Diagnostic Services and Procedures
Diagnostic Procedures are used to help assess and diagnose patients for cardiovascular disease. Diagnostic procedures are noninvasive and usually are performed on an outpatient basis.
Cardiovascular diagnostic procedures include:
Cardiac Catheterization is a diagnostic procedure that gives cardiologists a definitive picture of heart function and the coronary arteries. A catheter is inserted into an artery and guided to the coronary arteries. Real-time X-rays are taken of the arteries, showing narrowing and blockages. Images are taken of the main pumping chamber of the heart to check functions and valve motion.
Cardiac doppler reveals the speed and direction of blood flow within the heart. It uses sound waves which reflect off the moving red blood cells within the heart chambers.
Cardiac nuclear imaging, or perfusion scan, is a method of checking blood flow through the walls of the heart using radioactive tracer material. This usually is done along with a stress test.
Echocardiography uses ultrasound waves to investigate and display the action of the heart as it beats. Procedures include:
- Fetal to adult echodiagnostic procedures
- Transesophageal echocardiography (TEE)
- Stress echocardiography
Electrocardiography is a testing method commonly used to determine if the heart has been damaged. Also known as EKG, an electrocardiogram is a graphic record of the heart's electrical impulses.
Stress Tests
There are a number of types of stress tests, and they fall into one of two categories: exercising on the treadmill or being given a medication which takes the place of exercise.A stress test may be ordered for various reasons, some of which may be:
- To assist in the diagnosis of coronary artery disease
- To help evaluate irregular heart rhythms
- To help evaluate overall cardiovascular conditioning
- To check the effectiveness of procedures done to improve coronary artery circulation in patients with coronary artery disease
- To determine a safe level of exercise for those entering a cardiac rehabilitation program
A cardiologist will oversee all stress tests given at FMC and VVMC. Nuclear stress tests are interpreted by the cardiologist and the radiologist.
Regular Treadmill Stress Test
This test involves walking on a treadmill while a continuous 12-lead electrocardiogram, ECG, is monitored. The goal is to walk on the treadmill long enough to achieve a target heart rate based on your age. In most adults this can be achieved within four to nine minutes. Vital signs are monitored during the test.
Cardiolite Treadmill Stress Test (Also known as Nuclear Treadmill Stress Test)
This test involves walking on a treadmill while a continuous 12-lead EKG is monitored. An intravenous injection of the nuclear agent cardiolite also is done one minute before the treadmill is stopped. The goal is to walk on the treadmill long enough to achieve a target heart rate based on your age. In most adults this can be achieved within four to nine minutes. Vital signs are monitored during the test. After the treadmill exercise, you will be taken to the Nuclear Medicine department where two heart scans will be taken.
Stress Echocardiogram
This test involves walking on a treadmill while a continuous 12-lead EKG is monitored. The goal is to walk on the treadmill long enough to achieve a target heart rate based on your age. In most adults this can be achieved within four to nine minutes. In addition, cardiac ultrasound images are taken by a sonographer before and immediately following the treadmill exercise. This will take an extra five to 10 minutes. Vital signs are monitored during the test.
Adenosine Cardiolite Stress Test
This test is for people who are unable to walk on a treadmill, but do not have significant lung disease (such as emphysema or asthma). A continuous 12-lead EKG is monitored, and six-minute intravenous infusion of the medication adenosine is given. The medication does not increase heart rate, but helps blood vessels relax and open up. A nuclear tracer called cardiolite also is injected intravenously during the six-minute medication infusion. You then will be taken to the Nuclear Medicine department where two heart scans will be taken.
Dobutamine Cardiolite Stress Test
This test is for people who are unable to walk on a treadmill, and who also have lung disease (such as emphysema or asthma). A continuous 12-lead EKG is monitored, and an intravenous infusion of the medication dobutamine is given. The medication causes heart rate to increase, similar to when a person exercises. The medication is given for a period of time long enough to achieve a target heart rate based on age. In most adults this can be achieved within one to ten minutes. The nuclear tracer cardiolite then is injected into the intravenous line, and the dobutamine medication stopped. Vital signs are monitored during the test and until your heart rate returns to normal. You then will be taken to the Nuclear Medicine department where two heart scans will be taken.
Dobutamine Stress Echocardiogram
This test is for people who are unable to walk on a treatmill, and who also have lung disease (such as emphysema or asthma). A continuous 12-lead EKG is monitored, and an intravenous infusion of the medication dobutamine is given. A cardiac ultrasound is done before and during the medication infusion. The dobutamine medication causes heart rate to increase, similar to when a person exercises. The medication is given for a period of time long enough to achieve a target heart rate based on age. In most adults this can be achieved within one to ten minutes. Vital signs are monitored during the test and until your heart rate returns to normal.
Nuclear Stress Testing
Any type of stress test can be combined with the addition of a nuclear isotope for a more specific test result.
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