Services

Cardiovascular Testing

Arterial Doppler Study

An Arterial Doppler study is a noninvasive test that assesses arterial circulation, specifically blood flow in the arms or legs.

What happens during the test?

You will be asked to remove your shoes and socks and lie on the bed. The technologist will place blood pressure cuffs on you. Blood pressures will be taken from various points on your body, most likely from your arms and ankles, but possibly your fingers and toes as well.

The technologist will see and hear your arterial signal by using a small, pencil-shaped device called a Doppler probe, which makes a loud sound. The Doppler machine will make a "waveform" print-out of your pulses. The vascular physician who interprets the test will compare pressures and the quality of the different waveforms.

Will this test hurt?

Some people may experience minor discomfort when the blood pressure cuffs are inflated.

How long does the test last?

The test takes approximately 30 minutes.

BioZ

A BioZ is a noninvasive test that provides your physician with information about your heart's ability to deliver blood to the rest of your body, the amount of force your heart has to pump against with each heartbeat and the amount of fluid in your chest.

Why might I need a BioZ?

If you are being treated for high blood pressure, heart failure or lung disease, or if you  have a pacemaker or are on any cardiac drugs, a BioZ test provides information to your physician to help with decisions about your drug therapy or pacemaker settings

What happens during a BioZ?

Before the test begins, you will be weighed. Having your correct height and weight is essential to getting an accurate test result.

You will then be asked to loosen your clothes if needed and lie down. Electrodes will be placed on each side of your neck and on each side of your chest. The technician will also put a blood pressure cuff on your arm. The machine will then begin to measure your heart's function.

What is the difference between a BioZ and an EKG?

A BioZ  test measures the mechanical function of your heart, while an EKG measures the electrical function of your heart.

Cardiac Nuclear Imaging

Also called a perfusion scan, this test provides a way to check the blood flow through the walls of your heart.

What happens during the test?

A small amount of radioactive solution will be administered to you through an IV. This solution does not pose a radioactive hazard. A camera scans your body as the solution travels with your blood through your heart. The test may be performed before or after exercise; you may also have initial images taken while at rest. To increase your heart rate, you may be asked to exercise on a treadmill for several minutes. If you cannot exercise, medication may be administered to simulate the effects of exercise on the heart. When this process is complete, you will need to lie very still for up to 30 minutes.

What do I need to do to prepare for this procedure?

For 24 hours prior to this procedure, you will not be able to smoke or drink or eat anything containing caffeine. You will also be asked not to eat or drink anything for at least four hours prior to the test. Your doctor may also ask you not to take certain medications prior to the procedure.

Carotid Duplex Exam

A Carotid Duplex Exam checks the carotid arteries for narrowing or blockage. Ultrasound is used to obtain images of the arteries and a Doppler signal evaluates the speed of blood flow through the arteries.

What are carotid arteries?

The carotid arteries are a pair of arteries situated on either side of the neck which carry blood to the head and share in the circulation of blood to the brain.

Why might I need this exam?

This test may be ordered because of dizziness, fainting, vision problems or numbness in limbs, or if the doctor heard a noise in your neck called a “bruit,” or vascular murmur, through a stethoscope.

What happens during the test?

During the test, you will be asked to lie flat on the bed with your head turned to the side. The lights will need to be dim so the screen on the ultrasound machine can be seen properly.

The sonographer will use a probe called a transducer with a small amount of gel on your neck in the area of your carotid arteries. Ultrasound images will appear on the screen, and you may hear a pulsating sound during the test, which lasts about half an hour.

Dobutamine Stress Echocardiogram

A Dobutamine Stress Echocardiogram (DSE) is a noninvasive test that involves a heart-stimulating medication called dobutamine and an echocardiogram.

Why might I need a DSE?

A DSE evaluates the function of the heart and valves in patients who are unable to use a treadmill for a traditional stress test. It can also determine the likelihood of developing coronary artery disease, or evaluate the extent of disease in patients who have already been diagnosed.

How should I prepare for a DSE?

You may not eat, drink or smoke for four hours prior to the test. Also, make sure not to consume caffeine after midnight. Do not apply lotions or powder to the chest area.  You may take your prescribed medications the morning of the test with a sip of water.  However, your doctor may ask you to stop taking some heart medications prior to the test. Be sure to ask your doctor how to adjust your insulin and food intake if you are diabetic. If you have any questions about your medications, ask your physician.

What happens during a DSE?

Your medical history will be reviewed with the nurse.  Several EKG electrodes will be attached to your chest. In male patients, chest hair may be partially shaved to ensure better contact with the skin. The electrodes will be attached to the EKG monitor and a blood pressure cuff will be placed around your arm. Your blood pressure, heart rate and EKG will be closely monitored during the test.

You will be asked to lie on your left side on the exam table to obtain some pictures of your heart at rest.   Contrast may be used to obtain more clear images.

After the images are recorded, the nurse will begin giving you a medication called dobutamine through your arm.  This medication is used to increase your heart rate similar to if you were exercising.   Pictures will be taken while the medication is going in to see if there are any changes as your heart is beating faster and stronger.  Ater the test is over, your heart rate, blood pressure and EKG will continue to be monitored for another 10-15 minutes.

Does dobutamine have any side effects?

You may experience a warm sensation, dizziness, nausea or shortness of breath, or you may become jittery during the test. These symptoms will disappear shortly after the test.

Echocardiogram

An echocardiogram, often called simply an “Echo,” is a test to check for problems inside and around your heart. Ultrasound waves are sent into the heart through the chest wall and reflected back to the machine to create images that show your heart squeezing and relaxing, and your valves opening and closing in rhythm with your heartbeat.

Why might I need an echocardiogram?

Doctors may suggest an echocardiogram to evaluate your heart's valves, chambers and pumping function. They may also order an Echo if you have a heart murmur, high blood pressure or shortness of breath.

What happens during the exam?

You will be asked to remove your clothing from the waist up, put on a special covering and lie down on an exam bed. Electrodes will be attached to your chest to help with the interpretation of the echocardiogram.

The sonographer will spread a small amount of special ultrasound gel on your chest and press a device called a transducer firmly against your skin. You'll be asked to roll over onto your left side and follow the sonographer’s instructions about how to breathe.

Is the exam painful?

Some patients may experience discomfort from the pressure of the transducer on the chest or abdomen. However, this discomfort is usually mild and lasts only a short time. You should tell the sonographer if you become uncomfortable during the test.

What else can I expect during the test?

The lights will be dim so the sonographer can see your heart's image on the screen more clearly. You will be able to see the screen and watch the images, which will be in both black-and-white and color. You may also hear a pulsing "whoosh" sound. This is the blood flowing past the structures in your heart.

Most echocardiograms take less than half an hour.

EKG

An EKG is a noninvasive test that records the electrical activity (rhythm and rate) of your heart. This painless test is one of the simplest and quickest ways to determine how well your heart works.

What happens during an EKG?

You will be asked to lie down and may be asked to loosen your clothes. Ten sticky, plastic electrodes will be placed on your body – one on each arm and leg and six on your chest. The electrodes are connected to a machine that monitors your heart's activity. The entire procedure should take no more than 10 minutes.

Exercise Stress Echocardiogram

An Exercise Stress Echocardiogram (ESE) is a non-invasive test that combines a treadmill stress test and an echocardiogram.

Why might I need an ESE?

An ESE is used to evaluate the function of your heart and valves and determine how well your heart tolerates activity. It can also determine the likelihood of developing coronary artery disease or evaluate the effectiveness of your current cardiac treatment plan.

How should I prepare for the test?

You may not eat, drink or smoke for four hours prior to the test. Also, make sure not to consume caffeine after midnight. Do not apply lotions or powder to the chest area. Make sure to wear comfortable clothing and walking shoes to your appointment.

You may take your prescribed medications the morning of the test with a sip of water. Your doctor may ask you to stop taking some heart medications prior to the test. Be sure to ask your doctor how to adjust your insulin and food intake if you are diabetic. If you have any question about your medications, ask your physician.

What happens during an ESE?

Several EKG electrodes will be attached to your chest. In male patients, chest hair may be partially shaved to ensure better contact with the skin. The electrodes will be attached to the EKG monitor and a blood pressure cuff will be placed around your arm. Your blood pressure, heart rate and EKG will be closely monitored during the test.

You will be asked to lie on your left side on the exam table to obtain some pictures of your heart at rest.   Contrast may be used to obtain more clear images.  After the images are recorded  you will be asked to walk on the treadmill. The speed and incline will be increased gradually every three minutes. You will walk until your age-determined target heart rate is achieved. This may take up to 15 minutes. You will then be instructed to immediately lie down on the exam table so that pictures can be taken while the your heart is beating faster and stronger.  After the test is over, your heart rate, blood pressure and EKG will continue to be monitored for another 10-15 minutes.

Event Monitors

An Event Monitor is a small device used to record your heartbeat while you are experiencing symptoms related to your heart problems. The usual monitoring period is 30 days, but may differ depending on your physician's orders.

What does the Event Monitor do?

The monitor is attached to you with three electrodes. It is worn all day, every day, during the testing period.

If you experience a symptom while you are wearing the monitor, press the red RECORD or STORE button. The recorder will store your heart rhythm.  At your first opportunity, you must call the testing office and send the stored EKG data over the phone so it can be reviewed.

Holter Monitor

The Holter Monitor is a wearable device that creates a continuous recording of your electrocardiogram (EKG) data.

What does the Holter Monitor do?

The monitor is a small device that records your heartbeats for 24 hours. You will be asked to note your symptoms in an activity diary which will be reviewed in conjunction with your EKG recording. This will help your physician know if the symptoms you are feeling are related to your heart's activity.

You will be connected to the monitor with five electrodes. It is very important that these electrodes remain in place during the entire recording. You will not be able to take a bath, shower or go swimming during the testing.

Renal Artery Duplex Scan

A Renal Artery Duplex Scan is a test to check for problems in the arteries that supply your kidneys with blood. Ultrasound is used to obtain images of the arteries and kidneys.

Why might I need a renal artery duplex scan?

This test might be ordered if you have high blood pressure or past problems with the renal arteries, the blood vessels that supply blood to the kidneys. This test can check for possible narrowing of the arteries to the kidneys, or if you have had a stent in one of the renal arteries your doctor may want to be certain it is still open.

What do I need to do to prepare for the test?

You must not eat, smoke, chew gum or drink carbonated or caffeinated beverages for 12 hours before the test. If you are diabetic and on insulin, be sure to check with your doctor about adjusting your insulin since you will not be eating prior to the test. You may drink water and you may take your prescribed medications with water. If you have any questions about your medications, please ask your doctor.

What happens during the test?

During the test, you will be asked to remove outer clothing, put on a patient gown and lie on the bed. The lights will need to be dim so the screen on the ultrasound machine can be seen properly.

The sonographer will use a small amount of gel and a probe called a transducer on your abdomen. The transducer will be pressed firmly against your skin. The ultrasound images will appear on the screen. You will be asked to roll onto your side and hold your breath for short periods of time during the test, which lasts about 45 minutes.

Is the test painful?

There may be some discomfort from the pressure of the transducer on the abdomen, but it is mild and lasts only a short time. You should tell the sonographer if you are uncomfortable during the test.

Transesophageal Echocardiogram

Like other echo tests, a transesophageal echocardiogram records images of the heart walls and internal structures of the heart in order to assess their function. This test is unique in that sound waves are directed through the esophagus.

What happens during the test?

During the procedure, a scope is inserted into the esophagus behind the heart, allowing the doctor to view images of the heart. Your throat will be numbed with a spray before the procedure begins.  You will be given medication to help you relax.   You will be asked to swallow to pass the tube into the esophagus. The test generally lasts between 30 minutes and one hour.

What do I need to do to prepare for the test?

You will not be allowed to eat or drink for at least six hours prior to the test. Due to the numbing medication, no food or drink will be allowed for two hours after the test.

Treadmill Stress Test

A treadmill stress test is used to evaluate the impact of exercise on the heart. The test involves walking on a treadmill while data is gathered about the electrical activity in the heart.

Why might I need this test?

A treadmill stress test is used to evaluate the function of your heart and valves and determine how well your heart tolerates activity. It can also determine the likelihood of developing coronary artery disease or evaluate the effectiveness of your current cardiac treatment plan.

How should I prepare for the test?

You may not eat, drink or smoke for four hours prior to the test. Also, make sure not to consume caffeine after midnight. Do not apply lotions or powder to the chest area. Make sure to wear comfortable clothing and walking shoes to your appointment.

You may take your prescribed medications the morning of the test with a sip of water. Your doctor may ask you to stop taking some heart medications prior to the test. Be sure to ask your doctor how to adjust your insulin and food intake if you are diabetic. If you have any question about your medications, ask your physician.

What happens during the test?

Several EKG electrodes will be attached to your chest. In male patients, chest hair may be partially shaved to ensure better contact with the skin. The electrodes will be attached to the EKG monitor, and a blood pressure cuff will be placed around your arm. Your blood pressure, heart rate and EKG will be closely monitored during the test.

You will be asked to walk on the treadmill. The speed and incline will be increased gradually every three minutes. You will walk until your age-determined target heart rate is achieved. This may take up to 15 minutes. You will then be instructed to immediately lie down on the exam table so that pictures can be taken while the your heart is beating faster and stronger.  After the test is over, your heart rate, blood pressure and EKG will continue to be monitored for another 10-15 minutes.

Venous Duplex Reflex Doppler

A Venous Duplex Study is a test to check the blood flow through the veins of the arms or legs. Ultrasound is used to check for an obstruction or clot that may be slowing or blocking proper blood flow back to the heart.

What happens during the test?

You will be asked to remove the clothing on your arms or legs, depending on which test is being performed. You will lie down on a bed and the lights will be dimmed so the screen on the ultrasound machine can be seen properly.

The sonographer will use a probe called a transducer with a small amount of gel on the limb to be checked. The entire arm or leg will be examined. The test takes approximately 30 minutes per limb.

Venous Reflux

A Venous Reflux Study checks for reverse blood flow in veins in the legs.

What happens during the test?

You will be asked to remove outer clothing and put on a patient gown. The technologist will place multiple blood pressure cuffs above and below the knee.

While you are bearing no weight on the leg to be examined, the technologist will place a small amount of gel on a special device called a transducer and examine specific locations on the leg. During the test, which lasts about 45 minutes, the pressure cuffs will be inflated and deflated as needed.