Tests and Procedures

Information

Using ultrasound technology, an echocardiogram captures sound waves that are recorded as computer images. These images are interpreted by a board certified Cardiologist.

Why is this needed?

An echocardiogram is performed before stress and immediately afterwards to assess cardiac function and determine if there are any blockages present.

Preparation

No preparation is needed for this procedure.

Time Needed

The procedure takes about an hour. If you have a visit with a cardiologist after this test, plan on being with us about 90 minutes.

Information

• During the procedure, two large pads which stick to the skin on the surface of the chest are placed. Once the patient is sedated and comfortable an electric current (“shock”) is passed through the pads that converts the heart back to a normal electrical rhythm.
• The procedure is usually highly successful at restoring normal heart rhythm (sinus rhythm.)

Why is this needed?

• This procedure is used to restore the heart back to a normal rhythm if a patient is having a persistent heart rhythm disorder such as atrial fibrillation or flutter.

Preparation

• You will be asked not to eat or drink after midnight on the evening prior to the procedure.
• You may take all of your normal medications prior to the procedure, unless directed otherwise by your cardiologist or the team performing the procedure.
• You will be asked to remove your shirt and/or bra prior to this procedure and change into a gown.
• We recommend urinating just prior to this procedure so that you are comfortable during the procedure.

Time Needed

• A cardioversion typically takes 30-45 minutes to complete.
• Patients are typically on blood thinners prior to this procedure. If the patient hasn’t been on a blood thinner long enough prior to the procedure, occasionally a transesophageal echocardiogram (TEE) may be required before the cardioversion is performed. This can add an additional 60 minutes to the total procedure time.

Information

An echocardiogram is a study of the heart’s structure and function Using ultrasound technology high frequency sound waves are transmitted from a hand-held wand (like a microphone) placed on your chest at certain locations and angles. The sound waves “echo” off the heart’s structures and are sent to the computer, which interprets the echos into images (pictures) of the blood flow across the heart valves. The images help your cardiologist evaluate the structure and pumping action of the heart.

Watch our video about Echocardiogram play_circle_outline

Why is this needed?

An echocardiogram helps to diagnose many types of heart disease, including the following:

• Atherosclerosis (Coronary Artery Disease)
• Aneurysm (Bulging Vessel)
• Cardiomyopathy (Heart Muscle Disease)
• Heart Failure (Heart Muscle Weakness)
• Pericarditis (Infection)
• Valvular Heart Disease (Structural Defect)
• Left Ventricular Hypertrophy (Enlargement)
• Congenital (birth) Heart Disease

An echocardiogram may be done to evaluate signs or symptoms of the conditions above and/or problems with the heart such as abnormalities in motion of the heart wall, blood clots, and heart valve abnormalities. It also measures the strength of the heart muscle (ejection fraction).

Preparation

• There is no particular preparation needed prior to this procedure.
•  You should take all of your normal medications as prescribed before this procedure.
•  You will be asked to remove your shirt and bra if applicable, prior to this procedure.
•  We recommend urinating just prior to this procedure so that you are comfortable during the procedure.

Time Needed

The procedure takes about an hour. If you have a visit with a cardiologist after this test, plan on being with us about 90 minutes.

Information

This procedure assesses evidence of arrhythmias - either the heart beating too fast or too slow.  It captures every heart beat for the entire time the device is worn which is usually 24 to 48 hours, but can be worn for up to 7 days.

Watch our video about Holter Monitor play_circle_outline

Why is this needed?

Your doctor uses information captured on the Holter monitor to figure out if you have a heart rhythm problem. If standard Holter monitoring doesn't capture your irregular heartbeat, your doctor may suggest a longer-term monitor, which can record your heartbeat over several weeks.

Preparation

No preparation is needed for this procedure.

Time Needed

Placing the monitor takes about 10 minutes, however you must leave it on for the duration of the time your doctor recommends. It cannot be removed until you are done with the recording period.

Information

• This device requires inserting a small probe under the surface of the skin next to the breastbone using a syringe-like delivery device and a small “poke” or incision to place the device under the skin.
• The device requires only a small needle injection of a small amount of numbing medication into the skin where the device will be placed, and usually takes only a few minutes to place.
• Once healed, the device is usually difficult to see or feel and leaves minimal to no scar. where the device is placed.
• The device has a battery life of about 3-4 years, and can be removed through a similar procedure to the placement procedure.
• The device is slightly larger than a matchstick.
• The device reports back via a cellular phone-like mechanism to our central monitoring center to provide constant updates on any presence of a heart rhythm issue.

Why is this needed?

This procedure is used to monitor for episodic heart rhythm issues that occur too infrequently to be captured on a standard wearable device.

Preparation

No preparation is needed for this procedure.

Time Needed

This procedure takes about 20-30 minutes in total.

Information

• This test utilizes a small dose of a radioactive material (isotope) injected through an IV which flows in the blood stream and is “taken up” (absorbed) by the muscle in the heart.
• While the patient lies on their back on a bed (much like as if they were undergoing an x-ray) images of the heart are captured and recorded.
• The amount of radioactive material “taken up” by each area of the heart is then measured by a computer.
• This procedure determines if there is blockage in the arteries of the heart by how much radioactive material that area “takes up.”
• A “stress” component of this test can be accomplished via exercise on a treadmill or using a medication to simulate exercise.
• Please click on nuclear stress test for important information.

Watch our video about Nuclear Stress study play_circle_outline

Why is this needed?

• This test utilizes a small dose of a radioactive material (isotope) injected through an IV which flows in the blood stream and is “taken up” (absorbed) by the muscle in the heart.
• While the patient lies on their back on a bed (much like as if they were undergoing an x-ray) images of the heart are captured and recorded.
• The amount of radioactive material “taken up” by each area of the heart is then measured by a computer.
• This procedure determines if there is blockage in the arteries of the heart by how much radioactive material that area “takes up.”
• A “stress” component of this test can be accomplished via exercise on a treadmill or using a medication to simulate exercise.
• Please click on nuclear stress test for important information.

Preparation

No preparation is needed for this procedure.

Time Needed

The procedure takes about an hour. If you have a visit with a cardiologist after this test, plan on being with us about 90 minutes.

Information

This is a specialized ultrasound of the heart which involves sedating the patient and placing a thin ultrasound probe through the mouth and down through their swallowing tube (esophagus.) As the esophagus lies against the back wall of the heart, this vantage point allows the capture of very high resolution ultrasound images of the heart’s anatomy. It also allows visualization of structures that may not be well seen by an ultrasound performed from the skin’s surface.

Why is this needed?

Transesophageal echocardiograms are most commonly used to evaluate heart valves prior to surgery, to look for infection of a heart valve (endocarditis) or to assess for blood clots inside the heart.

 Like a standard echocardiogram, a transesophageal echocardiogram also evaluates all chambers of the heart and the function of all 4 valves inside the heart. It also allows for enhanced visualization of the vessels coming into and leaving the heart.

Preparation

• We ask that patients do not eat or drink anything after midnight prior to their procedure.
•  You should take all of your normal medications as prescribed before this procedure. You can take pills with sips of water as needed.
•  You may be asked to remove your shirt and bra if applicable, prior to this procedure.
•  We recommend urinating just prior to this procedure so that you are comfortable during the procedure.

Time Needed

The procedure usually takes about 60-90 minutes. You will need someone to drive you home after the procedure due to the need for sedation. You will be discharged to home, usually within 1-2 hours after the procedure is complete.