Echocardiography: An echocardiogram (echo) is an imaging test that uses sound waves (ultrasound). It gives your doctor information about the structures of the heart: the different chambers, heart valves, the flow of blood through the heart and how well the heart pumps. An echo is a safe and painless test.
A transesophageal echocardiogram (TEE) is a test that enables doctors to obtain images of the heart from inside the esophagus (the tube that goes from the mouth to the stomach). Since the esophagus lies close to the heart, the TEE allows very clear images of the heart structures and blood flow. This is done at the hospital.
Stress Echocardiography: This test is a combination of an exercise treadmill test and an echocardiogram (ultrasound) of the heart. An echocardiogram will be performed before and after you walk on a treadmill. The test will take approximately one hour.
Holter and Event Monitoring: Holter and event monitoring are two ways to record your heartbeat when you are away from the doctor’s office. The “monitor” is a small “EKG” machine that you carry with you. The monitor records your heartbeat for the doctor to review at a later time. A Holter Monitor records your heartbeat for 24 hours, while an Event Monitor is a 30 day recorder.
Carotid Duplex Scan: This is a painless test using ultrasound waves to evaluate the arteries of the neck that provide blood flow to the brain. The ultrasound technician uses a probe with some gel and rubs it on your neck. This is a painless test.
Arterial and venous duplex scans are painless tests using ultrasound waves to evaluate the arteries and/or veins of the legs or arms. Your doctor may ask you to have this test if he feels you are at high risk for blockages in these arteries or if you have been experiencing pain in your calves when you walk, which would make it difficult for you to walk any distance.
This is a simple test that helps the doctor determine a possible cause for fainting spells. It determines how your body responds to changes in position. During the test, you lie on a table that can be moved to nearly upright position while your symptoms, heart rate, and blood pressure are monitored. This is done at the hospital.
Nuclear Cardiac Imaging: This test provides information on the blood supply to the heart. It tells us if you have had a previous heart attack or problems with blood supply to the heart. This test combines exercise on a treadmill with nuclear imaging. Allow approximately 3 1/2 hours for the entire test. DO NOT USE CAFFEINE (No coffee, tea, pop or chocolate, including decaffeinated products), 24 HOURS PRIOR TO YOUR TEST.
Pharmacological Stress Testing: This test provides information on the blood supply to the heart. It tells us if you have had a previous heart attack or problems with blood supply to the heart. This test requires no exercise. Medication (Persantine) will be given through an IV. This test will take approximately 3 1/2 hours. DO NOT USE CAFFEINE
(No coffee, tea, pop or chocolate, including decaffeinated products), 24 HOURS PRIOR TO YOUR TEST.
Pacemaker Implantation: If your cardiologist diagnoses a problem with your heart’s electrical system, he may suggest a pacemaker. These small electronic devices keep track of your heartbeat and when called upon, will generate an electrical signal similar to the natural “pacemaker” of the heart. These signals help keep your heart at a regular rate, and can increase the rate when called upon, such as during exercise. Depending on your problem, you may get a pacemaker with one or two leads. The leads are positioned into the upper and/or lower chamber of the heart.
Evaluation and Management: To care for your pacemaker, you will be asked to see your doctor or pacemaker clinic (in the doctor’s office) for regular visits. During these appointments, the pacemaker battery and functions are checked, and the settings can be adjusted. Pacemakers last approximately 5-7 years, and replacement is usually a simple procedure.
Electrophysiologic Study: While cardiac catheterization studies the arteries, electrophysiology studies (EPS) study the electrical system of the heart. People who have intermittent fast or slow heart rates, irregular rhythms, dizziness or fainting spells may require an electrophysiology study. The procedure is done like a cardiac catheterization. A thin tube called a catheter is introduced into a vein in the groin and advanced to different electrical areas of the heart. This will determine if there are any problems and how to treat these abnormal heart rhythms.
If your cardiologist determines there is a problem with the electrical system of your heart, (through an electrophysiology study) and medication does not correct the problem, an ablation may be a treatment offered to you. This procedure uses catheters that are introduced into a vein in the groin, and advanced to an area where the electrical “problems” are located. These catheters destroy the electrical cells that are causing heart rhythm problems.
Implantation of Cardiac Defibrillators (AICDs): An implantable cardiac defibrillator is a small electronic device that is similar to a pacemaker, but also has the capability of restoring a lethal heart rhythm back to a normal heart rhythm and rate. You will be followed in the doctor’s office on a regular basis, to have your ICD checked for battery status and any stored abnormal rhythms that may require a change in medication or settings of the device.
Cardiac Catheterization: A catheter (a long, thin tube) is inserted into a large artery (usually from the groin) and advanced to the arteries of the heart. Contrast is injected through the catheter into the arteries of the heart while a series of x-ray images are recorded. This allows visualization of the arteries and any blockages that may be present. Pressures can also be recorded from different chambers of the heart to obtain information about the heart valves and overall heart function.
Coronary Balloon Angioplasty: When a blockage in any of the arteries of the heart is identified during a heart catheterization, many considerations are taken in regards to “mechanical fixes”. One of the options for treatment is a percutaneous balloon angioplasty (PTCA). A balloon is placed at the location of the blockage and inflated. This pushes the cholesterol buildup up against the wall and restores greater blood flow through the artery.
Stenting is another option in the “mechanical fix” treatments for blockage(s) in the arteries of the heart. The stent is a metal mesh that is delivered to a blocked artery through a balloon. The device is placed at the blockage, the balloon is inflated, which opens the stent. This pushes the cholesterol buildup against the wall of the artery and the stent reduces the chances that the blockage will come back.
Atherectomy:This procedure is another “mechanical fix” treatment for blockage(s) in the artery of the heart. Coronary balloons and stents push the cholesterol buildup against the artery wall, and an atherectomy device actually “cuts” out the blockage in order to increase the blood flow through the artery.