Diagnostic procedures

Echocardiography (both transthoracic and transesophageal)

This test uses ultrasound (high-frequency sound waves) to create a videotape of the heart’s chambers, valves, wall motion and blood flow patterns. This can be done by applying the ultrasound probe to the chest wall (transthoracic) or by passing the probe through the patient’s throat (transesophageal) in order to image the patient’s heart from inside the chest.

3D computerized imaging

Three-dimensional (3D) computerized imaging is an advanced form of CT scanning. It produces high-resolution, 3D images that can be manipulated using computer software.

Calcium scoring screening

Cardiac computer tomography is a screening method that records a series of detailed images of the heart’s blood vessels to detect calcium buildup in the coronary arteries and signs of coronary artery disease before damage to the heart has occurred.

Coronary CTA exam

Coronary CT angiography (CTA) is a noninvasive heart imaging technique using high-speed computed tomography to visualize your heart blood vessels. The scan can detect early signs of coronary heart disease that may be invisible in other heart tests. During the procedure, dye is injected into your arm through an IV line. You then lie on a special table that moves slowly into a large circular opening, where the scanning takes place.

Dobutamine stress echocardiogram

This test is chosen for patients who are unable to perform physical exercise. The drug dobutamine is given through an IV, causing the heart muscle to behave as though it was being exercised. An echocardiogram is performed during the infusion to measure the heart’s ability to pump under the stress of exercise.

Electrical cardioversion

This helps return an abnormal or irregular heartbeat (most commonly atrial fibrillation) to normal by using an electrical shock delivered through special patches on the outside of your chest and back. This improves blood flow throughout your body. Electrical cardioversion may help decrease symptoms from an arrhythmia including breathing difficulties and reduced energy levels. It may reduce your chances of suffering from heart failure or a stroke.

Event recorder monitoring

A cardiac event monitor records cardiac activity before, during and after a patient experiences symptoms. It is used when symptoms occur infrequently, but at least monthly. When pain or other symptoms begin, the patient starts the monitor by pressing a button. An event monitor is usually used for up to one month.

Holter monitoring

The Holter monitor provides a 24- to 48-hour tape-recording of heart signals. Every beat—normal or abnormal—is recorded. This test differs from a standard electrocardiogram (ECG) that only tests your heart at rest during a 12-second period. The Holter test evaluates heart function throughout a normal day. It can detect intermittent heart disturbances that may not occur in the doctor’s office or hospital setting.

Nuclear cardiology

This form of stress testing uses radioactive isotopes to take images of and evaluate blood flow to the heart muscle. The patient exercises on a treadmill to increase his heart rate. Once the targeted heart rate is achieved, an isotope is injected through an IV. After exercise is completed, the patient is transferred to the nuclear lab for imaging. The patient returns either the same day or the next day to the nuclear lab so images of the heart at rest can be taken.

Stress echocardiogram

The patient walks on a treadmill to accelerate his heart rate. Once maximum exercise capacity is reached, an echocardiogram is performed to measure the heart’s ability to pump under the stress of exercise.

Tilt-table testing

During a tilt-table test, blood pressure and heart rate are measured in response to changing positions. This test can be used to diagnose causes for fainting.

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