Cardiac Center of Texas, P.A. Powered by ZocDoc Doctor Directory


Pulmonary hypertension is a complex disorder with multiple pathologies.  This is the syndrome resulting from restricted flow through the pulmonary arterial circulation causing high pulmonary arterial resistance which has significant negative impact on right heart (RV) and eventually right ventricle failure.ph_med_hr

This is a serious condition with poor prognosis.  There are several new therapeutic modalities available but still has 14-16% mortality within one year.  Physicians can assess who has poor prognosis. Among these indicators and most important are 1. Poor exercise capacity, 2. Poor RV function by echocardiography, 3. High BNP in blood, enzyme indicative of heart failure. Primary pulmonary hypertension is much more common in females.

Primary cause, although still not completely known, but it has some genetic roots.  It is manifested as autosomal dominant disorder but incomplete penetration, i.e. can skip one or two generations. However, it is commonly associated with liver dysfunctions, connective tissue disorders (scleroderma, lupus, rheumatoid arthritis, etc.), HIV, drugs & toxins.  Patients who have a history of blood clots in the lungs can also develop pulmonary hypertension.  People who have COPD are also prone to this disorder.

Diagnosis heavily relies on a good history and physical exam.  Then EKG and echocardiogram with pulmonary function tests are essential for initial screening.  Confirmation is done by right heart catheterization.  Again, we must rule out other causes like COPD, left heart failure, HIV and connective tissue disorders.  At Cardiac Center, we can perform all these screening tests and we have pulmonary Hypertension specialists who are board certified interventional cardiologists, to perform right heart cath to confirm diagnosis.  These kinds of testing should only be done by qualified vascular specialists.

In early stages, patients may not have any symptoms.  The most common symptom is shortness of breath.  Patients also feel more tired and fatigued.  They may have chest pain with or without activity.  They also feel dizziness and a feeling of passing out.  Palpitations are also common in these patients.  When disease is advanced, they start having swelling of legs and then fluid accumulation in upper parts of the body.

Management requires multi-disciplinary collaboration.  Basic treatment includes oxygen therapy, careful diet, and tailored exercise.  All patients should be on blood-thinners like Coumadin.  Those patients should have a very tight preventative schedule for vaccinations and avoid pregnancy at all costs.  Diuretics are the first line of therapy to reduce fluid retention.  Some patients also benefit from calcium channel blockers.

Specific therapies are emerging and include so for these class of drugs to tackle this condition.

  1. Prostaglandis, which is usually given by IV and its main therapy for critically ill patients.  First drug showed mortality benefits was epoprosterol give continuous IV infusion.  This is followed by Treprostinil – can give s.c., Iloprost – aerosol rx 6 times per day
  2. Endothelial receptor antagonist
  3. Phosphodiesterase inhibitors

The last two are given in mild to moderate conditions.  We can combine the above medications to maximize benefits.  These patients need to be followed closely by pulmonary hypertension specialist in properly designated centers for pulmonary hypertension prescriptions.  They need to be seen for 3-6 month follow ups.

Cardiac Center of Texas to Offer Free Screenings for Peripheral Artery Disease



Cardiac Center of Texas will offer free screenings for peripheral artery disease, or PAD, for high-risk patients.


The screenings, which involve taking a person’s blood pressure in the legs and ankles, are painless and take about 10 minutes. They are available from 8 a.m. until 5:00 p.m. on Mondays and Wednesdays at Cardiac Center of Texas; registration is required. Call 972.529.6939.


Most often found in the legs, PAD is caused by the buildup of plaque (atherosclerosis).  It can cause pain, disability, organ failure and other serious consequences to lifestyle and health – even death.  Atherosclerosis in the peripheral arteries is often accompanied by the same problem in the coronary arteries, which is heart disease. Also, it is strongly associated with blockages in the carotid arteries in the neck which eventually could lead to stroke. Ten million US citizens over age 40 have PAD; the majority of them are asymptomatic.  That is why high-risk patients benefit from this screening.


Anyone experiencing leg cramping or pain with walking or leg pain at rest should get screened. Slow-healing wounds or sores on legs or feet also call for a screening. Those at-risk include those over 50 with diabetes, those who are obese or those who have a family history of heart disease. High blood pressure, high cholesterol, smoking, other circulatory problems, and a family history of PAD also put patients at advanced risk. Those who are African-American and Native-American also are at a higher risk.




PAD on its own threatens vital organs, risks loss of limb and life and affects productivity, lifestyle, and quality of life.  Also, PAD is associated with a much higher risk of heart disease.  So, it’s important to get screened if you have these risk factors:


  • Cold, painful, tingling or burning legs
  • Leg pain that subsides with rest, claudication
  • Loss of sensation in the legs
  • Poor wound healing
  • Over age 65
  • Established heart disease (i.e. heart attack, angioplasty, or bypass)
  • Over age 50 with Type I or Type II Diabetes
  • Over age 50 and a current smoker



CCTX has been serving Collin County since 2003.  We take pride in providing the best care and all diagnostic testing under one roof.  CCTX is equipped with a state of the art 64 slice CT for Heart Scans and Coronary Angiography.  We treat all aspects of cardiovascular disease including PFO, Coronary Artery Disease, Peripheral Vascular Disease, Varicose Veins, Carotid and Abdominal Aneurysm, Stroke, Deep Vein Thrombosis, and Arrhythmia.  Dr. Khan is a board certified vascular specialist and peripheral doctor.  Dr. M. Akram Khan has vast experience in complex coronary intervention.  He also performs angioplasty to unclog leg vessels to improve blood flow in the legs.  For more information about CCTx, visit or call 972-529-6939.

Cardiac Center of Texas again tops the innovation and technology application for Cardiac patients.

Press Release

MCKINNEY, Texas, March 15, 2017

Cardiac Center of Texas again tops the innovation and technology application for Cardiac patients.

Dr. Akram Khan implanted the first FDA/Medicare approved PFO closure device at Medical Center of Plano on March 13, 2017.  The patient had cryptogenic stroke with PFO and obvious right to left intracardiac shunt.


The St. Jude Medical AMPLATZER™ PFO Occluder is indicated for percutaneous transcatheter closure of a patent foramen ovale (PFO) to reduce the risk of recurrent ischemic stroke in patients predominately between the ages of 18 and 60 years, who have had a cryptogenic stroke due to a presumed paradoxical embolism, as determined by a neurologist and cardiologist following an evaluation to exclude known causes of ischemic stroke.


 Safe. Effective. Reproducible.

With the AMPLATZER PFO Occluder, you have access to a safe, effective and reproducible solution for PFO patients at risk for recurrent ischemic stroke. Both the device and procedure are:

  • Safe: Data from the RESPECT clinical trial showed low rates of Serious Adverse Events (SAEs) related to the device (2.0%) and procedure (2.4%) for the Device group.
  • Effective: Long-term follow-up data (average 5.9 years) from the RESPECT clinical trial shows a significant 45% relative risk reduction in favor of PFO closure with the AMPLATZER PFO device for prevention of any recurrent ischemic stroke, and a 62% relative risk reduction for prevention of recurrent ischemic stroke of unknown mechanism (cryptogenic).
  • Reproducible: 99% technical success and 96.1% procedural success.



CCTX has been serving Collin County since 2003.  We take pride in providing the best care and all diagnostic testing under one roof.  CCTX is equipped with a state of the art 64 slice CT for Heart Scans and Coronary Angiography.  We treat all aspects of cardiovascular disease including PFO, Coronary Artery Disease, Peripheral Vascular Disease, Varicose Veins, Carotid and Abdominal Aneurysm, Stroke, Deep Vein Thrombosis, and Arrhythmia.  Dr. M. Akram Khan has vast experience in complex coronary intervention.  He also performs angioplasty to unclog leg vessels to improve blood flow in the legs.  For more information about CCTx, visit or call 972-529-6939.



North Dallas Research Associates and Cardiac Center of Texas Begin Enrollment in TOBA II BTK Clinical Trial for New Peripheral Revascularization Treatment Option

Dr. Khan Deployed the First Below the Knee Tack System in the South East Region and Only Second in the Country      


MCKINNEY, Texas, March 2, 2017 /PRNewswire/ – North Dallas Research Associates and its private practice, Cardiac Center of Texas, announced today their participation in the Tack Optimized Balloon Angioplasty II Below the Knee (TOBA II BTK) clinical trial. TOBA II BTK is a study that offers physicians a new option to treat patients suffering from advanced peripheral artery disease (PAD) or critical limb ischemia (CLI). Using the Tack Endovascular System®, the innovative technology is designed specifically to repair dissections following standard balloon angioplasty in the popliteal and tibial arteries with minimal stress to the vessels.


“We’re very excited to enroll the first patient in Texas to be treated in this groundbreaking clinical study,” said Dr. M. Akram Khan, Cardiologist at Cardiac Center of Texas. “TOBA II BTK provides the latest vascular technology for those in the Dallas area suffering from advanced PAD.”

PAD is a disease of the blood vessels in the legs and feet that occurs when arteries become narrow or clogged and don’t receive enough blood flow to meet the body’s needs. A recent analysis suggests more than 8 million Americans have peripheral artery disease, with 12-20% of individuals ages 65+ being affected. When left untreated, PAD can lead to critical limb ischemia (CLI), a more serious form of the disease. There are more than one million people in the United States living with CLI. CLI patients experience similar symptoms to PAD patients; however, CLI symptoms can significantly increase in severity from pain when resting, to open sores, to life-threatening conditions like gangrene, and can eventually require limb amputation in some patients. According to the U.S. Department of Health and Human Services, clogged arteries in the legs, just like clogged arteries in the heart, put individuals at risk for heart attack or stroke.

The Tack Endovascular System is equipped with self-sizing technology that allows one Tack implant to fit arteries ranging from 1.5mm to 4.5mm in diameter. This flexibility eliminates the need to precisely size the device to the arterial diameter, which is necessary with conventional stents. The device then allows physicians to “spot treat” the vessel only where dissections are present, rather than leave dissections untreated or covering them with large metal stents. This technique minimizes the amount of implanted metal and reduces vessel trauma and inflammation.

“Advanced PAD and CLI are large areas of fast-growing unmet need, both clinically and from a health economics perspective,” added Dr. Khan. “Patients with CLI suffer from debilitating symptoms and have few effective treatment options. It is important for the medical community to collaborate in this study to further the treatment options for patients with such advanced disease.”

Additional information regarding this trial can be found at by searching the term NCT02522884.

About the Tack Endovascular System and the TOBA II BTK Clinical Trial For more information about the TOBA II BTK trial, please visit

About North Dallas Research Associates and Cardiac Center of Texas Established in 2003 by Dr. M. Akram Khan, NDRA has grown steadily for more than 10 years building expertise in clinical research operations. We are a team of professional and dedicated staff led by Dr. Khan, who manages and conducts a vast variety of clinical trials. Currently, the site has three principal investigators conducting clinical trials under various specialties.

For more information about North Dallas Research, visit

At the Cardiac Center of Texas, we provide the residents of McKinney, Allen, Plano, Frisco, and the surrounding Collin County area with the most advanced cardiology treatment and prevention options. Beyond providing exceptional cardiology and vein care, we treat you with exceptional care. From our doctors, to our front desk and healthcare staff, at the Cardiac Center of Texas, we are dedicated to treating you with respect and compassion.

For more information about this facility, visit

Tack Endovascular System® and Tack® are trademarks of Intact Vascular, Inc. CAUTION: Investigational device. Limited by Federal (United States) law to investigational use.” The Tack Endovascular System® is CE Mark Authorized under EC Directive 93/42/EEC. Not available for sale or use in the United States.

Media Contacts Irfan Ullah, Director of Clinical Research North Dallas Research Associates 4201 Medical Center Drive, Suite 380 McKinney, TX 75069

BIOTRONIK Launches CardioMessenger Smart Portable Remote Monitor For Implanted Device Patients

Cardiac Center of Texas first in North Texas to implant Pacemaker with New Monitor

LAKE OSWEGO, Oregon, May 24, 2016 — BIOTRONIK, a global leader in cardio- and endovascular medical technology, today announced the launch of CardioMessenger Smart in the United States. CardioMessenger Smart is a portable monitoring device, about the size of a modern smartphone, that keeps pacemaker, implantable cardioverter defibrillator (ICD), and insertable cardiac monitor (ICM) patients connected to their physician remotely, enabling more efficient care management‑-anywhere in the world. Dr. Akram Khan has implanted the first one of these pacemakers with the CardioMessenger Smart in North Texas.

“The clinical and economic benefits of remote monitoring have been well established over a decade of clinical studies,” stated Dr. Akram Khan of Cardiac Center of Texas. “But these benefits are only realized if patients consistently use the technology. When we make the remote monitoring process easy for patients, we increase the likelihood of patient adherence, which has been demonstrated to improve health outcomes.”

The portability of CardioMessenger Smart helps ensure patient compliance and the consistent transmission of data necessary for physicians to identify and prevent potential cardiac events. CardioMessenger Smart is fully automatic, providing data daily and at the time of an abnormal cardiac event via cellular network to physicians without any involvement or requirement from the patient.


Cardiac Center of Texas Opens Second Location

Cardiac Center of Texas recently announced plans to open its second office location in Plano, Texas in June of 2016. The new office will be approximately fifteen miles from its current location in McKinney, TX.

For Cardiac Center of Texas, a full service cardiology clinic, the additional office space means improved patient service, ability to accommodate patients in the Plano area, and room for growth.

Cardiac Center of Texas will now occupy Suite 209 in the Doctors 1 Building on the Medical Center of Plano campus.  “The additional office space will provide greater efficiency in how we serve patients. As we started to outgrow our current office and now that we have welcomed an additional interventional cardiologist, Venkata Chilakapati, MD, to the team, space and efficiency have been affected. We are now able to open more appointment times and improve patient flow and wait times. We expect this to improve convenience for the patients who prefer Plano, and most importantly our availability for more appointment opportunities,” said Practice Manager, Alicia Hicks.

“We were fortunate to find such a nice space so close to our current office. We really wanted to limit the impact that opening an additional office could have on our patients and our employees. I don’t think we could have found a better location for our team. Our new location and enhanced operational efficiencies will help us continue to grow and evolve to keep pace with our patients’ needs, allowing us to provide exceptional care along the way,” said Dr. M. Akram Khan, President and CEO.

Construction of the new space is slated to be complete near the beginning of June. If plans remain on schedule, Cardiac Center of Texas will move in early to mid-June, at which time the address for the second location will be:

1600 Coit Road, Suite 209
Plano, TX 75075

All of Cardiac Center of Texas’s phone numbers and fax numbers will remain the same.

About Cardiac Center of Texas
CCTX has been serving Collin County since 2003.  We take pride in providing the best care and all diagnostic testing under one roof.  CCTX is equipped with a state of the art 64 slice CT for Heart Scans and Coronary Angiography.  We treat all aspects of cardiovascular disease including Coronary Artery Disease, Peripheral Vascular Disease, Varicose Veins, Carotid and Abdominal Aneurysm, Stroke, Deep Vein Thrombosis, and Arrhythmia.  Dr. Khan has vast experience in complex coronary intervention.  He also performs angioplasty to unclog leg vessels to improve blood flow in the legs.

For more information about CCTx, visit or call 972-529-6939.

Recurrence of Varicose Veins after Endovenous Ablation

Venous Insufficiency is the most common cardiovascular disorder in the human species. It also is unique to human beings as animals do not get varicose veins.  Why? Because it is directly related to the erect posture of humans and is a direct influence of gravity.  This is why veins below the heart build up pressure and eventually get dilated and start refluxing.

Incidence of some variation of varicose veins is around 20% in the general population but the incidence of venous insufficiency is 40%.  For example, 50% of venous insufficiencies are hidden until you check for this with ultrasound.  Over time, varicose veins get bigger with increased pressure and damage to venous valves and this blood starts pooling into the lower extremities causing swelling, discomfort, edema, restless leg syndrome, and chronic skin changes.  If untreated up to this stage, it can lead to venous ulcers and infection.

Several years ago, varicose vein treatment was a nightmare.  For example, vein stripping was more of a brutal procedure with a high recurrence rate.  Then came endovascular techniques using laser and radiofrequency ablation.  Since then routine varicose vein surgery has proliferated and changed the venous disease dynamics.

Even with new endovascular techniques recurrence of varicose veins is still a significant problem in 15-18% within a year and especially in women.

The most common reason for recurrence is treating the wrong vein or treating only one source of the reflux.  It is common to have more than one area of venous reflux and identification of those areas is a pre-requisite to good success.

The most commonly ignored area is the pelvic veins. This is poorly understood and a difficult territory to visualize.  Some physicians take the easy way with the large saphenous vein and assumes everything will be okay.  But the source of the reflux is up higher in the pelvis and recurrence is common.  It is especially common in females.  Females with multiple births see 20% of the source of their reflux coming from pelvic veins.  There are two types of veins responsible for pelvic reflux.  Ovarian vein 7% and internal iliac vein 93%.

Significant reflux leads to lower abdominal pain, excessive menstrual bleeding, pain during intercourse, bladder and lower GI irritability, and lower extremity edema.  This is called Pelvic Congestion Syndrome.

Conventional superficial ultrasound does not identify pelvic congestion syndrome.  Some selected centers to have CT Venography or MRA to rule out venous reflux but it is not common practice and you can still miss the diagnosis.

Most useful diagnostic test in transvaginal ultrasound to identify dilated and refluxing pelvic veins. But most of the vein centers do not have this option available. That is why you see frustrated women having recurrences of varicosities after successful operations.

The clue to pelvic reflux is one of the symptoms discussed above and the examination where you can visualize vulvular varicosities and the thigh vein extending into medial aspect and going to the pelvis or entering posteriorly via buttock area.  That gives you a good clue to assess pelvic veins before fixing greater saphenous vein.  So we see at least 20% of women with surgery come back with some problem since new physicians do not recognize it and do not have the means to diagnose it.  Make sure you tell them any pelvic symptoms you have and ask them if they are capable of doing a transvaginal venous ultrasound.  Good Luck!