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64-Slice Computerized Tomography
CT (computed tomography), sometimes called a CAT scan, uses special x-ray equipment to obtain image data from different angles around the body. A computer is then used to process the information to demonstrate a cross-section of body tissues and organs. The 64-slice scanner represents a significant upgrade in CT technology that helps doctors diagnose cardiac and vascular disease better and faster for inpatients, thereby leading to earlier treatment and faster recovery.
64-slice CT Scanner Web Site
Echocardiogram
An ultrasound exam that uses sound waves to evaluate the size, pumping strength and
valves of the heart. Specialized tests include:
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Transesophageal: An ultrasound exam that uses sound waves to evaluate the size, pumping strength and valves of the heart. Sound waves are captured via a probe that is placed in the esophagus. Patients are lightly sedated for this procedure.
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Stress Echo: An ultrasound exam that uses sound waves to evaluate the size, pumpingnstrength and valves of the heart. The hearts function is assessed at rest and immediately following exercise (usually walking on a treadmill.)
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Pediatric Echo: An ultrasound exam performed infants and children under the age of fifteen to evaluate the size, pumping strength and valves of the heart. Very young children may require light sedation to keep them calm during the procedure.
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Dobutamine Stress Echocardiogram: An echocardiogram using medication to exercise the heart in order to evaluate heart function. This test is used if a patient is unable to walk on the treadmill.
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Vascular Ultrasound
An ultrasound exam uses sound waves to examine abnormalities in veins and arteries. Specialized tests include:
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Carotid duplex exam: An ultrasound exam to examine the arteries that supply blood to the head. This test is used to detect blockages that may have caused a stroke or stroke-like symptoms.
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Venous duplex exam: An ultrasound exam to examine veins in an extremity that has pain and swelling to rule out blood clot or deep vein thrombosis
(DVT).
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Arterial duplex exam: An ultrasound exam to evaluate arteries in an extremity that has pain or cramping.
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Renal artery exam: An ultrasound exam to evaluate the renal artery blood flow when a patient has unexplained or uncontrollable hypertension.
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Abdominal aortic exam: An ultrasound exam used to examine the abdominal aorta for aneurysm or other abnormalities.
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Superior mesenteric duplex: An ultrasound exam to evaluate the superior mesenteric artery and celiac arteries in patients with sudden weight loss.
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Transcranial Doppler: A Doppler exam to evaluate intracranial arteries for spasm and blockages.
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Ultrasound
Electrocardiogram (EKG)
The electrical impulses generated by the heart are recorded on graph paper to aid in the diagnosis of heart disorders. Specialized tests include:
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Holter Monitor: A Holter Monitor is worn for 24 hours to record the electrical activity of the heart (EKG)
while you go about your daily activity. This test is used to capture transient or abnormal heart rhythms.
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Event Monitor: An Event Monitor is worn for up to 30 days to detect infrequent disturbance in the hearts rhythm.
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Ambulatory Blood Pressure Monitor: A monitor worn for 24 hours to record multiple blood pressure readings throughout the day. This test is used to determine the degree and duration of hypertension.
Exercise Stress
Test
A test used to assess the effect of stress (exercise) on the heart. The patient is exercised (usually on a treadmill) to increase the heart rate while the EKG, blood pressure and symptomatic response are monitored to detect heart problems. Specialized tests include:
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Myocardial Perfusion: A diagnostic test using radioactive tracers to visualize the flow of blood to the heart muscle and aid in diagnosing narrowed or blocked vessels. This test is done in addition to the exercise stress test.
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Cardiopulmonary Exercise Stress
Test: An exercise stress test used to assess the lungs and heart at the same time. This test can be very useful in helping a doctor make a specific diagnosis between the extent of problems that may be originating from either source.
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Stress Test
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Echocardiogram Examines the Heart with Sound Waves
A safe and painless “echo” uses ultrasound (high-frequency sound waves) and a computer to diagnose heart problems
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During an echocardiogram, a small instrument called a transducer is held against the chest in four different locations. The transducer sends ultrasound waves into the body that bounce off various structures of the heart. The ultrasound machine receives the returning sound waves, and the computer creates a moving image of the heart. The images are displayed on a monitor. They can be recorded on videotape or stored digitally.
Why have an echocardiogram?
It can provide valuable information about the heart, including:
- The size of the heart chambers and the thickness of the heart muscle.
- The heart’s pumping strength, or the “squeeze” of the left ventricle (the heart’s main pumping chamber).
- Valve problems. Echo images can show the shape and motion of the four valves in the heart and whether a valve is leaking or does not open well enough.
- Echo images can also help to determine if there is fluid around the heart, blood clots or other masses inside the heart chambers, or abnormal holes between heart chambers.
Is it safe?
Very. Ultrasound has been used for more than 30 years, and there are no known risks or side effects. Ultrasound is painless, although there may be some slight discomfort from the pressure of the transducer.
What are the benefits?
This non-invasive test gives very good information about the structures of the heart and the blood flow through the heart with no risk to the patient.
What are the limitations?
It can be difficult to get quality images of the heart from patients who have broad chests, are obese or have lung disease.
How soon will you know the test results?
Usually patients discuss the results of the exam with their doctor at their
next appointment.
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Vascular Ultrasound Finds Problems in Blood Vessels
Uses sound waves to examine abnormalities in veins and arteries
In vascular ultrasound, a small instrument called a transducer sends ultrasound waves into the body. They bounce off blood vessels in the target area. The ultrasound machine receives the returning sound waves, and the computer creates an image of the blood vessels. The images are displayed on a monitor. They can be recorded on videotape or stored digitally.
Why do vascular ultrasound?
Usually to look for blockages in the arteries or blood clots in the veins. Different symptoms call for different kinds of vascular exams, such as:
- Carotid duplex exam. This is the most common test done in the vascular lab. It examines the arteries that supply blood to the head to find blockages that may have caused a stroke or stroke-like symptoms.
- Venous duplex exam. This test is used when a patient has swelling in a leg or other extremity. The physician may be concerned about a blood clot or deep vein thrombosis (DVT).
- Arterial duplex exam. This test is used when a patient has cramping or pain in an extremity, and the physician is concerned about a blockage in the artery.
- Renal artery exam. This test is used when a patient has unexplained or uncontrollable hypertension.
Is it safe?
Very. Ultrasound has been used for more than 30 years, and there are no known risks or side effects. Vascular ultrasound is painless, although there may be some slight discomfort from the pressure of the transducer.
What are the benefits?
Vascular studies are non-invasive and low in cost when compared to other types of tests. They provide important information about the structure of blood vessels and the blood flow through them.
What are the limitations?
Vascular studies may be less accurate if the patient is obese or if there is gas in the bowel.
How soon will you know the test results?
If the vascular physician is present during the test, you may get the results before you leave. Usually patients discuss the results of the exam with their own doctor at a later date.
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Patient undergoes EKG
testing.
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EKG Records Changes in Heart’s Electrical Activity
An electrocardiogram, or EKG, records the electrical impulses moving through the heart
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EKG, electrodes are placed on the chest, arms and legs with small suction cups. The electrical impulses generated by the heart are then recorded on a piece of graph paper. The entire procedure takes about five minutes.
Why get an EKG?
Symptoms such as chest pain, chest pressure, shortness of breath, dizziness or irregular heartbeat may prompt your physician to order an EKG. There are two main reasons to get an EKG:
- To record the heart rate and rhythm.
- To help diagnose a possible heart attack or other heart disorder.
An EKG may also be done prior to a surgical procedure or during a routine visit to your doctor’s office.
Is it safe?
Very. There are no risks, pain or complications associated with an EKG exam.
How soon will you know the test results?
The electrocardiogram is done by a technician, immediately interpreted by computer, and confirmed by a physician within a few hours. Your physician will contact you immediately if there are any serious abnormalities. Otherwise your physician will discuss the results with you at your next appointment.
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Holter Monitor Detects Changes in Heart Rhythm Over 24 Hours
Small, portable device continuously records information about the heart’s electrical activity
A Holter monitor is like a long-term, portable EKG, or electrocardiogram, which records the heart’s electrical activity while the patient carries on daily life. Several electrodes (small sticky patches) are applied to the chest and connected by wires to the recorder. The electrodes and wires are worn underneath clothing, and the recorder is carried with a shoulder strap. A cassette tape records the information for 24 hours or longer.
Why use a Holter monitor?
A Holter monitoring exam helps your physician determine how your heart responds to normal activities and cardiac medications. It is also used to:
- Assess transient and abnormal heart rhythms.
- Assess pacemaker function.
- Evaluate symptoms like dizziness, fainting, irregular heartbeats and shortness of breath.
Is it safe?
Very. There are no risks, pain or complications associated with a Holter monitor exam.
What are the benefits?
It’s an easy way for your physician to learn about potential heart problems or to monitor an existing one.
How soon will you know the test results?
Your test is interpreted by a physician within 24 hours. Your physician will contact you immediately if there are any serious abnormalities. Otherwise your physician will discuss the results with you at your next appointment.
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Event Monitor Detects Changes in Heart Rhythm Over Many Days
Small, portable recording device captures fleeting episodes of arrhythmia for up to a month
An event monitor is like a long-term, portable EKG, or electrocardiogram, which records the heart’s electrical activity. It can be worn up to 30 days, detecting infrequent disturbances in the heart’s rhythm while the patient goes about daily life. Each time the patient activates the monitor at the start of a symptom, the monitor captures 90 seconds of data.
How does it work?
It uses a “memory loop” to record an EKG before, during, and after the onset of symptoms. Patients can transmit the data to the lab by phone 24 hours a day for analysis.
Why use an event monitor?
It can detect transient, or infrequent, arrhythmia (irregularities of the heart rhythm) . The patient must be aware of what symptoms to watch for, because it is the patient who signals the monitor to start recording.
Is it safe?
Very. There are no risks, pain or complications associated with an event monitor.
What are the benefits?
It’s an easy way for your physician to learn about potential heart problems that occur infrequently.
What are the limitations?
The patient needs to be aware of the particular symptoms that occur with arrhythmia in order to activate the device.
How soon will you know the test results?
Transmissions are sent by phone. They are interpreted by a physician within a few hours. If there are any abnormalities, the patient’s physician is contacted immediately. The patient and physician usually discuss the results at a later date.
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Exercise Stress Test
What is a clinical stress test?
A clinical stress test is the assessment of a patient’s ability to tolerate increasing intensities of exercise while an electrocardiogram (EKG), blood pressure and symptomatic responses are monitored. Ultrasound images or myocardial perfusion imaging can also be used in order to increase the sensitivity of the stress test.
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How does a stress test work?
While monitoring the EKG, blood pressure and symptomatic responses, the patient is subjected to physical stress. Typically this is in the form of standard, graded exercise on a treadmill. For patients unable to exercise, a medicine can be given that increases the heart rate and substitutes for physical exercise. During this period of physical stress, heart problems can often be detected.
Why take an exercise stress test?
A stress test can provide valuable information about several medical conditions, including:
- Coronary artery disease. If the heart muscle isn’t getting enough oxygen, it is usually because of a critical blockage in one or more heart arteries. Oxygen demands created by the blockage may not be noticeable except during physical exertion.
- Electrical abnormalities. Heart rhythms that are too fast, too slow or irregular may be identifiable during a stress test.
- Peripheral vascular disease. An exercise test is often used to find out if there is adequate blood flow to the legs.
- Other exercise-related abnormalities. An exercise test can provide information about pulmonary disease and certain metabolic disorders.
- Functional capacities. A person’s fitness level or ability to do work can be revealed in an exercise test. This information can help a doctor trying to understand a medical problem.
Is it safe?
Complications associated with exercise testing are relatively rare. Knowing when not to perform the test and when to stop a test keep the incidence of complications to less than 1 percent.
What are the benefits?
Stress testing is a non-invasive, low-risk test that can provide lots of information about various disease processes. By placing a patient under physical stress, a disease that may be hidden while the heart is at rest can often be uncovered.
What are the limitations?
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How soon will you know the test results?
Your doctor will be contacted immediately if serious abnormalities are found. Usually doctor and patient discuss the results at a later date.
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Nuclear Medicine Test
Checks Blood Flow to Heart
Myocardial perfusion imaging uses radioactive tracers to show blood flow (perfusion) to the heart muscle (myocardium)
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This imaging exam involves three steps:
1. Blood flow is tested while the heart is at rest
An intravenous line (IV) is placed in the patient’s arm and a small amount of the radioactive tracer is injected. After a waiting period, the patient then lies flat on a bed and a gamma camera is positioned over the chest. The camera measures the radioactive gamma rays coming from the heart muscle.
2. The heart is put under stress.
To find out if the heart’s blood vessels are becoming blocked, a stress test is performed to dilate the vessels. If vessels are narrowed or blocked they do not dilate adequately, causing a restriction. This restriction limits the flow of blood to an area of the heart. Either an exercise treadmill or a drug called adenosine can be used to increase heart rate. At this point, a second radioactive tracer is injected into the patient’s IV.
3. Blood flow is tested while the heart is under stress.
Now the gamma camera takes a second set of images. They are compared to resting images to see how well blood flow is getting to the heart muscle.
Why do myocardial perfusion imaging?
- To investigate chest pain.
- To investigate arrhythmia.
- To assess the amount of heart muscle damage from a recent heart attack.
- To assess how well the heart is working before a major surgical procedure.
Is it safe?
The stress portion of test has some risks.
What are the benefits?
Myocardial perfusion imaging is a non-surgical, low-risk test that can provide lots of information about artery blockages in the heart. By placing a patient’s heart under physical stress, a disease hidden during the resting state may be uncovered.
How soon will you know the test results?
A physician will interpret the results on the day of your test, and the results will be sent to your doctor. Your doctor will discuss the results with you at a later time.
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