Non-Invasive Test Include:
Cardiac Event Detector: A CED uses a small portable EKG to record your heart rhythm over a period of time, usually several days or weeks. During that time, when you feel any symptoms, you press a button and the monitor records your heart rhythm.
Cardiac PET MRI: Cardiac PET (Positron Emission Tomography) MPI (Myocardial Perfusion Imaging) is a pharmacologic stress test with a high sensitivity and specificity meaning it is a very accurate form of imaging. Rubidium Chloride (Rb-82), a low dose radioactive tracer as well as a chemical stress agent is injected intravenously. This test is used to assess coronary blood flow which may identify blocked coronary arteries or heart muscle damage as well as stress and rest ejection fractions (the hearts pumping capability). The imaging lasts approximately thirty minutes. NO caffeine should be consumed twelve hours prior to the test. Two piece clothing should be worn.
Cardiac Viability: Cardiac PET (Positron Emission Tomography) Viability is a test to help your physician determine the viable (live and healthy) tissue in the heart muscle. A low dose radiotracer will be injected intravenously. Several blood sugar levels may be obtained via finger stick. The testing process lasts approximately four hours, much of which is waiting to allow the body's blood sugar levels to regulate. Two scans will be performed during this process which lasts approximately twenty minutes each. No food (including gum or mints) or drink should be consumed after midnight before the test. Bring your morning medicines with you to take when the test is complete. Do not take you medicines prior to the test (this includes injected insulin). Two piece clothing should be worn.
CT Super Scan: 3D real-time images of the heart are captured in a few seconds. A Calcium Scoring test, or more thorough examination can be performed to provide early detection of heart disease.
Doppler Echocardiography: A study of the blood flow through the heart using ultrasonic sound waves performed together with an echocardiogram.
Echocardiogram: A map of the position and motion of the heart walls and internal structures obtained from ultrasonic sound waves directed through the chest wall. This test can help determine whether there is a problem with the structure of the heart muscle or heart valves. Please allow 30 minutes to one hour for this procedure.
Enhanced External Counterpulsation (EECP): EECP is a noninvasive, outpatient procedure to relieve angina pectoris by improving coronary blood flow. EECP uses unique equipment to inflate and deflate a series of pneumatic compressive cuffs enclosing the lower extremeties.
Electrocardiogram (EKG): An EKG records the electrical activity of the heart. EKG measures the heart's rhythm and rate to determine irregularities in the heart beat.
Holter Monitoring: A 24-hour recording of the heart rhythm during normal daily activity. Monitor application takes 15 to 20 minutes. Please wear two-piece clothing with a button-up-the-front shirt or blouse.
Nuclear Exercise Stress Testing: Imaging of the heart following stress testing and the injection of Cardiolite, a low-dose radioactive tracer. This test is used to assess coronary blood flow which may identify blocked arteries or heart muscle damage. This test may require two visits to our office on consecutive days. Allow three hours to complete the first visit, and up to two hours if the second day visit is required.
Please wear two-piece comfortable clothing and comfortable walking shoes (tennis shoes). You should have no food or drink after midnight prior to your test. Please check with your physician regarding usual morning medications.
Pacemaker and ICD follow up: Specially trained nurses and physicians provide testing and programming of pacemakers and defibrillators.
Peripheral Vascular Sonography: These studies utilize ultrasonic waves to evaluate blood through arteries and veins. They provide information to help locate any blockages of these vessels. Please allow 30 to 90 minutes for this procedure.
Radionuclide Ventriculography (RVG): Imaging of the heart following injection of a low-dose radioactive tracer. It provides information about the heart's efficiency and pumping action. Some of these studies (MUGAs and First Pass Angiography) can be done at rest and stress. Gated Spect is done in conjunction with a nuclear stress test.
Stress Testing: A test used to screen for heart disease during which the pulse, blood pressure, and electrical activity of the heart are monitored during exercise. Allow one to one and one half hours. Please wear two-piece comfortable clothing and comfortable walking shoes (tennis shoes). You should have no food or drink two hours prior to your testing.
Tilt Table Testing: This test evaluates the potential reasons for fainting or syncope. Heart rhythm and blood pressure are carefully monitored while a patient rests on a special table. The table tilts the patient upright at a 70-80 degree angle for 20 to 40 minutes.
Invasive Test Include:
Biventricular pacemaker and ICD implantation: A small electronic device is implanted below the collarbone to treat congestive heart failure by pacing the left and right ventricles to resynchronize them.
Cardiac Catherization or Angiography: Insertion of a catherter (a long, narrow, flexible tube) through a blood vessel in the arm or leg which can then be positioned near the heart under x-ray guidance. This study provides essential information about all aspects of the heart. It is most frequently used to identify blockages in the arteries that feed the heart.
Catheter Ablation: A procedure where wires are placed into the heart, under x-ray guidance, and energy is sent through a special wire to destroy the heart cells causing the abnormal heart rhythm.
Coronary Angioplasty: A procedure using a balloon-tipped catheter to open the blockage of an artery and improve blood flow to the heart. It is performed in the same fashion as a cardiac catheterization.
Coronary Atherectomy: A procedure using a catheter-tipped cutting device to shave and remove plaque material from a diseased artery.
Coronary Stenting: Placement of a catheter-tipped wire mesh device to add support to a vessel after performance of either coronary angioplasty or coronary atherectomy.
Electrophysiology (EP) Study: A procedure where wires are placed into the heart, under x-ray guidance, to identify heart cells causing an abnormal heart rhythm.
ICD Implantation (Implantable Cardioverter Defibrillator): In this procedure a small electronic device is placed inside the body. The device tracks the heart rhythm and returns an abnormal heart rhythm to a normal rhythm.
Pacemaker Implantation: An electronic device designed to stimulate contraction of the heart muscle when it is no longer able to do so naturally. The device is placed just below the collarbone through a small surgical opening.
Peripheral and Renal Artery Angioplasty: A procedure using a balloon-tipped catheter to open blocked arteries supplying blood to the legs and kidneys.
Transesophageal Echocardiogram (TEE): The TEE test allows the physician to view the internal structures of the heart and its major vessels. A narrow, bendable tube with a special tip is inserted through the mouth and down the esophagus. The tip of this tube sends out sound waves that echo painlessly within the chest wall. The echocardiogram machine receives these waves and creates computerized images of the heart.
Medical Treatments Include:
Anticoagulant medications (blood thinners): Prevent blood clots from forming and keep blood clots that are already present from getting larger. These drugs can be administered in a hospital or taken at home orally.
Anti-lipid medications: Help to reduce plaque formation by lowering fat and cholesterol levels in your blood. Diet and exercise are the treatment of choice before these medications are prescribed.
Antiplatelet medications: Are used to prevent platelets from forming blood clots.
Hemorrheologic medications: Make the red blood cells more flexible to allow them to squeeze through a small narrowed vessel.
Thrombolytic drugs: Dissolve clots to restore blood flow. These are administered intravenously or intraarterially and require close observation in a hospital.