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As the first step in diagnosing your heart or vascular problem, your doctor or one of the hospital staff doctors will ask you questions about your health history, your current symptoms, and complete a brief physical exam. This is a good time to ask the doctor any questions you might have about what is happening to you. A brief examination may follow, and routine tests, such as blood pressure, urine and blood samples, and chest x-rays may be taken. Once this preliminary screening is completed, the doctor will tell you what other tests are needed and share the results of any tests you have had thus far, and what the next steps will be. If more information is needed, the doctor will recommend additional tests at this time.
There are many tests and procedures available to help determine if a person has cardiovascular disease, the type of disease, the severity, and the most effective treatment methods. Tests may be considered invasive or noninvasive. Tests may also be referred to as diagnostic or procedural as well. Definitions, description and special instructions will be provided in this section. If you have any questions about your test or procedure, it is very important to talk to your doctor and care team.
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| Types of Tests |
| Electrocardiogram (ECG or EKG): a recording of the electrical currents that cause the heart to beat. During this short and painless procedure, an ECG technician places electrodes—sensing devices—on your chest, arms, and legs. |
Holter Monitor: is a special way of observing your heart over an extended period of time using a portable 24 or 48 hour ECG.
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Cardiobeeper/Event Recorder: a small pocket-sized heart monitor you carry for one month. The monitor makes a recording of irregular heartbeats for your doctor to review and evaluate.
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Loop Monitor: a small pocket-sized 30-day heart monitor. The monitor makes a recording of irregular heartbeats for your doctor to review and evaluate.
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| Echocardiogram (Cardiac Ultrasound): a non-invasive test which shows your heart’s structure, motion, and blood flow. The test can help identify such problems as narrowing or leaking of valves, heart defects such as abnormal communication between the right and left sides of the heart, and heart muscle malfunction. The echocardiogram uses high-frequency sound waves to create two-dimensional images of the heart. |
Exercise Stress Echocardiogram: one way of seeing how your heart works during rest and exercise.
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Dobutamine Stress Echocardiogram: In this test, you’ll be given gradual doses of a medication called Dobutamine through an intravenous line (IV) in your arm while an echocardiogram is done. Your doctor uses this information to evaluate how your heart is working and how it reacts to the drug.
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Transesophageal Echocardiogram: a test where physicians obtain ultrasound images of the heart from a probe positioned in the esophagus.
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| Stress Test |
Exercise Stress Test: a safe way to put stress on the heart in a controlled setting. This test may be performed in a variety of ways: it involves walking on a treadmill, or it may involve receiving intravenous (IV) medications which simulate the effect of exercise on the heart. In either case, your cardiologist may also prescribe x-ray pictures of the blood flow to your heart (also called “nuclear imaging”), which involves giving you IV medications.
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Nuclear Stress Test: during this test, a small amount of radioactive tracer is injected into a vein. A special camera detects the radiation released by the tracer to produce computer images of the heart. Combined with exercise, the test can help determine if there is adequate blood flow to the heart during activity versus at rest.
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Nuclear Adenosine Stress Test: During the test, a small amount of radioactive tracer is injected into a vein. A special camera detects the radiation released by the tracer to produce computer images of the heart. Combined with a medication called adenosine (Adenoscan), the test can help determine if there is adequate blood flow to the heart during activity versus at rest.
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| Cardiac Catherization/Arteriogram (Vascular): During the procedure your doctor will insert a catheter into an artery in your groin or arm. This thin, flexible tube is directed through the artery, into the aorta, then into your heart. A special dye will be put through the catheter, which will allow the physician to see your heart’s arteries. |
| Vascular Ultrasound |
Duplex Scan is an ultrasound examination that allows doctors to evaluate the blood flow in the arteries or veins almost anywhere in the body. The term duplex implies the use of traditional ultrasound, in combination with Doppler technology. There are duplex scans of the carotid arteries in the neck, the abdominal aorta, the kidneys, and the arteries or veins of the arms and legs. It is a comfortable, painless exam in which a technologist applies a water-based gel to the skin and scans over it with a probe called a transducer. The image created provides information about the blood flow in that area. A vascular surgeon or radiologist interprets these images and report the information to your doctor.
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Aortic ultrasound is an examination of the structure and blood flow through the abdominal aorta, the large blood vessel that courses through the abdomen and provides circulation to the vital organs and limbs. These exams are often performed if there is an aneurysm (dilated area of the blood vessel) or one is suspected because of the way the vessel sounds or feels when the doctor examines the abdomen.
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Doppler test is a broad term that can be applied to almost all of vascular ultrasound. Doppler ultrasound uses sound waves to evaluate the blood flow through a vessel.
Color doppler allows us to see how well the blood fills the vessel. Pulsed wave dDoppler is the “noisy” part of the test. It provides information about the velocity of blood flow, which can aid in the detection of stenosis or narrowing of a blood vessel. Doppler tests can be useful to detect disease in arteries caused by plaque build up, or in veins caused by a blood clot.
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