Cardiac Diagnostics & Clinics

Cardiology Clinic

The Cardiology Clinic provides urgent assessment by a cardiologist to individuals who are experiencing chest pain or other serious cardiac-related symptoms that have not yet been diagnosed. Through diagnostic tests, such as electrocardiograms, graded exercise testing, and echocardiograms, risk factors are identified and treatment plans developed. A registered nurse provides education to assist patients in making important lifestyle changes that will improve their health and reduce further deterioration of their heart condition.

Dobutamine Stress Echocardiogram

This closely-monitored test helps to determine how well a patient's heart is pumping; it can also detect the presence and/or establish the significance of blocked arteries. The technician places small disks or electrodes on the patient's chest, which are attached to wires (or leads) that connect to an electrocardiogram (ECG) machine. The technician then uses sound waves through a transducer (a wand-like device) to look at moving images of the heart at rest. During this test, the patient is given a medication called dobutamine through an intravenous (IV) line. This will cause the heart to work as though the patient is exercising. Ultrasound images of the heart are recorded both before and while the patient is receiving dobutamine.

The test takes approximately 90 minutes to complete.

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Echocardiogram

An echocardiogram is a test that uses sound waves or ultrasound to produce a moving picture of the heart. These sound waves are transmitted through a wand-like device or transducer into the body. The sound waves bounce off the heart and return to the transducer as echoes, which are then turned into moving images of the heartthat can be viewed on a television monitor. This test allows the doctor to learn about the size and shape of the heart muscle and to evaluate its function, valves, and the flow of blood through the heart. It helps the doctor to diagnose any problems experienced by the patient and to prescribe the treatment that best meets the health needs of the individual.An echocardiogram is pain-free and presents no risk of injury to the patient.

The procedure takes about 30-45 minutes.

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Electrocardiogram (ECG)

An electrocardiogram (ECG) is a routine test used to record the heart’s electrical activity. This test can help a cardiologist identify any abnormalities in the heart’s rhythm. A technician will place small disks or electrodes on the patient's chest. These electrodes are attached to wires or leads connected to the electrocardiogram machine that will trace the path of electrical energy through the heart and provide a print-out for the cardiologist to review.

The procedure is painless and takes approximately 10 minutes to complete.

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Exercise Stress Test

An exercise stress test records the electrical activity of the heart at rest, during exercise, and after exercise. It enables the doctor to see how a patient's heart is performing during physical activity and, also, to identify possible heart complications during exercise. This test is performed by a technician who will place small disks or electrodes on the patient's chest and a blood pressure cuff around their arm. These electrodes are attached to wires or leads that are connected to the electrocardiogram machine. While hooked up to the machine, the patient is required to walk on a treadmill. Every two to three minutes, the technician will increase the speed and incline causing the patient to work harder. By doing this test, the doctor or technician is able to see any changes in the heart's electrical pattern and blood pressure levels, which may indicate that the heart may not be receiving enough oxygen.

This test takes approximately 30 minutes to complete.

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Holter Monitor

Holter monitoring is a test that records a patient's heart beat for 24, 48, or 72 hours. It provides the doctor with a continuous reading of the patient's heart rhythm over specific time periods. There is no pain or risk associated with this test.

The holter monitor is a battery-powered device with highly sensitive electrodes that can pick up the heart's electrical impulses. It records what the heart is doing when a patient is experiencing chest pains or irregular heart beats. The print out enables a doctor to diagnose any problems and prescribe a treatment plan that best suits the patient's needs.

For this test, a patient has to visit the hospital to have the monitor fitted and to receive instructions on how to use it. A technician will place small disks or electrodes on the patient's chest. These electrodes are attached to wires or leads that connect to a small device to be worn on a belt around the waist. The patient is advised to carry on a normal routine and keep a log of all the daily activities. The patient MUST NOT shower or bathe for the duration of the test, as it is important to keep the monitor and electrodes dry.

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Nuclear Cardiac Stress Test

When the heart is forced to work harder, as is the case during exercise, it needs more blood flow, which causes the arteries to dilate or to open up. However, if the arteries are clogged, they are unable to expand and this causes a restriction of blood flow to the heart and chest pain may result. To assess blood flow to the heart during both rest and exercise, an individual may be referred by their physician to have a nuclear cardiac stress test (also known as Myoview) performed.

The test requires that a radioactive substance called a tracer be injected into the patient’s bloodstream. The tracer is then detected in the areas of the heart that are deprived of adequate blood flow through the use of a special piece of equipment called a gamma camera.

During the procedure, the patient lies on the examination table while the gamma camera rotates around their chest area to take images of their heart while it is at rest. This process takes approximately 15 minutes. To take images of the heart during exercise, the patient will be required to walk briskly on a treadmill for approximately five minutes before having another set of images taken. If they cannot tolerate exercise at any level, they will be given an injection of a drug called Persantine, which will cause the arteries to open as if the body was at exercise.

As food, caffeine products and beta-blockers can affect the quality of the images, it is recommended that individuals do not have any breakfast the morning of and no caffeine for two days prior to their nuclear cardiac stress test. Individuals who take beta-blockers are advised to discuss with their doctor that they need to discontinue taking this medication two days prior to their test.

The test can take anywhere from 5 to 7 hours to complete.

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Stress Echocardiogram

A stress echocardiogram combines a standard exercise stress test and an echocardiogram. In this test, the technician places small disks or electrodes on the patient's chest and a blood pressure cuff around their arm. The patient exercises on the treadmill until the heart rate reaches a certain rate. The technician then uses sound waves through a transducer (a wand-like device) to look at moving images of the heart. This test can detect the presence and/or assess the significance of blocked arteries by a comparison of the ultrasound images of the heart before and after exercise. It enables the doctor to diagnose any problems the patient may be experiencing and prescribe a treatment plan to suit the individual's needs.

The test takes approximately 45 minutes to complete.

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Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram (TEE) is a test that uses sound waves to produce a moving image of the heart. Unlike a standard echocardiogram where the image is produced from the outside of the chest, this test produces an image from the inside. The doctor inserts a probe—a soft, tube-like device—into the patient's mouth and down the esophagus (or food pipe) until it is positioned directly behind the heart. The probe has a transducer on the end that bounces sound waves off the heart to create moving images on a television monitor. A TEE allows the doctor to obtain exceptionally clear images of the heart's structure.

A patient is normally sedated for the procedure, and the test takes approximately 20 minutes to complete, followed by a recovery period of approximately one hour.

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Special Note: A motor vehicle cannot be drive for 24 hours following the procedure.

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