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Mr. Emidio Romano Puliti, FNP MSN is a nurse in Baltimore, MD specializing in interventional cardiology, thoracic surgery and critical care (intensive care medicine). Mr. Emidio Romano Puliti, FNP MSN is affiliated with MedStar Franklin Square Medical Center, MedStar Health and MedStar Union Memorial Hospital.
MedStar Union Memorial Hospital
Cardiac Resynchronization Therapy (CRT)
A cardiac resynchronization therapy device, also known as a CRT or biventricular pacemaker, is a kind of pacemaker that can help the heart work more effectively. In certain kinds of heart failure, the ventricles, or larger chambers in the heart, stop working together. When they are no longer in synch, the heart can't pump enough blood to meet the body's needs. CRT can help keep the heartbeat regular and the ventricles contracting at the same time.
Just as with a standard pacemaker, a biventricular pacemaker consists of a small battery pack and electrical leads, or small wires that conduct electricity to the heart. CRT pacemakers have two or three leads, placed in the upper and lower chambers of the heart. The device measures the contractions of the heart, and if the heart begins to beat out of time it will send small, rhythmic pulses of electricity to resynchronize (hence the name 'cardiac resynchronization therapy) the contractions. This allows the heart to pump blood to the rest of the body more efficiently. Sometimes a CRT is combined with a different kind of device called an implantable cardioverter-defibrillator or ICD, which uses a higher burst of energy to restart the heart if it stops suddenly.
When a biventricular pacemaker is inserted, the wire leads are usually placed via a small incision near the shoulder, then threaded through a vein to the heart. The battery pack is placed under the skin of the chest near the collarbone. Once everything is in place, the leads are connected to the battery, and the CRT can begin helping the heart beat correctly.
It is normal to experience swelling and discomfort as the incisions from surgery heal. It takes time for the heart to adjust to the pacemaker, so vigorous activity should be kept to a minimum for the first few weeks. Strong magnetic fields may affect how the CRT functions, so patients may be advised to avoid them. As patients heart begins to pump blood more effectively, they should soon begin to feel stronger and less fatigued.
Heart Attack
A heart attack is a serious medical event that happens when the blood supplying oxygen to the heart is cut off, usually because of a blockage in an artery. This results in damage or death of part of the heart muscle. The heart can heal, but like any part of the body that was injured it leaves a scar. This scar tissue does not contract effectively, so the ability of the heart to pump is lowered after a heart attack.
A heart attack, sometimes called a myocardial infarction, can happen without warning. However there are certain factors that raise the risk of heart attack. Some of these are:
Heart attacks typically feel like pain or pressure in the chest that can radiate out to the back, arm, or jaw. Some other symptoms can include fatigue or weakness, shortness of breath, sweating, and nausea.
Treatment aims to increase blood flow to the heart muscle by opening up blocked blood vessels. Medications are sometimes used to dissolve clots in the arteries. Aspirin and other medications such as Plavix can thin the blood and make clots less likely to form. Dilators can widen blood vessels to make room for more blood to flow. Doctors can also use a procedure called catheterization to look at the blood vessels around the heart directly, place stents, or widen vessels using angioplasty. In extreme cases bypass surgery can be used to help blood flow better. After recovery, it is important to lead a healthy lifestyle and take any prescribed medications in order to protect the heart.
Heart Problems
The heart is one of the most important organs in the body. This smooth muscle expands and contracts rhythmically an entire lifetime, pumping blood to the lungs and then to every other cell in the body. When heart problems occur, it becomes difficult for the body to get the nutrients and oxygen it needs via the blood. So while there are a variety of illnesses and disorders that affect the heart, most of them cause weakness, exhaustion and shortness of breath. The most common heart conditions include heart disease, angina, arrhythmia, and valve disorders.
Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.
Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.
Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.
Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.
He is certified by the Board Certification: American Association of Nurse Practitioners and has a state license in Maryland.
Board Certification: Board Certification: American Association of Nurse Practitioners
Licensed In: Maryland
Mr. Emidio Romano Puliti, FNP MSN is associated with these hospitals and organizations:
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Mr. Emidio Puliti's areas of specialization are interventional cardiology, thoracic surgery, and critical care (intensive care medicine). These areas are among his clinical interests: rheumatic heart disease, myocarditis, and heart bypass surgery (CABG). Mr. Puliti's hospital/clinic affiliations include MedStar Franklin Square Medical Center and MedStar Union Memorial Hospital.