Outpatient Procedures
Commonly referred to as the Stress Test. Treadmill Testing takes about 45 minutes and evaluates the heart's response to increased activity, blood pressure and heart rhythm response to activity. It is also used in several ways to diagnose coronary artery disease.
The EKG records the heart's electrical activity to detect abnormal heartbeats (arrhythmias). It can even show a heart attack in progress.
The Holter monitor is used in diagnosing heart rhythm disturbances that may occur at times when you are away from the doctor. It is used in conjunction with a written diary or log of your daily events and activities. The Holter monitor allows doctors to relate those symptoms to actual variations in heart rhythms, providing them with further diagnostic information for determining the most course of treatment.
This test uses ultrasound-high frequency sound waves-to create a videotape of the heart's chambers, valves, wall motion, and blood flow patterns. This can be done by applying the ultrasound probe to the chest wall. The transesphageal echocardiogram is done by passing the probe down the patient's throat in order to image the patient's heart from inside the chest.
Peripheral Vascular Testing is comprised of Carotid Ultrasound, Renal Ultrasound, Abdominal Ultrasound, Arterial and Ankle Brachial Index and Venous Doppler.
- Carotid Ultrasound is a test utilizing sound waves to assess the blood flow through the carotid arteries.
- Renal Ultrasound utilizes sound waves to assess the size of the kidneys and the blood flow of the renal(kidney) arteries.
- Abdominal Ultrasound examines the abdominal aorta for possible aneurysmor dilation of the artery.
- Arterial Ultrsound and Ankle Brachial Index (ABI) is performed to evaluate the arteries of the legs for peripheral vascular disease. This is sometime the cause for claudication and leg pain.
- Venous Doppler is performed to detect possible deep venous thrombosis or blood clots in the veins of the legs or arms.
The heart is required to maintain a fast enough heartbeat and rhythm to keep blood flowing throughout the body. Pacemakers and Defibrillators are devices sometimes implanted in the body to keep the heart beating properly. Periodic checkups are required of these devices.
The lab is equipped to draw blood and send it to a processing laboratory that is contracted with your insurance plan.
Using a high resolution detector-camera in conjunction with a pharmacologic radionuclide and treadmill test, your doctor can perform a number of different nuclear cardiology studies of the heart:
A Myocardial Perfusion test can assess coronary artery disease utilizing the treadmill and a pharmcologic agent. We utilize several different agents in conjunction with the radioisotope depending on the diagnosis and patient history.
Cardiac Blood Pool Imaging, also known as a MUGA, is used to evaluate the left ventricular function including wall motion and blood ejection fraction.
With the patient sedated, pads are applied to the chest and an electrical impluse is delivered to correct some types of abnormal heart rhythms. This procedure is done as an outpatient in the hospital.
Event recording is often necessary when we cannot catch rhythm disturbances on a 24 Hour Holter Monitor or Electrocardiogram. This type of monitoring allows the patient to transmit rhythm disturbances from outside the doctor's office with a small transmitter device.
External Counterpulsation (ECP) is a non-invasive outpatient treatment for coronary artery disease that has not responded to conventional medical and/or surgical therapy. ECP therapy is intended to help relieve persistent anginal symptoms in those individuals who cannot be treated effectively with medication, or who are unsuitable, or unwilling to undergo invasive procedures such as angioplasty or bypass surgery.
ECP therapy typically consists of 35 one-hour treatments performed one to two times daily, 5 days per week. Using three sets of cuffs that wrap around the calves, thighs, and buttocks, serial inflations of the cuffs are performed, increasing blood flow and oxygen back to the heart. It is also believed that the pressure created by ECP therapy promotes the development of new pathways or collateral vessels that form natural bypass networks around narrowed or blocked arteries. As a result of this treatment, most patients experience a reduction in the frequency and severity of anginal symptoms, as well as, increased activity/exercise tolerance. Most patients tolerate ECP therapy with few side effects.
Transcranial Doppler (TCD) technology dramatically simplifies the detection of PFO’sor Patent Foramen Ovale. Patent Foramen Ovale (PFO) is increasingly being recognized as a cause of up to 56% of cryptogenic stroke and TIA’s, as well as a possible cause of migraine headaches. Other benefits of TCD include increased cost effectiveness and less patient discomfort compared to transesophageal echocardiography (TEE).
Transcranial Doppler (TCD) allows for non-invasive monitoring of cerebral blood flow. Embolic signals are detected after an injection of agitated saline (micro air bubbles) into an arm vein. This safe non-invasive procedure is done during resting conditions and during Valsalva.
