Here is an overview of the types of tests available at Swedish Covenant Hospital:
Echocardiogram
Echocardiography uses ultrasound waves to create images of the heart chambers, valves and surrounding structures. An echocardiogram shows the heart in motion, measures cardiac output and detects inflammation around the heart (pericarditis). It aids in the detection and diagnosis of abnormal cardiac anatomy, infections and abnormal blood flow through the heart valves.
An echocardiogram is used routinely to evaluate possible cardiac problems such as coronary artery disease, heart failure, heart muscle diseases and heart valve abnormalities.
What are the various types of echocardiograms that can be performed?
Depending on the purpose of the test, there are variations of echocardiography such as:
- M-mode Echocardiogram. Provides a view of the heart at high resolution. It is an excellent method to measure chamber dimensions and time cardiac events.
- Two-Dimensional Echocardiogram. Provides high-resolution images of the heart and vessels. This is the preferred noninvasive imaging technique for a variety of cardiovascular disorders, and the most common cardiac ultrasound technique in use today.
- Doppler Echocardiogram. Used in conjunction with a Two-Dimensional Echocardiogram. Cardiovascular activities are recorded and all necessary measurements made with computer measurement tools to then be viewed by a doctor.
- Stress Echocardiogram. Obtains high quality images of the heart via stress testing or exercise. For patients who are unable to exercise on a treadmill, medication may be used instead to mimic the effect of exercise.
- Transesophageal Echocardiogram (TEE). Produces dramatically clear cardiac images through the use of an ultrasonic device.
Cardiac Stress Test
A cardiac stress test is the analysis of the heart's electrical activity and rhythms before, during and after exercising on a treadmill or bicycle.
Many people with coronary artery blockage have minimal symptoms and an unchanged EKG while at rest. By exposing the heart to the stress of exercise during the test, signs and symptoms of heart disease may be revealed and can lead to a definitive diagnosis and treatment.
The test screens for the presence of heart disease and evaluates the physical status of previous surgical procedures, such as coronary artery bypass and angioplasty, as well as an individual's fitness level. It is performed in the presence of a physician, and is also known as a graded exercise test (GXT), exercise-tolerance test (ETT), exercise-stress test, exercise electrocardiography or treadmill test.
Stress Echocardiogram
A stress echocardiogram combines echocardiography – the use of ultrasound waves to create images of the heart chambers, valves and surrounding structures – with stress testing, the analysis of the heart's electrical activity and rhythms recorded on an EKG before, during and after exercising on a treadmill or bicycle.
The test screens for the presence of heart disease and may also be used to evaluate previous surgical procedures. Performed in the presence of a physician, the attending cardiologist will look for changes in the wall motion of the heart before and after the EKG.
Dobutamine Stress Echocardiogram
A Dobutamine stress echocardiogram is available for patients who are unable to exercise on a treadmill or bicycle. The test is similar to a stress echocardiogram, but performed by substituting the drug Dobutamine, which mimics the effect of exercise on the heart, for the exercise portion of the exam.
Nuclear Stress Test
A nuclear stress test uses a small, safe amount of Myoview, a radioactive substance, as a tracer to produce images of the heart taken before and after exercising on a treadmill.
Nuclear stress testing is routinely used to aid in the diagnosis of coronary artery disease and to evaluate the effectiveness of cardiac medications, open-heart surgery or angioplasty. You may be referred for a nuclear stress test if your original cardiac stress test produced abnormal results.
Persantine Nuclear Stress Test
A Persantine nuclear stress test is offered to patients who are unable to exercise on a treadmill or bicycle. The test is similar to a nuclear stress test, but performed by substituting the drug Persantine, which mimics the effect of exercise on the heart by dilating the arteries of the body and heart, for the exercise portion of the exam.
Holter Monitoring
The Holter monitor is a device that records your heart rate and rhythm continuously for 24 hours (or longer) while you are at your home. This means that it records each and every heartbeat over that time and gives the physicians at Swedish Covenant Hospital a constant reading of your heart's activity.
Holter monitoring is used to determine how the heart responds to normal activity. Other times, it may be used when a patient is given cardiac medication, has experienced a heart attack or been diagnosed with an abnormal or dangerous heart rhythm.
From this recording, a wide variety of information can be obtained, including:
- Day and nightime heart rates
- Arrhythmias, or abnormal heart beats
- Heart rhythm recordings during any symptoms
How does it work?
The Holter monitor is battery-powered and holds a regular-sized cassette tape. Electrodes on the chest are connected to wires from the Holter monitor, which is carried with the patient for the recording period. The electrodes pick up the electrical impulses of the heart, which are then recorded by the monitor.
While you are wearing the monitor, you will be asked to keep a log of your daily activities—what you did and at what time. This will help the doctor figure out what you were doing during times when there were abnormal readings.
What should I expect?
Holter monitoring is a painless test, since it is a recording device and does not send out electricity. You will need to go into your doctor's office to be fitted for the monitor. You may continue normal activities while wearing the monitor. After 24 hours (or more), you will go back to your doctor's office to have the electrodes removed.
Are there risks involved?
There are no risks associated with the test. However, you should be sure not to let the monitor get wet.
Event Monitoring
Event monitors are small devices that are used by patients over a longer period, typically one month. Similar to a Holter monitor, recordings from an Event monitor during symptoms help your doctor to examine any abnormalities in your heart rate and rhythm.
Once a recording has been made, it can be transmitted over the phone back to your doctor at Swedish Covenant Hospital.
How does it work?
Two electrodes on the chest connect two wires to the event recorder. The monitor is always on, but will only store the patient's rhythm when the patient or caregiver pushes the button. The intent is for most event monitors to be worn as much as possible every day to increase the chances of recording the patient's rhythm when he or she has symptoms.
What should I expect?
Event monitoring is a painless test, since it is a recording device and does not send out electricity.
Are there risks involved?
There are no risks associated with the test. However, you should be sure not to let the monitor get wet.
Electrophysiology Study
An electrophysiology study, performed through the Electrophysiology Program at Swedish Covenant Hospital, allows precise diagnosis of rhythm problems to determine the appropriate therapy. During the study, the physician examines electrical heart patterns through insertion of a catheter into the heart, and pinpoints and recreates the arrhythmia for observation and analysis.
Cardiac Catheterization
Cardiac Catheterization is a specialized X-ray examination of the heart that uses contrast dye inserted through a catheter to allow the doctor to view the condition of the heart chambers, valves and coronary arteries. It is also known as a "dye study of the heart" or coronary angiogram.
This procedure is used to look for any problems in the heart valves or main blood vessels, or to see if there is fatty buildup in the coronary arteries. It takes place in the Cardiac Catheterization Laboratory.
What treatment options might be recommended from this procedure?
If abnormalities are found, treatment may include medication, changes in daily habits, surgery, further cardiac tests or angioplasty.
