The Heart of Jacksonville Clinic | Fall 2017 | Part 1

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A publication of

How First Coast Cardiovascular Institute is redefining the patient experience.


IN IT FOR THE LONG RUN Fostering healthy lifestyles in Northeast Florida




A publication of


B R O U G H T T O Y O U B Y T H E S U R V I V O R S & C A R E G I V E R S O F T H E A M E R I C A N H E A R T A S S O C I AT I O N

Letter from the President Dear First Coast Residents,

Every day that I am in clinic, I have patients telling me that they have never seen staff in any medical office who are as compassionate and professional as ours. For that, I am grateful. Over the years, we have served thousands of patients from across the nation, from north to south. We often find ourselves blessed with patients who have taken every method of transportation to seek our help. For that, I am also grateful. Dr. Yazan Khatib President of FCCI and Jacksonville Clinic

We are proud to now offer expanded services for our patients through our vein clinic, which has grown from a service line in our

practice to its own comprehensive center. We cover the full spectrum of vein health from medical to aesthetic. Moreover, we are the only clinic in Northeast Florida that treats vein health from a 360-degree perspective. We treat the root cause of vein disease to ensure closer look at our vein clinic. We are also expanding our services to treat patients affected by kidney failure. Kidney failure is a condition affecting more than 600,000 American lives, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Many of these patients will undergo hemodialysis, a treatment method that

can be taxing both physically and mentally. We offer services in hemodialysis access management. Our outcomes for hemodialysis access management demonstrate how we have successfully reduced hospitalizations for these patients.

Over the years, we have served thousands of patients from across the nation, from north to south. We often find ourselves blessed with patients who have taken every method of transportation to seek our help.

long-term success for our patients. Turn to pages 11-12 for a

Outcomes matter and the only outcome that matters to us, is that of our patient’s health and well being. Turn to page 13 for more information on our hemodialysis access

An online Support Network of, and for, survivors and their family caregivers. Because you are not alone.

management services. We started this magazine as a way for our physicians to connect with the community about everything from healthy eating and living to new advancements in medicine. We are proud that this publication has turned into a small community for our residents. Thank you for joining us in edition three of

The Heart of Jacksonville Clinic magazine. We hope to see you back for many more. Sincerely,

J O I N U S T O D A Y. R E G I S T R A T I O N I S E A S Y A N D F R E E .

Yazan Khatib, MD President of First Coast Cardiovascular Institute & Jacksonville Clinic

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Endovascular Medicine:

REDEFINING A PHYSICIAN’S APPROACH TO VASCULAR DISEASE Dr. Vaqar Ali, endovascular specialist, is able to provide a unique approach to vascular disease.

Does a Gluten-Free Diet Protect Your Heart Health? “Gluten-free” is a term that we see more often than ever with food companies and diet trends stating that gluten is harmful. But, what exactly is gluten? Gluten is a general name for the proteins found in wheat, rye, barley and triticale (a cross between wheat and rye). Gluten helps foods maintain their shape, acting as glue that holds food together. It can be found in a variety of foods, some that you may not even realize. Gluten-free diets are recommended for people who have celiac disease – an autoimmune disorder where the consumption of gluten damages the intestines – or for people who are allergic to or sensitive to gluten. For those who have a gluten allergy, they are encouraged to seek the assistance of a registered dietitian to learn how to avoid potential nutritional deficiencies. Avoiding gluten reduces the consumption of whole grains, which are proven to have cardiovascular benefits. A new


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study published in the BMJ (formerly the British Medical Journal ), concludes that gluten-free diets should not be promoted for the prevention of coronary heart disease. Removing gluten from your diet not only reduces your consumption of whole grains, but also the B vitamins, iron and heart-healthy fiber that are found in gluten. Furthermore, gluten-free foods can be loaded with nutrients that should be limited on a heart healthy diet (for example, sugar, salts, saturated fats and trans-fats). e 2010 Dietary Guidelines for Americans recommends that half of all carbohydrates in your diet come from whole grain products. An additional study in the BMJ found that whole grain foods, as part of a healthy diet, may help lower your risk of developing heart disease, type 2 diabetes and even some forms of cancer. To reduce your risk of cardiovascular disease, it’s best to eat a balanced diet, including whole grains, fruits, vegetables and lean protein, instead of following a gluten-free diet.

First Coast Cardiovascular Institute

catheterization, requires the

sites in Florida to offer Zilver PTX,

(FCCI) leads the community in

expertise of a trained, board-

the world's first superficial

endovascular therapies that lead

certified endovascular specialist.

femoral artery. This allowed

to shorter procedural and

At FCCI, our robust team of

us to bring the latest advancements

recovery times.

endovascular specialists are all

to our patients, before anyone else,

board-certified in their fields,

leading to more sustainable

achieving the highest level of


In the past, vascular problems were primarily diagnosed and treated at hospitals with surgery


Our endovascular specialists will

as the primary treatment.

We were also the first in the area

always strive to prevent a condition

However, with the aggressive

to open a freestanding outpatient

from getting to a point where an

growth of endovascular medicine,

catheterization laboratory where

intervention is needed. However,

many patients are receiving all

our patients can receive most

when an intervention is necessary,

the care they need for vascular

endovascular interventions

rest assured we have access to

disease in an outpatient setting.

required. Most patients leave

the latest innovations. The result

the facility the same day.

for you? A better quality of life.

Contrary to traditional surgical techniques, endovascular

In addition to a team of board-

medicine uses minimally-invasive

certified physicians and an

technology to evaluate and treat

accredited facility, FCCI houses

You may need an

vascular diseases. These therapies

a clinical research department.

endovascular specialist for:

provide imaging techniques to

Our research team has proven

accurately assess the vasculature

success in advancing

of the heart, head, neck, legs and

endovascular interventions.

arms. These imaging techniques assist in determining whether blockages and diseases require further treatment or intervention.

• Coronary artery disease

For over a decade, we have

• Peripheral artery disease • Carotid arterial disease

participated in research that paved the way to many of the

• Circulatory issues

stents, pharmaceutical drugs and

Successful vascular care and

devices that are now the standard

management, with

of care. We were one of the first

Fall 2017

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Thank you Duval, Nassau and Clay County School Boards

Florida Counties Pass CPR in Schools Policy

Members of the Duval County School Board voted to require high school students to learn hands-on cardio pulmonary resuscitation (CPR) before they graduate, ensuring future generations of lifesavers. Duval County joins Clay and Nassau Counties in making CPR training in schools a sustainable policy. The American Heart Association (AHA) has been working with the school district to make this policy sustainable. Florida was the first state to introduce statewide CPR in school’s legislation; legislation that has now been adopted by 37 other states in the nation, including all southern states, except Florida. In just one hour of a student’s four-year high school career, this CPR training can provide the skills needed to help save lives, and it requires no certification. Seventy percent of out-of-hospital cardiac arrests happen in homes. The odds are high that if students are called on to act, they’ll be saving the life of a loved one. “The American Heart Association’s goal is to teach lifesaving CPR skills to as many teens and young adults as possible in Florida to help keep our communities safer, year after year,” said Paula Wright, member of the AHA First Coast Metro Board and Chairman of the Duval County School Board. “Having a new generation of lifesavers will benefit everyone, and CPR in schools will be the key to a change that will have invaluable impact on lives saved.” Only 46 percent of people who experience out-of-hospital cardiac arrest get the immediate help they need before first responders arrive, and less than 10 percent of victims survive. Given right away, CPR doubles or triples survival rates. Teaching CPR in schools will empower students to act in a cardiac emergency, giving victims the immediate help they need to survive until emergency medical services arrive.

First Coast Cardiovascular Institute (FCCI)

As an interventional cardiologist at First Coast Cardiovascular Institute and active board member


of the AHA, Dr. Yazan Khatib sees the immense benefit of CPR training in schools. “As heart disease remains the number-one killer in the U.S., it is safe to say nearly every student has been affected by a tragic case of heart disease,” said Dr. Khatib. “Including this policy in our students’ academic program empowers them to take action when warning signs occur.” Thanks to Duval, Nassau and Clay Counties for requiring high school students to learn hands-on cardio pulmonary resuscitation (CPR) before they graduate, ensuring we will sustain future generations of lifesavers. #CPRinschools


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We want to thank Drs. Lamba, Schimmel and Zia for volunteering to stay at our community hospitals during Hurricane Irma. We were proudly able to serve Memorial Hospital, Orange Park Medical Center and Putnam Community Medical Center despite the storm. We would also like to thank Dr. Nathan Bates who emergently came in to team up with Dr. Lamba and perform a procedure that saved a patient’s life. Thank you for your commitment to patient care.

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Changing the Landscape of

Cardiovascular Care in Putnam County An enhanced patient experience

When we first started caring for patients in Putnam County, our Palatka team and office were relatively small. Over the course of a few years, our patient following flourished. We could see the positive health impact we were making in the community and our commitment continued to grow.

A fully-accredited facility

Our facility has earned accreditation by several organizations for superior care. A team of board-certified specialists

We have a team of senior, board-certified physicians across the spectrum of cardiovascular care including interventional cardiologists, endovascular specialists, electrophysiologists and general cardiologists.

Our facility is home to vascular testing, echocardiography and nuclear cardiology laboratories. Southern charm

Putnam County is a fast-growing area in Northeast Florida. Located on the St. John’s River, Palatka attracts many nature-lovers from across the state. e patients in Putnam are truly one-of-a-kind. ey are warm people, who are appreciative of the innovative services we are bringing to the area.


Our facility has advanced cardiovascular care in the Putnam community. Previously, patients were often left having to travel to nearby areas such as Gainesville or St. Augustine to receive the full spectrum of cardiovascular care. Our new facility became the community’s one-stopshop for most cardiovascular needs, saving patients time and money.

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Reagan Carreira, RVT, RCS, vascular technician

Full-service cardiovascular testing

Latonya Green, ARNP, greets her patient with a smile. Exam rooms were designed to allow the provider and patient to sit face-to-face.

Need we say more? The smiling faces of our Palatka staff.


We are the first cardiology group to bring board-certified electrophysiology to Putnam County, a subspecialty focused on heart rhythms. This includes the prevention, management and treatment of conditions such as atrial fibrillation, palpitations and a range of other heart rhythm disorders.

In 2016, we decided to move locations to a larger office to accommodate our patients’ needs. Our office, located on 205 Zeagler Road, is less than a quarter mile away from Putnam Community Medical Center. e new facility houses six exam rooms, an outpatient catheterization laboratory and five recovery rooms.


e exam rooms of our new facility are spacious, allowing the provider and patient to sit face-to-face, fostering a strong relationship.

Structural Heart Disease Management

We are leaders in structural heart disease management with access to the latest technologies. We have been the first to perform the Transcatheter Aortic Valve Replacement (TAVR) in Clay County as well as the first to perform the MitraClip procedure in Northeast Florida.

Dr. Brett Sasseen (left) and Dr. Ziad Alnabki

A Commitment to Venous Disease

OUR FACILITY INCLUDES: A freestanding outpatient catheterization laboratory

Our accredited cath lab allows us to perform minimallyinvasive procedures in the comfort of our clinic.

Chronic venous insufficiency affects 25 million Americans. Our vein clinic is the first of its kind. We take a comprehensive approach to venous disease including non-surgical treatment options and follow-up care by a team of experts. To schedule an appointment at our Palatka office, please call 386.325.2836.

We offer a wide range of testing in-house.

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Spiced Salmon with Mango Salsa

Physician Spotlight There are over 120 medical specialties and subspecialties. Of all specialties, why did you decide to become a cardiologist?

If you are anything like us, you have a hard time deciding between spicy, smoky or sweet. Why should you have to choose? This spiced salmon with mango salsa

Dr. Jonathan Constantin

Dr. Youssef al-Saghir

recipe from Publix ApronsTM checks all the boxes on your list of taste buds. More importantly, it checks many boxes in terms of nutrients. Salmon is filled with nutrients like omega 3, protein and selenium — all of which

“ My role as a cardiologist is that of a teacher. I like how much time I am able to spend with each of my patients on education.”

can help reduce your risk of developing heart disease. Mangoes are a low calorie, nutrient dense fruit that’s available to add to your diet year-round. Paired together, the two create a dish that you, a doctor and a chef can all agree on.



1 mango

1. Preheat grill (or grill pan). Peel mango and cut into 1/4-inch cubes (1 cup). Chop onion (2 Tbsp) and cilantro. Squeeze limes for juice (1 1/2 tsp). Combine mango, onion, cilantro, lime juice, agave and 1/4 tsp salt. 2. Combine all spices and remaining 1/4 tsp salt. Cut salmon into four equal pieces (wash hands). Coat both sides of salmon with spray and spice mixture. Place salmon on grill (or in grill pan); grill 3 - 4 minutes on each side and until 145°F (or opaque and separates easily). (Or bake salmon in oven preheated to 400°F for 8 - 10 minutes.) Serve mango salsa over fish.

1 small red onion, finely chopped 3 Tbsp fresh cilantro, finely chopped 2 limes, for juice 1 Tbsp agave nectar (or honey) 1/2 tsp kosher salt, divided 1 tsp smoked paprika 1 tsp ground cumin 1/2 tsp chili powder

NUTRITIONAL INFORMATION CALORIES (per 1/4 recipe) 220kcal; FAT 8.00g; SAT FAT 1.50g; TRANS FAT 0.00g; CHOL 60mg; SODIUM 280mg; CARB 12g; FIBER 1.00g; SUGARS 10g; PROTEIN 25g; CALC 2%; VIT A 20%; VIT C 30%; IRON 4%

1 lb sockeye (or coho) salmon fillet, skin removed Cooking spray


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“ I previously followed my family tradition of becoming an engineer. There are actually many similarities — both fields require analytical thinking and a desire for working with your hands. The human element is the difference. Interventional cardiology starts with prevention and encompasses pharmacological as well as mechanical therapy.”

Dr. Gary Snyder

Dr. alan Schimmel

“ Heart disease is the number-one killer in the United States, yet so many deaths can be prevented with the right care and management. I decided to go into cardiology to become an active member in the prevention and management of heart disease.”

“ I found cardiology to be the perfect place to channel my compassion and commitment toward my patients. I have been able to use my specialty to care for communities around the world.”

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SERVICES 3 STEPS TO HEaLTHY VEINS DEEP VEINS 1. Schedule an appointment ere are certain signs and symptoms that can be a cause of concern. If you have any of these symptoms, call to schedule an appointment:

• Itchy or achy legs

is is a minimally-invasive procedure that uses a specifically designed ultrasound probe to image the deep veins in the legs, pelvis and abdomen from within the veins. is type of imaging gives an expanded view of the inside of the vein differentiating deep vein thrombosis, compression and other types of pathology affecting the venous circulation.

• Pain while walking or shortly after


• Swollen veins that look blue or bulging

is x-ray exam shows how blood is flowing throughout your veins to assess the presence of blood clots or identify a vein for a procedure.

• Swollen ankles or calves • Heavy, tired or restless legs

• Skin changes such as redness • Formation of ulcers • Painful intercourse

The Vein Clinic at First Coast Cardiovascular Institute:

Jacksonville’s PREMIER Comprehensive Vein Clinic Patients have many choices when it comes to vein clinics in Jacksonville. However, no vein clinic is quite as comprehensive as ours. e Vein Clinic at First Coast Cardiovascular Institute (FCCI) examines venous health in terms of each patient’s overall health and wellness. What makes us the most comprehensive vein clinic in Northeast Florida? Our services go beyond your vein health. Patients have seen first-hand the benefits of our approach in maintaining their overall care. Venous disease is a condition impacting a large portion of the U.S. population. Half of women and 40 percent of men suffer from a venous problem, according to the U.S. Department of Health and Human Services. However, often times, a patient comes in with symptoms that are suggestive of venous disease. After undergoing testing, we may find the patient does not have venous disease; their symptoms are actually indicative of


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another condition. Sometimes, this condition can even be lifethreatening such as heart failure. When this happens, we have a team of specialists that are board-certified in cardiovascular medicine, sleep medicine, wound care and pulmonology ready to care for the patient. No other vein clinic in the area houses a team of multi-specialists as extensive as ours under the same roof. “You can expect a 360-degree approach to your vein health, including cosmetically,” says Dr. Jason Roberts, Director of the Vein Clinic. “More importantly, you can expect a full assessment of your risk factors, signs and symptoms beyond vein health.” Our 10-year tradition of caring for thousands of patients in an outpatient setting is unmatched. From the simplest to the most complex of vein disease, we have positioned ourselves as leaders in the field.

Intravascular Ultrasound (IVUS)


• Varicose veins on abdomen

is is a procedure performed to widen the veins using an inflatable balloon, which results in improved blood flow.

2. Testing


We offer a range of testing to accurately evaluate your condition. is enables us to recommend treatment options. Our testing includes the most advanced forms of specialized ultrasounds.

Stents are used to keep the veins open to allow for adequate blood flow.

3. Treatment options If treatment is indicated, our physicians will recommend the treatment option most personalized to your condition and in alignment with your health goals. Our treatment options include everything from deep veins to superficial and cosmetic.

SUPERFICIaL VEINS Endovascular Laser is non-invasive laser procedure lasts about an hour. is technique uses heat to treat the underlying causes of varicose veins. ere is little to no pain associated and the success rate is 98 to 100 percent. Phlebectomy is procedure eliminates persistent varicose veins through a tiny needle puncture.

COSMETIC VEINS Spider Veins Spider veins are the result of blood vessels that collect close to the surface of the skin, giving the skin a distorted appearance. We are able to successfully eliminate the appearance of spider veins through injections. Reticular Veins Reticular veins are similar to varicose veins but are usually smaller in size and deeper under the skin’s surface. Reticular veins often give a blue, green appearance and may form into spider veins. We are able to eliminate reticular veins through minimally-invasive procedures such as sclerotherapy.

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How First Coast Cardiovascular Institute

is Improving Outcomes for Patients with Kidney Failure

Physician Spotlight Welcome Ziad Alnabki, MD, to the First Coast Cardiovascular Institute (FCCI) Family

Kidney failure happens when your kidneys are no longer able to efficiently filter toxins from your blood. When this happens, patients rely on treatments such as hemodialysis to replace some of these functions. Hemodialysis is an artificial means of removing waste products from the blood through an artificial kidney. This type of treatment requires an access point into the blood vessels, which is created through a minor surgery using a fistula or graft. The majority of hemodialysis patients in the U.S. rely on fistula or graft access to receive their dialysis treatment. While blood clots are a major complication of this procedure, there is also risk of infection. We are committed to the health of patients undergoing hemodialysis treatment. Our compassionate group of multispecialty physicians works together closely with the patient, their nephrologist as well as their dialysis nurses and technicians to ensure a comprehensive healthcare experience.

Dr. alnabki thinks of the heart as the center of your health. “There are many aspects of prevention and primary care intertwined in cardiology,” says Dr. alnabki. “Helping a patient prevent heart disease is also helping them prevent a multitude of other diseases.”

First Coast Cardiovascular Institute (FCCI) provides access management services including hemodialysis fistula and graft duplex scans at both of our outpatient cath labs in Jacksonville and Palatka. The test uses ultrasound imaging to directly visualize the hemodialysis fistula or graft to ensure proper blood flow, which can detect potential fistula or impending graft failure. If left untreated, these problems can prevent patients from receiving their hemodialysis treatment. We typically are able to see patients in less than 24 hours. In most cases, we are able to see them the same day. Our hemodialysis access patients receive expedited care, which reduces the likelihood of a full hemodialysis access failure and incidents of missed hemodialysis, keeping them out of the hospital. Nearly 100 percent (99.7%) of our patients had central venous catheters placed for less than 90 days. The longer the catheter is in place, the greater the risk for infection. Our clinical outcomes suggest that we are able to reduce infections, keeping our patients out of the hospital, and avoiding the need for a new hemodialysis access point. This reduces the overall cost of care and complications. Our patients are carefully monitored using ultrasound surveillance at specific times. We found the routine use of ultrasound surveillance reduced the amount of declots and early hemodialysis access complications in our patients. Additionally, it reduced the need for invasive procedures. We understand hemodialysis can be an exhaustive treatment process. We are passionate about improving the quality of life for patients with kidney failure in any way that we can.

Typical Wait Time

< 24 hrs. Most Cases = Same Day Dr. Ziad Alnabki, the newest addition to our team.

99.7% of our Patients Had CVCs

< 90 Days = Reduced Infections

Hospital Stays New Access Point

Creation Routine Use of Ultrasound Surveillance

Reduced Declots +

Early Access Complications 13

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Dr. Alnabki is an interventional cardiologist who holds board certifications in general cardiology, echocardiography and nuclear cardiology. He started his journey in medicine at the University of Damascus in Syria. He went on to complete his residency training in both cardiology and interventional cardiology at the University of Louisville in Kentucky where he received the “Best Teaching Fellow” award in 2013 (no surprise to us, at all).

Dr. Alnabki is passionate about improving health outcomes in Putnam County. “The Putnam community is capable of amazingly positive changes,” says Dr. Alnabki. “Building strong relationships with my patients and integrating fully into the community is important to me.” Dr. Alnabki is a member of several professional organizations including the American Medical Association and American College of Cardiology. Outside of clinic, Dr. Alnabki enjoys traveling and spending time with his wife and two children.

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Read What Patients are Saying about Us On The Web

First Coast Cardiovascular Institute


These days, word of mouth has gone digital. We love hearing what patients are saying about their experiences with our doctors and practice on the web.

“ Dr. Goel is a fabulous doctor. His procedure, an RF ablation, fixed my heart. Thank you, Dr. Goel.” –a Facebook comment

“ This group of people at Jacksonville Clinic & First Coast Cardiovascular Institute are each worthy of their angel wings! Thank you for giving us more time with our Dad! We will forever be grateful to you!” –a Facebook comment

“ Dr. Sasseen is a very personable and honest doctor. Willing to listen and offer different possibilities.” –a Healthgrades review

“ I have been going to Dr. Schimmel for more than four years. He has been good to me and always listens to my questions and concerns. He has made small talk with me, which I have always felt was done to help me feel more at ease. I would recommend Dr. Schimmel to anyone in need of a good cardiologist.” –a Vitals review

“ Dr. Constantin is a great doctor. I’ve been going to him for over seven years. He has seen other family members too and has been great to us.” “ Very thorough. (Dr. Khatib) is extremely informative, kind and he is just the best, in my eyes. He saved my life 14 years ago. If it (wasn't) for him, I wouldn't be alive. He always takes excellent care of me. at this point, 14 years and 10 stents later, I am able to be active and I don't get dizzy. He is perfect.”

–a Healthgrades review

–a Healthgrades review “ Your whole team rocks! I am 3,000 miles away and was unable to attend an appointment with my mother-in-law. To be given peace of mind that everyone is on the same page and that she is in good hands is a great gift. Thank you so very much.” –a Facebook comment

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along with its vast presence in the U.S. population, its mortality rates remain relatively high. More than half of those diagnosed will pass away within five years, according to Emory Healthcare. It is the goal of the First Coast Cardiovascular Institute (FCCI) team to give patients with CHF a chance at living a quality life with their diagnosis.

a DEDICaTED HEaRT FaILURE TEaM We have a multidisciplinary team dedicated to the treatment of patients with CHF including physicians who are board-certified in cardiovascular disease, interventional cardiology and electrophysiology. Brenda Murphy, ARNP, is a certified heart failure nurse practitioner who works closely with our team of physicians. Dr. Omer Zuberi is one of the few physicians in the area who is board-certified in heart failure. Dr. Zuberi says this board certification was important to him because he sees the distress CHF patients commonly face. “When patients find out about their diagnosis, they become worried about how this changes their ability to live their lives normally,” says Dr. Zuberi. Achieving the highest level of training equipped him with the knowledge necessary to treat these patients with the latest technology. In addition to expertise, our team holds passion. Every Wednesday, Dr. Sumant Lamba holds a heart failure clinic dedicated to patients with this condition. “I want these patients

*These reviews have been edited for spelling and grammar.


Congestive heart failure (CHF) is a condition affecting five million americans, according to Emory Healthcare. It is the reason for 11 million doctors’ visits every year and is responsible for more hospitalizations than all cancers combined.

Fall 2017

to know that despite the statistics, there is hope for them,” says Dr. Lamba. “We are partners in their care.”

a DEDICaTION TO INNOVaTION We utilize state-ofthe-art technology including hemodynamic monitoring to evaluate and treat patients. is technology assesses how well the heart is working by measuring the blood pressure inside the veins and arteries. is monitoring helps determine the treatment options that are most suitable for the patient’s conditions. One of these hemodynamic monitoring systems is the CardioMEMS device. Dr. Zuberi was the first in the area to implant the small device that improves care for heart failure patients. e device is the first FDA-approved heart failure monitoring device that has been proven to significantly reduce hospital admissions when used by physicians to manage heart failure. It works by transmitting frequent sensor readings from the patient’s home to their provider, allowing for personalized and proactive management to reduce the likelihood of hospitalizations.

RESEaRCH aND EDUCaTION We have a dedicated research team performing studies to advance care for heart failure patients. Our research team focuses on clinical trials for both pharmaceuticals and devices. Our most recent device trials include a software placed inside of a device to determine when a patient is going into heart failure based on their symptoms. is manages heart failure and prevents the condition from furthering in severity.

“New technology, coupled with our team’s passion, are producing miracles literally every day,” says Dr. Yazan Khatib, President of FCCI. Fall 2017

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Spotting a Heart Attack before It becomes a Heart Attack By Priscilla Christopher

Board Certified Sleep Medicine Specialists & Fully-Accredited Sleep Laboratories

• Nausea. You might not know it, but nausea (and other stomach pain) can be a symptom of a heart attack. If you experience sudden changes in indigestion, tell your doctor. Many conditions cause nausea, and you want to rule out heart attack.

Every 40 seconds, someone has a heart attack, according to the American Heart Associations’ (AHA) 2017 Heart Disease and Stroke Statistics Report. Its symptoms and warning signs vary based on several factors: age, family, personal health history, gender and lifestyle. Many people ignore warning signs long before the attack occurs.

Our sleep medicine specialists have dedicated their lives to restoring a healthy night’s sleep for their patients.

• Lightheadedness. Lightheadedness, combined with any of the above symptoms, is cause for concern. When it affects your ability to get through your day, it might be signaling a heart problem.

A heart attack typically occurs when a section of the heart is unable to receive oxygen-rich blood. If a heart attack goes without immediate treatment, the heart can lose its ability to pump effectively. Possible outcome? Heart failure or death. It’s important to recognize the symptoms and warning signs early and seek medical help right away.

• Cold Sweats. Sweating, without reason, can signal a potential heart attack. When combined with chest and upper body discomfort, consider medical treatment, without delay.

Daniel Thielemann, MD

To schedule an appointment with a FCCI cardiologist, call us at 904.493.3333.

Irram Hamdani, MD


Dr. Ameeth Vedre, cardiologist, promotes the prevention of heart disease.

How do you spot a heart attack? What signals should you watch for?

Working toward better sleep and heart health

The aHa’s most common heart attack symptoms include: • Chest Discomfort. If you experience a squeezing chest pain or an extending chest pain to other areas of your body, get help. • Upper body Discomfort. You can experience upper body discomfort, such as arm, back, jaw or shoulder pain, during an impending heart attack. Report upper body discomfort to your doctor or emergency room physician immediately.

Sleep apnea is recognized as a serious health problem that may impact patients who suffer from heart disease. As a leading provider of innovative sleep products and solutions, ResMed is committed to educating patients and physicians about the health risks of sleep apnea for patients with cardiovascular conditions.

• Shortness of breath. A worsening shortness of breath, without activity, can be a heart attack symptom. You should inform your physician and get an evaluation, with or without chest pain.

Speak with your doctor to learn more about the importance of sleep and its effect on heart health. © ResMed 2017


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Q&A Q: Dr. Andrea DeNeen takes a few minutes during her workday to practice meditation.

Meditation for Heart Health ere are many benefits to meditation that go beyond reducing stress. According to Harvard Medical School, people who meditate for at least 10 minutes every day may have a lower risk of developing heart disease. Meditation benefits your heart health by releasing neurotransmitters in the brain, which can decrease your heart rate and blood pressure. Dr. Andrea DeNeen, one of our cardiologists at First Coast Cardiovascular Institute, describes

There are many different forms of meditation, and while there is no right or wrong way to meditate, most have four common elements: a quiet location, a comfortable posture, a focus point and an open mind. If you’re still unsure how to start meditating, try these practices to get you started: • Listen to instrumental music while focusing your thoughts on the present moment. If you feel your thoughts start to wander elsewhere, simply re-direct your focus again to the present moment.

meditation as any technique that promotes relaxation. It can be something as simple as taking a walk in the park or petting your dog or cat. Dr. DeNeen believes it’s important to take time out for yourself every day. She says, “My day is not the same without taking a few minutes for myself in the morning.”

• Take a slow walk. Focus on matching your breathing to each step you take — as you breathe in, pick your foot up; and as you breathe out, plant it on the ground. • Breathe deeply. Inhale for four counts, hold for four counts, and exhale for eight counts. • Prayer.“Meditation comes in many forms,” says Dr. Yazan Khatib. “Prayer can be a spiritual form of meditation.” Ultimately, every individual will resonate with a different form of meditation. Be sure to choose the one that uplifts you the most.



T he H eart of J acksonville C linic

Fall 2017

What is your favorite proverb / quote / motto?

Dr. Lamba: “ Wear gratitude like a cloak and let it feed every corner of your life. Mine changes every day.” — Rumi Dr. Sasseen: “ One of the greatest gifts a physician can give is their time.”

Dr. Khatib: “ I think coffee is overrated, I love hot black tea with cardamom added to it.”

Dr. Zia: “ Listen with ears of tolerance. See through eyes of compassion. Speak with the language of love.” — Rumi

Dr. Zuberi: “ My favorite coffee order is a french vanilla latte.”

What is your dream destination?

Dr. Swain: “ One of my favorite things to do is go outside and enjoy nature. I would love to drive my Jeep out to Moab, Utah to explore the red rock landscape and Colorado River. I’ve never been, but it looks beautiful in pictures.”



What is your favorite coffee order?

Dr. Punjani: “ Only a life lived in the service to others is worth living.” — Albert Einstein

Dr. Schimmel: “ When life gives you lemons, you make lemonade. I have several stands around here.”



Dr. Bell: “ I have a lot of places on my bucket list. Right now my dream destination would be Isle of Capri or the Amalfi Coast of Italy. There are so many places yet to see!”

Where is your favorite place to travel/go on vacation?

Dr. Ali: “ A tall latte, every morning.” Dr. Al-Saghir: “ My favorite coffee order is a cappuccino.” Dr. Alnabki: “ I like espresso and black coffee.”

Dr. Illovsky: “ My favorite coffee order is an iced coffee with vanilla.” Dr. Constantin: “ Quad, grande, nonfat, cinnamon dolce latte.” Dr. Snyder: “ Skinny vanilla latte with caramel drizzle hot.” Dr. Vedre: “ My favorite coffee is filtered or brewed with powder from Kerala, India.”

Dr. Aleti: “ I don’t want to have to choose between tea or coffee so I get green tea over coffee.”


Dr. DeNeen: “ Frozen mocha frappachino for a splurge!”

What is your favorite genre to read?

Dr. Hamdani: “ I enjoy reading classic novels and recent medical journal updates.”

Dr. Thielemann: “ My favorite genre to read is history. All history is fascinating to me.”

Dr. Goel: “ My favorite place is home in Delhi, India.”

Fall 2017

T he H eart of J acksonville C linic