Overview

Echocardiogram is an ultrasound of the heart. The test shows live moving images of your heart. A technologist uses a gel to slide a microphone-like device over the chest area. No radiation is involved in the heart ultrasound.

• There is no special preparation required for an echocardiogram.
• Please wear a two-piece outfit.
• You should plan on being at the lab for about 30-60 minutes.

You will be exercising by walking on the treadmill. Your vitals and ECG will be monitored continuously. Ultrasound images will be taken before and just after exercise for Stress Echo studies.

• Please bring a list of all your current medications. Stop for 24 hours before the test the following medications: Metoprolol, Diltiazem, Acebutolol, Atenolol and Bisoprolol, unless advised otherwise by your referring doctor.
• On the day of the test, have a light meal before the test.
• Please bring comfortable shoes (preferably running shoes) and wear loose-fitting two-piece clothes (shorts and T-shirt).
• You should plan on being at the lab for about 30-60 minutes (exercise part of the test usually takes only 5-15 minutes).

Also known as an ambulatory ECG monitor, a Holter monitor records your heart rhythm for an entire 24 or 48 hour period. Wires from electrodes on your chest go to a battery-operated recording device worn on a belt or shoulder strap. While you are wearing the monitor, you may keep a diary of your activities and symptoms, which will later be correlated with the ECG recordings. Please carry out all your activities as usual except for bathing. Hook up takes 15-25 minutes.

A loop monitor is a patient-activated recording device which is used to record your ECG during symptoms suggestive of rhythm disturbances. The recorder can be easily taken off for bathing or shower needs. The recorded data will be analyzed and correlated with documented symptoms. Hook up takes 15-25 minutes.

Ambulatory blood pressure monitor will measure and record your BP readings for 24 or 48 hours. The recorder will take measurements of your blood pressure every twenty minutes during the day and every hour during sleep. Hook up takes 15-25 minutes. Please carry out all your activities as usual except for bathing.

No preparation is required. However, avoid exercising just before the test. You should plan to be at the lab for 10-20 minutes.

Coronary artery bypass grafting (CABG) surgery is the most common type of heart surgery. When medication and/or other procedures are not able to improve the blood flow to the heart, Bypass surgery improves the blood flow to the heart muscle, which provides relief of angina symptoms and may increase life expectancy.

During surgery, the patient is connected to the heart-lung bypass machine, which takes over the function of the heart and lungs during surgery. A portion of a blood vessel from the patient’s leg, arm or inner chest wall is used to bridge the blocked or diseased area and to improve blood flow to the heart muscle. The vein or artery will be attached to the aorta (large vessel that supplies blood to the heart) at one end and the other end will attach to the coronary artery below the area of blockage or disease. The diseased area is essentially “bypassed” and the coronary artery beyond the blockage receives the oxygen and nutrient-rich blood that is delivered to the heart muscle.

Beating heart surgery is a technique available for patients undergoing coronary bypass. Instead of using the heart-lung machine to support the patient’s circulation during surgery, the surgeons can use a different stabilizer that will enable them to perform the procedure without stopping the heart.

Heart valves can be abnormally formed as birth defects or damaged by rheumatic fever, bacterial infection, and calcific degeneration. Valves can also degenerate with the normal aging process. To compensate for these disorders, the heart is forced to pump harder. This excess work can weaken the heart, causing it to enlarge, and cause shortness of breath, chest pain, increased fatigue, swelling of the ankles and legs, dizziness or fainting.

If medications are no longer able to control the symptoms, heart valve surgery may be recommended. Some valves can be surgically repaired to help them open or close more efficiently.

An angiogram is an intricate procedure that allows a cardiologist (a doctor who specializes in functions of the heart) to guide a thin plastic tube called a catheter to the heart to determine if there is any narrowing or blockage within the coronary arteries (arteries that supply the heart muscle).

Freezing is injected into one side of the patient’s groin area. The patient may feel some pressure in this area as the doctor finds the artery and makes a small incision. Once the incision is made, a sheath is inserted into the artery and acts as a guideline or tunnel for the catheter to follow to the heart. The patient will not feel the catheter as it moves through their artery and into their heart.

At different times during the test, small amounts of contrast media (dye) are injected into the coronary arteries or chambers of the heart in order for sharper images to be taken. As the contrast media is injected, the patient may be asked to take a deep breath and to hold it while a series of x-rays are taken and recorded onto film.

The patient will then be transferred to a stretcher and taken to the recovery area for approximately three to four hours for close observation and routine care.

When the angiogram has been completed, a nurse will remove the sheath and apply firm pressure to the puncture site using a mechanical clamp to stop the bleeding.

The cardiologist will briefly review the results with the patient immediately following the test.

Percutaneous Coronary Intervention (PCI) or angioplasty is a specialized procedure used to clear blockages within the coronary arteries—arteries that supply the heart muscle. Depending on the location and severity of the blockage and the patient’s specific risk factors, a balloon, as well as a stent or a stent with medications embedded within it, are utilized during the procedure.

A thin plastic tube called a catheter with a special balloon is inserted into the coronary artery at the site of the narrowing. By inflating the balloon, it opens and stretches the artery slowly, which results in improved blood flow to the heart. If required, a metal coil called a stent may be used to keep the coronary artery open. Once the stent is inserted, it is enlarged and pressed against the sides of the blood vessel.