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Buffalo General Medical Center
100 High Street
Buffalo, NY 14203

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Cardiac Services
Heart and Lung Center

Heart and Lung Center

(716) 859-7280

Buffalo General Medical Center
100 High Street – B-Building, 8th Floor
Buffalo, NY 14203

Follow-up care for pacemakers, defibrillators and cardiac resynchronization devices.

The heart has an internal electrical system that controls the rhythm of the heart beat, so problems with the heart’s electrical system can cause abnormal heart rhythms. A pacemaker can help ensure a person’s heart rate remains normal. An implantable cardioverter defibrillator (ICD), contains a pacemaker to manage the heart’s rhythm as well as a defibrillator to shock the heart to restore a more normal rhythm.

Pacemakers and ICDs require regular evaluation to ensure they are set according to the patient’s changing needs, to monitor device battery status, and to gather the computerized diagnostics needed to help the physician manage the patient’s care. Patients are offered the opportunity to discover if they are a candidate for a device, and the medical team helps patients who already have pacemakers, defibrillators or ICDs maintain their devices. Remote follow-up is also available to patients with certain devices. This is especially valuable to the heart failure patient with cardiac resynchronization devices, allowing the center to have access to the most current data stored in these devices.


Leon Levinsky, MD

General Cardiology

(716) 859-7280

Cardiologists utilize the latest technical advances in the diagnosis and clinical management of cardiovascular disease for adult patients. Each patient is assessed as an individual, with a comprehensive history and physical performed by a board-certified cardiologist.

The patient's treatment plan may include medication management, both noninvasive and invasive testing, recommendations for lifestyle changes and other non-surgical procedures. At times, a particular surgical procedure may be advised.

The cardiology team evaluates both inpatients and outpatients when requested. Once a cardiologist has been consulted on a case, they become the patient's cardiologist, whatever the patient's status may be. This ensures a continuum of care, which is second to none.


Susan Graham, MD
Joseph Paris, MD
Sridhar Vijayasekaran, MD
Stanley Fernandez, MD

Heart Failure Center

(716) 859-7280

What is Heart Failure?

Heart failure does not mean the heart has stopped working. It actually means that the heart’s pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body’s needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened.

What Causes Heart Failure?

Heart failure is caused by many conditions that damage the heart muscle. A person may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms of heart failure are related to the changes that occur to the heart and body and may be moderate to severe, depending on how weak the heart is.


The Heart Failure Specialists are specially trained to diagnose and treat heart failure. They will review the patient's medical records and order any additional testing that may be needed to make a diagnosis.  They will also be able to determine the cause and severity of heart failure and develop the treatment plan.


Susan Graham, MD
Laurie Salerno, A.N.P.

Syncope Consultation and Tilt Table Testing

(716) 859-7280

What is Syncope?

Syncope (SIN'ko-pe) is temporary loss of consciousness and posture, described as "fainting" or "passing out."

Syncope is a common condition that affects men and women of all ages both with and without other medical conditions. It becomes more prevalent with advancing age, occurring in as many as six percent of people over age 75. The spells may be a benign nuisance or may be a warning of something more serious.

What Causes Syncope?

Syncope is often caused by blood pressure that is too low (hypotension), which causes a shortage of oxygen to the brain. This leads to lightheadedness or a "black out" episode (loss of consciousness). Temporary impairment of the blood supply to the brain can be caused by heart conditions, as well as conditions that are not directly related to the heart, including:

  • Emotional stress
  • Pain
  • Pooling of blood in the legs due to sudden changes in body position
  • Overheating
  • Dehydration
  • Heavy sweating
  • Exhaustion

What Are the Symptoms of Syncope?

  • "Blacking out"
  • Light-headedness
  • Falling for no reason
  • Dizziness
  • Drowsiness
  • Grogginess
  • Fainting, especially after a meal or after exercise
  • Feeling unsteady or weak when standing


All patients with syncope should be evaluated by a doctor. If needed, a primary care physician can provide a referral to the syncope clinic where the specialists will perform a thorough examination in order to determine the cause of the syncope. Previous medical history will be evaluated and additional testing may be ordered to determine the cause of the condition.

Testing at the Syncope Clinic may include imaging, rhythm monitoring and electrophysiology testing. When heart conditions are not suspected, tilt-table testing can be used to detect causes of temporary loss of consciousness. Tilt-table testing involves placing the patient on a table with a foot-support. The table is tilted upward and blood pressure and pulse is measured while symptoms are recorded.

Once a diagnosis is made, a treatment plan can be initiated with the goal of preventing recurrences and treating any detected abnormalities.


Donald Switzer, MD

Pulmonary Hypertension

(716) 859-7280

What is Pulmonary Hypertension?

Pulmonary hypertension generally results from constriction, or stiffening, of the pulmonary arteries that supply blood to the lungs. Consequently, it becomes more difficult for the heart to pump blood forward through the lungs. This stress on the heart may cause it to enlarge, and eventually fluid can build up in the liver and other tissues, such as in the legs.

What Causes Pulmonary Hypertension?

Pulmonary hypertension can be caused by diseases of the heart and the lungs or can occur on its own.

Symptoms of Pulmonary Hypertension?

  • Shortness of breath that worsens with activity
  • Cough
  • Fatigue
  • Lethargy
  • Chest pain (angina)
  • Rapid breathing
  • Swelling in the legs
  • Passing out/dizziness

Many people with pulmonary hypertension may have no symptoms at all, especially if the disease is mild or in early stages.


The first step in diagnosis of pulmonary hypertension is to clinically suspect it (usually occurs from an echocardiogram or EKG). This may be done as part of an evaluation of another disease that can lead to pulmonary hypertension (such as scleroderma or chronic obstructive pulmonary disease) or based on the patient's signs and symptoms as described above.

The pulmonary specialists are trained to diagnose and treat pulmonary hypertension.  They will review the patient's medical records and order any additional testing that may be needed to make a diagnosis and to initiate a treatment plan.


William Gibbons, MD

General Pulmonary

(716) 859-7280

All adult patients with lung disease, from the sickest patient who might require lung transplants to those at risk for developing lung disease, can benefit from the care of a pulmonologist.

Pulmonologists and other healthcare professionals work closely with patients, their primary care physicians and families to coordinate health care and hospitalization services, as well as arrange for outpatient and home-based care when necessary. Each patient is assessed with a comprehensive history and physical performed by a board-certified pulmonologist.


Aman Pande, MD
Manoj Jacob Mammen, MD