Diagnostic/Testing

Diagnostic Programs

Holter Monitor Evaluations provide a continuous tape recording of a patient's EKG for 24 or 48 hours. Thirty day event monitors are also available.  Since a Holter Monitor can be worn during the patient's regular daily activities, it helps a medical provider correlate symptoms of dizziness, palpitations (a sensation of fast or irregular heart rhythm) or black outs. Holter monitoring is much more likely to detect an abnormal heart rhythm when compared to the EKG which lasts less than a minute. It can also help evaluate the patient's EKG during episodes of chest pain, during which time there may be telltale changes to suggest ischemia or reduced blood supply to the muscle of the left ventricle. Holter monitor evaluations are available five days a week by appointment.

Graded Exercise Tests
can be performed using a treadmill or an exercise bicycle. Gradually increasing workloads stress the heart while the patient’s EKG, blood pressure, oxygen saturation and response to increasing workloads are monitored. Physician-directed graded exercise tests are available five days per week. Graded exercise tests directed by an exercise physiologist are available for low risk patients. 

Resting Echocardiograms use high-frequency sound waves from a wand (transducer) placed on your chest to produce images outlining the heart’s valves and chambers and their movement. Doppler ultrasound and color Doppler monitor how blood flows through the heart’s valves. This test assesses the heart’s function and gives information about valve problems, disease of the heart muscle, pericardium (the sack that surrounds the heart), valves, congenital heart problems, and heart tumors. 

Treadmill Stress Echocardiograms involve exercising on a treadmill while you are closely monitored. The test is used to evaluate your heart and valve function at rest and with exertion. The test is conducted to determine how well your heart tolerates activity, to evaluate the function of your heart and valves, and to determine your likelihood of having coronary artery disease (blocked arteries).

Bike Stress Echocardiograms involve an echocardiogram, (ultrasound of your heart), an electrocardiogram (ECG) and a supine bicycle attached to a bed. The supine bike allows the patient to pedal (exercise) while lying flat on the bed. This allows the echocardiogram to be performed. The bike stress echocardiogram compares the performance of your heart at rest to the performance of your heart during exercise, or stress. This can be helpful in the diagnosis of cardiac disease in the early stages of development, or to assess the progress of patients with known cardiac disease. During the test, you will lie on your back on the examination bed and pedal a bike that is attached to the bed in order to evaluate your heart during exercise. You will be closely monitored. The entire examination is approximately an hour. 

Dobutamine Stress Echocardiograms
are used when a physician wants to assess the heart muscle under stress. This diagnostic test is designed for patients unable to do physical exercise for any reason (such as orthopaedic limitations like hip or knee problems). An intravenous medication called Dobutamine is used to elevate the heart rate and mimic the effects of exercise on the heart. During the procedure, a transducer sends out ultrasonic sound waves which move through the skin and other body tissues to the heart tissues, where the waves echo off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer interprets the echos into an image of the heart walls and valves. 

Transesophageal Echocardiogram (TEE) uses an ultrasound transducer (which produces high frequency sound waves) to provide pictures of the heart's valves and chambers and help your medical provider evaluate the pumping action of the heart. The ultrasound transducer is positioned on an endoscope (a long, thin, flexible instrument about 1/2 inch in diameter). The endoscope is placed into your mouth and passed into your esophagus (the "food pipe" leading from your mouth into your stomach) to provide a close look at your heart's valves and chambers without interference from the ribs or lungs. A transesophageal echocardiogram is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart’s valves. TEE is often used when the results from standard echo studies were not sufficient or when your doctor wants a closer look at your heart.

All of the above programs and tests require a written order with the appropriate diagnosis signed by the patient’s practitioner prior to being performed.