Frequently Asked Questions on Heart Services

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General Cardiology

A cardiologist is a physician that specializes in cardiovascular care.

Cardio – Heart
Vascular – Vessels

Although age alone is not necessarily the only factor to determine if you should see a heart specialist, any woman older than 55 years old or a man older than 45 years old should consider seeing a cardiologist as they are at higher risk for cardiac diseases. If you have a strong family history of cardiac disease with a mother or sister with a heart attack before the age of 65 or a father or brother before the age of 55, you will benefit from seeing a cardiologist. If you have high cholesterol or suffer from uncontrolled hypertension (HTN) consider seeing a cardiologist.
Several health conditions, your lifestyle and your age and family history can increase your risk for heart disease. High blood pressure is a major risk factor for heart disease. Other factors are high cholesterol, smoking, lack of exercise, diet, obesity and even family history.
  • First heart attack: About 7 out of every 10 people who experience their first heart attack have high blood pressure.
  • Heart failure (long-term): About 7 of every 10 people with chronic heart failure have high blood pressure.
  • Other related conditions like stroke and kidney disease (gradual loss of kidney function where the kidneys fail to filter waste products from the blood properly).
When your blood pressure is high, your blood vessels lose elasticity and become stiffer and less flexible, leading to heart disease. This results in damage to the vessels. How this injury happens is not very well understood. This injury causes plaque formation in specific areas of the blood vessels, not throughout their whole length. The majority of the plaque buildup appears to happen around areas where the artery twists or branches. This is believed to occur as a reaction to unstable blood flow due to blood pressure. If the blood flow is altered there is an increase in the pulsing of the blood flow and the pressure is increased. This pressure between circulating blood and the lining of the vessel finally results in the lining becoming disrupted (the injury) and plaque starting to build up. Another mechanism through which high blood pressure may be involved in heart attacks is through rupture of the plaque. When a plaque builds up inside a vessel, and that vessel has high pressure inside it, pieces of that plaque can break off, or rupture. The rupture of the plaque causes the blood inside that vessel to clot because the body treats this rupture like an injury. This is similar to the clot (scab) that forms when you cut your skin. Because this is happening inside a small vessel, the clot grows and blocks the flow of blood through that vessel. This can result in a heart attack. When your blood pressure is high, your heart works harder, causing it more stress. In addition, high blood pressure will initially make your heart muscle get thicker as any muscle will do when it is working against high resistance. Take a look at somebody that lifts heavy weights regularly, their muscles are bigger. However, if the high blood pressure is not controlled, the heart will eventually get weak through remodeling of the muscle that grows without appropriate blood flowing to that area.

Invasive cardiologists have the ability to perform invasive procedures and diagnostic tests used to diagnose and treat some cardiovascular conditions such as blocked arteries, pacemakers, loop recorders and transesophageal echocardiograms. We are pleased to offer invasive cardiology services, when needed, to our patients.

Typically, a referral is not needed to be seen by a cardiologist. However, your insurance may require this, therefore, it would be advisable to affirm this with your insurance company.
Cardiologists treat many conditions related to the heart and vascular system including, but not limited to: coronary artery disease, heart failure, heart attack, heart valve disease, heart arrhythmias, congenital abnormalities, arterial and venous disease.

Yes. A cardiologist will be able to detect a heart condition that you might not be aware of having. They can also complete a pre-exercise stress test to evaluate your exercise capacity, your blood pressure response to exercise and any presence of arrhythmias on exertion.

Yes. Although there are some similar aspects of coronary artery disease (CAD) in men and women, heart disease in women presents differently and many times the treatment is different.

About the Doc

Nitza I. Alvarez, MD

Dr. Nitza Alvarez is a Board Certified Cardiologist and Fellow of the American College of Cardiology. She has been providing cardiac care since 2010. She graduated from medical school with honors and completed her specialty – Cardiac Fellowship at Albany Medical Center in New York. She holds board certification in Internal Medicine, Cardiovascular Disease, Nuclear Medicine, and Echocardiography.

Currently, Dr. Alvarez holds privileges at:

  • UF Health Villages
  • UF Health Leesburg
  • Outpatient Surgery Center of Central Florida

Dr. Alvarez’s expertise is in women’s heart health. As a cardiologist, she specialized in the management of cardiovascular disease. However, she has a special interest in women’s heart diseases.

Dr. Alvarez hosts Walk with the Doc every 2nd Saturday of the month at no cost. Wine with a Doc is an upcoming event intended for you to come and interact with the doctor without feeling pressure to use her services as your cardiac provider.

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