Non-invasive Cardiac Testing
Here are some tips to help you with the non-invasive testing procedures that we most commonly may order or perform.
Stress Test
You may be scheduled for an routine exercise or cardiolite stress test or persantine cardiolite stress test. For a routine exercise or cardiolite exercise stress test, you are asked to walk on a treadmill. Different levels of exercise are used with the treadmill depending ones ability. With the cardiolite portion, images are made using a nuclear radioisotope material. The radioisotope is injected into the vein and allows for visualization of the heart. Images are made at rest and after exercise and the pictures are compared. A persantine cardiolite stress test involves using a medications to similarly stress the heart or mimic exercise. Thus, images can be made before and after stress.
If you are scheduled for any of these tests, please bring or wear comfortable walking shoes and clothing. Long slips or dress for the ladies are sometimes uncomfortable and should be avoided, if possible. You may have a light breakfast, no caffeine, and no milk products the day of your test. Please take your medications as usual and bring your prescribed medications with you. A cardiolite or persantine cardiolite stress test will take on the average 4 hours from start to finish. A routine exercise stress test will take on the average 1 hour.
Echocardiogram
An echocardiogram is a test that utilizes a ultrasound pulse wave to records heart images, heart structure and heart function. A transducer is placed on the outside of the chest wall echotechnology is used to "bounce" sound waves off the heart to measure the function of the heart, look at the walls of the heart and the valves.
There are no specific recommendations prior to this test. An invasive type of echocardiogram is the transesophageal echocardiogram (TEE), please see invasive cardiac testing for details.
Electrocardiogram (EKG)
Electrodes are placed on the chest wall and the electrical activity of the heart is measured and recorded. The heart is looked at from several angles, the traces may show irregular heart beats, previous injury or infraction or an acute event. Pacemakers are also evaluated by using the EKG.
Holter Monitors and Event Monitors
These devices are used for monitoring the rhythm of the heart. The holter monitor is usually worn for 24-48 hours and the event monitor is used for longer periods. The event recorder or monitor is used to detect heart electrical activity during symptoms or events. It helps with further evaluation of syncope or presyncopal episodes.
Pacemaker or Cardiodefibrillator Check
If this is your initial check after insertion of a device, please bring the device box with you, if appropriate, after a pacemaker insertion you will be given a box, not with a defibrillator. You will be taught how to use it so that telephonic measurement and follow-up can be preformed. The nurse will check your incision site and teach you follow up care. We usually follow patients telephonically in a pacemaker clinic, however, if your primary care doctor prefers, he/she may follow you.
Lab Test
If you are having a protime measurement for you coumadin, there are no specific instructions. However, if you are unsure of your dosage, please bring your bottle of medication with you or you protime book with you to your visit. If you are coming in for a lipid profile (which measures the amount of fat you have in your blood), we would prefer that you come in a fasting state; nothing to eat or drink after midnight the night prior. You can have your medications (except your diabetic medication) with a sip of water.
MUGA
A MUGA test is a test that measures the function of the heart. A radioisotope is utilized with nuclear scanning to measure the ejection fraction (EF) or pumping action of the heart.
Tilt Table Test
This test is preformed at the hospital to determine the cause of recurrent syncope or loss of consciousness or lightheadedness. The patient is placed on a special table that allows the patient to be placed in a tilted upright 70 degree angle. During the study the patient is observed for any symptoms of syncope, particularly vasovagal syncope. This is characterized by a change in the heart in which it beats slower and/or the blood pressure may drop causing the patient to become lightheaded or to pass out. Medications occasionally may be used to elicit such a response, and to further test for such an episode.