Nuclear Stress Testing
This procedure is used in the evaluation and management of patients with chest pain or shortness of breath who are suspected of having coronary disease or who have had previous coronary procedures such as angioplasty, stent placement or bypass surgery. We perform nuclear stress testing in our office on a daily basis using the services of a full time nuclear technologist and state of the art equipment. The test requires a 3-hour fast, followed by treadmill or drug stress testing and is completed with a heart scan. The test takes about 3 hours to complete due to the waiting time between scans.
Echocardiography and Stress Echocardiography
Echocardiography (also known as Doppler Echo) is a sound picture or sonogram of the heart and is used to evaluate patients for conditions that can produce chest pain, shortness of breath or palpitations. The gowned patent lies on the exam table with the left side down. A technician positions the sound probe under the left breast or chest. Images are viewed in real time for preliminary diagnosis and recorded on videotape for later analysis. No preparation is required for a resting echocardiogram, which requires about 20 minutes to complete. When performed with a treadmill test, images are taken before and after exercise. The exercise or stress echo does require a 3 hour fast.
In this procedure, the technician positions a sound probe over the carotid arteries on both sides of the neck. The carotid artery is the blood vessel, which carries blood to the brain. Thickening or narrowing of the artery due to cholesterol accumulation can be easily visualized. The test is used to evaluate patients with stroke like symptoms or to assess the risk for future stroke.
Patients with evidence for irregular heart beating often wear a 24-hour solid-state recorder known as a Holter Monitor that is attached to the chest with electrodes and worn on a belt. After the device is returned the following day, the continuous EKG recordings it contains are downloaded to a computer and analyzed for patterns of irregular heartbeat. If the patient presses the event button at the time the symptoms occur, an explanation for the complaints may emerge. In some instances, when the irregular heart beat occurs less frequently, a "transient event recorder" is needed. We offer several types of these monitors. Some models do not require patient activation because the device can automatically send an abnormal recording to a central monitoring station.
Peripheral Arterial Doppler
This procedure determines the presence or absence of blockage in the leg arteries of patients with leg pains upon walking. A technician takes the blood pressure in the thigh, calf and toes using a hand held Doppler probe, which detects pulses in the legs even if they are decreased. The examination is non-invasive and requires about 30 minutes to complete.
Microvolt T Wave Alternans Testing
This procedure is performed on a treadmill in a similar manner to a routine stress test. A sophisticated computer is attached through electrodes on the patient's chest. The computer measures minor electrical variations in each heart beat to determine if a patient with ventricular premature beats and a weakened heart muscle is susceptible to a dangerous heart rhythm known as ventricular tachycardia. This noninvasive test, if negative, may eliminate the need for more invasive testing.