Cardiac tests give your doctors important information about your heart and circulation.
This information can be used to determine the best treatment for your condition.
Not all of these tests will be performed. Your doctor will determine which ones are
best for you after evaluating your condition and symptoms.

Echocardiogram.  An echocardiogram takes sound wave pictures of your heart. The technician places a hand-held plastic ultrasound probe against your chest. A computer shows the sound waves reflected as an image of your heart on the screen. There are no known side effects from these sound waves and the test does not hurt although you will feel the pressure of the probe on your chest. The test takes about 30 minutes and no preparation is required. The image gives the doctors a wealth of information about your heart. It shows the 4 chambers of your heart, the strength of your heart muscle, the presence of fluid around the heart, problems with your heart valves, congenital heart disease and information about the pressures within your heart. Your doctor may also order a stress echocardiogram in which a medicine called dobutamine is infused into your vein to increase the contraction of your heart.

Electrocardiogram (EKG).  An EKG is a way of recording the electrical activity of your heart. It is performed by placing 10 recording leads on your body (1 on each arm, 1 on each leg and 6 on your chest around your heart) while you lay on your back. The test does not hurt and has no side effects and only takes a few minutes. This test gives the physician a look at multiple angles of the heart's electrical activity and helps, along with other tests, to diagnose any abnormalities.

Exercise Tolerance Test (ETT).  This test involves taking a continuous electrocardiogram (EKG) and blood pressure measurements while you are walking or jogging on a treadmill. Sometimes this test can detect heart disorders which are otherwise missed while you are at rest. Bring comfortable walking shoes and comfortable loose fitting clothes. You will be asked not to eat within 1 hour before the test. Your doctor may advise that you do not take some of your medication before this test. You also may be asked to exercise on a bicycle. Your heart will be monitored the whole time and a professionally qualified person will be with you. The test takes about 30-45 minutes.

MVO2.  This treadmill test measures the gas exchange in your lungs while monitoring you with an EKG. You will breathe into a breath analyzer that measures the gas exchange in your lungs. A special plastic probe will be clipped to your finger to measure the oxygen in your blood while you exercise.

Holter Monitor.  Your doctor may order a holter monitor in addition to the telemetry monitor that you will wear on the unit. The holter monitor has more wires than the telemetry monitor and records your heart rhythm continuously on a tape. You may need to wear this monitor for 48 hours total. The tapes will then be sent to a special lab where they will be analyzed to detect any arrhythmias or abnormal patterns. It is important to wear the monitor as much of the 48 hours as possible and to keep a diary of any symptoms, activities or times you need to remove it for showering or dressing. If the monitor patches bother your skin your doctor may prescribe hydrocortisone cream to relieve the itching.

MRI Scan.  An MRI is done in a large cylinder with a strong magnetic field and uses radio waves to create images of the inside of your body. There is no radiation associated with MRI. Our machine can take special pictures of the heart and its movement and function and may take from 20 minutes to two hours. An IV may be placed in your arm before the test and for some tests you will not be able to eat after midnight before the MRI. All jewelry, watches and metal objects must be removed because of the magnet and you must tell your doctor and technician if you have any metal in your body (metal clips, plates, fragments). We have movies, music, tapes, DVD's, CD's and headphones for your comfort during the time you are in the machine; you may also bring your own selection to listen to or view. The MRI does make a thumping sound and your headphones or earplugs can be used to muffle the sound. You will be asked to lie on the MRI bed and a belt will be placed around your abdomen to monitor when you breathe in and out. A pad will be placed behind your back and on the front of your chest. These are part of the MRI and will take pictures of your heart. When you are in the machine the technologist will be able to see and talk with you. You may be asked to hold your breath for 10-25 seconds at a time while we take pictures. Your heart rhythm and the oxygen level of your blood may be monitored during the test. Sometimes a special medication is injected which "stresses" the heart by increasing blood flow in the heart and serves as an alternative to exercising on a treadmill. This test can help detect heart disease. A contrast agent given through your IV is sometimes used to brighten areas of the MRI images. Your doctor will discuss this with you before giving you any medication.

MUGA or RNA Scan (Radionuclide Angiography).  This test helps determine how the ventricles of the heart are functioning and can help detect blockages in coronary arteries restricting blood flow within the heart. This procedure requires two intravenous injections. The first prepares the blood and then fifteen minutes later you will receive a second injection, a small amount of the radionuclide technetium 99m. You will lie on a table with electrodes on your chest to monitor your heart and a special camera will be positioned over your heart. You will be asked to remain very still while your blood pressure, pulse and heart rhythm are monitored. Then you will put your feet in bicycle pedals while lying on the table. You will pedal while the workload is increased and in the last couple minutes of the test pictures of your heart will be taken with the special camera. Your doctor will use these measurements and pictures to evaluate your heart function. The radioactive injection you receive is safe and your body will eliminate it through your kidneys within approximately 24 hours. Females will be tested for pregnancy as the procedure is contraindicated during pregnancy.

PET Scan.  Positron Emission Tomography (PET) scans can be used to study the blood flow and metabolism of the heart. The most common use in cardiology is to detect heart muscle that is weak but not irreversibly damaged. This is important because weak muscle can still benefit from angioplasty or a bypass operation whereas damaged muscle probably cannot. The night before the procedure you will not be able to eat or drink anything, you may take any morning medications the doctor orders with a sip of water. An IV will be placed before the scan. The PET camera is shaped like a doughnut and the table you are lying on will move into the center hole of the camera. The process may take 2-3 or more hours. Females will be tested for pregnancy as the procedure is contraindicated during pregnancy. For more information see the PET Scan home page.

Telemetry Monitoring.  While on our unit almost all patients wear a telemetry monitor. This monitor consists of a box that can fit in your pocket or in a fanny pack and has five wires that are applied to your chest area. This monitor transmits your heart rate and rhythm to central monitors located in the nurses' station. The central monitor will alarm if you have any abnormal rhythm and will print out a strip of the rhythm. The staff will also review the stored recordings every few hours to make sure they have not missed any alarms. The alarm will also discharge for "artifact" or false readings. The trained staff can tell the difference between real and false readings and will contact the doctor if there is any question about your rhythm.

Thallium/Technetium Perfusion Scan.  This procedure shows how well your heart muscle is being supplied with blood at rest and after exercise. It will show if you have a decreased blood flow to the heart muscle during exercise and if so, whether the blood flow improves with rest. You will be asked not to eat or drink any caffeine from midnight before the test. You may have water. You will have an IV inserted for this test and you will be connected to a cardiac monitor and blood pressure cuff. For the exercise portion of the test you will walk on a treadmill machine. A nurse and physician will be present. You must tell them if you experience any chest pain or shortness of breath or other problems while you exercise. Let the staff know one minute prior to your needing to stop exercising. At that time the radioactive substance, thallium-201 or technetium 99m, will be injected through the IV. You won't feel anything or react to the injection. You will continue to exercise for 1 more minute. You will then be taken to the scan room and lie on a narrow table with your arms raised over your head. It is important to lie still while the camera scans over your heart for about 30 to 45 minutes. You will then go back to your room and return about 2 hours later so your heart can be scanned after resting. A second small dose of thallium is given prior to the second scan. After this scan you will return to your room unless another test is scheduled. If you are unable to walk on the treadmill, your doctor may inject some medication that simulates your heart's state during exercise. As an alternative to exercise, the physician may "stress" the heart with medications such as dipyridamole or adenosine which increases blood flow in the heart. Tell the doctor if you have periodic wheezing or asthma. Females will be tested for pregnancy as the procedure is contraindicated during pregnancy.

Transesophageal Echocardiography (TEE).  A TEE is a test that looks at your heart using ultrasound waves and is used only in special cases. Your heart's structure and valves and blood flow can be visualized in more detail than standard echocardiograms. First your throat will be numbed with an anesthetic spray and medication will be injected into your IV to help you relax. A long flexible transducer will be placed from your mouth into the esophagus and lined up with the heart. The transducer will gather sound waves that bounce off the heart structures and the doctor will be able to view these on a screen. This information can be very valuable in your diagnosis. You will need to be without food or water for six hours before the test and several hours after the test. You will not be able to drive for 24 hours after the test. If you are discharged before then you must have someone drive for you.