The Fight Against Cardiovascular Disease Is Strong in Westchester

Healthcare organizations up their game against America’s No. 1 killer.

Cardiovascular disease has been the leading cause of death in the United States for as long as anyone has been counting. The American Heart Association reports that this disease accounted for 928,741 deaths in 2020. Coronary heart disease was the leading cause (41.2%) of deaths attributable to cardiovascular disease, followed by stroke (17.3%), and other diseases of the cardiovascular system. According to the Centers for Disease Control, about 695,000 people died from heart disease in 2021 — that’s one in every five deaths. In the US, there’s a heart attack every 40 seconds.

The statistics are grim, but healthcare providers are constantly fighting back. “Heart disease is certainly a formidable adversary,” says Gregory Pontone, MD, associate medical director of Ambulatory Quality & Physician Services at White Plains Hospital. “We recognize the urgency and importance of combating the disease,” as do other Westchester County health organizations.

White Plains Hospital
Photos courtesy of White Plains Hospital

We collaborate with Montefiore. They give us the support we need as a nationally recognized center bringing care to White Plains.
Gregory Pontone, MD
White Plains Hospital

White Plains Hospital

“Our approach to heart disease begins with meticulous diagnoses at the forefront, because diagnosis is the beginning of treatment,” Pontone says. WPH says it is the only hospital in the Hudson Valley and Fairfield County to have a PET/MRI scan, the most advanced technology available to diagnose ischemic (blocked blood flow) and non-ischemic cardiac disease. The hospital’s Center for Advanced Medicine & Surgery (CAMS) offers other non-invasive cardiology imaging and testing that includes EKG, ECHO, stress tests, CT scans, and more.

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Treatment from the Interventional Cardiology team is at one of three full-service cardiac catheterization labs that offer interventional and emergency coronary angioplasty (opening of blocked coronary arteries). An electrophysiology program cares for patients with atrial fibrillation (aFib) with advanced procedures to manage aFib with pacemakers, ablation surgery, and other treatments. It operates at the Kleinman AFib Center, which opens in 2024.

WPH’s newest offering is its Structural Heart Program, through its affiliation with Montefiore. This program, which debuted in December 2023, delivers multi-specialty care for patients with advanced and complex valvular and structural heart disease through minimally invasive treatments for patients with advanced cardiac disease.

For more advanced or difficult disease, the Montefiore Cardiac Surgery Program at White Plains Hospital brings world-renowned cardiac surgeons and specialists to the hospital’s state-of-the-art operating rooms to treat high-risk patients.

Cardiac heart failure services are provided both in the hospital and at satellite offices. “We collaborate with Montefiore. They give us the support we need as a nationally recognized center bringing care to White Plains,” Pontone says. “Their specialists are here on a weekly basis, and we will be expanding that in the future, so Westchester patients can get advanced cardiac heart failure care right here in their own backyards.”

On the prevention side, ambulatory cardiology practices are engaged in risk management of diseases like high blood pressure, high cholesterol, diabetes, weight control, and more. “We take those seriously, and we are expanding offices throughout the county to serve patients where they live and provide preventive care in their communities,” he says.

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William A. Jakobleff, Jr. MD, (left) associate professor, Department of Cardiothoracic and Vascular Surgery at Montefiore Medical Center/Albert Einstein College of Medicine, and Robert E. Michler, MD, surgeon-in-chief, professor and chairman, performed the first ever open-heart surgery procedure at White Plains Hospital.
William A. Jakobleff, Jr. MD, (left) associate professor, Department of Cardiothoracic and Vascular Surgery at Montefiore Medical Center/Albert Einstein College of Medicine, and Robert E. Michler, MD, surgeon-in-chief, professor and chairman, performed the first ever open-heart surgery procedure at White Plains Hospital. Photos courtesy of White Plains Hospital.

Phelps Hospital/ Northwell Health

Heart disease is, “frankly, on the rise,” says Binoy Singh, MD, former chairman of the Department of Cardiovascular Medicine at Phelps Hospital. He oversees all cardiac services at the hospital and practices at Northwell Health Physician Partners Cardiology in Yorktown Heights. “So, it is that much more imperative to take a comprehensive approach to understanding your cardiovascular health and create a prevention plan to get to more birthdays without bad things happening to you.”

That plan begins with “collecting data on all the parts and variables” of the cardiovascular system, he says. “Prevention starts by understanding all those variables and how they are working — securing data through diagnostic testing. That is a part of planning to prevent events, such as heart attack and stroke. We use a lot of diagnostic tools — echocardiogram, stress profusion studies, PT and CT scanning, different tools in our toolbox to answer questions about the components of the [cardiovascular] system.”

Binoy Singh
Photos courtesy of White Plains Hospital

“Prevention starts by understanding all those variables and how they are working, securing data through diagnostic testing that is a part of planning to prevent events like heart attack and stroke.”
Binoy Singh, MD
Formerly of Pehlps Hospital

Once the data is gathered, and “we know the level of risk, we talk about things like exercise, using these data sets to build exercise programs tailored to the individual — a personalized exercise prescription,” he says. They also cover dietary and other lifestyle changes and help patients track their progress by “serially testing data points,” like weight, blood pressure, and other measurable numbers.

The whole cardiovascular disease program, he says, is based on four principles:

  1. Patient-centric care is a priority. “It’s a privilege to have the opportunity to work with them,” Singh says.
  2. Service excellence is delivered “each and every time you encounter a patient.”
  3. Recognizing the need to provide easy access and an expansive, integrated network of care delivery. “We are not working in silos anymore.”
  4. Lead by “truly raising the bar for health in our community. Leading means communication and clarity.”

Singh has worked to incorporate heart disease awareness among all the other health lines. “We developed, for the first time in Westchester County, one of most robust cardiology programs to include ob/gyn, maternal fetal medicine, oncology, neurology, surgery, to help other providers optimize their work by working across disciplines,” he says.

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Along with general cardiovascular care, they offer other programs for specific diseases. “We have a dedicated cardiac amyloid team, a hypertrophic myopathy team, a heart failure and shock team, an electrophysiology team,” he says. “We added a very successful cardiac cath lab at Northern Westchester Hospital.” And Phelps Hospital opened the Center for Advanced Procedures in December 2023, a multidisciplinary neuroscience facility to care for patients with the most complex cerebrovascular problems relating to blood flow to the brain. “We are a nationally recognized center for stroke management,” Singh says.

Westchester Medical Center
Photo courtesy of Westchester Medical Center

“When treating individuals who are at risk of developing heart disease, you want to be aggressive and proactive.”
Joshua Melcer, MD
Westchester Medical Center

Finally, the organization has spent “several million dollars investing in modernization of diagnostic equipment in office settings,” he says. “You don’t have to go to the hospital for routine testing like ultrasound and other technologies. They are brought right to our offices and are convenient and close to patients’ homes.”

Westchester Medical Center / New York Medical College

In 2019, Westchester Medical Center created its Cardiovascular Health Promotion and Disease Prevention Program (CHPDP), known informally as CHIP DIP. The COVID-19 pandemic temporarily got in its way, but “once the pandemic seemed to pass, there was an excellent opportunity to launch this program in April 2022, and the program has really taken off,” says Joshua Melcer, MD, cardiologist and clinical lead for the program. “It’s gotten rave reviews.”

Physicians in the advanced service cardiac catheterization laboratory at Westchester Medical Center(Left to right): Srihari Naidu, MD; Jason Jacobson, MD; Sei Iwai, MD
Physicians in the advanced service cardiac catheterization laboratory at Westchester Medical Center(Left to right): Srihari Naidu, MD; Jason Jacobson, MD; Sei Iwai, MD. Photo courtesy of Westchester Medical Center.

Cardiology has long focused on “treating patients after they have a problem, rather than trying to get to them before things become an issue,” Melcer said. “When treating individuals who are at risk of developing heart disease, you want to be aggressive and proactive. This is extremely important for disadvantaged populations where cardiovascular diseases often develop earlier in life, which places additional stress on these communities as well as the entire health system.” The CHPDP program offers diagnosis and treatment before the onset of disease.

The program stresses prevention, education, and wellness as it assesses and manages the many factors that can lead to cardiovascular disease, such as genetics, environment, stress, and access to healthy food options. Patients who enroll receive a full health survey, physical exam, and screenings. They are then counseled on healthy lifestyle choices regarding diet, exercise, smoking cessation, and the like. Patients who have stuck with the program have seen their LDL (bad) cholesterol drop an average of more than 17 points, their blood pressure drop 5 points, and measures of blood sugar drop “significantly,” he says. “One patient lost more than 100 pounds, and whenever she sees us, she gives us a huge hug for changing her lifestyle and empowering her to take her heart health into her own hands.”

Along with CHPDP, WMC recently launched a new Same-Day Cardiology Program. Now, anyone who is experiencing non-emergency heart issues can receive skillful cardiology care on a same-day basis or within 24 hours, without having to wait for an appointment with a cardiologist or visiting an emergency room. “Patients often notice warning signs and symptoms of heart problems, “but they blow that off because they don’t want to go to the ER or urgent care. If they can get seen the same day, that can prevent a full-blown heart attack or stroke from happening,” says Srihari Naidu, MD, professor of Medicine at New York Medical College, which is affiliated with WMC.

Serious symptoms, as always, require calling 911. But for those with general, non-life-threatening concerns who would like to be involved in the program, the office can be reached at 914.909.6917 between 8:30 a.m. and 5 p.m., Monday to Friday. The program’s dedicated cardiology advanced practitioner will answer the call and determine eligibility for a same-day appointment at the Ambulatory Care Pavilion. If admitted, the patient will be seen by a cardiologist from the Heart and Vascular Institute for full assessment.

Melcer says some patients have been sent directly to the ER to receive stents. Others have been diagnosed and reassured all is fine, or scheduled for follow-up in a timely fashion. “The program saves lives,” he says. “We are excited to be able to have these two unique programs available to the community, and we hope people will utilize them.”

Naidu adds that WMC/NYMC is “still investing in technology for heart disease, so we have the most technology and tool kits to treat the vast variety of cardiovascular disease problems. We can fix pretty much any valve problem through minimally invasive procedures. We have an advanced electrophysiology program and can do some fancy ablations with alcohol injections — we are the only hospital doing it in this area, I think.”

Burke Rehabilitation Hospital

Recovering from a heart attack, stroke, or other cardiovascular disease event often requires rehabilitation. These events can cause serious and even permanent damage to the heart, lungs, brain, and other organs. Unfortunately, rehab is underutilized.

“Even though cardiac rehab has been shown to provide benefits, only 10 to 30 percent of patients are referred to rehab after a heart attack,” says Nomeda Balcetis, MD, director of Cardiopulmonary Rehabilitation at Burke Rehabilitation Hospital. “It’s important to educate patients about the benefits in preventing recurring problems and prolonging life.”

The reasons for rehab’s underuse include doctors who aren’t aware of its benefits, availability of bed space, insurance coverage restrictions, and patients’ motivation, she says. Yet, “cardiac rehab is in the American Heart Association guidelines. It prolongs life, decreases returning to the hospital, patients feel better, have less fatigue, can resume normal life and be active, and avoid disability,” Balcetis says.

In addition to its 150-bed hospital in White Plains, Burke, part of the Montefiore Health System, has 12 outpatient locations in Westchester County, the Hudson Valley, and the Bronx, with more sites planned, including one in Nyack opening spring 2024.

Burke Rehabilitation healthcare
Photo courtesy of Burke Rehabilitation

Cardiac rehab is in the American Heart Association guidelines. It prolongs life, decreases returning to the hospital, patients feel better, have less fatigue, can resume normal life and be active, and avoid disability.
Nomeda Balcetis, MD
Burke Rehabilitation Hospital

Patients receive either in-patient or outpatient care for cardiac and stroke recovery. It usually comprises about two to three hours a day of physical, occupational, speech, swallowing, or other therapies as needed. Stroke rehab may include psychological, cognitive, and memory assessment and counseling as well. And all patients are educated about smoking cessation, diet, exercise, and communicating with their cardiologists for disease management strategies. “We ensure they follow up with their doctors when they leave,” Balcetis says.

They can also use the facility’s health center whenever they want to exercise, she says. “We encourage them to maintain healthy lifestyle in our setting.”

David Levine is a frequent contributor to 914INC.

Related: A Guide to Westchester County’s Hospitals

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