Cardiology

Premier care for your heart

Get exceptional care for your body’s most vital organ. Our cardiologists find and treat diseases of the heart and blood vessels, help prevent complications, empower patients through education, and provide ongoing support. We’re an advanced-practice clinic with physicians who subspecialize in structural cardiology, vascular cardiology, and electrophysiology. We exist on the forefront of research and technology to better protect our patients’ futures.

Our cardiologists believe it’s possible to provide world-class medicine in a small community—and do so every day. In the 1980s and 90s our visionary physicians, including Dr. John Greves, led the charge to bring echocardiography, cardiac catheterization, and open-heart surgery to Vancouver. In 2016, we performed the county’s first transcatheter aortic valve replacement, a life-saving alternative to open-heart surgery. Because we know that local, leading-edge care increases access to critical interventions and saves lives, we never stop pursuing the best treatments for our patients.

Physicians in the Cardiology Department offer a full range of services. Some of the most common conditions we care for include:

• Adult congenital heart disease
• Chest pain
• Coronary artery disease
• Heart failure
• Heart rhythm disorders
• Heart valve disease
• Hypertension
• Palpitations
• Venous disease (varicose veins)
• Peripheral vascular disease

We offer a variety of advanced technologies and treatment options, such as:

• Coronary angiography and stent placement
• MitraClip™
• Pacemaker and defibrillator implantation
• Pacer and cardiac device clinic
• Patent foramen ovale (PFO) closure
• Peripheral angiography and angioplasty
• Radiofrequency varicose vein ablation
• Transcatheter aortic valve replacement (TAVR)
• Watchman™

We offer testing and monitoring options, including:

• Cardiac CT
• Cardiac monitors
• Echocardiography
• Electrocardiography
• Electrophysiology studies (EPS)
• Heart rhythm monitoring
• Nuclear imaging
• Stress testing

Do I need a referral to see a cardiologist?

Yes, please ask your primary care provider for a referral.

What should I bring to my first appointment?

If you are already a patient at Vancouver Clinic, we have your health history and everything we need in our medical records system. If you are a new patient, please contact your doctor’s office and ask them to transfer a copy of your medical records, including your cardiac history, to us. Also bring a list of your current medications.

What happens if I need to see a specialist within cardiology?

If after your initial cardiology appointment you and your doctor determine you need specialty support, you may be referred internally to a cardiologist with specific training in interventional or structural cardiology, vascular medicine, cardiac imaging, or electrophysiology.

What if I need follow-up labs, imaging, or testing?

Most follow-up work can be done at Vancouver Clinic. For lab tests, simply visit one of our clinical laboratories after your appointment. For imaging studies and stress testing, your provider will put in a referral and a scheduler will contact you to arrange an appointment. A follow-up visit will be scheduled with your provider after your results are complete so that you can discuss what to do next. If you have set up MyChart@TVC, your results will be sent to you. If you have questions, you can discuss them during your follow-up visit with your provider.

New tools offer exciting alternative to open-heart surgery, medications

Cardiologists today are witnessing a renaissance. New technologies are allowing doctors to fix life-threatening heart issues through precise procedures instead of open-heart surgery. Many patients who wouldn’t have previously qualified for surgery now have a solution. Individuals who in years past would have had to endure an invasive operation and arduous recovery can now go home within a day or two.

What’s more, innovative devices are also helping heart patients get off medications, improving their quality of life.

“It’s amazing that it’s happening in our lifetime,” says Dr. Nathan Boyer, Vancouver Clinic cardiologist.

Learn about four pioneering therapies offered by Vancouver Clinic cardiologists:

Transcatheter aortic valve replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for patients with aortic stenosis, a condition that occurs when the heart’s aortic valve narrows. A narrow valve restricts blood flow to the aorta, the largest artery in the body. The heart becomes less successful at delivering oxygen-filled blood to the body even while it works harder than ever.

Traditionally, aortic stenosis required open-heart surgery to replace a failing aortic valve. However, doctors now know that TAVR is a safer and equally effective option—even for low-risk patients. During the procedure, doctors insert a catheter into the leg to guide an expandable valve into the heart—replacing, but not removing, the old value. Once in place, the new valve functions like a normal, healthy valve with proper blood flow.

Learn more about our first TAVR procedures.

MitraClip™

The left side of the heart is divided by an important structure called the mitral valve. The valve has two “leaflets” that keep blood flowing in one direction by opening and closing at the correct time. If they don’t close completely, blood can leak backward into the heart—a condition called mitral regurgitation (MR).

This is where the MitraClip™ comes in. Doctors insert the clip through a vein in the leg, threading it all the way up to the heart. The clip is like a very expensive safety pin that tethers the two leaflets together. Once the clip is in, the problem resolves immediately.

The MitraClip is also approved for patients who have problems with their left ventricle—those with “secondary MR.”

PFO closure device

About 20 percent of adults today have a patent foramen ovale (PFO)—a hole between the top two chambers of the heart. The hole is generally harmless and most people don’t even know that they have it. However, in a small number of people, tiny blood clots travel through the hole and into the brain, causing a stroke.

A PFO closure device helps keep blood clots from reaching the brain by permanently plugging the hole. PFO closure devices are usually inserted into the heart via a catheter in the groin. Medical trials show that PFO implants prevent more strokes than medication alone. However, it’s important to remember that strokes can be caused by a variety of issues, and PFO devices only reduce the risk of PFO-caused strokes.

Learn about a Vancouver Clinic patient’s experience with a PFO closure.

WATCHMAN™

The WATCHMAN™ device is a one-time implant that prevents left atrial appendage blood clots from entering the bloodstream and blocking a blood vessel in the brain, resulting in a stroke. This quarter-size barrier is an alternative to blood thinners.

The device is self-expanding, shaped like a jellyfish, and made from nitinol (nickel-titanium alloy). The top of it is covered with a permeable polyester fabric that acts like a filter initially, but becomes covered with a patient’s own cells within 45 days.

Not all strokes are the result of a clot traveling to the brain from the left atrial appendage. Other causes can include high blood pressure and narrowing of the blood vessels to the brain. The WATCHMAN implant will not prevent these other causes of stroke and does not cure atrial fibrillation. A cardiologist can review a patient’s specific situations and options.

Visit WATCHMAN FAQ to learn more.