Departments

Sometimes, an athlete—seemingly in peak physical condition—experiences sudden cardiac arrest on the playing field due to an undiagnosed heart condition. Yale Medicine’s Sports Cardiology Program is dedicated to preventing such tragedies through comprehensive screening, evaluation, and management of cardiovascular disease in athletes. The Sports Cardiology Program brings a multidisciplinary approach to the identification and treatment of potentially life-threatening cardiac abnormalities in athletes. The program provides two distinct services: Pre-participation screening of college and university athletes to detect any potential abnormalities before they compete Consultation and care for athletes of any age who either have known cardiovascular disease or who have symptoms that could be related to cardiovascular disease Yale Medicine specialists begin with an electrocardiogram (ECG), which records the electrical activity of the heart, to check for a variety of cardiac conditions. When screening college and university athletes, Yale experts interpret the ECG, offer recommendations for follow-up care, if needed, and work closely with the school to monitor and advise the athlete going forward. Yale physicians have been performing ECG screenings for Yale University athletes since 2015. With the launch of the Sports Cardiology Program, Yale Medicine is now performing screenings for athletes at three local universities, as well as the Connecticut Whale women’s professional hockey team. In addition to a pre-participation screening of college athletes, the Sports Cardiology Program provides ongoing clinical care for athletes of any age (including children) who have a known cardiac condition or symptoms that may indicate cardiac abnormalities, such as passing out or palpitations. In both cases, the goal is to develop an effective diagnosis, treatment, and management strategy for the athlete and provide recommendations on whether and how the athlete can safely participate in competitive sports. The foundation of Yale Medicine’s program is its multidisciplinary approach to these issues. A team of experts from many specialty areas works together to provide comprehensive, integrated services and holistic care for athletes. The program’s director, Rachel Lampert, MD , is a sports cardiologist, electrophysiologist, and arrhythmia specialist who frequently writes and speaks on preventing sudden cardiac arrest in athletes. Dr. Lampert has conducted extensive research in this area, including studies on whether athletes with implanted defibrillators can safely participate in sports. The Sports Cardiology Program also features imaging teams that use highly specialized diagnostic tools such as cardiac MRIs and echocardiography. The team also includes experts in adult and pediatric arrhythmia, cardiac channelopathies, cardiomyopathy, genetic cardiovascular diseases, and more. In addition, Dr. Lampert and her team frequently partner with Yale’s Sports Medicine Pro

The Preventive Cardiovascular Health Program at Yale (PCHPY) brings a personalized approach to cardiovascular disease prevention. Patients referred to the program meet with one of our cardiologists for an in-depth consultation that takes into account their biology and biography, along with information from advanced diagnostic testing. This approach leads to a more personalized, evidence-based approach to cardiovascular risk assessment. Using this information, and in partnership with patients, we design tailored programs to reduce cardiovascular risk and improve well-being. PCHPY brings together experts in cardiovascular disease prevention, including cardiologists, nutritionists, exercise physiologists and health psychologists. We also work together with Digital Technology Solutions (Information Technology) and digital health companies to offer high-tech/low-burden approaches to cardiovascular care. Our team is highly attuned to the challenges of maintaining a healthy lifestyle and taking medication, and understands that a one-size-fits all approach often falls short. Instead, we strive to understand and integrate each person’ priorities, preferences and goals into the care plan. This program is particularly focused on people who are: At increased risk for cardiovascular disease, including people with: Severe hypercholesterolemia or familial hypercholesterolemia or elevated Lp(a) Family history of premature coronary artery disease (before the age of 60) Poorly controlled hypertension Underlying inflammatory condition (e.g., rheumatoid arthritis, HIV) A diagnosis of ischemic heart disease or coronary artery disease Women with cardiovascular disease Individuals seeking a more personalized approach to cardiovascular health PCHPY additionally works with communities to identify and address barriers to cardiovascular health, focusing on environmental and social factors that contribute to disparities in health outcomes.

At Yale Medicine, our team of highly trained vascular surgeons are here to help with a variety of circulation issues. This includes anything from blocked blood vessels and stubborn wounds to conditions that could lead to losing a limb. Our goal is to give complete care that's as easy on you as possible, which is why we focus on techniques that don't require major surgery, like treatments done inside the blood vessels themselves. Our doctors give personalized and complete care to adults with vascular problems. We rely on the newest and most advanced equipment and methods to diagnose and treat these conditions. Specialized care is offered in the following areas: Abdominal and thoracic aortic aneurysm: Bulges in the main artery that can occur in the belly or chest area. Aortoiliac occlusive disease: Blocked arteries that supply blood to the abdomen, pelvis, and legs. Carotid artery stenosis: Narrowed arteries in the neck that can reduce blood flow to the brain. Claudication: Treatments to help relieve cramping in the legs while walking or exercising Diabetic ulcers: Sores that are slow to heal in people with diabetes. Dialysis access: For patients who need dialysis (a treatment for kidney failure), we create an entry point into the bloodstream that the dialysis machine can use. Foot ulcers: Sores on the feet that can develop due to poor circulation or other health issue. Lower extremity artery conditions Lower extremity vein conditions Renal vascular disease: Conditions that affect blood flow to the kidneys. Thoracic aortic aneurysm and aortic dissection: Bulges and tears in the part of the main artery that runs through the chest. Thoracic outlet syndrome: Discomfort or circulation problems caused when blood vessels or nerves just below the neck are compressed. Varicose veins: Treatments to remove or reduce enlarged veins that appear most often on the legs. Visceral artery disease: Blood vessels that supply the internal organs, ensuring they're not narrowed or blocked.

Timely treatment is essential to maximizing quality of life after a stroke. At the Yale Stroke Center, our highly skilled physicians take pride in delivering safe, patient-centered, and efficient care. We provide emergency treatments for conditions such as acute stroke and brain bleeds, where immediate interventions are required, but also elective treatments for aneurysms and other vascular lesions that are discovered incidentally. A dedicated neurovascular surgeon is on call and ready to mobilize a team at a moment’s notice—24 hours a day, 7 days a week. We streamline access to emergency neurovascular care for referring physicians, guaranteeing that patients will receive the timeliest and best care anywhere. Our collaborative team includes neurologists, neurosurgeons, and neuroradiologists, as well as physical medicine and rehabilitation specialists, working together to deliver cutting-edge interventional treatment and imaging. In the emergency department, radiologists are always available to provide readings of imaging scans so that patients can proceed as quickly as possible to treatment. We have an array of 3-D imaging workstations to ensure doctors can pinpoint where they need to concentrate care. We work closely with Yale New Haven Hospital’s emergency medical service and emergency department teams to rapidly diagnose and treat acute stroke and other cerebrovascular disorders 24 hours a day. Our Y Access Line allows for the quick and easy transfer of patients to Yale New Haven Hospital. We also offer SkyHealth, an emergency patient transport helicopter, staffed by highly skilled medical professionals, including a critical care flight nurse and a trained paramedic. Life-saving interventions are delivered en route, for the best possible clinical outcomes. Our state-of-the-art, VISIUS Surgical Theater is equipped with a powerful MRI and an integrated, bi-plane X-ray angiography system that allows our experts to better visualize arteries and vessels. The ability to receive preoperative diagnostic imaging; open micro-surgery; percutaneous, catheter-based endovascular treatments; and postoperative checks all in the same room is unique in the tri-state area. Our services include: A dedicated neurointensive care unit A stroke consult service with a patient- and family-centered approach to the treatment and rehabilitation of patients with cerebrovascular disease Specialized stroke clinics for community physician referrals, stroke consults, and primary and secondary stroke prevention Telemedicine Program Through our Stroke Telemedicine Program, our neurologists use a video- and image-sharing telecommunications system to provide acute stroke care consultative services to outlying hospitals in the state. Yale New Haven Hospital is the only hospital in Connecticut to offer stroke telemedicine services. Within minutes of making an initial call to the Stroke Telemedicine Program, an on-call neurologist can examine a patient at the remote hospital to hel

At Yale Medicine, our cardiovascular physicians specialize in all types of heart conditions. Our expert teams focus on heart-related health issues, such as heart disease genetics, heart rhythm problems, heart failure, heart and blood vessel conditions, and heart transplants. Our cardiologists do more than just see patients; they also conduct research to learn more about the complexities of various heart diseases and investigate better ways to treat them. Through their work in five research centers at Yale our cardiologists participate in major research initiatives focused on all aspects of heart health. Our research teams are comprised of experts from all over the world—eight different countries and four continents, to be exact! Specialized care is offered in the following areas: Adult congenital heart disease Arrhythmia Cardiac imaging Cardiomyopathy and congestive heart failure Coronary heart disease General cardiology (including stress tests and holter monitoring) Peripheral vascular heart disease Vascular heart disease

We have a robust history in advancing the practice of cardiovascular catheterization and intervention, and we offer a full spectrum of cardiac care in our state-of-the-art facilities. We care for patients throughout the region at locations throughout Connecticut, and are a national and international referral center for specialty percutaneous interventional procedures, commonly known as angioplasty. Our physicians specialize in complex coronary disease, structural heart disease, and peripheral vascular diseases, and we operate one of the largest carotid artery disease programs in New England. We also have a Comprehensive Coronary Physiology Program that provides care for patients with chest pain that is chronic, unexplained or difficult to manage. Our interventions include: Transradial coronary intervention Coronary chronic total occlusion recanalization and coronary reentry transcatheter aortic valve implantation Intravascular ultrasound and physiologic translesional pressure assessment Rotational atherectomy Thrombectomy Proximal and distal embolic protection Drug eluting stents Advanced hemodynamic support Atrial septal defect, patent foramen ovale, and ventricular septal defect closure Alcohol septal ablation for hypertrophic cardiomyopathy Aortic and mitral valvuloplasty Left main and multivessel percutaneous coronary intervention (PCI) Various peripheral vascular interventions

Covering every aspect of health care for adults, Internal Medicine is the largest department in the Yale School of Medicine, and the largest clinical service at Yale New Haven Hospital. We provide comprehensive and specialized services in all areas in a variety of outpatient settings as well as the Veterans Affairs (VA) Connecticut Health Care System campus in West Haven. Our culture of collaboration and research gives patients access to expert opinions from nearly 1,000 doctors, as well as opportunities to get tomorrow’s health care today through more than 100 clinical trials. Most importantly, we attend to our diverse community of patients with compassionate, thorough care. Specialized care is offered in the following areas: Allergy & clinical immunology Cardiovascular medicine Digestive diseases Endocrinology General internal medicine Geriatrics Hematology Infectious diseases Medical oncology Occupational health & environmental medicine Nephrology Pulmonology, critical care & sleep medicine Rheumatology International reputation for work in understanding function, independence, and quality of life in older persons Key research breakthroughs of the past decade that include the development of a protective Lyme bacillus disease vaccine, exploration of the underlying causes of allergic disease, and the discovery of novel inherited immunological diseases Largest interventional cardiology program in Connecticut Major referral center for patients with type 1 and type 2 diabetes, as well as other metabolic conditions Nationally ranked program in kidney diseases and the largest kidney transplant program in New England, with multidisciplinary care clinics One of the largest peripheral vascular programs in the country, with leadership and participation in multiple new percutaneous device trials Once of only a few motility centers in Connecticut to provide all motility procedures and services Unique medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S.

Our highly skilled cardiologists expertly treat and diagnose heart failure—a chronic, progressive condition in which the heart muscle can’t pump enough blood to meet the body's needs. In addition to caring for cardiac patients at Yale New Haven Hospital, we provide treatment to the rapidly growing number of outpatients living with heart failure in the community. We treat each patient with a personalized plan, carefully monitoring medications on an ongoing basis while minding other issues that affect cardiac health. We also educate patients and their families about lifestyle changes, prescribe and oversee exercise rehabilitation programs, and facilitate communication between the many professionals involved in outpatient care. Our physicians work as part of a multidisciplinary team to offer patients comprehensive care with the goal of prolonging their life and improving its quality. Treatment options may include medications, short- or long-term mechanical support, or heart transplant. Before treatment begins, we perform cardiac diagnostic procedures, such as stress tests, catheterization, and biopsies. We collaborate with cardiac-trained radiologists to provide noninvasive imaging studies including positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and 2D and 3D electrocardiography. At the Center for Advanced Heart Failure at Yale New Haven Hospital, we treat the full continuum of heart failure and offer a variety of medical and surgical treatment options. The center cares for patients with an LVAD (left ventricular assist device), a battery-operated mechanical pump that is surgically implanted and helps maintain the heart’s pumping ability when it can’t work effectively on its own. This is the only long-term mechanical circulatory support for patients otherwise ineligible for heart transplant. Our surgeons regularly perform heart transplants and LVAD implantations, and our heart transplant survival and post-LVAD rates are among the best in the region.

Our advanced vascular medicine specialists are part of a long tradition of innovation in the diagnosis and treatment of peripheral artery disease, a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. At our Vascular Clinic, we employ all state-of-the-art percutaneous intervention (angioplasty) techniques and work in collaboration with a multidisciplinary team. Our goal is to help patients manage their symptoms. We also want to stop the progression of atherosclerosis, or the buildup of plaque, in patients’ arteries. That, in turn, reduces risk of heart attack and stroke. Lifestyle changes, including quitting smoking, are the single most important step. In the event that lifestyle changes are not enough, medicine to prevent blood clots, lower blood pressure and cholesterol, and control pain might help manage the condition.

About Us At Yale Medicine, our cardiac surgery team consists of internationally recognized heart surgeons who provide personalized, compassionate care for adult and pediatric patients. We understand the challenges of living with a heart condition and are committed to partnering with patients and their families to find the best treatment plan and offer ongoing support after surgery. Our team includes highly experienced, board-certified cardiac surgeons along with an expert group of cardiologists, cardiac-focused nurses, physician assistants, and nurse practitioners. Our cardiac surgeons collaborate with Yale's cardiologists, vascular surgeons, and internists to manage heart-related issues such as heart failure, coronary artery disease, heart valve conditions, and heart rhythm disorders. Our surgeons perform the latest, most advanced techniques in minimally invasive and traditional surgeries to treat a full range of cardiac diseases and conditions, including: Coronary artery bypass grafting (CABG) Valve repair and replacement (aortic and mitral) Aneurysm repair (aortic, thoracic aortic, left ventricular) Arrhythmia (abnormal heart rhythm), including hybrid ablation heart failure and artificial heart or ventricular assist devices Heart failure, including artificial heart or ventricular assist devices Heart transplantation Congenital heart diseases in children and adults

The Yale Thoracic Outlet Syndrome Program provides dedicated evaluation and treatment of patients with Thoracic Outlet Syndrome (TOS), a condition in which the subclavian vein, artery, or brachial plexus is compressed as it travels from the chest to the arm between the collarbone and the first rib. TOS may cause swelling, discoloration, numbness, or tingling of the patient's arm, limiting activities of daily living and quality of life. Patients with TOS may be young, athletic, or use excessive overhead shoulder movements for their profession or recreation. The Yale Thoracic Outlet Syndrome Program offers a multidisciplinary approach to patients with this debilitating condition. Our team includes vascular and thoracic surgeons, diagnostic and interventional radiologists, physical therapists, advanced practice providers, and nurses who work together to provide early diagnosis and comprehensive management at an individual level. TOS is divided into three types, based on the predominant structures affected. Neurogenic TOS is the most common type, affecting the brachial plexus nerves. Patients may experience neck, shoulder, or arm discomfort or headaches. Patients often report that symptoms began after experiencing a traumatic injury. Experts believe this occurs most commonly due to the shortening and thickening of the anterior scalene muscle, which connects the spine to the first rib. Venous TOS is the next most common type, with complete or high-grade blockage of the subclavian-axillary vein (located between the first rib and the collarbone). Patients often report previous repetitive overhead shoulder movements, such as pitching or swimming. Patients may present with swelling of the whole arm, discoloration, and pain. Arterial TOS is the least common type, although it is the most dangerous. Chronic compression of the subclavian artery may lead to a blockage or the creation of an aneurysm—a weakening and ballooning of the artery. Patients may present with a cold, painful arm and difficulty moving or feeling their fingers. We recognize that TOS is a complex condition and that treatment is highly specific to each patient. On a patient’s first visit, we perform a detailed history and physical exam. If TOS is suspected, a variety of specialized diagnostic tests may be performed to support the diagnosis. For patients presenting with neurogenic TOS, physical therapy may be the first-line therapy. This may treat the scalene muscles, muscles surrounding the spine, and the muscles that support the thoracic outlet and shoulder. Botox® therapy of the anterior scalene muscle is another treatment option for patients with persistent symptoms. While conservative treatment is often successful in alleviating symptoms of neurogenic TOS, surgical decompression may be recommended if patients do not find long-term relief. For patients presenting with venous or arterial TOS, our vascular surgeons will first perform revascularization to relieve symptoms

Our program offers innovative care for patients with advanced and complex structural heart disease. From diagnosis to treatment, our team is dedicated to treating all forms of structural heart disease, some of which are congenital, or present at birth, and others that develop with age. We take the utmost care in treating these defects, which can affect the interior walls of the heart, the valves inside the heart, and the arteries and veins that carry blood to the rest of the body. As the first program in the state of Connecticut dedicated to the care of adult patients with complex congenital heart disease, we offer the full spectrum of care, providing regular inpatient and outpatient services to adult congenital heart patients. We offer an array of imaging, exercise testing, and surgical options, as well as less invasive catheterization therapies. Our multidisciplinary team includes interventional experts in congenital cardiac catheterization and electrophysiology who have decades of combined experience in the field. Our cardiothoracic surgical team has expertise in congenital heart disease and adult cardiac surgery with experience that spans three decades. Other members of the team include experts from the Yale General & Advanced Heart Failure Program, as well as a wide array of subspecialists in related areas, including liver and kidney disease. Adolescents and adult patients can expect to receive detailed education about their underlying congenital heart defect, its management, and the implications for future functioning. We ensure that our patients with pediatric congenital heart disease will be managed in the context of adult medicine with a multidisciplinary team that includes pediatric and adult cardiologists, adult pulmonologists, genetic counselors, and social workers. Our center provides state-of-the-art diagnostic imaging, including echocardiography and MRI. We work closely with Yale Medicine High-Risk Obstetric and Maternal-Fetal Medicine Programs to provide obstetrics and perinatology services to women with congenital heart disease, and we provide referrals for fetal echocardiography in cases where it is appropriate.