Services Provided by Cardiac Solutions

Cardiology Procedures

Heart ExamHeart Catheterization

What is heart catheterization?
Heart (cardiac) catheterization is a procedure in which a very thin flexible tube is inserted through a blood vessel into the veins, arteries, and chambers of the heart. The tube is called a catheter. It is usually inserted through a blood vessel in the arm, groin or neck.

Heart catheterization can:

What happens during the procedure?
You are given a sedative, which will you fell relaxed, but you will stay awake. You are also given a local anesthetic to numb the area where the catheter is inserted.

The doctor will insert the catheter through a small cut in the skin. The catheter is passed through the blood vessels toward the heart. X-rays are used to follow the position of the catheter. You will not feel the catheter as it passes through your blood vessels.

The health care provider will direct the tip of the catheter of precise positions in the heart and its blood vessels. The catheter is attached to a device that measures blood flow and blood pressure in various places in the heart and blood vessels.

If pictures of the heart chambers , valves, or coronary arteries are needed, a special kind of liquid (called contrast or dye) is injected through the catheter. During this injection, moving x-ray pictures are recorded. This procedure is called angiography.
When the procedure is finished, the health care provider will remove the catheter and apply pressure over the area where the needle was inserted to control any bleeding. The procedure takes about an hour.

Developed by Donald L. Warkentin, MD
For McKesson provider Technologies.

Coronary Intervention, PTCA Stent (Angioplasty)

What is angioplasty?
Angioplasty is a procedure in which your health care provider inserts a balloon catheter into a blocked artery to unblock the artery. The blocked artery may be anywhere in the body. If the blocked artery is a blood vessel that supplies blood to the heart, the procedure is called coronary angioplasty, or percutaneous transluminal coronary angioplasty (PTCA).

When is it used?
Arteries can become blocked or narrowed by plaque. Plaque is a buildup of fats, cholesterol, and other substances on the inside walls of the arteries.

Angioplasty is used to treat symptoms caused by:

Coronary angioplasty may be done during a heart attack to reduce heart muscle damage from the heart attack.

What happens during the procedure?
You will be given medicine to help you relax and a local anesthetic to numb the area where the catheter will be inserted. You will stay awake during the procedure.

Your doctor will put a catheter into a blood vessel in our arm or groin. A catheter is a very thin flexible tube into the narrowed blood vessel. Another catheter is advanced over the wire. This second catheter has a deflated balloon at the tip.

When the balloon reaches the narrow part of the artery, the doctor inflates the balloon. Inflating the balloon stretches the narrowed artery. The doctor then deflates the balloon and removes the catheter and balloon. The stretching of the artery greatly improves blood flow through the artery. Often a metal mesh device, called a stent, is left in the artery to improve chances that the blood vessel will stay open.

How can I take care of myself?

Developed by McKesson Provider Technologies.

Transesophageal Echocardiogram (TEE) Doctor Exam

What is a transesophageal echocardioagram?
A transesophageal echocardiogram (TEE) is a special test that uses sound waves and a computer to look at our beating heart. For this test, you swallow a device called a transducer, or probe. The transducer is carefully placed in your esophagus behind your heart. (The esophagus is the tube that caries food from the throat to the stomach.) The probe sends high-frequency sound waves to your heart. The sound waves bounce (echo) off your heart. A computer uses the echoes to create a moving picture of the heart.

Having the transducer in your esophagus allows ultrasound waves to create very clear moving pictures of your beating heart. The heart valves, chambers, blood vessels, and the heart muscle can be carefully measured and examined.

When is it used?
TEE is used to see parts of the heart that can’t be seen with a standard echocardiogram that uses a transducer on the outside of the chest. Because the probe is much nearer to your heart when it is inside you, rather than on the outside of your chest, the TEE gives much clearer pictures than a standard echocardiogram.

The most common reasons to use TEE are to diagnose infections of the heart valves (endocarditis), to identify small blood clots in the heart, and to find small holes in the heart that allow blood to pass between the two upper chambers of the heart the left atrium and the right atrium).

TEE maybe used to diagnose a problem called aortic dissection. The aorta is the large blood vessel leading from the heart to the rest of the body. This vessel sometimes develops a split or tear between the layers of its wall, allowing bleeding into the wall. If a large amount of bleeding occurs, it may separate the layers of the aorta and cause it to burst. This can have serious consequences, including death. The nearness of the transducer to the aorta allows your health care provider to get very good pictures of the aortic wall.

What happens during the procedure?
The TEE may be done in your health care provider’s office or as an outpatient procedure at the hospital. Your heartbeat and breathing will be checked. The back of your throat will be sprayed with local anesthetic, which will make y our throat numb and keep you from gagging. You will be given medicines that make you feel relaxed, but you will stay awake. The health care provider will then help you swallow the probe.

The procedure may be as short as a few minutes or last for a half hour or longer. The ultrasound waves from the probe are recorded for later review by the health care provider.

What are the benefits?
TEE can give information about your heart that is not available from any other test. Prompt treatment of a problem can improve your outlook.

Written by Donald L. Warkentin, MD
Published by McKesson provider Techonologies

CardioversionElectrical Cardioversion

What is electrical cardioversion?
Electrical cardioversion is used to make your heart beat normally by passing an electric shock through the chest to the heart. The electric shock is used most often to revive a person when the heart stops. It restores normal heart rhythm and has saved many lives. It is a very safe way to change an abnormal heart rhythm to normal.

The single, rapid, high-voltage electric shock to the hart causes all the heart muscle cells to stop beating for a moment. This allows your heart to restart itself with a normal heart rhythm. The heart then beats normally again. To be successful, the shock must be delivered at just the right time during a heartbeat.

When is it used?
Abnormal heart rhythms (arrhythmias), such as atrial tachycardia and ventricular tachycardia, may cause very rapid heart rates. The heart rate may be so fast that the blood does not circulate well. For some people with coronary artery of heart valve disease, this fast heartbeat may be life threatening. Cardioversion can quickly restore normal circulation.

Some other rhythm problems, such an atrial flutter or atrial fibrillation, are not very fast but are abnormal and inefficient. If you are having problems because of an abnormal heart rhythm, your doctor might suggest treatment to return the heart rhythm to normal. Medicine is sometimes used to try to return the heart to a normal rhythm. When drugs don’t work, your doctor might suggest cardioversion.

What happens during the procedure?
You will be given a tranquilizer and a sedative. These drugs will relax your muscles and put you to sleep. You will not feel pain during the procedure. The health care provider will put electrodes on your chest for a fraction of a second. The electrical charge passes through two large, hand-held electrode paddles or two large adhesive patches placed on your chest. Abnormal heart rhythms usually return to normal with the first shock, but more shocks may be needed. Your health care provider will check your heart rhythm with an electrocardiogram (EKG or ECG). Your will probably be unconscious from the anesthesia for less than five minutes and will not remember the shock.

What happens after the procedure?
You will be monitored in the recovery room or coronary care unit for a short time. Your chest might be a little sore, and may have ring-like marks on your chest where the electrode paddles were placed. These marks will fade after several days.

When you are fully recovered from the anesthesia, you will probably be allowed to go home. Sometimes you may need to stay in the hospital overnight. The health care provider may prescribe drugs to help you heart keep its new rhythm.

What are the benefits of having the procedure?
Your heart usually returns to a normal beat, reducing discomfort and abnormal work for your heart. The procedure has fewer complications than treatment with most drugs.

Peripheral AngiographyPeripheral Angiography

A peripheral angiogram or arteriogram is an examination of the peripheral arteries in your body, other than your coronary arteries. The peripheral arteries typically are those that supply the brain, the kidneys, and the legs. Peripheral angiograms are most often done to examine the arteries which supply blood to the head and neck, or the abdomen and legs. Arteries do not show up on regular x-rays, so during your angiogram you will receive a contrast dye which makes the arteries visible under x-ray.

Peripheral angiograms are done under local anesthesia. You will have an intravenous, (IV) catheter placed in your arm and you may be given a mild sedative. The procedure takes from one to three hours, and there will be time after the procedure during which you will be closely monitored. Many people can go home after the procedure but some need t stay in the hospital overnight for additional monitoring after an angiogram.

Renal Angiogram

What is a renal angiogram?
An angiogram, also called an arteriogram, is an x-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages.

A renal angiogram is an angiogram of the blood vessels of the kidneys. A renal angiogram may be used to assess the blood flow to the kidneys.

Fluoroscopy is often used during a renal venogram. Fluoroscopy is a study of moving body structures-similar to an x-ray “movie.” A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.

How is an angiogram performed?
In order to obtain an x-ray image of a blood vessel, an intravenous (IV) access is necessary so that a contrast dye can be injected into the body’s circulatory system. This contrast dye causes the blood vessels to appear opaque on the x-ray image, thus allowing the physician to better visualize the structure of the vessel(s) under examination.

Many arteries can be examined by an angiogram, including the arterial systems of the legs, kidneys, brain, and heart.

For a renal angiogram, IV access may be obtained through a large artery such as the femoral artery in the groin. Once the IV access is obtained, the contrast dye is injected and a series of x-ray pictures is made. These x-ray images show the arterial, venous, and capillary blood vessel structures and blood flow in the kidneys.

Other related procedures that may be used to diagnose kidney problems include kidney, ureters, and bladder (KUB) x-ray, computed tomography (CT scan) of the kidneys, kidney biopsy, kidney scan, kidney ultrasound, and renal venogram.

Reasons for the procedure.
A renal angiogram may be performed to detect abnormalities of the blood vessels of the kidneys. Such abnormalities my include, but are not limited to the following:


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