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Diagnostic Investigations offered include:
12 lead electrocardiogram(EKG): A recording of the electrical activity of the heart obtained by connecting small metal discs called electrodes through the skin. During this safe noninvasive test, the electrodes are attached to the skin on the chest, arms, and legs, which are connected to a machine that translates the electrical activity into line tracings on a paper. Usually obtained within 5 minutes. It is performed either at rest or during a stress test or as an ambulatory procedure during event/ holter monitoring.
Echocardiography is primarily used to look for:
The noninvasive transthoracic exam is performed usually by a skilled technician and the procedure takes less than 30 minutes. The physician will perform the transesophageal exam if it is indicated for a particular patient. Make sure to let your physician know of any allergies you may have and if you have any swallowing difficulties prior to this procedure. You will be asked to come on empty stomach except your medications for 8 hrs before the procedure. If you are on anticoagulation, instructions will be given to hold them for a duration depending on your condition. Your throat will be numbed and you will be sedated during the procedure and be expected to swallow a flexible transducer about the size of your finger. The procedure gives excellent images of your heart and has minimal side effects, and helps one make decisions regarding the question at hand. The entire procedure may take 30-60 minutes. After the procedure you will be asked not to eat or drink for 2 hrs and not to drive for 24 hrs. Stress and nuclear imaging: A variety of tests for evaluation of coronary artery disease and the viability or the pumping ability of the heart including: Stress Echo: Treadmill/ Bicycle or Pharmacologic(Dobutamine) SPECT: Treadmill/ Pharmacologic(Persantine or Adenosine) Thallium rest-redistribution study MUGA Detailed instructions will be given prior to the day of the test. Cardiac catheterization and angiogram: This test is usually performed in the setting of a chest pain or heart attack, to diagnose a blocked coronary artery. The gold standard test for conclusive determination of the presence or absence of blockage of the coronary arteries and determination of its distribution and suitability for medical management or for its correction either surgical or interventional. This involves passing of an arterial catheter to the origin of the coronaries in the aorta through puncture of an artery in the groin, arm or neck. This is followed by injection of a contrast dye into the coronary system through the tip of the catheter, which opacifies the coronary tree. Simultaneously, high quality x-ray images of the coronaries are obtained in different projections which could be saved for off-line analysis. In addition, a variety of hemodynamic information can be obtained at the same time and if desired and indicated a right heart catheterization can be performed at the same time. Depending on your situation and based on the findings on the angiogram, you would be recommended either no treatment or medical management (if no blockage or insignificant blockage or for advanced uncorrectable blockages), intervention in the form of angioplasty with stent insertion( if correctable critical blockages in one or two suitable vessels), or a coronary bypass graft surgery (CABG) (if critical blockage in three or more vessels or in the left main coronary artery ). If intervention is advisable and if the angiogram is being performed at a place that can handle the interventions and its potential complications, the intervention could be performed at the same time. Prior to the procedure, inform your physician of any allergies to iodine/ shell fish or to any medications including to local anesthetic agents, if you are a diabetic and if you have any kidney problems. You will be asked to come fasting on the day of procedure. The procedure is usually performed under local anesthesia. The procedure usually takes about 1-3hrs and at the end of the procedure, when the sheath that allows access to the artey is removed, pressure will be applied to the site for about 15-30 minutes. If entered through the groin, you will be instructed to keep that leg straight in bed for about 1-4hrs and then to avoid lifting weights more than 5 lbs for upto 5 days after the procedure. Potential complications associated with the procedure include:
Therefore it is very important to notify a physician or go to the emergency room with any symptoms including continued local bleeding, appearance of hives/ wheezing/ shortness of breath/ chest pain/ palpitations/ pallor/ decreased, increased or absent urination, symptoms of brain attack including unilateral weakness/ slurred speech and facial asymmetry. Disclaimer:The information provided here is for general purposes only, please talk to your provider for actual care as it pertains to your needs. |