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Services

The offices of Drs. Caren and Urman offer comprehensive non-invasive diagnostic cardiovascular services for our patients. This includes consultation with one of our cardiologists as well as an ongoing evaluation and management of cardiovascular problems. We believe that prevention of heart disease offers the best outcome, and we offer services designed to promote primary and secondary prevention of cardiovascular disease.

Cardiology Consultation

A cardiology consultation is usually requested by your general internist, family doctor or sometimes another specialist or surgeon when he or she wishes to have a cardiac specialist (cardiologist) use his or her expertise to evaluate you. This might be one of many reasons from concern over a known or possible serious cardiac problem to a more general evaluation. It might also include situations where you, your personal physician or your regular cardiologist wish you to have a confirmatory or second opinion. Dr. Caren and Urman start by speaking to you and examining you, reviewing any pertinent records available and possibly doing further diagnostic testing.

For more information on “What is a cardiologist?”, Click here

Preventive Cardiac Evaluation (Cardiac Risk Factor Evaluation and Treatment)

This is a thorough evaluation starting with an interview and physical exam to determine if further testing (lab work or other diagnostic testing) is indicated to reduce the odds of cardiac events or disease in the future. This can be “primary prevention” (no known history of heart disease but perhaps risk factors warranting concern such as family history of heart disease) or “secondary prevention” in someone with a known history of heart disease or problems.

For more information on preventive cardiology, Click here

Enhanced Access Membership Program

  • Personalized concierge services not covered by private insurance or Medicare.
  • Three annual membership options to choose from (Select, Premier and Concierge Plans)
  • Increasing levels of priority and enhanced access for routine appointments and testing
  • Increased phone and email access to our staff and doctors on routine matters
  • Priority completion of administrative paper-work with fees waived
  • Validated parking and convenient VIP parking for office visits.

Please contact our office manager, Gwen Owens at 310.659.0714 for more information.

Testing

Each of our diagnostic tests may require certain preparations. Your doctor will inform you of these preparations when your test is scheduled. For all tests below (except for blood tests) we ask all patients to wear loose, comfortable clothing to their test and avoid wearing cologne, perfume or jewelry. For all tests below, please take your usual medications unless instructed otherwise by your physician. DO NOT DISCONTINUE any medication without first talking with your physician.

FOR ALL STRESS TESTS (Exercise stress echo, exercise stress test and myocardial perfusion imaging): Do not have anything to eat or drink for three hours before the study and NO CAFFEINE-CONTAINING FOOD, DRINKS or medications for 24-hours prior to nuclear myocardial perfusion stress testing). Wear or bring comfortable clothing and rubber-soled shoes.

Ambulatory Blood Pressure Monitor

24-hour Ambulatory Blood Pressure Monitoring allows your physician to review your blood pressure range for 24 (or occasionally 48) hours. Your physician may recommend this type of testing whenever there is a question of whether your blood pressure might only be elevated at the doctor’s office (“white-coat hypertension”) or if there is a question of response to blood pressure medications.

In addition to the monitor, patients will be given a diary to monitor their symptoms or activity that the doctor can use to correlate with potentially very high or low blood pressures. Allow 30 minutes for hook-up in our office with explanation of its use. Patients need to return to the office approximately 24 hours later to return the device.

Please click here for more information about Blood Pressure Monitors.

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Atherosclerosis Screening with Carotid IMT 

Carotid IMT (intima-media thickness) ultrasound allows your physician to find the earliest signs of plaque buildup in arteries (atherosclerosis).  Atherosclerosis is the process that ultimately can lead to heart attacks and strokes.  Using an easy, quick and painless ultrasound technique, the earliest signs of hidden plaque buildup (first seen as increased thickness of the artery wall) can be recognized.  Much more sensitive than regular carotid ultrasound vascular imaging, this special technique, Carotid IMT, has been shown to correlate with future risk of stroke and heart attack.

COR Medical Group, the offices of Drs. Jeffrey Caren and Mark Urman, is the first private medical office in not only the Greater Los Angeles area but actually in all of California (and one of the first private offices in the US) offering CardioHealth®, the latest technology to find the earliest signs atherosclerosis.  The CardioHealth® technology is the result of well-validated standardization of the Carotid IMT technique which itself has been around for several years but up until now had not gained widespread use due to difficulty with reliable, reproducible and accurate imaging technique and interpretation (except in a handful of very experienced research centers nationwide).  However, the technology behind CardioHealth® has overcome these obstacles to allow routine reliable and accurate clinical testing which is why Drs. Caren and Urman are among the first to have adopted it in their practice for their patients. 

It is important to discuss with your cardiologist if you are an appropriate candidate for Carotid IMT imaging.  Unlike CAT scans of the heart, there is no radiation exposure and testing takes just a matter of minutes.  Results of the carotid IMT ultrasound imaging study and a full CardioHealth® Report including your risk factors for cardiovascular disease are available soon thereafter. 

“You are as old as your arteries.” 

-Attributed to Physician Sir William Osler (known as the “father of modern medicine”), early 20th century 

Click here for more information on Carotid IMT, atherosclerosis screening and CardioHealth®.


Echocardiogram (echo)

Echocardiography (commonly known as an echo) is a technique that uses sound waves to create images of the heart. These images allow physicians to assess the valves of the heart, as well as the size and function of the chambers. This test is performed by moving a transducer across the chest to produce images of the chambers and valves within the heart. Your doctor may ask you to undergo an echo in order for the cardiologist to:

  • Assess the overall function and size of your heart.
  • Determine the presence of heart disease.
  • Follow the progress of valve disease or heart failure over time.
  • Evaluate the effectiveness of medical or surgical treatments.

This test requires you to lie on your left side (and briefly on your back as well) for approximately 30 - 45 minutes although you should plan on spending at least one hour from your arrival at the office until you leave.

Please click here for more specific information

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Electrocardiogram (ECG or EKG)

During an electrocardiogram, electrodes are placed on your upper body and legs to obtain an “electrical image” of the heart. This routine non-invasive test evaluates the heart rhythm, determines whether the electrical system of the heart is functioning properly, and whether parts of the heart might be enlarged or damaged. This test generally takes less than 5 minutes.

There are several reasons for your doctor to recommend an ECG, some of which may include:

  • To determine the cause of chest pain, palpitations, dizziness or shortness of breath
  • To make sure the blood is receiving adequate blood flow
  • To ensure that the heart is strong enough to withstand surgery
  • To see if the heart is enlarged for patients with a history of high blood pressure

Please click here for more specific information

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Event Monitor

Event Monitoring is a painless way to record your heartbeat away from the doctor's office. An event monitor is a small limited electrocardiogram (ECG) that you carry with you to record irregular heartbeats, which are reviewed by your doctor at a later time. Patients can simply press a button when they experience an irregular heartbeat. You will usually carry this monitor for two to four weeks. Your physician may recommend this type of testing whenever you experience symptoms like dizziness, palpitations, skipped beats or other sensations which may occur during normal day to day activities, but not necessarily while you're in the physician's office. Allow 15 - 30 minutes for hook-up in our office with explanation of its use.

Please click here for more specific information

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Exercise Stress Echo

An exercise stress echocardiogram produces images of the heart while the patient is at rest and during exercise in order to determine the size and function of the heart, including its chambers and valves. The test is used to:

  • determine how well your heart tolerates activity and your level of fitness;
  • evaluate the function of your heart and valves;
  • determine your likelihood of having coronary artery disease (blocked arteries); and
  • evaluate the effectiveness of your cardiac treatment plan.

What happens during the test?

The technician will first perform a resting EKG, resting echocardiogram, measure your resting heart rate and take your blood pressure. You will then be asked to start exercising and gradually increase your rate of exercise until you are exhausted. Then you will get off the treadmill and quickly return to the exam table and lie on your left side so the technician can perform another echocardiogram. The appointment will take about one hour.

Please click here for more specific information and to review consent form

For more on stress testing visit:

Exercise Stress Test

This test requires you to exercise on a treadmill while your heart rhythm is continuously monitored with an electrocardiogram (ECG). The test may be performed to:

  • determine how well your heart tolerates activity and your level of fitness
  • evaluate the function of your heart and valves
  • determine your likelihood of having coronary artery disease (blocked arteries); and
  • evaluate the effectiveness of your cardiac treatment plan.

What happens during the test?

The technician will first perform a resting EKG, measure your resting heart rate and take your blood pressure. You will then be asked to start exercising and gradually increase your rate of exercise until you are exhausted. This test will take approximately 45 minutes to one hour (including getting you hooked up, explaining the test and monitoring you after exercise). For patients who cannot walk on a treadmill, we can arrange for non-exercise (pharmacological stress test) protocols.

Please click here for more specific information and to review consent form

For more on stress testing visit:

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Holter Monitor

24-hour Ambulatory Electrocardiographic (Holter) Monitoring allows your physician to review your heart's activity for 24 hours. Your physician may recommend this type of testing whenever you experience symptoms such as dizziness, palpitations, skipped beats or other sensations which may occur during normal day to day activities, but not necessarily while you're in the physician's office.

In addition to the monitor, patients will be given a diary to monitor their symptoms that the doctor can use to correlate with irregularities within the heart. Allow 30 minutes for hook-up in our office with explanation of its use. Patients need to return to the office approximately 24 hours later to have the device removed.

Please click here for more specific information

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Lab Tests

Our medical assistants are trained and experienced at drawing blood. Blood Drawing blood generally takes less than 5 minutes and routine results are usually available within 24 to 48 hours. Some specialized testing can take longer. You will be contacted if results come back abnormal, and can choose to be contacted for normal results as well.

There are several reasons for your doctor to recommend blood work, some of which include:

  • To evaluate your risk of developing heart disease.
  • To determine the effectiveness of medication for patient with artery blockages or heart attack
  • To determine the overall health of patients with certain symptoms

Please click here for more specific information

Myocardial Perfusion Imaging (Exercise or Pharmacological Nuclear Stress Testing)

During myocardial perfusion imaging, electrodes are placed on your upper body to obtain an electrocardiogram (ECG or EKG) and to monitor your heart rhythm continuously during the stress test. The stress test will be performed with the patient exercising on a treadmill or a medication called adenosine for those who are unable to exercise.

In a myocardial perfusion study, a small amount of a short-acting radioactive material called a tracer or isotope is given through an IV in your arm prior to and during stress testing. Computer-generated images of the heart will be taken at rest and after exercise or adenosine. The camera will allow us to visualize the blood supply to your heart muscle and observe its function before and after exercise or stress.

This test will take approximately 2 - 3 hours and is done in our other office in the same building on the third floor: 8635 West Third Street in Suite 355-W.

Please click here for more specific information and to review consent form

For more on nuclear heart scans:

For more on stress testing:

If you have any questions about any of the above tests that your doctor has recommended for you or you are scheduled for, please feel free to call our office at (310) 659-0714.

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