Heart Services
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Diagnosis

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There are many forms of heart disease, and Memorial Hospital offers a variety of non-invasive methods for diagnosing your individual situation.

Cardiac and Vascular Diagnostics

New and advanced diagnostic tests are continuously being introduced to further understand the complexity of heart disease, injury, and congenital (present at birth) or acquired abnormalities. The following are just a few of the diagnostic tests that are being used to further understand and identify cardiovascular disease. For more specific information, consult your cardiologist or other healthcare provider.

Electrocardiogram (EKG) is a simple, painless test that shows how fast your heart is beating, determines whether the rhythm is steady or irregular and measures the strength and timing of electrical signals as they pass through each part of your heart. The reasons your doctor may perform an EKG include:

  • Evaluate causes of chest pain and other heart-related symptoms, such as shortness of breath, fainting, fatigue
  • Identify the source of irregular heartbeats
  • Assess your heart prior to surgery
  • Evaluate the effectiveness of some heart medications

Holter or Ambulatory Monitoring is an EKG machine that takes measurements on a continuing basis for 24-48 hours to monitor for irregularities in heart rhythm and rate during different types of activities, such as exercise, work, and sleep. The heart’s electrical activity is recorded on a small portable machine worn continuously.

ECG TracingStress test (treadmill or exercise ECG) is a test that is performed while a patient walks on a treadmill to monitor the heart during exercise. Breathing and blood pressure rates are also monitored. A stress test may be used to detect coronary artery disease, and/or to determine safe levels of exercise following a heart attack or heart surgery. There are various types of stress tests. Your cardiologist will work with you to determine which type best meets your needs. Echocardiography, also known as an “echo,” is a type of hand-held ultrasound that uses high- pitched sound waves to produce an image of the heart’s size, structure, and motion. An “echo” is a good reflection of the health of the heart and can provide valuable information about abnormal rhythms as well as performance of your heart’s valves.

 

  • Treadmill Echo (Stress Test) compares your EKG at rest to your EKG after your heart has been stressed through exercise.
  • Dobutamine Echo is a type of Stress Test that uses intravenous medication to mimic the effects of exercise on the heart when the patient is unable to walk on the treadmill.
  • Transesophogeal Echo (TEE) provides very detailed ultrasound images by viewing the heartfromtheinsidethechest–outward. Animagingprobeisadvanceddownthethroat allowing the physician to view the heart through the wall of the esophagus.

Tilt Testing is performed while a patient is connected to blood pressure and ECG monitors and secured on a table that tilts the patient from a lying to standing position. The test helps determine if the patient has sudden drops in blood pressure or slow heart rates with changes in position, which may be the cause of fainting spells.

Diagnostic Cardiac Catherization (angiogram) is a test in which your cardiologist places a small catheter (hollow tube) into an artery in your upper leg or wrist/arm and up into the heart. A special dye is then injected through the catheter and moving X-ray pictures are made to trace the movement of blood through the arteries and heart chambers. This test demonstrates narrowing in the arteries, heart chamber size, the pumping ability of the heart, the ability of the valves to open and close, as well as measurement of the pressures within the heart chambers. A cardiac cath can evaluate or confirm the presence of coronary artery disease, valve disease, or disease of the aorta.

Additional imaging procedures, called intra-vascular ultrasound (IVUS), fractional flow reserve (FFR), and optical coherence tomography (OCT) may be performed along with cardiac catheterization in some cases to obtain detailed images of the walls of the blood vessels.

With IVUS, a miniature sound-probe (transducer) is positioned on the tip of a coronary catheter. The catheter is threaded through the coronary arteries and, using high-frequency sound waves, produces detailed images of the inside walls of the arteries. IVUS produces an accurate picture of the location and extent of plaque.

With FFR, a special wire is threaded through the artery and a vasodilator medication is given. This test is functionally performing a very high quality stress test for a short segment of the artery.

Optical Coherence Tomography (OCT) is a technique for obtaining sub-surface images of plaque in heart blood vessels during a cath, at a resolution equivalent to a low-power microscope. It is effectively ‘optical ultrasound,’ imaging reflections from within tissue to provide cross-sectional images. Benefits of OCT include real-time subsurface images of blood vessels at near- microscopic resolution to detect detailed tissue shapes.