Cardiovascular Care at NCH

Medical Cardiology

Focused on your health, from prevention through rehabilitation.

Diagnosing and treating heart disorders

NCH's team of independent and employed cardiologists focus on non-invasive evaluation of heart diseases and disorders to develop a plan for healthy living. Patients with a history of heart disease, suspected valve disease, chest pain with unknown cause or irregular heart rhythms may be referred by their physician for a non-invasive evaluation.

Staying well after a cardiac event

If you've had a suspected heart problem, a heart attack, or deal with chronic management of heart disease, NCH also offers a variety of focused programs and clinics to help you manage your specific condition.  This comprehensive, personalized approach makes NCH unique.  Ask your cardiologist about NCH's follow-up care programs including:  Pulmonary RehabilitationCardiac RehabilitationCardiac Device ClinicHeart Failure & AFib Clinic and Home Care.

The best way to fight heart disease is through prevention 

NCH offers a wide range of lifestyle modification programs aimed at helping you take control of your health. These programs will give you valuable guidance on diet, weight control, quitting smoking and stress reduction. Additionally, NCH offers heart health educational seminars throughout the year that cover a wide variety of topics including heart attack symptoms, women's heart attack symptoms, heart valve disease symptoms and more.

Learn about the Atherton Heart Failure & AFib Clinic

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Are you at risk for heart disease?

Early warning signals for heart disease, including mild heart attack symptoms, signs of heart failure and heart blockage symptoms, can be difficult for individuals to detect. If you have two or more of the following factors, you could be at risk.

  • Women 55 and older or who are postmenopausal
  • Men 45 or older
  • Family history of heart disease
  • High cholesterol
  • High blood pressure, or hypertension
  • Diabetes
  • History of tobacco use
  • Sedentary lifestyle
  • Overweight or obese

Women's heart attack symptoms often vary from men's

Recent studies have shown that women are more likely than men to have "silent" or unrecognized heart attacks. Not all heart attacks start with sudden, crushing chest pain; they may start out mild and worsen over time; or start, stop and start again. Women are more likely to have nausea, pain high in the abdomen or burning in their chest. These are the most common warning signals for heart attacks:

  • Pain or discomfort in the center of the chest that lasts more than a few minutes, or goes away and comes back
  • Chest discomfort with sweating
  • Pain that spreads from the chest to the arm, neck or jaw
  • Shortness of breath, particularly at rest
  • Tiredness or upset stomach

There are a number of screenings that might be recommended by your physician to help diagnose cardiovascular disease early:


Cardiac calcium scoring - A preventative cardiology test to help determine if build-up of cholesterol in the coronary arteries has begun to occur.  This non-invasive, quick procedure called calcium scoring or CT heart scan uses minimal radiation to detect atherosclerosis due to the build-up cholesterol plaques in the coronary arteries.  Specifically, the test detects tiny deposits of calcium that are present in the arteries when build-up starts to occur.  In time, this buildup narrows the arteries or even blocks blood flow to the heart, resulting in angina, a stroke or heart attack.  

Coronary CT Angiogram - If your calcium scoring shows a possible risk or you have known risk factors for heart disease, you may need to have a coronary CT angiogram. This non-invasive test uses high-resolution x-rays along with a special injected dye to provide detailed pictures of the heart - it structure and the blood vessels. It can show any significant blockage of the main heart arteries, identifying where the blockage is located and how big the blockage is—or whether there is a bulge (aneurysm) or a buildup of fatty material called plaque in a blood vessel. This test is often used in conjunction with other tests or when heart symptoms are difficult to explain.

Other non-invasive cardiovascular diagnostic testing options include:
  • Stress testing/electrocardiogram (ECG) - Tests done during exercise or at rest to evaluate heart blockage symptoms and screen for blockage of the coronary arteries that may cause symptoms or lead to a heart attack
  • Holter monitors and event monitors - To detect and record abnormal heart rhythms
  • Echocardiography/transesophageal echocardiography (TEE) - Tests using sound waves to create an image of your heart to assess the health of its structure and chambers
  • Vascular ultrasound - To measure blood flow in your arteries
  • Tilt table tests - To check for sudden drops in blood pressure if your position changes
More invasive procedures might be needed to fully understand or treat a cardiac condition. These include: 
  • Cardiac catheterization - To further diagnose cardiac issues by inserting a catheter to evaluate heart valve abnormalities, to measure the pressure within the heart’s chambers, and to detect blockages through direct visualization of coronary arteries. Learn more about interventional cardiology
  • Peripheral vascular procedures - To diagnose and treat blood vessels in the arms, legs and neck for better circulation. Learn more about vascular procedures
  • EP study - To diagnose abnormal heart rhythms by checking the electrical activity and pathways in your heart. Learn more about EP studies
Meet the Team
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Cardiologists diagnose and treat cardiovascular diseases using the latest non-invasive and non-surgical techniques such as echocardiography, CT angiography, cardiac catheterization and interventional procedures.

Our multidisciplinary cardiovascular team is comprised of experts in cardiac specialties including: cardiologists, cardiovascular surgeons, vascular surgeons, thoracic surgeons, interventional radiologists, advanced practice nurses and physicians assistants. We work together to assess a patient's needs and ensure a detailed care plan is developed for each patient.

See full team
NCH Team Member

Paul A. Ruzumna, M.D.

Chief, Cardiology Department

NCH Team Member

Alan Spiegel, M.D.

Medical Director, Non-Invasive Cardiology

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