Patient Testing and Procedures
Angioplasty/Stenting Angioplasty is used to re-open your arteries. A small balloon is inflated inside the blood vessel to stretch and open the artery allowing the blood to flow freely. Sometimes the vascular surgeon inserts a small mesh tube called a stent to support the artery in staying open.
Aortic Ultrasound Scan Ultrasound imaging is used to measure the diameter of the aorta (the main artery to the body) to detect an aneurysm. An aneurysm is an enlargement or ballooning of the aorta that may lead to fatal rupture of the vessel.
Cardiac Nuclear Myocardial Functional Imaging This is a test to show how well the walls of the heart move and how much blood the heart pumps out, this is called an Ejection Fraction (EF). This also involves the use of a radioactive substance, which is injected at rest. Combined with computer technology, these images make 2-D or 3-D pictures and can show how well the heart is working.
Cardiac Nuclear Myocardial Perfusion Imaging Is a test to show how well the heart is working. Another name for it is SPECT (Single photon emission computed tomography) myocardial perfusion imaging (MPI). This type of nuclear imaging utilizes a radioactive substance (called a tracer). The tracer is injected at rest and also during a stress test and gives off energy that a special camera captures as images. Combined with computer technology, these images make a 3-D picture of how well the heart muscle is receiving blood through the heart arteries. The stress test may be on a treadmill or may involve the infusion of a pharmacologic drug that simulates stress. Together the Rest and Stress SPECT scans can show if you have blocked or narrowed arteries or damaged heart muscle. This is helpful in diagnosing coronary heart disease.
Carotid Duplex Scan Ultrasound measurement of blood flow is performed in the carotid arteries in the neck to detect the presence of blockages in the circulation to the brain. The carotid scan can measure the severity of that blockage and help determine the risk of future stroke.
Chest X-Rays The chest x-ray shows the size and shape of the heart, and any diseases in your lungs or other chest structures.
Dobutamine Stress Echo A Dobutamine Stress Echo involves taking a medication called dobutamine, while closely monitored. The medication stimulates your heart and makes it "think" it is exercising, while your heart and valve functions are evaluated.
Doppler Test The Doppler examination measures circulation to both legs to detect peripheral arterial disease (PAD). PAD can lead to serious problems like leg ulcers, gangrene, and amputation in the most serious cases. Even when PAD is mild, this test identifies patients who have higher risk factors of heart attack and stroke, and who may therefore benefit from the medical treatment of these associated conditions.
Echocardiogram, or ECHO Echocardiography is a test of heart structure and movement utilizing ultrasound (sound waves). An echocardiogram may be performed to evaluate the structure and function of the heart valves. It can be used to evaluate the size and pumping ability of the heart chambers and how well the valves in the heart open and close.
EKG, ECG, or Electrocardiogram Electrocardiography is a non-invasive procedure for recording electrical changes in the heart. The record, which is called an electrocardiogram (ECG or EKG), shows the series of waves that relate to the electrical impulses which occur during each beat of the heart. Electrodes are applied to specific sites on the arms, legs, and chest. When attached, the electrodes are called leads; usually 12 leads are employed.
Exercise Echocardiography This is an echocardiogram performed during exercise, when the heart muscle must work harder to supply blood to the body. This test is able to detect heart problems that might not be evident when the body is at rest and needs less blood. For patients who are unable to exercise, a drug called Dobutamine simulates the effects of exercise.
Holter Monitor/Event Monitors Holter monitoring is continuous monitoring of the electrical activity of a patient's heart muscle (electrocardiography) for 24 hours, using a special portable device called a Holter monitor. Patients wear the Holter monitor for 24 hours while carrying out their usual daily activities. This is used to help determine whether someone has an otherwise undetected heart disease, such as abnormal heart rhythm (cardiac arrhythmia).
Event monitors are the same as Holters except patients wear these for 30 days. These are used to capture abnormal heart rhythms that do not occur within a 24 hour period.
Nuclear Scan/Cardiac Perfusion Dobutamine Imaging This diagnostic tool is especially useful if a standard exercise test is inconclusive or your doctor suspects that results may be falsely positive or negative. A small amount of weakly radioactive material (Thallium, or Cardiolite/Technetium) is injected into a vein while you’re resting or exercising (stressing the heart). If you are unable to exercise, or if your physician prefers, an IV drug, such as Persantine, Adenosine, or Dobutamine may be used to “stress” the heart. The radioactive material allows a camera to detect parts of the heart that aren’t getting enough blood because of a narrowed, blocked, or damaged arteries (i.e. coronary artery disease).
Stress Echocardiogram Stress Echoes are performed on patients who can not walk on the treadmill This procedure is performed as an alternative, due to a current condition that is putting “stress” on their heart. This can be done with exercise or with a drug infusion through an intravenous line. The stress test shows weather your heart pumps normally during exercise and your coronary arteries can meet your heart’s increased demand for blood.
TEE (Transesophageal Echocardiogram) Transesophageal echocardiography is a diagnostic test using an ultrasound device that is passed into the esophagus of the patient to create a clear image of the heart muscle and other parts of the heart. A tube with a device called a transducer is passed down into the patient's throat and into the esophagus (the food tube that connects the mouth to the stomach). The transducer directs ultrasound waves into the heart, and the reflected sound waves picked up by the transducer are translated into an image of the heart. It is especially useful in cases in which conventional echocardiography (a test where the transducer is kept on the patient's chest) cannot offer a good image, such as when the patient is obese or has a thick chest wall.
Treadmill Exercise Stress Test A diagnostic procedure used to determine heart response to physical exertion (stress). You’ll simply walk on a treadmill (or, sometimes, pedal a bicycle) while your heart rate, blood pressure, and ECG are monitored. It shows how long you are able to exercise, whether you have symptoms, and whether there are abnormal changes on the ECG, which may signify blockage or narrowing in the arteries surrounding your heart.