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Cardiac Diagnostic Screenings and Tests

Echocardiogram or Cardiac Stress Test with Echocardiogram

echocardiogram patient

An Echocardiogram (or cardiac ultrasound) is an ultrasound of the heart. It measures blood flow through the heart and also enables physicians to view the heart valve structure and heart wall function. It is helpful in determining heart size and ventricular function. Echocardiography can also detect heart clots and damage after a heart attack. It is often used in conjunction with Doppler ultrasounds.

A Stress Echocardiogram consists of an Echocardiogram, which produces images of the heart including the heart valves before and after exercise. You will have an Echocardiogram and exercise, immediately followed by another Echocardiogram. This will evaluate your heart’s response to exercise and will demonstrate abnormalities in heart wall motion.

Why have an Echocardiogram?

  • Size of the chambers
  • Dimension of each cavity
  • Thickness of the walls
  • Pumping power

Echocardiography is used to study the heart and surrounding structures and to detect life-threatening cardiovascular disorders. This information helps provide an accurate assessment of the heart's true functionality.

About the Procedure:

The patient lies on an exam table while a technologist moves a transducer over the chest and heart region. A small amount of gel is applied during this procedure. The patient will be asked to lay still, change positions or hold your breath.

Patients Can Expect:

  • The exam should take approximately 30 to 45 minutes to complete.
  • These tests are painless and non-invasive.
  • Some prior preparation may be needed. Your doctor will inform you beforehand.

What to Bring:

  • Physician referral form
  • Current medical insurance card
  • Driver’s license or other government-issued identification
  • Wear comfortable clothing. (Avoid metal straps, buttons, zippers)

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EKG

An electrocardiogram (EKG or ECG) is a test that checks for changes in the heart while the patient exercises. Sometimes ECG abnormalities can be seen only during exercise or while symptoms are present.

During the test, specialists monitor the heart while the patient exercises on a treadmill or a stationary bicycle. Small disks, called electrodes, are applied to the patient’s chest and are connected to wires called leads. The leads are connected to a monitor that records the electrical activity of the heart. The level of exercise is gradually increased to see how the patient’s heart responds to exercise.  

An ECG is done to help find the cause of chest pain or other symptoms, and to determine treatment plans for people with heart problems. Sometimes cardiologists perform the test without exercise. This may involve medication that has the same effect on the heart as exercise.

Patients can expect:

  • Some prior preparation, including no food or fluid for a minimum of 4 hours before the test.
  • No food or drink items containing caffeine (coffee, tea, chocolate, cola) for at least 12 hours before the test.
  • The patient may be advised to stop taking certain medications before the test.

What to Bring:

  • Physician referral form
  • Current medical insurance card
  • Driver’s license or other government-issued identification
  • Wear comfortable clothing. (Avoid metal straps, buttons, zippers)

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Holter Monitor

Holter Monitoring is a 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 while carrying out their usual daily activities. Holter monitoring is used to help determine whether someone has an otherwise undetected abnormal rhythm (cardiac arrhythmia), or inadequate blood flow through the heart.

Event/MCT Monitoring - Event monitors (or mobile cardiac telemetry) are similar to Holter monitors in that they monitor and record a patient's heart rhythm. Event/MCT monitors are worn for up to 30 days, however, because your physician wants a longer monitoring period. You can perform all your normal daily activities with an Event/MCT monitor, but they must be taken off for showers, bath, pool, hot tub, etc. Staff will instruct you how to remove and re-attach the electrodes and leadwires, and other basic maintenance. Event/MCT monitors transmit heart rhythm data to a monitoring center throughout each day, so if an arrhythmia is detected, your physician will be alerted usually within a few hours.

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Stress Testing - Cardiac Exercise or Treadmill

Exercise Stress Test-- During this test, specialists monitor the heart while the patient exercises on a treadmill. Small disks, called electrodes, are applied to the patient's chest and are connected to wires called leads. The leads are connected to a monitor that records the electrical activity of the patient's heart (EKG). The level of exercise is gradually increased to see how the patient's heart responds to exercise.

Preparation for testing: Once your physician has ordered the test and received authorization from your insurance carrier, you will be notified of some additional preparation.

Please note: For all these types of stress tests, it is required that patients should have nothing by mouth (food or fluid) for a minimum of 4 hours before the test.

It is also very important that you do not eat or drink items containing caffeine (coffee, tea, chocolate, cola) for at least 12 hours before the test. Consult with your physician for definitive preparation instructions. Caffeine can interfere with test results. This includes decaffeinated coffee or tea, since they do contain small amounts of caffeine. You may also need to stop taking some medications before the test, so be sure to let your doctor know in advance about any medications you are taking.

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Stress Testing - Cardiac Pharmacologic

Pharmacologic Stress Tests-- If a patient is physically unable to exercise, the staff can give the patient a medication that has the same effect on the heart as exercise. The patient wears the same electrodes for the EKG as described above so that doctors can monitor the way the heart performs under the conditions of the drug.   Pharmacologic stress testing is always done with either Nuclear or Echocardiogram imaging (see below) and simply substitutes medicine stress for treadmill stress.

Preparation for testing: Once your physician has ordered the test and received authorization from your insurance carrier, you will be notified of some additional preparation.

Please note: For all these types of stress tests, it is required that patients should have nothing by mouth (food or fluid) for a minimum of 4 hours before the test.

It is also very important that you do not eat or drink items containing caffeine (coffee, tea, chocolate, cola) for at least 12 hours before the test. Caffeine can interfere with test results. This includes decaffeinated coffee or tea, since they do contain small amounts of caffeine. You may also need to stop taking some medications before the test, so be sure to let your doctor know in advance about any medications you are taking.

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Stress Testing - Nuclear Medicine

A Nuclear Cardiac Stress Test measures blood flow to your heart muscle at rest and during stress. It is performed similar to a routine exercise stress test but provides images in addition to those of an electrocardiogram. During a nuclear stress test, a radioactive substance is injected into your bloodstream. This substance mixes with your blood and travels to your heart. A special scanner — which detects the radioactive material in your heart — creates images of your heart muscle. Inadequate blood flow to any part of your heart will show up as a light spot on the images — because not as much of the radioactive substance is getting there.

Preparation for testing: Once your physician has ordered the test and received authorization from your insurance carrier, you will be notified of some additional preparation.

Please note: For all these types of stress tests, it is required that patients should have nothing by mouth (food or fluid) for a minimum of 4 hours before the test.

It is also very important that you do not eat or drink items containing caffeine (coffee, tea, chocolate, cola) for at least 12 hours before the test. Caffeine can interfere with test results. This includes decaffeinated coffee or tea, since they do contain small amounts of caffeine. You may also need to stop taking some medications before the test, so be sure to let your doctor know in advance about any medications you are taking.

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