Cardiology Procedures

Aorta Ultrasound

The aorta is the largest, highest pressure artery in the body that distributes blood from the heart to all areas of the body. High pressure can cause the weakened portion of the wall to enlarge or balloon. This weak spot is called an aneurysm and may leak or rupture causing internal bleeding and/or death. The abdominal aorta ultrasound can detect aneurysms as well as blockages in the lower portion of the aorta below the diaphragm. It can also be used to check the aorta after repair. Fasting is required before this test is performed. Usually there are no presenting symptoms of an aneurysm so these are usually diagnosed initially by an incidental test or on physical exam.

Carotid Doppler study

This is a painless ultrasound exam of the arteries in the neck which supply blood to the brain. It is used to assess the plaque build up in these arteries. The test takes approximately 30 minutes.

Chest X-ray

This is simply an x-ray of your chest which can provide your doctor with information about your heart and your lungs.

CT Scan

A CT can see inside the heart and other parts of the body. CT scan will image areas that cannot be seen on regular x-ray examinations. CT makes it possible to diagnose certain diseases earlier and more accurately than with other imaging tools. Because most diseases are better treated when found early, CT scans can help save lives.

Echocardiogram

This procedure is often referred to as an echo or ultrasound of the heart. An echocardiogram allows us to see the beating heart through the use of ultrasound technology. With an echo we can assess the strength of the heart muscle, the function of the heart valves, look at the pericardium (the sac which contains the heart), and the origin of the aorta and pulmonary arteries. We can also estimate pressure inside certain chambers of the heart. There a numerous reasons why your doctor may order an echocardiogram. We will use echo to evaluate chest pain, shortness of breath, swelling of the legs and feet, heart murmur, congestive heart failure, heart attack, previous angioplasty or coronary bypass surgery, palpitations, hypertension, and pulmonary hypertension. 

EKG/ECG (electrocardiogram)

An EKG is a simple test that records in real time electrical activity of the heart. A normal EKG will represent a short six to twelve second event of what your heart is doing.  Your physician will want an EKG on you for many reasons including, but not limited to:

• to keep a baseline EKG for your chart to have for comparison if something looks abnormal down the road
• if you complain of dizziness or lightheadedness to see if your heart is too slow
• if the heart sounds irregular on exam.
• if you complain of “palpitations”
• if you are complaining of chest pain

Evaluation of Cardiac Function with Radionuclide Ventriculography – MUGA

Radionuclide ventriculography is a non-invasive study, which provides information about the pumping function of the heart. In patients with coronary artery disease, and in those who have had a heart attack, the assessment of the pumping function of the heart (also known as the ejection fraction) is essential in the prediction of both long-term and short-term survival.

A small dose of an imaging agent is injected into the blood stream and pictures of the four chambers of the heart are taken using a special camera (gamma camera). These techniques can also provide information about the function of the valves of the heart, the integrity of all the cardiac chambers, and can be used to monitor the effect of different drugs on the heart muscle (in patients with cancer who are treated with chemotherapy). The evaluation of cardiac function with radionuclide ventriculography is accurate and non-invasive and continues to play a critical role in predicting outcomes in patients with heart disease.

Inferior Vena Caval Filter (IVC Filter)

This procedure is basically an attempt to keep a blood clot found in the legs (DVT) from traveling to the lungs and causing a potentially deadly pulmonary embolus (PE). Most often we do this procedure when a patient has a blood clot in their legs and is unable to be treated successfully or safely with traditional blood thinning medications.

Lower extremity arterial study

The blood pressures are measured at your ankles to see if you have evidence of clogged arteries in your legs. An ultrasound machine is used to examine these arteries to evaluate them for plaque and blockages.

Myocardial Perfusion Imaging (MPI) Stress Test

Myocardial Perfusion Imaging (MPI) Stress Test is also known by other names such as a nuclear medicine stress test, cardiolite stress test, sestamibi stress test, or stress SPECT. The test is a noninvasive way to assess the blood flow to the muscle of the heart. We inject a nuclear tracer into the blood stream and the tracer is taken up by the heart muscle cells that receive good blood flow. We image the heart with a camera that senses gamma rays released by the tracer. This provides us with a map of where the blood flow to the heart is adequate. We will scan your heart once at rest to produce a baseline image. You will then undergo some type of stress that increases the workload of the heart (either with you on the treadmill or receiving IV medication such as dobutamine or adenosine) followed by a second scan that shows the quality of blood supply at peak exertion. We compare the two images to determine if there are any areas where the blood flow worsens with physical stress. Such a finding would suggest the presence of blockage in the coronary arteries.

We generally use the MPI stress test as the first step in evaluating any patient we suspect of having coronary artery disease. Symptoms such as chest pain or discomfort, shortness of breath, and exertional intolerance are common reasons for which we perform this study. We often do this test on patients with no symptoms if they are found to have an EKG abnormality or are anticipating a major surgery. We can also use nuclear stress testing evaluate the status of a previously placed coronary stent. 

Peripheral Angiogram (Peripheral Arteriogram)

Peripheral angiograms (arteriograms) are considered the gold standard for testing the arteries which supply the blood to the head and neck or those to the abdomen and legs. Peripheral angiograms do not include the brain or heart vessels. The type of treatment your particular condition may require will be determined by your angiogram. These are minimally invasive, outpatient procedures and usually you may go home after the procedure.

When angiograms are performed during a surgical procedure, the length of time in the hospital will be individualized by your condition. Because these procedures involve the use of a contrast material to allow visualization of the blood vessels on an imaging screen, you may be prescribed medication to take before the procedure to protect the kidneys and will be asked to drink more water the day before the procedure.

Renal Duplex

An ultrasound machine is used to examine the arteries that carry blood flow to the kidneys, as well as to examine the flow within the kidney itself. The best pictures are obtained if you are fasting for 6 hours prior to the exam.

Transesophageal Echocardiogram

A Transesophageal Echocardiogram (TEE) is a special type of echocardiogram, or ultrasound of the heart, that allows us to obtain very detailed images of the structures of the heart. We pass a small ultrasound probe down the esophagus (swallowing tube) and take pictures of the heart from inside your body. This test is performed to evaluate the valves of the heart, the pumping function of your heart, and to look for any blood clots or birth defects of the heart. We would recommend a TEE if we suspect valve leakage or narrowing, infection in the heart, or if you have a stroke without a clear cause. We sometimes perform this test prior to a cardioversion, or electrical shock of the heart, to look for blood clots in your heart that could lead to a stroke. 

Venous Doppler study

An ultrasound machine is used to examine the veins in your legs or arms to see if they contain blood clots, or to evaluate the veins from the leg used in heart bypass surgery.