Dr.Medina provides service and office hours at two convenient locations
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Other Specialty Areas
Dr. Medina, Tampa Cardiologist, has over 30 years of experience evaluating and treating patients with diseases of the heart and the blood vessels. Consequently, he is frequently asked to render a "second opinion" for a patient that had been seen by another cardiologist, or has been recommended a certain test or treatment.
These evaluations are treated by Dr. Medina with a great deal of respect, both to the questions that the patient may have about the recommendations of the "first opinion" provider, but also to the input of all the other providers that have seen the patient first.
These cases tend to be more complex, and sometimes extra time is required to review the testing already performed, and sometimes very extensive records. Also, these are cases where the patient has significant doubts and questions about potentially risky procedures recommended, or the possible toxicity and side effects of medications. In other cases there is frustration about the persistent symptoms in spite of extensive evaluations and treatments. Second opinion consults are usually more time consuming, and represent a special challenge, that Dr. Medina enjoys undertaking. After extensive review of the records, and learning about the patient's doubts and questions, and after a thorough physical examination (and additional testing if necessary) , Dr. Medina will render an independent opinion, that he will discuss in detail with the patient.
This is a very important part of Tampa cardiologist Dr. Medina's practice.The experience gained from his invasive-interventional practice, knowing the heart inside out, allows him to evaluate the risk of an individual patient more in depth.
Is that chest pain the harbinger of a heart attack, or a pulled muscle?
Is my exercise capacity adequate?
Should I push it, or cut back?
Is my shortness of breath from my heart, or from my lungs?
How about palpitations, or "missed beats?"
How important is to keep my weight down?
What is the "obesity paradox?"
Is a high HDL-cholesterol more important than a low LDL-cholesterol?
These questions and others are answered every day in our offices. Dr. Medina likes to emphasize the individual nature of risk assessment and management, as every person is different, and numbers alone don't tell the whole story. He uses sophisticated non invasive techniques, that allow him to gain in-depth knowledge of each case.
These include calcium score and CT angiography of the heart, echocardiogram and ultrasound, various forms of stress testing, even for people that cannot exercise. Take for example a person with elevated cholesterol numbers. Many questions come up right away: Is his or hers "good cholesterol " (HDL) also high? How about the triglycerides? What other risk factors does he or she have? Family history? Diabetes, high blood pressure? The carotid ultrasound is an invaluable tool the Tampa cardiologist Dr. Medina uses to determine the presence and severity of arterial plaque. We want to be more aggressive in treating risk factors, if we know that atherosclerosis is already present.
There are many people that suffer from blocked arteries of the lower extremities. These symptoms need to be evaluated, to avoid later complications, such as non-healing ulcers on the skin, and even loss of the limb.
Tampa Cardiologist Dr. Medina has extensive invasive-interventional expertise in procedures applied to the circulation in the lower extremities. These include angiography, angioplasty, stenting, atherectomy, thrombectomy and LASER, to name a few. Dr Medina has many patients who were unable, to walk more than a few yards, and now walk for miles. These patients are usually glad to recover function in their legs, and, by being able to exercise, will improve their chances to stay free of cardiac disease as well.
The evaluation usually starts with careful analysis of the pulses and blood pressure in the lower extremities, sometimes using ultrasound and doppler techniques as well. Only after thorough clinical evaluation do we recommend angiography, which nowadays can be done non-invasively, such as CT angiography. There is a great deal of overlap with coronary artery disease, and when a patient presents with one, we always suspect the other as well. This is why it is beneficial to evaluate your leg pain with somebody, like Dr. Medina, who has expertise in both.
Many cardiovascular problems may be addressed by your primary care provider, and by cardiovascular specialist with various degrees of training and experience. Tampa Cardiologist Dr. Medina is an invasive-interventional specialist, with especial training and experience in cardiac and peripheral vascular imaging by invasive means, that is with cardiac and peripheral catheterization methods. He also specializes in angioplasty and stent implantation, as well as other methods such as atherectomy and LASER. Whereas any good cardiologist is prepared to do a history and physical examination focusing on the heart and circulation, an invasive-interventional specialist such as Tampa cardiologist Dr. Medina, will know your heart "inside out." We believe that such intimate knowledge of the heart and circulation represent a significant benefit to the patient with cardio-vascular problems, even if he or she may never need such procedures. On the other hand, if you need an invasive procedure, you want somebody with the vastest experience, who can do the procedure safely, and with minimal risk, and has the best chance of reaching a satisfactory and long lasting result. Tampa cardiologist Dr. Medina has over 30 years of experience doing these procedures, he trained with the pioneers, including Dr. Andreas Gruentzig, the creator of balloon angioplasty. He has been for many years one of the busiest interventionalist at the Pepin Heart Center, and has served as the Director of the Catheterization Laboratory as well as the Chief of the Cardiology section. He now continues practicing both there, at the Florida Hospital of Tampa, as well at St. Joseph Hospital North, in Lutz. Both are state of the art facilities, with a proven track record of efficacy and safety in the Tampa Bay area. Having an invasive-interventional specialist as your private cardiologist will give you the best chance to receive the least invasive and most effective treatment, many times avoiding open heart surgery.
Dr. Robert MedinaDr. Medina is a clinical and invasive-interventional cardiologist, with over 30 years of experience. He trained at Hahnemann University in Philadelphia, and has practiced in Tampa since 1984.
He is Board Certified in Internal Medicine and Cardiovascular Diseases, and is a Fellow of the American College of Cardiology.
Dr. Medina has been a pioneer of cardiac and peripheral vascular procedures in the Tampa Bay area.
Most Common Services Provided
- Clinical evaluation and management: Each initial visit with Dr. Medina is scheduled for 45 minutes to one full hour, during which he will review your records, take a detailed clinical history and perform a detailed physical examination. An electrocardiogram is an integral part of this initial evaluation. He will then give you feedback about his initial impression, and propose a plan to get to the bottom of your problem. This will frequently involve further testing.
- Exercise stress test: walking on a treadmill while your electrocardiogram and vital signs are continuously monitored.
- Nuclear stress test: The stress test is frequently performed without exercise, for example if you have difficulty walking. In these cases a substance is injected that can simulate the effects of exercise.
- Imaging stress test: The stress test is frequently combined with imaging, either by ultrasound (stress echo), or with radionuclide scanning procedures (nuclear stress test). These methods greatly increase the accuracy of the testing.
- Echocardiogram: (ultrasound of the heart) is used to determine cardiac function, the status of the heart valves and other anatomical details.
- Carotid ultrasound: used to visualize the carotid arteries of the neck, and other vessels. Both in the heart and the vessels, it is combined with color-flow doppler interrogation, to determine the function of the heart valves and the degree of blockage of the arteries.
- Follow-up appointments: These are set up to discuss the results of the testing, and further recommendations, and to determine the response to the recommended treatments. Dr. Medina usually sees patients soon after the initial visit, and at regular intervals thereafter. The frequency of follow up appointments is determined by the severity of your condition, and the response to the treatment.
- Arrhythmia Service: Holter monitoring, event recorders and loop recorders: These are devices to detect cardiac rhythm disturbances, available in the clinic. Our arrhythmia service includes also the implantation and monitoring of cardiac pacemakers and defibrillators.
- Second opinion consultation: See "Second Opinion Service"
- Cardiac catheterization, coronary angiography, percutaneous transluminal coronary angioplasty, atherectomy and stent implantation (see "Why do I Need an Invasive-Interventional Cardiologist")
- Peripheral vascular disease evaluation and management: Percutaneous angioplasty, thrombectomy, atherectomy and stenting of the arteries of the legs, arms or internal organs.
- Evaluation and treatment of refractory hypertension: renal artery stenting, and in the future, renal denervation procedures.