Services Provided by Cardiac Solutions
Consultations
http://www.heartauthority.com/
http://www.heartsite.com/index.html
http://www.hearthub.org/
Resting EKG
(Electrocardiogram: ECG or EKG)
What is an electrocardiogram (ECG or EKG)?An electrocardiogram is a recording of the electrical activity or the heart.
Each beat of the heart is started by an electrical impulse from special cells in the right upper chamber of the heart. The electrical pulse travels to other parts of the heart and causes the heart to squeeze and pump blood. The electrical signals can be detected on the body surface. The ECG records these electrical signals. With the ECG Cardiac Solutions can study the pattern of the signals. Many different diseases and conditions affect the ECG pattern.
A resting EKG takes no more than 5 to 10 minutes to administer. An EKG taken during exercise, called a stress test, takes longer. The examiner attaches electrodes to the chest, wrists, and legs with a special gel. A recording machine will trace a wave pattern for each wire lead. For a resting EKG, the person must remain still and quiet.
http://www.americanheart.org/presenter.jhtml?identifier=3005172
http://www.webmd.com/heart-disease/electrocardiogram
Holter Monitor
What is a holter monitor?
A Holter monitor is a continuous recording of a patient’s ECG for 24 hours. Since it can be worn during the patient’s regular daily activities, it helps our physicians correlate symptoms with ECG findings. Since the recording is done during a 24 hour period, on a continuous basis, Holter monitoring is much more likely to detect an abnormal heart rhythm when compared to the ECG which lasts seconds. It can also help evaluate a patient’s ECG during episodes of chest pain, during which time there may be changes to suggest reduced blood supply to the muscle of the left ventricle.
How is the test performed?
The chest is cleansed with an alcohol solution to ensure good attachment of the sticky ECG electrodes. Men with hairy chest may require small areas to be shaved. The ECG electrodes are applied to the chest. Thin wires are then used to connect the electrodes to a small recorder. The recorder is secured to the patients belt or be placed in the patients pocket. The recorder is worn for an hour and the patient is encouraged to continue his or her daily activity. To avoid damaging the equipment by getting it wet, patients are asked not to shower for the 24 hour period that the monitor is on. A diary will be provided when the monitor is hooked up. The diary should only be written in to document any symptoms. Time, activity and symptom should be documented so that the ECG can be referenced at the time the symptom occurred. Holters must be returned at the 24 hour mark, back to the office so that other patients can utilize the equipment.
www.heartsite.com
Event Monitor
What is cardiac event monitoring?
Cardiac event monitoring is used to monitor the activity of your heart while you go about your normal activities. It is used to detect heart rhythm irregularities that might otherwise go undiagnosed. The event monitor is to be worn for 10 days.
How does it work?
When you feel symptomatic, you will record your ECG and then transmit it to the Cardiac Monitoring Center. We will ask you about your symptoms and activity, review your ECG, and then send a report to your physician.
What happens at the end of the monitoring period?
Your physician will review your ECG data and tell you about the results. After the 10 day period you can dispose of the monitor by placing it in the envelope provided with the monitor and mail it to be recycled. The Cardiac staff is available 24 hours a day 7 days a week if you have any questions during your testing time.
www.heartsite.com
Blood Pressure Monitoring
Blood pressure refers to the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as blood moves through arteries, arterioles, capillaries, and veins; the term blood pressure generally refers to arterial pressure, i.e., the pressure in the larger arteries, the blood vessels that take blood away from the heart. Arterial pressure is most commonly measured via a sphygmomanometer, which historically used the height of a column of mercury to reflect the circulating pressure (see Non-invasive measurement)
Every visit with Cardiac Solutions, your blood pressure is taken and recorded.
http://www.heartauthority.com/heartauthority/hypertension.asphttp://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-basics
http://www.hearthub.org/hc-high-blood-pressure.htm
Ultrasounds
Echocardiogram
What is an Echocardiogram?
An echocardiogram is a painless procedure that uses sound waves and a computer to look at your beating heart. A device called a transducer sends high-frequency sound waves into your chest. The sound waves bounce (echo) off your heart. A computer uses the echoes to create a moving picture of the heart.
When is it used?
An echocardiogram is used to help diagnose heart problems. It can show the size of the heart’s chambers, the thickness of the chamber walls, how the chambers and heart valves are working, if there is fluid collecting around the heart, and how efficiently the heart is pumping.
The echocardiogram may show signs of:
- Blood clots in the heart
- Previous heart attacks
- Previous rheumatic fever
- Heart problems you were born with
- Tumors
- Infections or other problems with the heart valves
How do I prepare for the procedure?
There is no preparation for this exam.
What are the benefits?
This procedure does not cure a heart problem, but it helps your provider diagnose heart problems you might have. It can help your provider plan your treatment.
Work Cited:
Written by Donald L. Warkentin, MD.
For McKesson Provider Technologies
www.americanheart.org/presenter.jhtml?identifier=3005161
http://www.medterms.com/script/main/art.asp?articlekey=18326
Abdominal Ultrasound
What is an abdominal ultrasound?
An abdominal ultrasound uses reflected sound waves to produce a picture of the organs and other structures in the upper abdomen. Occasionally a specialized ultrasound is ordered for a detailed evaluation of a specific organ, such as a kidney ultrasound.
What does it evaluate?
Abdominal aorta, which is the large blood vessel (artery) that passes down the back of the chest and abdomen. The aorta supplies blood to the lower part to the body and the legs.
Arterial Doppler Studies
Arterial Doppler
What are arterial Doppler studies?
An arterial Doppler study is a painless procedure that uses sound waves to listen to the blood flow in your arteries. High-frequency sound waves are sent into your blood vessels. A computer uses echoes of the ultrasound waves to show blood flow in your blood vessels. Fast blood flow usually means the artery is partially blocked.
When are they used?
The test is usually used to tell your doctor if the artery in your neck that carries blood to the brain is partially blocked. Blockage in the vessels of your legs may cause pain in your legs when you walk.
How do I prepare for the procedure?
No special preparation is necessary.
Venous Ultrasound Studies
What is a Venous Ultrasound Study?
This involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
What is the diagnostic purpose of this procedure?
Doppler ultrasound study is a special ultrasound technique that evaluates blood flows through a blood vessel.
Carotid Artery Ultrasound
What is carotid artery ultrasound?
Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound exams do not use ionizing radiation (x-ray). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels. Ultrasound imaging is usually a painless medical test that helps physicians diagnose and treat medical conditions. An ultrasound of the body's two carotid arteries, which are located on each side of the neck and carry blood from the heart to the brain, provide detailed pictures of these blood vessels. A Doppler ultrasound study may be part of a carotid ultrasound examination.
Why is this ultrasound important?
Carotid artery disease is a condition that causes the carotid arteries to become narrow or blocked. The carotid arteries are two large blood vessels on each side of the neck. These blood vessels bring blood to the brain and eyes. A narrowing or blockage of the arteries slows or stops blood flow to the head and can cause temporary symptoms such as dizziness, feeling faint, partial blindness, or numb feelings. A blocked carotid artery can also cause stroke or death.
Nuclear Testing
http://yourtotalhealth.ivillage.com/nuclear-stress-test.html
Exercise Stress Test (Treadmill)
What is an exercise test?
An exercise test records the electrical activity of the heart on an electrocardiogram and takes blood pressure readings while you walk on an exercise treadmill. The exercise treadmill test is used to check for heart disease and see if treatment for heart disease is effective.
When is it used?
An exercise test is done when your health care provider thinks you might have heart disease. The most common heart disease is caused by narrowing of the coronary arteries. The coronary arteries are the blood vessels that supply blood, oxygen, and nutrients to your heart. The arteries can become narrowed when substances such as cholesterol build up inside the artery.
Many people with narrowing of the coronary arteries have no symptoms when they are at rest. Exercise increases the work of the heart. The heart needs more blood when it works hard. If the supply of blood to the heart cannot keep up with the amount of blood the heart needs, changes in the ECG will occur. Recording the ECG before, during and after exercise shows these changes. The exercise test helps check for narrowing in your arteries.
What are the benefits?
Exercise testing is one of the safest and most widely used tests for heart disease in the U.S. It is a quick way to check your heart’s arteries for narrowing or blockage.
How do I prepare for the procedure?
Please follow all instructions given to you by the receptionist at the time the appointment was scheduled.
Work Cited:
Written by Donald L. Warkentin, MD
For McKesson Provider Technologies
http://www.heartsite.com/html/regular_stress.html
http://www.americanheart.org/presenter.jhtml?identifier=4568
Chemical (Pharmaceutical) Stress Test
How does an Isotope Stress Test Work?
A chemical or pharmacological stress test combines an intravenous medication with an imaging technique to evaluate the LV. In these cases, the medication serves the purpose of increasing the heart load instead of using exercise. Stress causes normal coronary arteries to dilate, while the blood flow in a blocked coronary arteries is reduced. This reduced blood flow may have reduced isotope uptake in a nuclear scan. The agent that is commonly used in pharmacologic stress testing is dipyridamole (Persantine).
When is a Chemical Stress Test Performed?
Treadmill stress testing is the rest of choice when a patient is able to exercise because of the physiologic effect that exercise has on the blood pressure and heart rate. It also helps give the physician an idea about the patient’s exercise tolerance and whether or not exertion has any adverse effects on the patient’s symptoms or irregular heart beats. Additionally, one does not have to contend with any potential side-effects of chemical stress, even if they are usually minor.
However, exercise may not be possible because of physical limitations like back trouble, joint disease, marked fatigue, unsteady gait, prior stroke, dizziness, shortness of breath, etc. In such cases, chemical stress testing is employed. In other words, pharmacologic or chemical stress test is performed in situations where patients are unable to perform more than moderate exercise due to severe arthritis, prior injury, reduced exercise tolerance (as a result of debilitating illnesses, etc.) or in patients who are unable to increase the heart rate (as in some with heart pacemakers or in the setting of certain diseases that keep the heart from speeding up.)
MUGA Scan
A MUGA scan (Multi Gated Acquisition Scan) is a nuclear medicine test to evaluate the function of the heart ventricles. It is also called Radionuclide Angiography. It provides a movie-like image of the beating heart, and allows the doctor to determine the health of the heart’s major pumping chambers. The advantages of MUGA is that it is more accurate than an echocardiogram and it is non-invasive.
Purpose
MUGA is typically ordered for the following patients:
- With known or suspected coronary artery disease, to diagnose the disease and predict outcomes
- With lesions in the heart valves
- With congestive heart failure
- Who have undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, or medical therapy, to assess the efficacy of the treatment
- With low cardiac output after open-heart surgery
- Who are undergoing cardiotoxic drug agents such as in chemotherapy or immunotherapy (herceptin)
- Who have had a cardiac transplant
Procedure
At a high level, the MUGA test involves the introduction of a radioactive marker into the bloodstream of the patient. The patient is subsequently scanned to determine the circulation dynamics of the marker, and hence the blood.