|
At My Heart Partners, PC we strive to give you the very best service possible. You are our #1 concern. There are many services that we provide for you that will inform, diagnose, or treat a specific cardiovascular symptom. We will give you educational material, direct you to our related links page, discuss your questions one on one, or perform the necessary tests. Most likely we will do a combination of things to enhance your understanding and cardiovascular healing for a lifetime. To help you develop a heart healthy lifestyle, cookbooks are available for purchase at My Heart Partners. The following is a list of tests performed at our office or by our physicians at the hospital. If you have any questions about the procedure, by clicking on it, you will be taken to a description, and in most cases there will be a picture of the actual images acquired during the procedure.
Click here for cardiology related links. This common technique uses high frequency sound waves to study the heart. High resolution images are obtained of the structure and function of the heart muscle and of the four heart valves. This procedure involves the use of harmless sound waves that are transmitted into the heart using a probe placed on the chest wall . The reflected sound waves are converted into moving pictures of the heart and valves. Blood flow through the heart valves can be accurately measured using "Doppler" techniques. Pressures inside the heart can be then calculated. This test is considered non-invasive, as it does not require the use of needles or catheters. Many aspects of the structure and function of the heart can be evaluated using Cardiac Echo including diseases of the heart muscle and valves, infections of the heart lining and valves, tumors, masses, the presence of blood clots in the heart chambers, abnormal pressures within the heart, and abnormal fluid collections around the heart. In addition, both the squeezing and relaxation properties of the heart are studied. Intravenous contrast agents may be used to enhance the images in select patients. There is no preparation required for this test. ................................................................................................... This test combines exercise on a treadmill or chemically induced stress and ultrasound evaluation of heart muscle function to evaluate the possible restriction of blood flow to the heart muscle (coronary artery disease). After resting pictures are obtained of the heart muscle, the patient either exercises on the treadmill to the development of symptoms or a predetermined target heart rate. At peak exercise or peak stress, the ultrasound images are repeated and compared to the resting images. The ability of the heart muscle to increase its function with exercise or stress is evaluated and correlated with patient symptoms. This test may also be used to evaluate the safety of patients to exercise to a particular workload and a prescription may be given for safe exercise levels. The patient is asked not to eat, drink, or smoke anything four hours prior to testing. Please wear comfortable clothing and walking shoes. It would be helpful for women to wear a two piece outfit. Many medications also interfere with the detection of blood flow restrictions to the heart muscles, such as caffeine (coffee), calcium channel blockers, beta blockers and nitroglycerin compounds. If any questions about medication, please call the office. ...................................................................................................
The patient is asked not to eat, drink, or smoke anything four hours prior to testing. You should wear comfortable clothing and walking shoes. It would be helpful for women to wear a two piece outfit. Many medications also interfere with the detection of blood flow restrictions to the heart muscle, such as caffeine (coffee), calcium channel blockers, beta blockers and nitroglycerin compounds. If any questions about medication, please call the office. ................................................................................................... This ultrasound evaluation of heart structure and function is considered invasive as a sound probe is passed into the food tube (esophagus) after appropriate anesthesia of the gag reflex and sedation of the patient. This test is very helpful for evaluating the fine details of the heart, especially in detecting sources of blood clots that may come from the heart. Infections of the lining of the heart or heart valves may be directly visualized. Small communications between the heart chambers such as atrial septal defects or ventricular septal defects are seen in great detail. The patient is asked not to eat or drink anything for 8 hours prior to the procedure to optimize the success of the procedure. Immediately before the test, the throat is numbed using a spray or gargle solution and the patient is sedated with an intravenous medication. ................................................................................................... With this imaging technique, radioisotopes such as technetium are injected intravenously at rest and after exercise or chemical stress. These radioisotopes accumulate in the heart muscle best in the areas with normal blood flow and to a lesser degree in areas of the heart muscle with a restricted blood supply. Images are obtained using a specialized "gamma" camera. The images obtained during the resting state and after stress are compared side by side in an effort to diagnose restrictions Coronary Artery Dilators such as Persantine or medications that enhance the hearts squeezing action and heart rate may be used to evaluate the blood flow to the heart muscle in those patients who are unable to exercise on a treadmill. The patient is asked not to eat or drink for 8 hours prior to the nuclear study to optimize imaging of the blood supply to the heart. Caffinated beverages should also be avoided. Many medications also interfere with the detection of blood flow restrictions to the heart muscles, such as caffeine (coffee), calcium channel blockers, beta blockers, and nitroglycerin compounds. For additional information, click here. ................................................................................................... Disturbances of the heart rhythm, either slow or fast, can be responsible for symptoms such as palpitations, light headedness, dizziness, fainting or near-fainting spells, shortness of breath, or chest pain. A recording device (AHM) is usually worn by the patient for 24 hours and the patients heart rhythm is recorded during usual daily activities. The heart rhythm is then played back and correlated with patient symptoms. In those patients with difficult to diagnose heart rhythm disturbances that may not show up in a 24 hour recording may qualify for implantation of a device under the skin that may be left in place until the rhythm disturbance is recorded. After the documentation of the heart rhythm disturbance, the device is then removed. Radio waves are used to communicate with the device to play back the heart rhythm disturbance in the doctor's office. There is no preparation required for this test. However, it would be helpful for women to wear a two piece outfit. ................................................................................................... In those patients who have had a permanent pacemaker implanted, radio waves are used to communicate with the pacemaker to evaluate the pacemaker's function, battery life, the integrity of the leads, and many times retrieve any heart rhythm disturbances that may have occurred. Single chamber pacemakers are usually evaluated on a yearly basis and dual chamber pacemakers are evaluated every six months. There is no preparation required for this test. However, it would be helpful for women to wear a two piece outfit. ................................................................................................... This non-invasive test is performed by comfortably securing the patient to a table which is tilted from the horizontal position usually up to a 60 degree angle to evaluate the presence or absence of nerve reflexes that are involved in maintaining blood pressure while standing. The blood pressure, heart rate, heart rhythm, and patient symptoms are monitored during this study. This test may uncover the underlying reason for fainting spells. ................................................................................................... This test is considered to be invasive as catheters are introduced through the artery and vein in the groin and guided up into the appropriate positions in the heart using x-rays. The pressure inside the heart chambers can be directly measured using thin hollow tubes and contrast agents (x-ray dye) may also be injected through the tubes into the heart or blood vessels to study the details of blood vessel anatomy. Cardiac catheterization is most commonly used to evaluate the build up of blood clots or cholesterol inside the heart's blood vessels (coronary arteries). To date, coronary angiography is the most accurate diagnostic test for determining the presence and severity of coronary disease. Patients with complex cholesterol narrowing of several blood vessels feeding the heart muscle may be referred thereafter for bypass surgery. This test is required prior to consideration for possible bypass surgery. Modern medical technology has provided cardiologists with the tools to dilate and "prop open" narrowed blood vessels caused by hardening of the arteries (atherosclerosis) without surgery. A coronary stent is a small, metallic, tubular structure that is mounted on a small angioplasty balloon. The angioplasty balloon with the stent in place is threaded into the diseased blood vessel by way of the groin (femoral artery). The balloon is inflated in the diseased blood vessel causing a stretching of the stent. After the cardiologist is satisfied that the stent is optimally deployed, the balloon is deflated and removed from the body, leaving the stent in place to "prop open" the diseased blood vessel. The biggest role for the use of stents is to reduce the possibility of the narrowing of the blood vessel after an angioplasty procedure. More recent development in the area of stenting of coronary blood vessels include the use of radioactivity or drug coated stents themselves to reduce the possibility of re-narrowing of the treated blood vessel. ................................................................................................... Coronary angioplasty, sometimes called PTCA or PCI , is a catheter-based procedure performed by an interventional cardiologist in order to open up a blocked coronary artery and restore blood flow to the heart muscle. Angioplasty now is used as an alternative treatment to coronary artery bypass surgery (CABG) more than half the time. It is less invasive, less expensive, and faster to perform, with the patient usually returning home the next day. The main disadvantage has been that 20%-30% of the time, the artery closes up again within six months, a process called restenosis , requiring another procedure. However, in the past 18 months, drug-eluting stents have become available and they have been shown to reduce this rate to single digits, making PCI much more successful over time. Some cardiologists feel that the great majority of patients with coronary artery disease today can be treated with angioplasty and drug-eluting stents. Angioplasty is performed on an elective basis to treat coronary artery disease, but is also performed on an emergency basis to treat a heart attack. ................................................................................................... A stent is a small, lattice-shaped, metal tube that is inserted permanently into an artery. The stent helps hold open an artery so that blood can flow through it. Drug-eluting stents are stents that contain drugs that potentially reduce the chance the arteries will become blocked again. When is it used? A stent is used to hold open an artery that has become too narrow due to atherosclerosis. In atherosclerosis, plaque builds up on the inner walls of arteries, the blood vessels that carry oxygen-rich blood throughout the body. As the artery walls thicken, the pathway for blood narrows. This can slow or block blood flow. How does it work? The stent acts as a scaffold, remaining in place permanently to help keep the artery open. A stent is inserted through a main artery in the groin (femoral artery) or arm (brachial artery) and threaded up to the narrowed section of the artery with a tiny catheter (balloon catheter.) When it reaches the right location, the balloon is slightly inflated to push the plaque out of the way and expand the artery (balloon angioplasty). Some stents are stretched open (expanded) by the balloon at the same time as the artery. Other stents are inserted into the artery immediately after the angioplasty procedure. Once in place, the stent helps holds the artery open so that the heart muscle gets enough blood. Drug-eluting stents contain a drug that is released locally over time. What will it accomplish? The stent opens the narrowed artery so that an adequate supply of blood can be restored. What are the risks? The stent placement procedure can cause infection, blood clots, or bleeding. Other rare complications of coronary stents include chest pain, heart attack, or tearing of the blood vessel. The stent can move out of place (stent migration). In some cases, plaque can reappear in the stented artery (in-stent restenosis). Drug-eluting stents have additional risks other than those listed here. When should it not be used? Stents should not be used in patients who can not tolerate angioplasty, or who are sensitive (allergic) to the stent materials. They can not be used in patients who can not be placed on blood-thinning (anti-platelet) medication. Drug-eluting stents have additional restrictions. ................................................................................................... By attaching a specialized device called a transducer to a catheter wire, an intravascular ultrasound (IVUS) uses ultrasound technology to take moving pictures from inside the heart. This technique is used mainly on the coronary arteries. IVUS provides information about the degree of vessel obstruction as well as the shape and size of plaques. Since IVUS requires the insertion of a catheter wire, this procedure is considered invasive. |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
