Cardiology at Methodist Hospital

Cardiovascular care at Methodist Heart and Lung Institute

Located on the campus of Methodist Hospital is the centerpiece of the Methodist Heart network — our award-winning cardiovascular program at the Methodist Heart and Lung Institute. The Methodist Heart and Lung Institute features 24/7 in-house cardiologists, ensuring patients in Bexar County and surrounding communities have continual access to various comprehensive treatment options.

We offer the highest level of specialty care services ranging from the largest heart transplant and Extracorporeal Membrane Oxygenation (ECMO) programs to the only aortic center in South and West Texas. We pride ourselves on providing the most comprehensive level of cardiovascular care for the most complex patients in Central and Southwest Texas.

For more information about our cardiovascular services, call us today at (210) 575-0386.

Cardiovascular conditions we treat

Our team of experts provide care for a wide range of conditions, including:

Cardiogenic shock

Cardiogenic shock (CS) is a life-limiting condition, occurring when your heart cannot pump enough blood to the vital organs in the body. CS most commonly happens as a result of a severe heart attack, but can also happen with a decline in cardiac function (such as acute or worsening heart failure). If not treated promptly, the condition can become fatal or cause serious complications.

The goal of the Methodist Hospital cardiogenic shock program is to provide a seamless transition of care for patients who can benefit from the use of mechanical circulatory support (MCS) devices our program has to offer. Early identification and timely intervention can improve outcomes in patients experiencing cardiogenic shock. Prioritization of catheterization can lead to earlier revascularization as well as provide a hemodynamic profile to better assess CS state and the need for a higher level of care.

Methodist Hospital is a cardiogenic shock hub — an experienced, high-volume center with interventional and heart failure cardiology, durable MCS capability, heart failure cardiothoracic surgery, and an on-call cardiogenic shock team.

We are available 24/7 to assist the immediate evaluation and management of cardiogenic shock patients. Physicians can call (210) 575-SHOC (7462) to speak with our team.

Our team should be contacted for patients with:

• Cardiac index persistently < 2, OR lactate ≥ 3 for > 4 hours
• Any CS criteria met on IABP/Impella or MCS + 1 vasopressor
• Any CS criteria met on ≥ 1 inotrope or vasopressor*

* Specifically, at doses of: Dobutamine ≥ 5, Dopamine ≥ 5, Milrinone ≥ 0.5, Norepinephrine ≥ 0.1, Epinephrine ≥ 0.1, Vasopressin ≥ 0.04, Phenylephrine ≥ 0.1 mcg/kg/min

Cardiogenic shock criteria:

• If LVEF < 40% WITH Evidence of End-organ hypoperfusion:
• (Lactate ≥ 3, ↓urine output (< 0.5 ml/kg/hr), cool extremities, or AMS)
• AND /OR
• Hemodynamic Criteria: SBP < 90 mmHg for 20 minutes, HR >100, or
• Pulse Pressure < 20 mmHg

Patients referred to our program have a dedicated team of experts who take a multidisciplinary team-based approach to provide early activation and assessment. Our team provides tailored treatment plans to best suit the patient’s needs, including timely initiation of mechanical circulatory support and hemodynamic-guided management.

At Methodist Hospital, advanced treatment options are available when necessary to either temporarily support the heart as it recovers or to aid as a bridge to long-term therapies, such as heart transplantation. Methodist Heart and Lung Institute's distinctive ECMO program is the primary ECMO provider for one of the largest regions in Texas. Our program has been designated as an ECMO Center of Excellence, the most prestigious designation in critical care by the Extracorporeal Life Support Organization.

Cardiogenic shock advanced treatment options

• Short-term MCS
  • Intra-aortic balloon pump
  • Impella (Percutaneous LVAD)
  • Extracorporeal membrane oxygenator support (ECMO)
• Impella RP/ Impella RP Flex
• ProtekDuo
• Destination therapies
  • Durable MCS (Surgical LVADs)
  • Heart transplantation

To speak to a Methodist Hospital cardiogenic shock clinician, please call (210) 575-SHOC (7462).

Specialized treatment centers and programs

Depending on your cardiovascular condition, we offer multiple treatment centers and programs designed to help you navigate your diagnosis, including:

• Cardiovascular specialty programs
• Extracorporeal Membrane Oxygenation Program
• Methodist Heart and Lung Institute Adult Congenital Heart Center
• Methodist Heart and Lung Institute Aortic Center
• Methodist Heart and Lung Institute Cardiopulmonary Rehabilitation Center
• Methodist Heart and Lung Institute Heart Failure and Transplant Center
• Methodist Heart and Lung Institute Heart Valve Center
• Methodist Heart and Lung Institute Lung Center
• Methodist Heart and Lung Institute Vascular Center

Advanced technologies and procedures

Taking care of the most heart, lung and vascular conditions in South Texas means we have to stay current on the newest procedures and technologies. From advanced tools for diagnosing conditions to the latest surgical technologies, the Methodist Heart and Lung Institute is at the forefront of new technologies and the latest medical procedure, including:

• Convergent Maze procedure — Uses radiofrequency (heat) to produce lesions (scar tissue) to block abnormal electrical signals in the heart
• Extracorporeal membrane oxygenation (ECMO) — Form of life support used for babies, children and adults with life-threatening heart and/or lung problems
• Minimally invasive coronary artery bypass graft (MICS–CABG) — This approach to a CABG procedure is performed using only a few small incisions in the chest, instead of having to open up the chest cavity for open heart surgery
• Hybrid procedures — These procedures can combine surgeries so patients receive the benefits of multiple surgeries while only having to undergo the surgical process once
• Implantable cardioverter defibrillator — A new option for patients at risk for Sudden Cardiac Arrest
• Left atrial appendage closure (LAAC) device — A first-of-its-kind, proven alternative to long-term warfarin therapy for stroke risk reduction in patients with non-valvular atrial fibrillation
• Transcatheter aortic valve replacement (TAVR) — This is a minimally invasive procedure used to replace the aortic valve when it has narrowed or is failing to open properly.
• Transcatheter mitral valve repair (TMVR) — A minimally invasive treatment for patients with mitral regurgitation, this procedure is ideal for patients who are unable to undergo surgery but are experiencing adverse effects from a mitral valve leak
• Ventricular assist devices (VAD) — These devices take over the function of one of the ventricles in your heart, taking blood from the heart’s chambers and help pump it to the body, supporting the heart. There are two types:
  • Left ventricular assist device
  • Right ventricular assist device

The patient journey

Visiting Methodist Heart and Lung Institute

The Methodist Heart and Lung Institute is located on the west end of the Methodist Hospital campus. Excluding our rehabilitation program, appointments are on the sixth floor.

If you’re arriving for our cardiac rehab program, please proceed to the second floor of Methodist Plaza. This building is on the north side of Medical Drive across from Methodist Hospital. Methodist Heart and Lung Institute Cardiopulmonary Rehabilitation Center is in suite 255.

For help checking in, stop by our information desks. The main desk is in the central tower by the front entrance. It’s open Monday through Friday, from 7:00am to 2:00pm. Our Garage 2 desk is by the ER entrance off Louis Pasteur Drive. It’s open daily from 7:00am to 9:00pm.

If you need to reach our ER, call (210) 575-4444. For patient information, call (210) 575-7100.

Parking at Methodist Heart and Lung Institute

The closest visitor parking is in the parking lot off Floyd Curl Drive and Medical Drive. You’ll find additional space in our three garages. We also provide valet parking. The service costs $8 per day, per visit.