Non-Invasive Diagnostic Services
We are pleased to offer the following tests for initial evaluation and follow-up of cardiac and vascular illness. Most all tests can be provided in the office setting on the day of the request or within one to three days after testing.
Purpose
An echocardiogram is a non-invasive ultrasound exam helpful in the diagnosis of multiple forms of heart disease. Two-dimensional images allow evaluation of the severity of valve disease, chamber size measurement, and calculation of ejection fraction.
Preparation
The exam takes approximately one hour and requires no special preparation by the patient. Patients should wear loose, comfortable clothing.
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Purpose
This exam evaluates carotid blood flow and possible causes of stroke or transient ischemic attack.
Preparation
The exam takes about 1 hour. It requires no specific prep and no special clothing.
Purpose
The abdominal vascular exam is a non-invasive exam helpful in diagnosis of abdominal aortic aneurysm and evaluation of abdominal bruits.
Preparation
The exam takes 1-2 hours. Patients must fast for an 8-hour period prior to testing. Loose fitting, comfortable clothing is suggested.
Purpose
This arterial exam is a non-invasive exam helpful in evaluation of arterial insufficiency. At-rest ankle brachial pressures are obtained, as well as post exercise, to evaluate physiologic changes in pressure.
Preparation
The exam takes 30 minutes. No special preparation is required, although it is helpful for patients to wear shorts.
Purpose
This arterial exam is a non-invasive exam helpful in evaluation of arterial insufficiency. Ultrasound is used to determine the location and severity of disease. At-rest ankle brachial pressures are obtained, as well as post exercise, to evaluate physiologic changes in pressure.
Preparation
The exam takes 1½-2 hours. Patients may have a light meal prior to testing. Loose fitting, comfortable clothing is suggested
Purpose
Venous study is helpful in locating deep venous thrombosis (vein clot)
Preparation
This exam takes 1-1½ hours and requires no special preparation.
Cardiac Stress Evaluation
Purpose
Exercise Treadmill is useful in the diagnosis of exercise-induced cardiac ischemia and aids in evaluating therapy. Patients are exercised on an incline treadmill to reach peak tolerance. Vital signs and EKG are closely monitored during this test.
Preparation
Exercise Treadmill Testing takes 1 hour. Heart rate, blood pressure, and ECG are closely monitored throughout the exam. Nothing to eat 3 hours prior to the test, except water which is encouraged. Beta blockers and other medications, as instructed, should be withheld for 24 hours prior to the test. Patients are advised to wear loose fitting clothing and comfortable walking shoes.
Purpose
This test can detect cardiac muscle damage or conditions that may lead to damage through the injection of a small amount of heart-sensitive radioisotope. The heart is subsequently imaged with a special camera. Images are obtained at rest and after treadmill exercise stress testing. For those patients unable to exercise, the drug Persantine can simulate exercise by increasing the patient heart rate and blood pressure.
Preparation
The test takes approximately two hours. Preparation for the exam requires that beta blockers, Viagra, and other medications, as instructed, be withheld for 24 hours prior to the exam. Patients must avoid caffeine and decaf products for 24 hours prior to testing. Nothing orally, except water, 4 hours prior to the test.
Purpose
Stress Echocardiogram is a non-invasive ultrasound combined with exercise treadmill examination, used to diagnose wall motion abnormalities resulting from ischemic disease. In addition, the viability of damaged heart muscle, regurgitant lesions, and intracardiac pressures can be evaluated.
Preparation
Stress Echo takes about 1 hour. Heart rate, blood pressure, and ECG are closely monitored throughout the exam. Nothing to eat 3 hours prior to the test, except water which is encouraged. Beta blockers and other medications, as instructed, should be withheld for 24 hours prior to the test. Patients are advised to wear loose fitting clothing and comfortable walking shoes.
Purpose
As an alternative to Stress Echo, Dobutamine Echocardiography is a non-invasive stress ultrasound useful in patients who are unable to exercise. This examination uses Dobutamine, and occasionally atropine, to pharmacologically increase the patient’s heart rate.
Preparation
The exam takes approximately 2 hours. Heart rate, blood pressure, and ECG are closely monitored throughout the exam. Beta blockers, Viagra, and other medications, as instructed, should be withheld for 24 hours prior to the exam. Nothing orally, except water, 4 hours prior to the test. Patients should wear loose, comfortable clothing.
Cardiac Rhythm Evaluation
12 lead electrocardiogram to evaluate resting abnormalities in heart rhythm and cardiac status.
The King of Hearts Monitor selectively records heart rhythm as patient symptoms occur. Patients manually trigger recordings. Worn for a two-week period, this method is appropriate for infrequent symptoms. The monitors are designed for telephone transmission of ECG tracings over an extended period of time.
This monitor provides continuous tracking of cardiac rhythm for changes correlating with patient symptoms. Worn for 24 hours, the Holter Monitor is the best choice for symptoms that occur frequently.
Prescribed for follow-up of pacemaker and defibrillator function. A transmitter is supplied to the patient, who is contacted on a regular basis for pacemaker checks.
Invasive Diagnostic / Therapeutic Services
General Information
We are pleased to offer the following tests for invasive evaluation and therapy for specific illnesses. All invasive tests must be performed in an approved, outpatient or inpatient cardiac catheterization suite. They can be scheduled after consultation with one of our physicians to perform the appropriate diagnostic or therapeutic procedure in a variety of convenient locations. Not all procedures are available at all locations, nor are all procedures covered by insurance at all locations. Insurance approval and scheduling can be done through the office at the time of consultation.
Invasive Catheterization Evaluation
Purpose
Cardiac catheterization is an invasive examination where after appropriate sedation and local anesthesia, catheters are threaded from an arm, neck, or leg artery and/or vein into the heart and great vessels to measure pressures and/or oxygen content within that cardiac chamber or vessel.
Preparation
This examination usually requires approximately 30 minutes. It requires arrival at the appropriate facility approximately 90 minutes before the scheduled exam with the patient fasting for four to six hours prior to the test. Aspirin and other platelet inhibitors are not normally restricted prior to the exam, but other forms of anticoagulation may be restricted and the patient must check with the physician prior to the test for specific instructions. Appropriate gowns and clothing will be provided during the test. Iodine or shellfish sensitivity should be brought to the attention of the healthcare providers before the test is performed.
Purpose
This invasive examination occurs with the injection of iodine-based contrast dye into the artery to further outline and detect vascular abnormalities in that vessel.
Preparation
Angiography is performed as part of cardiac catheterization when appropriate. No other special preparation beyond that described for cardiac catheterization is needed.
Purpose
This invasive examination involves placement of catheters within the heart to assess the electrical system function of the heart. Attempts to provoke an abnormal cardiac rhythm with pacing, intravenous medication, etc. may be attempted concomitantly.
Preparation
This examination normally requires approximately 60-120 minutes. It must be done in an approved facility with specialized technician training and equipment. Patient preparation is similar to that for cardiac catheterization (refer to Cardiac Catheterization Preparation above)
Purpose
This examination involves placement of a scope through the pharynx after appropriate sedation and anesthesia to then image the heart and great vessels with the use of ultrasound. It is done to assess valve function, cardiac muscle
function, possible cardiac tumors or masses, etc.
Preparation
This test can be performed on an in or outpatient basis. It requires arrival approximately 60 minutes prior to the test in an outpatient facility. The patient must be fasting for at least 8 hours prior to the test. No other special preparation or clothing is required. No medications need be held prior to the examination.