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A cardiac stress test is a test performed to evaluate arterial blood flow to the heart muscle with exercise compared to blood flow at rest. The test is painless and easy. The patient has electrodes placed on their chest and are hooked up to the stress test machine. The patient walks slowly on the treadmill and periodically the treadmill speed increases until target heart rate is achieved. This test will allow the physician to determine if there is a significant blockage in the heart’s arteries.
A nuclear stress test combines the stress test with pictures (images) obtained by the nuclear gamma camera. To obtain these pictures, the patient receives a small dose of an isotope intravenously which allows the gamma camera to more precisely determine any blockages in the coronary arteries with a great deal of accuracy. The test is painless, and requires that the patient be at our facility for 3-4 hours. The patient must fast after midnight for this test. The patient can drive home after this test.
An echocardiogram uses high frequency sound waves to evaluate the heart chambers and valves. It is useful in determining the strength of the heart. Often it is used with Doppler ultrasound to more precisely evaluate blood flow across the valves and detect any valve disease.
This test is done similar to the nuclear stress test (above); however the patient does not have to walk on the treadmill. Instead, the patient receives a chemical called Lexiscan (Regadenoson) that “recreates” the effect of exercise. An isotope is given intravenously before and after this medication. The test requires the patient to be at our facility for 3-4 hours, and is painless. Patients must abstain from caffeine consumption minimum of 12 hours prior to this test. The patient can drive home after this test.
This is a non-invasive test that combines two tests, a stress test and an echocardiogram. The echocardiogram is an ultrasound of the heart and provides a “bird’s eye” view of the heart. The test begins with the sonographer acquiring images of the heart’s internal structure, size and movement. Then electrodes are placed on the patient’s chest and the patient walks on a treadmill and their EKG and BP are monitored. When the patient attains target heart rate, the patient lies down on a table immediately and echocardiography images are quickly taken again. No fasting or IV is needed in this test. The test takes about 30 minutes.
This test is an invasive echocardiogram that is done in the hospital on an outpatient basis. The patient fasts overnight and goes to the hospital. An IV is placed and the patient receives sedation. Then the patient gargles with medicine that numbs their “gag reflex”. Next, a soft probe is placed in their esophagus (food pipe) and advanced to the level of the stomach. This provides excellent, crystal clear images of the heart. The test is painless and takes the physician about 20 minutes or less to perform. Since the patient receives sedation, they must have someone drive them home.
This is a test that is useful in screening patients for risk of stroke. It takes 15-30 minutes. In this test jelly is placed on both sides of the neck and the ultrasound probe is moved up and down the neck to image the carotid arteries. The carotid arteries supply blood to the brain, and any blockage in the carotid artery will be readily seen with this test.
This is done on patients who have an existing pacemaker or AICD/ICD device. The test involves placing a “wand” over the patient’s device and takes the physician about 5-10 minutes to analyze the function of the device. The test is painless and requires no preparation. The device can be reprogrammed if needed at the time of analysis.
Aorta duplex ultrasound is used to evaluate the aorta, the main artery through the trunk, which can develop an aneurysm (ballooning of the major artery) that can grow to the point of rupture of the aortic wall. An abdominal aortic aneurysm (AAA) may not be detected on routine physical examinations, but ultrasound duplex imaging provides an accurate, safe and non-invasive means to measure the aortic size. A hand held device called a transducer is placed at various locations on the abdomen and used to detect the blood flow& measure the aorta size. There is no pain during this test only a slight pressure is felt. The procedure takes approximately 45 minutes.
A holter monitor is a device that records an EKG over a period of 24 hrs. It includes electrodes that are attached to your chest, and a small digital recording device that documents a continuous EKG. The patient is hooked up in the office and goes home with the device and returns it the following day. This is done to determine the presence of an abnormal heart rate or rhythm. It is small and worn like a beeper attached to your waist.
A cardiac event monitor is a small recorder that records the heart’s electrical activity for more than 24 hours upto 3 weeks. This is done to determine the presence of an abnormal heart rate or rhythm. When patients experience symptoms, they activate the monitor to make a brief recording of the heart’s electrical activity. It is small and worn like a beeper attached to your waist.
In this test the patient lies on a table and blood pressure cuffs are placed on the thigh, calf, and ankle and inflated. Next a Doppler ultrasound probe is utilized to image the size of the arteries in the legs and to determine if there are any blockages. Blood velocity is also measured to determine the extent of any blockage and artery elasticity is also determined. The test takes about 45 minutes.