Services Provided

Stress Testing and Cardiac Imaging

Treadmill Test / Echocardiogram Stress Test / Nuclear Stress Test / Nuclear Stress Test with Pharmaceutical Stress / MUGA (Multigated Acquistion Scan) test / CT Coronary Angiogram / CT Coronary Calcium

Ultrasound

Echocardiogram / Echocardiogram with Bubble Study / Carotid Duplex / Venous Duplex ultrasound of the upper or lower extremities> / Arterial Duplex Ultrasound of the upper or lower extremities or abdominal organs

Electrophysiology

Pacemaker Implantation and follow-up / Defibrillator Implantation and follow-up / Implantable Loop Recorder Implantation and follow-up / Holter/Event Monitoring / Invasive electrophysiology study / Arrhythmia Ablation including SVT, Atrial Fibrillation, and Ventricular Tachycardia

Heart and Vascular Catheterization

Left and right heart catheterization / Stent Implantation / Transcatheter Aortic Valve Replacement (TAVR) / Percutaneous closure of atrial and ventricular septal defects / Percutaneous of patent foramen ovale / Angioplasty of the lower extremity / Lower Extremity Venous Ablation

Other Tests:

24 Hour blood pressure monitoring / Ankle Brachial Index Measurement

Treadmill Stress Testing

Also known as a stress test, or exercise treadmill test, this test helps the doctor find out how well your heart handles work.  A patient is hooked up to equipment to monitor the heart and the patient walks on a treadmill.  The speed on the treadmill is increased and is tilted to produce the effect of going up a small hill.  As the patient begins to exert more effort, the heart begins to work harder, which requires more oxygen.  This causes the heart to pump more blood.  The test will show the doctor if the blood supply is reduced in the arteries that supply the heart.  This test is usually recommended by a doctor to diagnose coronary artery disease, or diagnose a possible heart-related cause of symptoms such as chest pain, shortness of breath or lightheadedness.  Instructions for this test include the following:

  • Please wear comfortable clothes including sneakers or rubber soled shoes.
  • Take all of your prescribed medications unless your doctor tells you otherwise.
  • Avoid caffeine (coffee, tea, chocolate, soda, etc.) starting 24 hours before the test.
  • You can eat a small meal up to 2 hours prior to your test. Diabetic patients may eat a small meal as necessary to ensure proper maintenance of blood sugar.
  • Please arrive 15 minutes prior to your test time to complete any necessary paperwork that is needed for your testing. Also please bring your insurance cards, a photo ID, and a list of your current medications.

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Echocardiogram Stress Test

An Echocardiogram Stress Test is given to help evaluate the condition of your heart and arteries. A cardiac sonographer will perform a resting echocardiogram, which provides a graphic outline of the heart’s movement created from ultrasound vibrations echoed from the heart’s structures.  After the echocardiogram test, you will exercise on a treadmill, gradually increasing the intensity of the exercise.   During the treadmill test, you will be closely monitored by a physician.  When the treadmill portion of the exam is finished, you will be asked to have another echocardiogram performed.  Instructions for this test include:

  • Please wear comfortable clothes including sneakers or rubber soled shoes.
  • Take all of your prescribed medications unless your doctor tells you otherwise.
  • Avoid caffeine (coffee, tea, chocolate, soda, etc.) starting 24 hours before the test.
  • Do not eat or drink anything except water for four hours before the test.
  • Do not smoke on the day of the test, as nicotine will interfere with the results of your test.
  • Please arrive 15 minutes prior to your test time to complete any necessary paperwork that is need for your testing. Also please bring your insurance card(s), a photo ID, and a list of your current medications.

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Nuclear Stress Test

This test helps determine the amount of blood flow of your heart muscle at rest and during stress.  It can also be used to determine the extent of a coronary artery blockage or the extent of damage from a heart attack. You will receive an intravenous dose of a radiopharmaceutical.  Images of your heart will be taken under a gamma camera for 7 to 20 minutes.  We will then perform a treadmill stress test and at a specific heart rate, you will receive a second dose of the radiopharmaceutical.  You will then be provided the ability to eat a snack.  Forty minutes later, a second set of images will be taken under the gamma camera, again for 7 to 20 minutes.  Instructions for this test include:

  • Wear comfortable clothing including rubber soled shoes or sneakers as you will be walking on a treadmill test.
  • Take all of your prescribed medications unless your physician tells you otherwise.
  • Avoid caffeine (coffee, tea, chocolate, soda, etc.) starting 24 hours before the test.
  • You may eat a small meal up to 2 hours prior to your test.
  • Please arrive 15 minutes prior to your test time to complete any necessary paperwork that is needed for your testing. Also please bring your insurance card(s), a photo ID, and a list of your current medications.

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Nuclear Stress Test with Pharmaceutical Stress

This test helps determine the amount of blood flow of your heart muscle at rest and during stress.  It can also be used to determine the extent of a coronary artery blockage or the extent of damage from a heart attack.  This test is designed for patients who may not be able to increase their heart rate through exercise or who have a certain abnormal rhythm on their EKG.  You will receive an intravenous dose of a radiopharmaceutical.  Images of your heart will be taken under a gamma camera for 7 to 20 minutes.  A drug will be given to you through the IV line to increase blood flow to the heart.  This is the exertion part of the test.  An additional dose of the pharmaceutical will be given to you.  You will then be provided the ability to eat a snack.  Forty minutes later, a second set of images will be taken under the gamma camera, again for 7 to 20 minutes.  Instructions for this test include:

  • Wear comfortable clothing including rubber soled shoes or sneakers as you will be walking on a treadmill test.
  • Take all of your prescribed medications unless your physician tells you otherwise.
  • Avoid caffeine (coffee, tea, chocolate, soda, etc.) starting 24 hours before the test.
  • You may eat a small meal up to 2 hours prior to your test.
  • Please arrive 15 minutes prior to your test time to complete any necessary paperwork that is needed for your testing. Also please bring your insurance card(s), a photo ID, and a list of your current medications.

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MUGA (Multigated Acquistion) Scan

A MUGA scan is a diagnostic test used to evaluate the pumping function of the ventricles (lower chambers of the heart).  During the test a small amount of radioactive tracer is injected into a vein.  A gamma camera detects the radiation released by the tracer to produce computer-generated movie images of the beating heart.
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CT Coronary Angiogram

A coronoary CT angiogram is a test that can check for narrowed arteries in your heart (coronary artery disease) that could explain chest pain or could put you at risk of a heart attack.  In a CT angiogram, a dye that is visible on the CT scan is injected through an IV line.   A CT scan machine produces images of your heart and its blood vessels.  Instructions for this test include:

  • Do not eat anything for about four hours before the test.
  • You can drink water, but avoid caffeinated drinks (coffee, tea, soda, etc.) as they can speed up your heart rate (which could make it difficult for your doctor to get clear pictures of your heart.

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CT Coronary Calcium Scan

This test is a specialized X-ray test that provides pictures of your heart that can enable your doctor to detect and measure calcium-containing plaque.  Plaque inside the arteries of your heart can eventually grow and restrict or block the flow of blood to the muscles of the heart.  The measurement of calcified plaque with a heart scan may enable your doctor to identify possible coronary artery disease before you have signs and symptoms.  A CT Coronary Calcium scan is considered useful for people who have a known moderate risk of heart disease or when the risk is uncertain.

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Echocardiogram

This test takes videos of the heart with sound waves.  An echocardiogram is used to look at your heart’s structure and check how well your heart is working.  During the test, you will lie on a bed on your left side or back.  Using a special probe, a sonographer will move it over your chest area.  Ultra-high frequency sound waves will pick up images of your heart and valves.

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Echocardiogram with Bubble Study

In a bubble echocardiogram, the echocardiogram is performed, and then a bubble of saline is injected into a vein in the arm.  As the saline moves through the heart, the sonographer follows it.  The saline makes certain heart functions more visible, highlighting problems in the left ventricle, the major pumping area of the heart, along with issues with the valves.

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Carotid Duplex

A Carotid Duplex is an ultrasound test that shows how well blood is flowing through the carotid arteries.  The carotid arteries are located in the neck and supply blood directly to the brain.  The test can be used to detect blood clotting (thrombosis), narrowing in the arteries (stenosis), and other causes of blockage in the carotid arteries.

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Venous Duplex ultrasound of the upper or lower extremities

A Venous Duplex Study uses sound waves to check the venous flow in the legs and arms for possible blood clots (deep vein thrombosis), which may cause pain or swelling.  It may also help diagnose arteriosclerosis of the arms or legs, or venous insufficiency.

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Arterial Duplex Ultrasound of the upper or lower extremities or abdominal organs

An Arterial Duplex Ultrasound of the upper or lower extremities is performed to detect blockage of the blood vessels in the arms or legs.

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Pacemaker Implantation and follow-up

A pacemaker is a small device that helps your heart beat more regularly.  It does this with a small electric stimulation that helps control your heartbeat.  A pacemaker is implanted under the skin on your chest and is hooked to your heart with tiny wires.  A pacemaker will work only when needed.  They go on when your heartbeat is too slow, too fast or irregular.   During follow up, a pacemaker interrogation is performed.  This interrogation is a complete analysis of the pacemaker’s function.  It allows adjustment of pacemaker rate, electrical output, and evaluation and adjustment of many other parameters.

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Defibrillator Implantation and follow-up

Implantable cardioverter defibrillators, or ICDs, look similar to a pacemaker and continuously monitor the heart rhythm to detect overly rapid arrhythmias such as ventricular tachycardia or ventricular fibrillation.  The ICD corrects the heart rhythm by delivering precisely calibrated and timed electrical shocks to restore a normal heartbeat when one of these incidents has occurred.  During follow up, an ICD interrogation is performed.  The interrogation is a complete analysis of the ICDs function.

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Implantable Loop Recorder Implantation and follow-up

An Implantable Loop Recorder is a device that detects abnormal heart rhythms.  It helps to detect why a person may be having palpitations or fainting spells, especially if these symptoms don’t happen very often.  They device can be used for as long as 12 – 24 months.

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Holter/Event Monitoring

Holter and event monitors are small, portable electrocardiogram devices that record your heart’s electrical activity for long periods of time while you do your normal activities.  They can record how fast your heart is beating, whether the rhythm of your heartbeats is steady or irregular, and the strength and timing of the electrical impulses passing through each part of your heart.  Information from these recordings can help diagnose an arrhythmia, or irregular heartbeat.

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Invasive electrophysiology study

Electrophysiology is a branch of cardiology that deals with the diagnosis and treatment of heart rhythm disorders.  This involves the implanting of pacemakers, ICD’s, and implantable loop recorders.  In addition, electrophysiology involves the procedure of ablations.

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Arrhythmia Ablation including SVT, Atrial Fibrillation, and Ventricular Tachycardia

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Left and right heart catheterization

A heart catheterization is a procedure to examine how well your heart is working.  It is performed to find out if you have disease of the heart muscle, valves or coronary arteries.  It provides information on how well your heart works, identifies problems and allows for procedures to open blocked arteries.  During a heart catheterization, your cardiologist may:

  • Take X-rays using contrast dye injected through the catheter to look for narrowed or blocked coronary arteries. This is also known as a coronary angiography.
  • Perform a percutaneous coronary intervention (PCI) such as a coronary angioplasty with stenting to open up narrowed or blocked segments of a coronary artery.
  • Check the pressure in the four chambers of your heart.
  • Take samples of blood to measure the oxygen content in the four chambers of your heart.
  • Evaluate the ability of the pumping chambers to contract.
  • Look for defects in the valves or chambers of your heart.
  • Remove a small piece of heart tissue to examine.

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Stent Implantation

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Transcatheter Aortic Valve Replacement (TAVR)

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Percutaneous closure of atrial and ventricular septal defects/ Percutaneous of patent foramen ovale

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Angioplasty of the lower extremity

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Lower Extremity Venous Ablation

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24 Hour blood pressure monitoring

This process involves wearing a portable monitor that involves measuring blood pressure at regular intervals (usually 30 minutes) over a 24 hour period.  This test is used to help diagnose hypertension, and hypotension.

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Ankle Brachial Index Measurement

The ankle brachial pressure index is the ration of the blood pressure at the ankle to the blood pressure in the upper arm (brachium).  Compared to the arm, lower blood pressure in the leg is an indication of blocked arteries due to peripheral artery disease (PAD).

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