Diagnostics and Testing: Clinical Services

Cardiac Catheterization (Left and Right Heart)
Used to see the structure and function of the heart as well as any blockages in the arteries that feed the heart (called coronaries). A catheter (a long, narrow, flexible tube) is inserted through a blood vessel in the arm or groin and guided to the heart. A dye is injected through the catheter causing the blood flow through the coronary arteries to show up on X-rays.
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Coronary Artery Calcium Scoring (CAC Score)
Used to assess the amount of calcium in the arteries that feed the heart (coronaries). A quick CT scan of the heart is done with minimal radiation. Scoring software then provides a number that is related to the amount of calcium. Calcium proves the presence of atherosclerosis (plaque build up) and can help guide treatment. The higher the score the greater the risk of heart problems.
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Coronary CT Angiography (CCTA)
A dye is given through an IV and then a high speed CT scanner is used to take pictures of the heart. This test can provide images of the coronaries (the arteries that feed the heart) similar to cardiac catheterization (see above) without entering the arteries. It is often used in patients whose stress test findings are unclear or to assess cardiac structures and anatomy better.
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Contrast Echocardiogram
A dye is injected through an IV. High frequency sound waves are then used to produce a moving picture of the heart. This technique is used to improve the images obtained using ultrasound to improve the accuracy of the test.
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Dobutamine Stress Echocardiogram
A combination of an echocardiogram and a stress test. A medication called Dobutamine is given through an IV to produce an effect on the heart similar to exercise. The echocardiogram produces moving pictures of the heart to see the structure and function of the heart as well as the flow and direction of the blood. This is often used in individuals who are unable to exercise on a treadmill.
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Echocardiogram
Used to check the structure and function of the heart as well as the flow and direction of the blood. High-frequency sound waves are used to produce moving pictures of the heart.
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Electrocardiogram (EKG, ECG)
Used to measure the rate, rhythm, and type of heartbeat while lying still. Small patches (electrodes) are placed on the chest, legs and arms. Wires are connected to the patches and an electrical recording is taken.
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Electrophysiologic Studies (EPS)
Used to check the electrical system of the heart to determine causes of abnormal heart rhythms. Special catheters (small tubes) are inserted through a vein in the groin and guided into the heart. The catheters contain wires used to record the heart's electrical activity and may be used to stimulate areas of the heart muscle.
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Endomyocardial Biopsy
A special catheter is inserted in a vein and guided to the heart. Then a very small tissue sample is taken from the heart muscle. This test is often used in heart transplant patients or in patients with some types of heart failure where the cause is unclear.
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Event Monitoring
Patches (electrodes) are placed on the skin, and wires are connected to them. The wires connect to a small recorder carried by the patient like a pager. When symptoms occur, the patient activates the device and the electrical activity of the heart is recorded and stored. The information can then be sent over the phone to a monitoring station that can match the patient's symptoms to the EKG activity. The device can be kept for 30- 60 days and can be removed for showering, etc.
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Exercise Stress Echocardiogram
A combination of an echocardiogram and treadmill stress test. An echocardiogram is done before and immediately after exercise to compare the structure and function of the heart.
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Holter Monitoring
The heart's electrical activity is recorded over a 24-hour period to measure the rate, rhythm and type of heartbeat. Patches (electrodes) are placed on the skin, and wires are connected to them. The wires connect to a small recorder carried over the shoulder or around the waist, and the patient is asked to keep a diary of activity while wearing the monitor.
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Intravascular Ultrasound (IVUS)
A special catheter is inserted in a blood vessel and guided to the heart. High-frequency sound waves are used to see the inside of these vessels. This is often used during attempts to open blocked arteries to obtain better results.
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Implantable Loop Recorder
A small device with a battery life of 18-24 months is placed under the skin below the collarbone to evaluate the heart's rhythm during symptoms. The patient is given an activator and instructed on use during symptoms. Once the Loop Recorder is activated the information can be retrieved utilizing a programmer in the office.
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Non-Invasive Vascular Testing or NIVL
High frequency ultrasound is used to look for problems in arteries and veins in the neck, arms, legs, and abdomen. These tests are often used in patients with PAD (Peripheral Arterial Disease).
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Nuclear Isotope Adenosine Testing
Used to check the blood supply to the heart muscle. A radioactive substance is given through an IV before and after receiving an IV medication called Adenosine. A special camera is used to take pictures of the heart muscle. This test is used with people who are unable to walk on a treadmill.
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Nuclear Isotope Exercise Testing
Used to evaluate the blood supply to the heart muscle. A radioactive substance is given through an IV before and after exercise. A special camera is used to take pictures of the the heart muscle. Exercise consists of walking on a treadmill with continuous monitoring of heart rhythm and blood pressure.
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Peripheral CT Angiography (CTA)
An dye is given through an IV and then a CT scanner is used to take pictures of the arteries in the head, neck , abdomen, pelvis or legs depending upon the area of concern. This allows a non-invasive way of looking for problems in blood vessels and to help plan treatment of blockages or aneurysms (enlargements or swellings).
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Tilt Table Test
Used to help determine the reason for a patient passing out or nearly passing out. The patient lies down on a special table. The table is tilted to a standing position for up to a 20 minute interval while symptoms are checked. Heart rate and blood pressure are continuously monitored throughout the procedure. The test may be repeated after an IV injection of a medication called Isuprel, which has an effect on the heart similar to that of exercise.
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Transesophageal Echocardiogram
A narrow probe is placed into the esophagus (the tube that goes from the mouth to the stomach) to obtain ultrasound images of the heart. Since the esophagus is very close to the heart, this test allows very clear pictures of the heart muscle and valves to be taken. Sedatives are given for patient comfort. On rare occasions, anesthesia is sometimes required.
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Treadmill Stress Testing
Also called a stress test or graded exercise test. The patient walks on a treadmill while monitored by a 12-lead EKG. Blood pressure response and symptoms with exercise are also recorded. This test is frequently combined with imaging (such as nuclear or ultrasound) to improve accuracy.
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