Electrocardiogram (ECG, EKG)
This is a painless procedure that takes 5-10 minutes. Electrodes are placed on the patient’s arms, legs, and chest in different locations. The electrode placement allows the viewing of electrical activity in the heart from several directions. The ECG gives information about heart rate and rhythm. It also provides information about areas of the heart muscle that are not receiving enough blood and oxygen. It can tell the physician if you are having a heart attack or have had one in the past.
Echocardiogram (ECHO)
This is a procedure in which sound waves are used to evaluate the heart. Information is obtained concerning the heart’s size, muscle function, valve function, and internal structure. A small instrument called a transducer is covered with a gel-like substance and pressed firmly on the chest. It is then moved back and forth on the chest. The sound waves produce an image of the heart that is seen on a small television screen. These images are recorded for the doctor to read and for documentation. This test takes 15-45 minutes and is usually painless. Some people experience some chest tenderness when the transducer is rubbed on the chest.
Exercise Stress Test (Graded Exercise Test, Exercise Tolerance Test, Stress Test)
During this procedure, you will be connected to a monitor very similar to the monitor used to perform an EKG. You will then walk on a motor-driven treadmill or pedal an exercise bike. While you are exercising, a physician and technician will be monitoring your heart’s electrical activity, blood pressure, and heart rate.
This test evaluates the severity of the disease and examines abnormal heart rhythm. The test evaluates your exercise capacity and can be used to plan for your treatment and rehabilitation. This test takes 30-45 minutes. You will be asked to sign a consent prior to taking this test, giving the physician permission to test you. You may experience general fatigue or leg fatigue during the test. If you experience any chest, art, jaw, neck, or shoulder pain please inform the physician and technician immediately.
Exercise Myocardial Perfusion Scan
This test is done in conjunction with a stress test (described above). Prior to the start of the stress test, an IV is started. While you are walking on the treadmill or riding the bike a small amount of radioisotope will be injected into the IV. You will be asked to exercise another minute to ensure the radioisotope is circulated to your heart muscle. After completion of the stress test, you will be given a scheduled time to return to the lab for pictures to be taken (½-2 hours). To take the pictures, you will be asked to lie on a table while the scanner is placed over your chest. It may be necessary for you to return to the lab on the following day for more pictures, but this is not always necessary. This test gives your doctor a visual picture of the heart muscle. As with a plain exercise test, you will be asked to sign a consent form after all of the risks involved have been explained to you.
IV Persantine Myocardial Perfusion Scan
This is a test designed for patients that might have difficulty exercising to the desired level. An IV is started and medication (Persantine) is injected into the IV. This medication makes the heart respond as if you were exercising. A physician and nurse will monitor your heart’s electrical activity, blood pressure, and heart rate just as during an exercise stress test. You may still be asked to walk on the treadmill for a short distance if your physician believes this will be of benefit. At the correct time, the radioisotope is injected into the IV and the scan images are taken as described in the Exercise Myocardial Perfusion Scan. Some of your current medications may need to be held for several days prior to the test. If this is necessary your doctor or nurse will tell you.
Cardiac Catheterization (Coronary Angiography)
This test is used to determine the severity and location of the blocked arteries, the degree of the heart muscle damage, and the function of the heart valves. You will be asked to sign a consent for this procedure after it has been explained to you and all of the risks reviewed.
A thin, flexible hollow tube (catheter) is inserted into the patient’s leg or arm and is gently threaded through the artery and/or vein until it reaches the heart. Dye is injected to visualize the chambers of the heart and the coronary arteries. The test is performed in the cardiac cath lab. X-ray machines make it possible to visualize the heart. When the dye is injected you may feel hot or flushed, but this should last only 20-30 seconds. You are awake during the procedure, but often the doctor will give you a sedative before the test to help you relax. The test usually takes one hour.
After the test is completed, the catheter is removed and a pressure bandage or sandbag is applied to the puncture site. When you get back to your room the nurses will be checking you carefully for several hours and you will be asked to lie in bed for at least six hours. Please let the nurse know if you notice any bleeding around the bandage or your leg or arm becomes cold or numb. You may experience some discomfort at the puncture site and the area around the site may become discolored (bruised).
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