Coronary Artery Disease

Coronary artery disease, also known as coronary heart disease, is the leading cause of death in the United States. Though there is no cure, it’s often manageable through lifestyle changes such as a more healthful diet, regular exercise and quitting smoking.

Symptoms

Chest pain or tightness is often the first sign of coronary artery disease. This discomfort, known as angina, can spread to the jaw, neck, back, arms and other parts of the body. Pain often intensifies with physical activity or an emotional event. Rest or medication (nitroglycerin) usually relieves the pain.

Some people also experience:

  • Shortness of breath.
  • Fatigue.
  • Heartburn.
  • Indigestion.
  • Nausea.
  • Sweating.

A normal heart and coronary arteries:

HVI Coronary Arteries

Causes

When plaque accumulates in the wall of coronary arteries that bring blood and oxygen to the heart, these small blood vessels begin to narrow. The plaque buildup, which includes cholesterol and other substances, can eventually block blood flow to the heart.

If the heart muscle gets inadequate amounts of oxygenated blood, you might begin to feel the first signs of coronary artery disease. Beyond angina, the disease might weaken the heart enough to cause more serious conditions such as heart failure (when the heart loses its ability to pump blood efficiently) or an irregular heartbeat, also known as arrhythmia.

Diagnosis/Treatment

Some risk factors, such as family health history, are irreversible. But lifestyle changes can prove lifesaving when a healthful diet and exercise are combined with stress management. Excess weight, poor diet, a sedentary lifestyle and smoking each increases the risk of coronary heart disease. Your doctor will want to establish a baseline, measuring blood pressure, sugar levels and cholesterol.

Several tests can help diagnose coronary heart disease:

Electrocardiogram: A device that measures the heart’s electrical activity, its rate and regularity.

Echocardiogram: An ultrasound test that uses a transducer to send out high-frequency sound waves toward the heart. The device, when moved over the chest and abdomen, turns the echoes of sound waves redirected from various parts of the heart into detailed images of organs, blood flow and tissues.

Stress Test: A measure of your heart rate as you walk on a treadmill that tells doctors if your heart works properly when required to pump more blood.

Chest X-ray: A picture of the chest area, including the heart and lungs, captured by X-rays.

Coronary angiogram: A type of X-ray that determines, by detecting dye injected with a cardiac catheterization – a procedure that uses a long tube called a catheter placed in an artery or vein to reach through blood vessels to your heart – if your arteries are narrowed or blocked.

Holter Monitor: A portable device worn for two days that records the heart’s electrical activity, including heartbeats. A patient who feels symptoms while wearing the device can press a button that records heart rhythms at that time.

Lifestyle Changes

Start with a diet your heart will like. The National Heart, Lung and Blood Institute, part of the National Institutes of Health, says your doctor will likely recommend a diet that includes:

  • Fat-free or low-fat dairy products, such as fat-free milk.
  • Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week.
  • Fruits, such as apples, bananas, oranges, pears, and prunes.
  • Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans.
  • Vegetables, such as broccoli, cabbage, and carrots.
  • Whole grains, such as oatmeal, brown rice, and corn tortillas.

What to avoid:

  • A lot of red meat
  • Palm and coconut oils
  • Sugary foods and beverages
  • What makes your cholesterol levels rise:
  • Saturated Fat: Red meat is a primary source.
  • Trans fat, or trans fatty acids: Foods with hydrogenated oils and fats.

Check the labels on baked goods, crackers, stick margarine and other foods.

Your goal: Limit saturated fat to no more than 6 percent of your daily calories. A 2,000-calories-a-day diet should cap saturated fat at 13 grams.

Preventive Cardiology

The Heart & Vascular Institute provides the most comprehensive services for the prevention and management of cardiovascular disease in the region. Its programs and services are tailored to help people with known or suspected heart disease, or those recovering from a heart attack or cardiac surgery.

Treatment

Aside from lifestyle changes, your doctor might prescribe medications for coronary heart disease or high (LDL) cholesterol or, if that fails, surgery.

Medications: Lipid-lowering statins are the only effective drugs against coronary artery disease. Regular use of aspirin, often the low-dosage baby type, can help lower the risks of both angina and a heart attack.

Medications are also available to lower your blood pressure and prevent blood clots that can lead to a heart attack or stroke. Calcium-channel blockers, which widen coronary arteries, lower blood pressure by increasing the blood supply to the heart. Beta blockers and ACE (angiotensin-converting enzyme) inhibitors also lower blood pressure.

Nitroglycerin, another drug that widens coronary arteries, is often prescribed to control chest pain.

Should you take statins?

Many physicians are reluctant to prescribe statins because of side effects that can include liver problems, muscle aches, memory loss and diabetes. But Dr. Paul Thompson, chief of cardiology and co-physician-in-chief of the Hartford HealthCare Heart & Vascular Institute, says such fears should not discourage anyone from taking statins.

Dr. Thompson, in an article in the Journal of the American Medical Association, cautioned that patients who take 80 percent of their statin dose have a 45 percent greater chance of dying than patients who take the prescribed dosage faithfully.

"Yet thousands of patients avoid these life-saving medications," he wrote, "because of the presence of, or concern about, possible statin-associated adverse effects."

Procedures

The Hartford Hospital Cardiac Catheterization Laboratory’s coronary angioplasty program is the largest in New England for treating coronary arteries that have been blocked completely for extended periods.

These chronic total occlusions, or CTO, typically did not respond to angioplasty.

Technological improvements, however, now make it possible to open blockages more efficiently at lower risk. Hartford Hospital’s doctors, led by program directors Dr. Jeffrey Hirst and Dr. Daniel Fram, have performed more than 200 procedures, called chronic total occlusion percutaneous coronary intervention, with close to 90 percent success. (National data shows a success rate between 40 percent and 50 percent.)

Dr. Daniel Fram explains the procedure that avoids open-heart surgery for patients with a blocked coronary artery:

Angioplasty, developed in 1977, remains an essential method to treat coronary artery disease when medications fail. It is not major surgery. Doctors use the technique to open blocked arteries, even replace them, by placing a catheter in the narrowed artery, inserting a deflated balloon and then inflating it. Once inflated, the balloon compacts fatty acids against artery walls. If needed, doctors can ensure the artery remains open by placing a stent, or mesh tubing, in the artery

 Other procedures:

Coronary thrombectomy: Used when a coronary blockage includes a blood clot, or thrombus. Thrombectomy catheters, equipped with a suction feature, remove the clot before a balloon angioplasty and stenting.

Coronary atherectomy: For blockages so hardened that neither a balloon nor a stent can expand fully during an angioplasty procedure. The drilling motion of devices like the rotational atherectomy catheter – this one has a diamond tip – breaks through extraordinarily dense plaque.

Hartford Hospital also uses newer technology, the Diamondback catheter, that features a brass burr embedded with diamond dust to cut through plaque buildup in an orbital motion.

Cutting balloon: The cutting theme continues with this device, which uses thin razor blades to slice through plaque and give your narrowed artery some needed elasticity to accommodate a stent.

A closer look at angioplasty:


Specialist in Coronary Artery Disease

Name Specialties Location
Bleich, Steven, MD Bleich, Steven, MD 860.522.0604
  • Cardiovascular Medicine
  • Echocardiography
  • Nuclear Cardiology
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  • Glastonbury
Pousatis, Sheelagh, MD Pousatis, Sheelagh, MD
4.9 /5
82 surveys
860.696.5520
  • Cardiac Surgery
  • Hartford
Barbour, Mohamad Firas, MD Barbour, Mohamad Firas, MD
4.9 /5
177 surveys
860.242.8756
  • Cardiovascular Medicine
  • Bloomfield
Alter, Eric Louis, MD, FACC, RPVI Alter, Eric Louis, MD, FACC, RPVI 203.254.2452
  • Cardiovascular Medicine
  • Echocardiography
  • Internal Medicine
  • Nuclear Cardiology
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  • Fairfield
  • Fairfield
  • Milford
  • Stratford
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Peckham, Elizabeth Nicole, APRN Peckham, Elizabeth Nicole, APRN
4.9 /5
54 surveys
860.886.0023
  • Cardiovascular Medicine
  • Norwich
  • Plainfield
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Gifford, Edward D., MD, FSVS, FACS, RPVI Gifford, Edward D., MD, FSVS, FACS, RPVI
4.9 /5
84 surveys
860.522.4158
  • Vascular Surgery
  • Endovascular Surgery
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  • Hartford
  • Mystic
  • Norwich
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Ali, Ayyaz, MD, PhD Ali, Ayyaz, MD, PhD
4.8 /5
61 surveys
860.696.5520
  • Cardiac Surgery
  • Hartford
Dawiczyk, Stephania, APRN, FNP Dawiczyk, Stephania, APRN, FNP
4.8 /5
172 surveys
860.886.0023
  • Vascular Surgery
  • Norwich
  • Hartford
  • Mystic
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Aitcheson, Elizabeth, MD, MPH, RPVI Aitcheson, Elizabeth, MD, MPH, RPVI
4.9 /5
112 surveys
860.522.4158
  • Vascular Surgery
  • General Surgery
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  • Hartford
  • Mystic
  • Norwich
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Sanders, Graig, PA-C Sanders, Graig, PA-C
4.8 /5
263 surveys
203.867.5300
  • Cardiovascular Medicine
  • Guilford
  • Branford
  • Hamden
  • New Haven
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Sussman, Eric, MD Sussman, Eric, MD
4.9 /5
81 surveys
860.278.0070
  • Neurosurgery
  • Endovascular Surgery
  • Interventional Neuroradiology
  • Vascular Neurology
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  • Hartford
  • Middletown
  • Torrington
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Phelan, Christopher, MD, FACC Phelan, Christopher, MD, FACC
4.9 /5
234 surveys
860.522.5712
  • Cardiovascular Medicine
  • Hartford
Martinez, Fidel, MD Martinez, Fidel, MD
4.8 /5
168 surveys
860.489.1132
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Torrington
Franke, Sara, APRN Franke, Sara, APRN 203.315.5300
  • Cardiovascular Medicine
  • Branford
  • Guilford
  • Hamden
  • New Haven
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Glotzer, Owen, MD Glotzer, Owen, MD
4.7 /5
105 surveys
860.522.4158
  • Vascular Surgery
  • Hartford
  • Mystic
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Horblitt, Adam, MD Horblitt, Adam, MD
4.9 /5
218 surveys
203.867.5300
  • Cardiovascular Medicine
  • Branford
  • Guilford
  • Hamden
  • New Haven
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Matmati, Kelly, MD Matmati, Kelly, MD
4.7 /5
35 surveys
203.332.1949
  • Neurology
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  • Bridgeport
  • Bridgeport
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Kreiter, Marina, APRN Kreiter, Marina, APRN 860.886.0023
  • Cardiovascular Medicine
  • Norwich
Teopengco, Ryan, APRN Teopengco, Ryan, APRN 860.886.0023
  • Cardiovascular Medicine
  • Norwich
Harris, Jessica, PA-C Harris, Jessica, PA-C 860.886.0023
  • Cardiovascular Medicine
  • Norwich
Robertson, Tara, APRN, DNP Robertson, Tara, APRN, DNP 860.972.1212
  • Cardiovascular Medicine
  • Fairfield
  • Trumbull
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Egom, Emmanuel, MD, PhD, FACC, FRCPC Egom, Emmanuel, MD, PhD, FACC, FRCPC 860.628.0703
  • Cardiovascular Medicine
  • Southington
  • Wallingford
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Cheema, Mohiuddin, MD Cheema, Mohiuddin, MD
4.9 /5
188 surveys
860.696.5520
  • Cardiac Surgery
  • Vascular Surgery
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  • Hartford
Golub, Robert Joel, MD, FACC Golub, Robert Joel, MD, FACC 203.265.9831
  • Cardiovascular Medicine
  • Echocardiography
  • Nuclear Cardiology
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  • Wallingford
Casey, David Madigan, MD, FACC Casey, David Madigan, MD, FACC
4.9 /5
348 surveys
860.886.0023
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Norwich
  • Mystic
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Wagner, Anja, MD, FACC Wagner, Anja, MD, FACC 203.845.2160
  • Cardiovascular Medicine
  • Echocardiography
  • Internal Medicine
  • Nuclear Cardiology
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  • Bridgeport
  • Fairfield
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Lee, Maximilian H., MD, FACC Lee, Maximilian H., MD, FACC 860.522.0604
  • Cardiovascular Medicine
  • Internal Medicine
  • Nuclear Cardiology
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  • Hartford
  • Avon
  • Glastonbury
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Dougherty, Kevin Russell, MD, FACC Dougherty, Kevin Russell, MD, FACC 860.522.0604
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Hartford
  • Farmington
  • Glastonbury
  • Wethersfield
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Farrell, Hannah Stanton, PA-C Farrell, Hannah Stanton, PA-C
4.8 /5
121 surveys
860.522.4158
  • Vascular Surgery
  • Hartford
  • Meriden
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Criscuolo Beck, Aimee Jude, PA-C Criscuolo Beck, Aimee Jude, PA-C
4.8 /5
142 surveys
860.636.2010
  • Cardiovascular Medicine
  • Middletown
Guerin, Elizabeth T., PA-C Guerin, Elizabeth T., PA-C 860.522.4158
  • Vascular Surgery
  • Hartford
  • Glastonbury
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Haider, Jawad, MD, FACC, RPVI Haider, Jawad, MD, FACC, RPVI
4.8 /5
146 surveys
860.524.3070
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Bloomfield
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Walden, Jeffrey Howard, MD, FACC Walden, Jeffrey Howard, MD, FACC 860.522.0604
  • Cardiovascular Medicine
  • Hartford
  • Glastonbury
  • Manchester
  • Wethersfield
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Portnay, Edward Lowell, MD, FACC, FSCAI Portnay, Edward Lowell, MD, FACC, FSCAI 203.353.1133
  • Interventional Cardiology
  • Stamford
Memon, Sarfaraz, MD Memon, Sarfaraz, MD 860.524.3070
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Hartford
  • Norwich
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Paoletti, Daniel C., PA-C Paoletti, Daniel C., PA-C 203.264.5911
  • Cardiovascular Medicine
  • Oxford
Duvall, William, MD Duvall, William, MD 860.972.2976
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Hartford
Elwan, Ahmed M., MD Elwan, Ahmed M., MD 860.258.3477
  • Cardiovascular Medicine
  • Wethersfield
  • Cromwell
  • Farmington
  • Glastonbury
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Jain, Akhilesh Kumar, MD, FACS, RPVI Jain, Akhilesh Kumar, MD, FACS, RPVI
4.9 /5
108 surveys
860.522.4158
  • Vascular Surgery
  • Endovascular Surgery
  • General Surgery
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  • Hartford
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Oligino, Eric Joseph, MD, FACC Oligino, Eric Joseph, MD, FACC
4.9 /5
327 surveys
860.522.5712
  • Cardiovascular Medicine
  • Hartford
  • Farmington
  • Manchester
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Tally, Kevin Joseph, MD, FACC Tally, Kevin Joseph, MD, FACC 860.522.0604
  • Cardiovascular Medicine
  • Advanced Heart Failure and Transplant
  • Internal Medicine
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  • Hartford
  • Glastonbury
  • West Hartford
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Ferraro-Borgida, Melissa Joy, MD, FACC Ferraro-Borgida, Melissa Joy, MD, FACC
4.8 /5
382 surveys
860.522.5712
  • Cardiovascular Medicine
  • Cardio-Obstetrics
  • Echocardiography
  • Nuclear Cardiology
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  • Hartford
  • Farmington
  • Manchester
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Farrell, William Joseph, MD, FACC Farrell, William Joseph, MD, FACC 203.265.9831
  • Cardiovascular Medicine
  • Internal Medicine
  • Interventional Cardiology
  • Nuclear Cardiology
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  • Wallingford
Lenhart, Kevin Kalman, MD Lenhart, Kevin Kalman, MD
4.9 /5
352 surveys
203.888.8510
  • Cardiovascular Medicine
  • Oxford
  • Branford
  • Derby
  • Hamden
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Selter, Jared Gideon, MD, FACC Selter, Jared Gideon, MD, FACC 203.445.7093
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Trumbull
  • Bridgeport
  • Fairfield
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Hashim, Sabet W., MD, FACS Hashim, Sabet W., MD, FACS
5.0 /5
160 surveys
860.696.5520
  • Cardiac Surgery
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  • Bridgeport
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Feingold, Andrew David, MD, FACC Feingold, Andrew David, MD, FACC 860.522.0604
  • Cardiovascular Medicine
  • Internal Medicine
  • Nuclear Cardiology
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  • Hartford
  • Avon
  • Glastonbury
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Borer, Steven Michael, DO, FACC, DipABLM Borer, Steven Michael, DO, FACC, DipABLM
4.9 /5
376 surveys
860.522.5712
  • Cardiovascular Medicine
  • Nuclear Cardiology
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Thande, Njeri, MD Thande, Njeri, MD
4.8 /5
166 surveys
860.636.2010
  • Cardiovascular Medicine
  • Echocardiography
  • Nuclear Cardiology
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  • Middletown
Adajian, Allison Y., PA-C Adajian, Allison Y., PA-C 860.223.0800
  • Vascular Surgery
  • Plainville
  • Meriden
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Katsetos, Manny Christos, MD Katsetos, Manny Christos, MD 860.229.6811
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • New Britain
Lorenz, David Patrick, MD, FACC Lorenz, David Patrick, MD, FACC 203.845.2160
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Endovascular Medicine
  • Internal Medicine
  • Vascular Medicine
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  • Norwalk
  • Bridgeport
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Shah, Parth S., MD, MPH, FACS Shah, Parth S., MD, MPH, FACS
5.0 /5
120 surveys
860.223.0800
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  • Endovascular Surgery
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  • Plainville
  • New Britain
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Atef, Amr Mohamed, MD Atef, Amr Mohamed, MD
4.9 /5
257 surveys
860.886.0023
  • Cardiovascular Medicine
  • Norwich
Swales, Heather Hunt, MD Swales, Heather Hunt, MD 860.224.5694
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  • Nuclear Cardiology
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  • New Britain
Kramer, Daniel G., MD, FACC Kramer, Daniel G., MD, FACC
4.9 /5
365 surveys
860.522.5712
  • Cardiovascular Medicine
  • Hartford
  • Farmington
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Hagberg, Robert Carl, MD Hagberg, Robert Carl, MD
4.9 /5
186 surveys
860.696.5520
  • Cardiac Surgery
  • Hartford
Thompson, Craig Alan, MD Thompson, Craig Alan, MD 860.524.3070
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Endovascular Medicine
  • Vascular Medicine
Show Less
  • Hartford
Malkin, Robert Douglas, MD Malkin, Robert Douglas, MD 860.229.6811
  • Cardiovascular Medicine
  • Internal Medicine
  • Interventional Cardiology
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  • New Britain
Granquist, John Dickson, MD, FACC Granquist, John Dickson, MD, FACC 860.522.0604
  • Cardiovascular Medicine
  • Advanced Heart Failure and Transplant
  • Internal Medicine
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  • Hartford
  • Glastonbury
  • Windsor
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Merkatz, Kenneth Alan, MD Merkatz, Kenneth Alan, MD 860.258.3477
  • Cardiovascular Medicine
  • Internal Medicine
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  • Wethersfield
  • Enfield
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Spivack, George, MD Spivack, George, MD 203.265.9831
  • Cardiovascular Medicine
  • Wallingford
Rizvi, Asad Ali, MD, FACC Rizvi, Asad Ali, MD, FACC 860.524.3070
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Echocardiography
  • Nuclear Cardiology
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  • Hartford
  • Norwich
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Richards, Kyle A., MD, FACC, FASNC, RPVI Richards, Kyle A., MD, FACC, FASNC, RPVI
4.7 /5
31 surveys
860.886.0023
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Norwich
Windels, Mary Hyde, MD, FACS, RPVI Windels, Mary Hyde, MD, FACS, RPVI
4.9 /5
114 surveys
860.522.4158
  • Vascular Surgery
  • Endovascular Surgery
  • General Surgery
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  • Hartford
  • Meriden
  • Norwich
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Duncan, Brett Hunter, MD, FACC Duncan, Brett Hunter, MD, FACC
4.9 /5
377 surveys
860.522.5712
  • Cardiovascular Medicine
  • Nuclear Cardiology
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  • Hartford
  • Farmington
  • Manchester
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Fram, Daniel Bruce, MD Fram, Daniel Bruce, MD 860.524.3070
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Hartford
Agin, Elliot David, MD, FACC Agin, Elliot David, MD, FACC
4.9 /5
193 surveys
203.874.1512
  • Cardiovascular Medicine
  • Echocardiography
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  • Milford
Sadiq, Immad, MD Sadiq, Immad, MD
4.8 /5
36 surveys
860.524.3070
  • Interventional Cardiology
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  • Endovascular Medicine
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  • Hartford
  • Norwich
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Azemi, Talhat, MD, FACC, RPVI Azemi, Talhat, MD, FACC, RPVI
4.9 /5
61 surveys
860.524.3070
  • Interventional Cardiology
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  • Echocardiography
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  • Nuclear Cardiology
  • Vascular Medicine
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  • Hartford
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Ansari, Ehsan, MD Ansari, Ehsan, MD 203.573.1435
  • Cardiovascular Medicine
  • Internal Medicine
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  • Waterbury
Mamuya, Komsu Fidel, MD, FACC Mamuya, Komsu Fidel, MD, FACC 860.258.3477
  • Cardiovascular Medicine
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  • Wethersfield
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Divinagracia, Thomas V., MD, FACS, MPH, RPVI Divinagracia, Thomas V., MD, FACS, MPH, RPVI
4.9 /5
75 surveys
860.522.4158
  • Vascular Surgery
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Hammond, Jonathan Acton, MD Hammond, Jonathan Acton, MD
4.9 /5
85 surveys
860.696.5520
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Khachane, Vasant B., MD Khachane, Vasant B., MD 203.407.2500
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  • Hamden
Fusco, Daniel Stephen, MD Fusco, Daniel Stephen, MD
5.0 /5
87 surveys
203.576.5708
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Squitieri, Rafael Paolo, MD Squitieri, Rafael Paolo, MD
4.9 /5
204 surveys
203.576.5708
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Jordan, Jenna S., APRN Jordan, Jenna S., APRN 860.572.5400
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Hanretta, Kelly Colleen, DO Hanretta, Kelly Colleen, DO
4.9 /5
120 surveys
860.572.5400
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Carreras, Edward Thomas, MD, FACC, FSCAI Carreras, Edward Thomas, MD, FACC, FSCAI 203.380.3910
  • Interventional Cardiology
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  • Echocardiography
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  • Stratford
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Singh, Parmanand, MD Singh, Parmanand, MD
4.9 /5
125 surveys
860.489.1132
  • Echocardiography
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  • Nuclear Cardiology
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  • Torrington
Piccirillo, Bryan James, MD Piccirillo, Bryan James, MD
4.9 /5
58 surveys
860.524.3070
  • Interventional Cardiology
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  • Hartford
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Al-Damluji, Mohammed, MD Al-Damluji, Mohammed, MD 860.636.2010
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Middletown
Ayach, Mouhanad, MD, RPVI Ayach, Mouhanad, MD, RPVI
4.9 /5
118 surveys
860.223.0800
  • Vascular Surgery
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  • Plainville
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Ingrassia, Joseph James, MD, RPVI Ingrassia, Joseph James, MD, RPVI
5.0 /5
34 surveys
860.524.3070
  • Interventional Cardiology
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  • Echocardiography
  • Nuclear Cardiology
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  • Hartford
  • Winsted
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Decena, Katharine T., MD Decena, Katharine T., MD
4.8 /5
260 surveys
860.886.0023
  • Cardiovascular Medicine
  • Echocardiography
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  • Norwich
Saucier, Stephanie J., MD, FACC, RPVI Saucier, Stephanie J., MD, FACC, RPVI
4.9 /5
204 surveys
860.972.1695
  • Cardiovascular Medicine
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  • Hartford
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Yaffee, David, MD Yaffee, David, MD
4.9 /5
135 surveys
860.696.5520
  • Cardiac Surgery
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  • Hartford
Aleria, Danielle, APRN Aleria, Danielle, APRN 860.886.0023
  • Cardiovascular Medicine
  • Norwich
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