We provide primary and secondary prevention services (diagnostic, interventions, consultation, and focused medical management) to men, women and children with risk factors for heart disease, stroke, and diabetes.  These patients would typically be identified and referred by their primary care physician for consultation but may also be self referred.  A typical referral might be a patient with one or more of the following:

• A significant family history of heart disease with “normal” lipid profile
• Abnormal lipid profile
• Diabetes/ pre-diabetes
• Metabolic syndrome
• Polycystic ovarian syndrome
• Medication  induced lipid abnormalities
• Non-responders to lipid lowering therapy/ intolerance to medications
• Pediatric patients with obesity, cholesterol abnormalities or prediabetes
• Very high risk patients (10 year risk > 30%) who have already had a heart attack or stroke and wish to aggressively prevent subsequent events
• Need for multidrug therapy
• High cholesterol but no other risk factors in a patient who does not want to take medications, advanced testing can help determine how high risk they truly are.

The diagnostic tests, medical interventions and management are tailored to meet the individual needs of the patient and the referring physician.  Some of the diagnostic tests that may be used include:

• NMR lipoprofile (Advanced lipid testing including LDL particle #) www.liposcience.com
• Hs CRPor LpPLA2 (PLAC) ( inflammatory markers) http://www.plactest.com/
• Lipoprotein Analysis (Apo B, Lipoprotein (a))
• Homocysteine
• Vitamin D deficiency work up
• Additional labs to work up secondary causes cholesterol abnormalities (Thyroid testing, anemia, liver, kidney, diabetes testing)
• Exercise prescription/ weight management
• Stress reduction
• Diagnosis of Genetic conditions (familial hypercholesterolemia, familial combined hyperlipidemia, familial defective Apo B, Autosomal Recessive hypercholesterolemia, beta-sitosterolemia, hypoalphlipoproteinemia, hypertriglyceridemia, Familial dysbetalipoproteinemia, lipoprotein lipase deficiency)
• Noninvasive Carotid Intima Media Thickness testing (CIMT) also referred to as B mode ultrasound, to detect asymptomatic early evidence of plaque  in neck arteries, this correlates with disease in the heart.
• Referrals for coronary CT angiography, stress testing, cardiac diagnostic invasive procedures, cardiac rehabilitation if indicated: 

Consultation and medical management services are specific to managing and reducing cardiac risk.  Patients are required to have a primary care physician for their routine medical needs and ongoing medical management.