and perform a physical exam. Depending on your history and prior testing, you may be sent for specialized imaging tests. After your tests are complete you will meet with your cardiologist, who will review the tests with you and determine if additional consultations with other specialists within the Center are needed. If you need to meet with one of the multidisciplinary specialists, they will be consulted within 1 to 2 days. The Advanced Ischemic Heart Disease Center physician will provide you with a plan of care.
How long will you stay at Cleveland Clinic?
To complete all testing, you will need to stay in the Cleveland area for 1 to 2 days.
After Your Visit
Most follow-up will be done in 6 months to 1 year or as needed. There is an opportunity for telephone follow-up as well.
Let the appointment office know if you are having acute symptoms. When you make your appointment, ask the secretary for the name and desk number of your physician.
Appointments are located on the first or second floor (J1 or J2) of the Sydell and Arnold Miller Family Pavillion, depending on the physician, 9500 Euclid Avenue, Cleveland, Ohio
Use our secure online form to submit an appointment request 24/7. We will receive it and follow-up with you as soon as possible.
Mon. - Fri., 8 a.m. - 5 p.m. (ET):
Cleveland Clinic Heart and Vascular Institute physicians, surgeons, and researchers continue to research into new treatments and therapies with the goal of improving patient care and outcomes into the future.