Cardiovascular Diagnostic Imaging, Testing, and Treatment

Before prescribing a test to diagnose heart disease, your doctor needs more information. Start with a physical exam. Your doctor will want to listen to your heart, check your blood pressure and determine your heart rate, then review your personal and medical history.

Here are some of the tests your doctor might recommend:

Blood Test

Abnormal levels of potassium, thyroid hormone or other substances in the blood can indicate a heightened risk of an arrhythmia (irregular heartbeat).

Stress Tests

Exercise: A baseline test, on a treadmill, that makes your heart work increasingly harder. When the body demands more oxygen, requiring the heart to pump more blood, you doctor will see if the arteries that supply the heart get enough blood. Your heart’s activity is measured with an electrocardiogram. If abnormalities are found, a stress echocardiogram test might be ordered if your doctor suspects coronary artery disease. A stress echo, as it's called, uses ultrasound to get detailed information about the heart's four chambers.

Pharmacological: Medication dilates blood vessels and increases blood flow, replicating the effects of exercise in patients unable to use a treadmill. 

Cardiopulmonary (CPET): A measurement, via electrocardiogram, of oxygen use and carbon dioxide production as you ride a stationary bicycle. It gives your doctor a good idea how your heart, lung and muscles are working.

Myocardial Perfusion Imaging: This non-invasive imaging test, called a nuclear stress test, can reveal areas of the heart with insufficient blood flow and assess the efficiency of the heart muscle’s pumping action. The two methods: Single photon emission computed tomography (SPECT) and positron emission tomography (PET).

Cardiac Blood Pool Scan: An alternative to an echocardiogram that provides a snapshot of the beating heart while measuring how much blood is ejected by the left ventricle with each beat. How it works: After a radioactive substance known as a tracer is injected into a vein, a gamma camera follows the flow of blood through the heart and lungs. Also known as the multiple gated acquisition scan, or MUGA, or radionuclide ventriculography.

Technetium-Pyrophosphate Imaging for Cardiac Amyloidosis: A scan that uses the radioactive isotope pyrophosphate to check for cardiomyopathy, an abnormality of the heart muscle.

EKG/ECG

An electrocardiogram records the spikes and dips of your heart’s electrical activity, typically with a device connected to a laptop that stores the results. 

Coronary Angiogram (Cardiac Catheterization)

A technology that uses dye and special X-rays to reveal the interior of your coronary arteries. This test requires cardiac catheterization, with small tubes inserted in a vein or artery (in the leg, arm or neck) that reach the heart so you doctor can use blood samples and blood pressures to evaluate the organ. Because an angiogram uses more powerful X-rays than a conventional chest X-ray, doctors will perform only when it’s considered essential. 

Right Heart Catheterization

A catheter guided to the right side of the heart and into the pulmonary artery -- the heart’s main artery that brings blood to the lungs -- allows your doctor to check blood flow and measure pressure in the heart and lungs. 

Cardiac Computed Tomography Angiography (CTA)

Where a traditional angiogram requires a catheter, this test uses a powerful X-ray machine.  

Calcium Scoring

A non-invasive CT scan of the heart, also known as cardiac scoring or heart scan.

Transthoracic Echocardiogram (TTE)

The most frequently recommended type of echocardiogram, an ultrasound test that relies on a transducer that sends high-pitched sound waves to create moving pictures of your heart.

Holter Monitor

A device worn by the patient that records the heart’s electrical signals for a much longer period, usually 24 or 48 hours.

Event Recorder

A wearable device, similar to an EKG, that records the heart rhythm.

Loop Recorder

A device implanted in they in the chest area that acts like an EKG, monitoring your heart’s electrical signals. 

Tilt Table Test

Blood pressure, heart rate and heart rhythm monitored while the patient shifts from lying down to standing up. In this scenario, blood pressure and heart rate change to ensure the brain gets enough blood. If they don’t change, this could explain why a patient fainted.

EP (Electrophysiology) Study

A wire inserted through a vein into your groin or arm to the heart records the heart’s electrical signals. This test is useful for doctors who wish to stimulate your heart to cause an arrhythmia, giving them insight into which medicines might help.

Cardiac MRI (Magnetic Resonance Imaging)

Detailed images of your heart are available through an MRI’s powerful magnetic field and radio waves.

Carotid Artery Duplex Scan

Two types of ultrasound, conventional (B-mode) and Doppler, look for blockages in your carotid arteries.

Vascular Studies

Tests using ultrasound that evaluate the blood flow in your arteries and veins. Doppler ultrasound provides a view of blood flow and any indication of a blockage. Color Doppler uses colors to highlight blood flow.

Myocardial Viability Study

A viability scan that evaluates blood flow from the heart after an injection of a radioactive drug called Thallium 201. When taken after a heart attack (myocardial infarction), the test reveals healthy heart muscle. (The drug does not accumulate similarly in scarred heart muscle.)

Transesophageal Echocardiogram (TEE)

This test uses ultrasound, like an echocardiogram, but the echotransducer that produces the high-frequency sound waves is placed down your throat and into your esophagus.

Chest X-Ray

A basic chest X-ray helps your doctor determine if your pacemaker, defibrillator or other heart device is positioned properly.

Venogram

A view of your veins, using a special dye and X-rays, that can help diagnose deep vein thrombosis or other vein abnormalities.

Ankle Brachial Index Test

A measurement of blood pressure at the ankle and in the arm, either while you’re at rest or as part of an treadmill test, used to assess peripheral arterial disease of the legs.


Diagnosis and Treatment

You may be sent to a Heart & Vascular Institute vascular and endovascular surgeon if your doctor is concerned about narrowing or abnormal enlargement of a blood vessel.

As part of your visit with one of our specialists, we may recommend additional imaging tests.

Our Vascular Labs:

Our vascular imaging laboratories include ultrasound and other noninvasive tests to measure blood flow throughout your body. We offer a fully accredited IAC (Intersocietal Accreditation Commission) Vascular Lab at locations throughout the Hartford HealthCare network. All of our vascular and endovascular studies are interpreted by physicians awarded Registered Physicians in Vascular Interpretation (RPVI) certification. 

Schedule your noninvasive vasular testing at one of these locations:

Here are some of the diagnostic tests we might order after seeing you in the office:

Computed Tomography Scan (CT Scan)

CT scans allow us to see the inner workings of your arteries in fine detail. To look at the flow as well as the size of your arteries, your physician might order a CT angiogram. This is a noninvasive test that allows us to see both blockages and aneurysms with precision. A CT angiogram uses an injection of contrast dye via a peripheral intravenous (IV) line, a short catheter usually placed in the forearm. Our team will work with your primary care doctor to make sure you can safely receive contrast dye and get the results you need. 

Magnetic Resonance Imaging (MRI)

MRI is another way to look at your arteries and veins. Sometimes an MRI can be helpful if we want to see how other structures affect the function of your arteries and veins. An MRI can give us additional information about surrounding bone, muscle and nerves. If you absolutely cannot receive contrast dye for a CT angiogram, we may use gadolinium, a type of dye for MRI scans, to light up your arteries or veins. The advanced imaging center at Hartford Hospital now offers MRI imaging with feraheme for patients with severe kidney disease. 

Diagnostic Angiogram

Sometimes even the best noninvasive test still doesn’t give us the answers we need to both diagnose and treat your condition. If that’s the case, we may perform an angiogram (to look at arteries) or a venogram (to look at veins). This is done via a small puncture in an artery or vein. It’s usually a same-day procedure. Depending on why the test is performed, we might also perform minimally-invasive treatment at the same time.

Here is an overview of the Vascular and Endovascular treatment options we may recommend:

Medical Management

Because vascular disease is a chronic condition, our first recommendation is often to manage your vascular disease without a procedure. Various options for medical management include lifestyle modifications such as smoking cessation, exercise such as physical therapy or a supervised walking program. We also might prescribe medications to treat your disease and prevent you from developing complications of your vascular disease. These include common medications such as a baby aspirin and more complex medications focused on improving symptoms.

Endovascular Therapy

Endovascular means treatment from within the blood vessel. Using ultrasound and X-rays, our physicians can navigate through arteries and veins to provide minimally invasive treatment. Sometimes we use tubes, called catheters, to inject dye and take high-resolution pictures of your arteries to see a blockage or an aneurysm. This is called an angiogram.

Other treatments include opening blockages with a balloon or a stent, or delivering a stent-covered with Gore-Tex or polyester fabric to seal an aneurysm. 

Minimally invasive treatment is often available as a same-day procedure. Sometimes it requires a one-night stay in the hospital. Most important is that you are seeing a specialist who can provide all types of treatment options. That’s the benefit of seeing one of our vascular and endovascular surgeons.

Surgical Options

Our team of vascular and endovascular surgeons perform simple and complex open surgeries at our Hartford HealthCare hospitals throughout Connecticut. You are taken care of by a team of fellowship-trained, board-certified specialists in vascular surgery who are committed to quality care and excellent results. The Heart & Vascular Institute’s high-volume Aortic Center at Hartford Hospital uses the latest multidisciplinary approach to ensure that patients who need complex open surgery get the best results possible.

Our Cardiovascular Diagnostic
Imaging and Testing Physicians:

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Name Specialties Location
Abreu, Joseph Edward, MD, FACC 860.489.1132
  • Cardiovascular Medicine
  • Torrington
Agarwal, Arun, MD 860.223.0220
  • Cardiovascular Medicine
  • Internal Medicine
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  • New Britain
Agin, Elliot David, MD, FACC 203.874.1512
  • Cardiovascular Medicine
  • Echocardiography
  • Internal Medicine
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  • Milford
Aithal, Keshava Harthattu, MD, FACC, FACP 860.636.2010
  • Cardiovascular Medicine
  • Internal Medicine
  • Nuclear Cardiology
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  • Middletown
  • Marlborough
  • Old Saybrook
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Alter, Eric Louis, MD 203.254.2452
  • Cardiovascular Medicine
  • Echocardiography
  • Internal Medicine
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  • Fairfield
Altszuler, David Jay, MD 203.265.9831
  • Cardiovascular Medicine
  • Glastonbury
  • Wallingford
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Amir, Doron, MD 203.334.2100
  • Cardiovascular Medicine
  • Bridgeport
  • Fairfield
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Ansari, Ehsan, MD 203.573.1435
  • Cardiovascular Medicine
  • Internal Medicine
  • Interventional Cardiology
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  • Waterbury
Arcoleo, James Anthony, DO 860.749.1985
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Endovascular Medicine
  • Vascular Medicine
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  • Enfield
Arora, Sabeena, MD 860.886.0023
  • Cardiovascular Medicine
  • Internal Medicine
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  • Norwich
Atef, Amr Mohamed, MD 860.886.0023
  • Cardiovascular Medicine
  • Internal Medicine
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  • Norwich
  • Willimantic
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Augenbraun, Charles Barry, MD 203.353.1133
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Internal Medicine
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  • Stamford
  • Norwalk
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Azemi, Talhat, MD 860.972.5083
  • Interventional Cardiology
  • Cardiovascular Medicine
  • Endovascular Medicine
  • Internal Medicine
  • Nuclear Cardiology
  • Vascular Medicine
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  • Hartford
Beach, Yan, APRN 860.276.5107
  • Cardiovascular Medicine
  • Southington
Beasley, Michael, MD 860.889.8331
  • Cardiovascular Medicine
  • Norwich
Berman, Jeffrey Neal, MD 203.445.7093
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • Trumbull
  • Fairfield
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Berns, Ellison M., MD 860.258.3477
  • Cardiac Electrophysiology
  • Cardiovascular Medicine
  • Internal Medicine
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  • Wethersfield
Bernstein, Frederic Jacob, DO 860.545.9401
  • Pediatric Cardiovascular Medicine
  • Pediatrics
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  • Hartford
Bhatt, Paras Satish, MD 860.889.9180
  • Cardiac Electrophysiology
  • Cardiovascular Medicine
  • Internal Medicine
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  • Norwich
  • Mystic
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Bingham, Abigail, APRN 860.972.1793
  • Cardiovascular Medicine
  • Hartford
Birney, Paige M., PA-C 203.576.6000
  • Cardiovascular Medicine
  • Bridgeport
Bleich, Steven, MD 860.522.0604
  • Cardiovascular Medicine
  • Internal Medicine
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  • Hartford
Blitzer, Mark Lawrence, MD 203.867.5400
  • Cardiac Electrophysiology
  • Cardiovascular Medicine
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  • New Haven
Borer, Steven Michael, DO, FACC 860.522.5712
  • Cardiovascular Medicine
  • Internal Medicine
  • Nuclear Cardiology
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  • Hartford
  • Farmington
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Borkowski, Robert D., MD 860.229.6811
  • Interventional Cardiology
  • Cardiovascular Medicine
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  • New Britain

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Our Cardiovascular Diagnostic Imaging and Testing Locations: