Frequently asked questions

Cardiology Consultation for Outpatients

All our physicians are dedicated, full-time clinical cardiologists. We have been providing cardiology consultative services in the MetroWest area for over three decades. We provide comprehensive cardiology consultative services for all manner of cardiac conditions, including pre-surgical evaluation, second opinion consultations, and ongoing follow-up of our existing patients. Our physicians are committed to seeing you promptly and to take extra time to communicate to you and your family our treatment plan.

Cardiac Consultations for Inpatients

Physicians from the Heart Center of MetroWest are always available day and night to manage the medical needs of cardiac patients who require inpatient hospital care. We are available for comprehensive cardiology consultation, especially for patients in the Coronary Care Unit, Intensive Care Unit, and Telemetry Units. These inpatient consultations are available at MetroWest Medical Center and a physician is on call 24 hours a day, 7 days a week.

Cardiac Catheterization Laboratory

Our cardiologists perform diagnostic and interventional procedures in the James C. Dangel cardiac catheterization laboratory at MetroWest Medical Center. This minimally invasive procedure involves directing small flexible tubes (catheters) up to the heart by accessing the artery in either the wrist or groin. The wrist approach (radial artery) is usually both safer and more comfortable for patients and is used in approximately 90% of all of our cases at MWMC. IV contrast dye is then injected into the coronary arteries to identify blockages. The procedure is also used to measure pressures in the heart, evaluate the heart’s pumping function and also assess the severity of heart valve problems.

Patients who are found to have a significant blockage in a coronary artery might then be candidates for a percutaneous coronary intervention (PCI). A PCI involves threading a small wire down the vessel past the blockage. Balloons are then delivered over the wire and inflated at the site of blockage. A stent, which is a metal cylinder, is then expanded inside the artery to fully relieve the blockage and reduce the chance of it returning in the future.

Dr. James Alderman and Dr. Christopher Gange provide coverage for the MWMC Primary PCI or “STEMI” program. This service provides 24 hour coverage every day of the week for patients who are suffering from an acute myocardial infarction (heart attack). These patients need emergency angioplasty and stent placement to relieve their acutely blocked heart artery. The national goal is to open the blocked artery within 90 minutes of a patient’s arrival to the emergency room. MetroWest Medical Center’s program consistently reaches this goal on nearly every case and has an average “door to balloon” time of less than 60 minutes.

Cardiac Rehabilitation Services

Under the directorship of our Heart Center Cardiologists, both acute and maintenance cardiac rehabilitation programs are offered to our patients at MetroWest Medical Center. These highly successful programs are medically supervised. The primary purpose is to expedite recovery from cardiac events or conditions through individualized exercise prescriptions and enhanced patient education and risk factor modification. The ultimate goal is to reduce the chance of further progression of a patient's cardiovascular illness. Please contact us for further information and if you wish to join one of our programs.

Electrophysiology Services

Electrophysiology (EP) is a subspecialty of cardiology focusing on the management of abnormal heart rhythms. Symptoms of abnormal heart rhythms can include palpitations, fluttering and fainting spells. These symptoms can be evaluated in our office where we provide our patients with ambulatory heart monitors. Once a diagnosis is made, many of these abnormal heart rhythms can be successfully treated in the state of the art electrophysiology laboratory located at MetroWest Medical Center. At this facility, our cardiologists can perform a wide range of procedures to treat abnormal heart rhythms including ablations and the insertion of pacemakers and defibrillators.


An echocardiogram is a test that uses sound waves to take pictures of the heart, obtaining important information regarding your heart’s size and function. It is especially useful in aiding the management of patients with coronary artery disease, valvular heart disease, congestive heart failure, and congenital heart disease. Our Echocardiography Laboratory is staffed by cardiologists who are board certified by the National Board of Echocardiography.

Stress Testing

Stress testing is a fundamental diagnostic exam to assess cardiac function and health. It is commonly used to determine whether coronary artery disease is present and can give powerful prognostic information in patients with known heart disease. It also can be used to determine your exercise capacity, problems or to determine the effects of exercise on your heart rhythm. A cardiologist will interpret your test and will make recommendations regarding necessary follow-up.

Stress Echocardiography

A stress echocardiogram is the combination of a stress test and echocardiogram. A standard stress test is performed followed by an echocardiogram to assess the function and structures of the heart after exercise.

Advanced Cardiac Imaging

Using powerful magnetic fields, MRI can non-invasively evaluate the anatomy and function of the heart. The information obtained during a cardiac MRI study often cannot be obtained by other cardiac imaging technologies. It is available as a joint program with the Heart Center of MetroWest and MetroWest MRI. Cardiovascular Computed Tomography is an emerging technology that can aid in the non-invasive evaluation of coronary artery disease. Our physicians can arrange for coronary CT angiography when other imaging modalities do not provide the necessary information.

Anticoagulation Clinic

The Heart Center of MetroWest offers a full-time clinic focused on educating and safely managing patients who require anticoagulation with warfarin for conditions such as atrial fibrillation and mechanical heart valves. We are able to obtain an international normalized ratio (INR) result in our clinic with a finger stick. This allows us to obtain results with the patient in the office and provide dosing instructions at the time of testing. We also provide our patients with perioperative instructions when it becomes necessary to temporarily hold anticoagulation for various procedures.

Cholesterol (Lipid) Clinic

Abnormal cholesterol levels increase patients’ risk of having heart attacks and strokes. The Heart Center of MetroWest has created a cholesterol clinic to help patients improve their cholesterol levels and reduce their risk of heart attacks and strokes. This clinic is under the direction of Dr. James Alderman and assisted by Elizabeth Leighton, NP.

Atrial Fibrillation Clinic

The Atrial Fibrillation Clinic at the Heart Center of MetroWest is focused on providing our patients with state-of-the-art care for the treatment of their atrial fibrillation. Each patient undergoes an extensive evaluation to first determine if there are any triggers which may be contributing to their atrial fibrillation. After all potential triggers are addressed, each treatment option is reviewed in detail. These discussions focus on medical therapy and ablation therapy. The clinic is directed by Dr. Patrick Blomberg who is a board certified electrophysiologist with extensive experience in performing atrial fibrillation ablations.

Cardiac Device Clinic

The Heart Center of MetroWest has a full-time clinic dedicated to monitoring patients with pacemakers, defibrillators, and implantable loop recorders. Patients followed in our clinic have their devices checked routinely over the phone and periodically in our office.

Vascular Testing

The Heart Center of Metrowest provides the following vascular ultrasound imaging examinations:

- Imaging of the carotid arteries in the neck that can develop blockages which increase the risk of stroke

- Imaging of the abdominal aorta in patients at risk of an aneurysm

- Imaging of the kidney arteries for blockages which can predispose patients to kidney failure and/or difficult to control hypertension

- Imaging of the leg veins to exclude the presence of DVT (blood clots)

- Imaging of the leg veins to assess for reflux or leaking in the leg veins (venous insufficiency). This condition is a very common cause of ankle swelling and also leg symptoms such as heaviness, aching and burning. When this condition is present and the patient’s symptoms persist despite therapies such as leg elevation and compression stockings, the Heart Center can then offer an ablation procedure. A vein ablation involves directing a very small catheter (wire) into the leaking leg vein and delivering radiofrequency (heat) to the vein. This procedure very often will then significantly improve patient’s leg symptoms and may also help their swelling.

Nuclear Imaging

Comprehensive cardiac imaging services enable our physicians to provide state-of-the-artdiagnostic evaluation and follow-up treatment for our patients. In many circumstances, pictures need to be taken of the heart following a stress test in order to obtain more detailed information. A Nuclear stress test is a non-invasive test that can determine whether there are blockages in the coronary arteries, and whether there has been a previous heart attack. It also provides powerful prognostic information in patients with known heart disease. Our Cardiac Imaging Laboratory is directed by cardiologists who are board certified in Nuclear Cardiology.