Du Cardiology does most testing in the office. We also coordinate with outside facilities to provide advanced imaging and diagnostic testing as tools to aid in detection of disease.
EKG
Perhaps the most common heart screen test performed is the EKG. This test is used to determine heart rate, rhythm and if any heart damage has occurred. It produces a graph of the heart’s electrical pulse which can be read by your cardiologist to decide what treatment or further testing may be needed.
Echocardiogram
An echocardiogram, often referred to as an “echo,” uses high frequency sound waves to produce images of the heart. This test allows your physician to evaluate the structures of your heart, including the muscle, valves, and pericardium.
Pre-Procedure Instructions
Take your normal medications on the day of your echocardiogram. Do not use powders, oils, or lotions on your chest or abdomen on the day of your exam. Wear a two-piece outfit (no dresses). A gown will be provided.
During the Test
You will be asked to remove your clothing from the waist up and wear a gown. Three electrodes (small stickers) will be placed on your chest and upper abdomen to monitor your heart’s electrical activity during the exam. The ultrasound transducer (a small, hand-held wand) with gel on the end will be rubbed across your chest in several areas. You will be asked to change positions to assist in obtaining different images of your heart. Most of the test is typically performed as you lay on your left side with your arm resting on the pillow by your head. You may be asked to hold your breath at times during the exam. You should not feel any major discomfort during an echocardiogram. Some slight discomfort is occasionally felt from the pressure of the transducer on your chest. An echocardiogram generally takes from 30-45 minutes to complete.
Post-Procedure
After your test is complete, you may get dressed and return to normal activities immediately. Before you leave, you will be scheduled to receive your results from your physician.
Stress Echocardiogram
A stress echocardiogram, often referred to as a “stress echo,” is the combination of an exercise stress test and an echocardiogram. It can be ordered if you have experienced chest pain, shortness of breath, dizziness, or palpitations. The doctor can evaluate the presence or absence of coronary artery disease with this combination of exercise and imaging.
Pre-Procedure Instructions
Do not eat or drink caffeinated products (coffee, tea, soda, or chocolate) for 24 hours prior to your test. Do not take medications called beta blockers for 24 hours prior to your test. Do not eat anything for 4 hours prior to your test. Wear a two-piece outfit (no dresses), and a gown will be provided.
During the Test
You will be asked to remove your clothing from the waist up and wear a gown. The ultrasound transducer (a small, hand-held wand) with gel on the end will be rubbed across your chest in order to obtain resting images of your heart. You will be asked to lay on your left side with your arm resting on the pillow by your head. You may be asked to hold your breath at times during the exam. Electrodes (small stickers) will be placed on your chest to monitor your heart’s electrical activity during the exercise portion of the test. Men may have portions of their chest shaved. After learning how to use the treadmill, you will begin several minutes of exercise. The treadmill starts at a slow pace and gradually increases in speed and incline as the test continues. You will continue on the treadmill until you have reached your target heart rate. It will be stopped immediately if you experience fatigue, shortness of breath, or chest pain. Your heart rate and blood pressure are monitored during and after the test. When you have reached your target heart rate, you will return to the exam table, lying on your left side, in order to obtain the stress images of your heart by ultrasound. You will continue to be monitored until your heart rate and blood pressure return to normal.
Post-Procedure
After your test is complete, you may get dressed and return to normal activities immediately. Before you leave, you will be scheduled to receive your results from your physician.
ETT/Cardiac Stress Test
This test involves walking on a treadmill or moving belt. During the test you will be attached to an Electrocardiogram ( ECG). This will record the electrical activity of your heart. You will also have your blood pressure recorded at regular intervals. The test has many stages, each lasting three minutes. The speed and incline of the treadmill will increase at each stage. An Exercise Tolerance Test is performed on people who have chest pains or symptoms of angina. A positive result will confirm a diagnosis of coronary artery disease. If the test is positive your cardiologist will then choose the next intervention necessary to confirm the extent of the coronary artery disease.
Cardiac Nuclear Medicine
By producing an image of the heart, radioactive “tracers” such as Myoview and Cardiolyte can increase the accuracy of a traditional stress test. Nuclear scanning of the heart shows how well blood flows to the heart muscle. It’s usually done in conjunction with an exercise stress test on a treadmill, but can also be performed using medicines such as adenosine or Lexiscan that effectively simulate the effects of exercise on the heart. Cardiac Nuclear Stress Imaging helps determine whether coronary artery stenoses (blockages) are so severe as to limit blood flow to the heart muscle when it needs it most… during physical activity. In addition, nuclear imaging allows a determination of the heart’s pumping function (ejection fraction).
When a patient reaches his or her maximum level of exercise, or after simulating exercise with medications, a small amount of tracer is injected into a vein. The patient then lies down on a table under a camera that detects the energy emitted from the radioactive tracer and generates pictures (or scans) that reflect the heart’s blood flow both at rest and following stress. If a portion of the heart muscle is under-perfused (doesn’t receive a normal blood supply), a deficiency of tracer activity in that area will appear on the finished images as a “defect”.
At Du Cardiology, resting pictures are first obtained using a Technetium agent. Next, stress is performed using treadmill exercise or medications (adenosine stress test). At the peak of exercise, Cardiolite is injected into the bloodstream to determine the heart’s blood flow during activity. Our “tracers” and methods are both widely used and quite safe. Cardiologist, nurses, and technologists with expertise in nuclear cardiology supervise and analyze these tests.
Abdominal Aortic Ultrasound
An abdominal aortic ultrasound is a non-invasive imaging procedure that uses high-frequency sound waves to produce images of your aorta, the largest artery in your body. Most aortic aneurysms produce no symptoms. Symptoms that can be present (often once the aneurysm is quite large) are chest, back, or abdominal pain or a pulsating feeling in the upper abdomen.
Pre-Procedure Instructions
Do not eat or drink anything after midnight prior to your exam. Take any morning medications with small sips of water. If you are diabetic, do not take your insulin or pills on the morning of the exam. Wear a two-piece outfit (no dresses).
During the Test
You will lie on your back with your abdomen exposed. Gel will be applied to your abdomen, and an ultrasound transducer (a small, hand-held wand) will be rubbed across your abdomen in order to obtain images of your blood vessels. You should not feel any major discomfort during an abdominal aortic ultrasound. Some slight discomfort is occasionally felt from the pressure of the transducer on your abdomen. An abdominal aortic ultrasound generally takes from 20-30 minutes to complete.
Post-Procedure
After your test is complete, you may wipe the gel off and return to normal activities immediately. Before you leave, you will be scheduled to receive your results from your physician.
Carotid Artery Ultrasound
A carotid artery ultrasound is a non-invasive imaging procedure that uses high-frequency sound waves to produce images of your carotid arteries, the arteries responsible for delivering oxygenated blood to your brain. A carotid ultrasound helps detect blockages of blood flow (caused by clots or plaque) and dissections (a split between the layers of the artery wall). This test can also be used to check the carotid artery after surgery or placement of a stent.
Pre-Procedure Instructions
Wear a shirt with an open collar (no turtlenecks). You may be asked to remove necklaces or dangling earrings.
During the Test
You will lie on your back. An ultrasound transducer (a small, hand-held wand) with gel on the end will be rubbed on each side of your neck in order to obtain images of your blood vessels. You may be asked to turn your head slightly in either direction to expose your neck. You should not feel any major discomfort during a carotid artery ultrasound. A carotid ultrasound generally takes from 20-30 minutes to complete.
Post-Procedure
After your test is complete, you may wipe the gel off and return to normal activities immediately. Before you leave, you will be scheduled to receive your results from your physician.
Peripheral Artery Ultrasound
A peripheral artery ultrasound is a non-invasive imaging procedure that uses high-frequency sound waves to produce images of the arteries in your arms or legs. A peripheral artery ultrasound helps detect blockages of blood flow (caused by clots or plaque), aneurysms (dilations of a weakened arterial wall), and dissections (a split between the layers of the artery wall). This test can also be used to check the arteries after arterial bypass surgery or placement of a stent.
Pre-Procedure Instructions
Take your normal medications on the day of your exam. Do not use powders, oils, or lotions on your legs on the day of your exam.
During the Test
You will be asked to remove your pants, and a sheet will be provided. You will lie on your back. Gel will be applied to each of your legs or arms, and an ultrasound transducer (a small, hand-held wand) will be rubbed on your skin in order to obtain images of your blood vessels. You may be asked to change positions in order to obtain images of each artery. You should not feel any major discomfort during a peripheral artery ultrasound. Some slight discomfort is occasionally felt from the pressure of the transducer. A peripheral artery ultrasound generally takes 50-60 minutes to complete.
Post-Procedure
After your test is complete, you may wipe the gel off and return to normal activities immediately. Before you leave, you will be scheduled to receive your results from your physician.