What is an Electrocardiogram (ECG)?
An electrocardiogram, the most common cardiac test, assesses the heart’s electrical activity. You may have an ECG annually or more often based on your symptoms or health concerns.
Every heartbeat is triggered by an electrical impulse generated from special cells in the heart. An ECG, which records electrical signals as they travel through the heart, can identify acute heart attacks, problems with the electrical circuit or the size of your heart and electrolyte abnormalities.
The Day of Your Test
You don’t have to do anything to prepare for an ECG. The test should take approximately 5 minutes. It’s important to stay still during the ECG so that the image is clear for the doctors to review.
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What is a Cardiac Event Monitor?
A cardiac event monitor, or wearable cardiac monitor, identifies arrhythmias (an irregular heartbeat) and other abnormalities of the heart's electrical system.
Some monitors record heart activity only during an abnormal heartbeat or when initiated by the patient. Others record every heartbeat for 24-48 hours.
Your doctor usually recommends you wear a monitor from 24 hours to 30 days.
What you need to know about wearing a cardiac heart monitor.
Most monitors cannot get wet, so you must remove it before swimming or bathing.
You will be taught how to make a notification. You should record any symptoms you experience while wearing the monitor. Otherwise, you can continue with your usual daily activities.
Are there any risks associated with a cardiac event monitor?
There are no significant risks with wearing an event monitor.
Some discomfort or skin irritation where the electrodes are placed is possible.
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What is an Echocardiogram?
An echocardiogram assesses the heart’s function and structures using ultrasonic sound waves to create pictures of the heart and its structures.
An echocardiogram can also reveal:
- Evidence to suggest clogged arteries of the heart.
- Enlargement of the heart due to changes in the heart muscle.
- Heart defects you’ve had since birth.
- Weakened heart muscle or problems with the heart’s relaxation.
- Dilation of part of the heart or of the aorta.
- Valve problems.
- Tumors, infection and inflammation.
The day of your test.
You will be asked to remove clothing from the waist up, put on a gown and lie on the a and on the exam table on your left side. Then you will be connected to an ECG monitor.
You might require an IV for special contrast to provide better images of the heart.
A comprehensive echocardiogram typically takes 30-45 minutes
Are there any risks associated with an echocardiogram?
For some people, lying still and relatively flat on the table may cause discomfort.
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What is a Stress Test
A stress test checks for blockages in the arteries that supply the heart muscle with blood.
During exercise, the heart muscle demands more blood flow. A normal artery dilates to supply more blood, but a blocked artery cannot.
The muscle that isn’t receiving enough blood may produce symptoms (chest pain, shortness of breath) and the ECG may show abnormal changes.
What you need to know about a stress test.
A stress test evaluates your heart’s exercise tolerance after you’ve experienced unexplained fatigue and shortness of breath. It also checks how your blood pressure responds to exercise and whether you have any irregular heartbeats caused by exercise.
The study can diagnose a blocked artery correctly 67 percent of the time. About 10 percent of patients may have a false positive test.
Your exercise duration is also a good prediction of overall survival.
The day of your test.
On the day of your test, do not eat or drink anything unless instructed to by your doctors. Some heart medicines should not be taken one to two days before the test. Follow instructions from the doctor’s office closely.
Wear comfortable clothing and shoes that you can walk in.
Here’s what you can expect:
- Your heart rate and blood pressure are measured at rest.
- ECG electrodes will be attached to the chest and connected to the ECG machine.
- A 12-lead ECG is recorded during the entire test.
- The treadmill is started at a slow pace. The speed and incline increase every 3 minutes.
- Your blood pressure will be measured at each stage.
The goal is for you to reach 85 percent of the maximum heart rate for your age.
The test can be stopped when you reach the target heart rate, if you have symptoms or cannot continue. It also can be stopped if your blood pressure is too high or too low.
After the exercise portion of the test, you will be monitored during the recovery phase until your ECG is normal and your heart rate and blood pressure are close to where you started the test.
Are there any risks associated with a stress test?
The risk of a stress test is very small, similar to what you would expect from strenuous exercise. Rare complications include sustained irregular heartbeats, unrelieved chest pain or even a heart attack. Our medical staff will treat them immediately.
The test usually takes an hour or less, including preparation.
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What is a Nuclear Stress Test?
A nuclear stress test combines a radioactive dye and imaging equipment to provide images of your heart, usually one set during rest and another after physical exertion.
This test, which measures blood flow to your heart muscle, also can be performed with medication instead of exercise.
What you need to know about a nuclear stress test.
- Diagnoses coronary artery disease.
- Looks at the size and shape of your heart.
- Guides treatment of heart disorders if you have already been diagnosed with coronary artery disease.
The day of your test.
- Do not eat or drink the day of the test.
- Some heart medicines should not be taken one to two days prior to the test. Follow instructions from your doctor’s office closely.
- It is important not to have any caffeine for 12-24 hours prior to a nuclear stress test.
- Bring your inhaler to the test with you.
How long the test takes depends on the type of nuclear stress test.
If the test is done in one day: Approximately 3-3.5 hours (with times of waiting in between).
If the test is done in two days: The first day approximately 1-1.5 hour, the second day 1.5-2 hours.
What to Expect: Resting Pictures
- An IV will be placed.
- An isotope that will tag your blood will be administered in the IV.
- You will wait 45-60 minutes.
- You then will get on a table that is connected to the camera for the first “resting” photos of your heart.
- The camera will move around you.
- This lasts about 20-25 minutes.
What to Expect: Stress Portion of Test
- Your heart rate and blood pressure are measured at rest.
- ECG electrodes will be attached to the chest and connected to the ECG machine.
- A 12-lead ECG is recorded during the entire test.
You will either be asked to exercise on the treadmill as described previously or you will be given medication to simulate exercise:
- Medication given into your IV causes dilation of the heart’s arteries.
- The medication lasts 3-5 minutes.
- You may feel your heart racing, or a brief episode of shortness of breath.
The type of stress is based on your history, physical exam and symptoms
Your cardiologist then compares all images to see if there is decreased blood flow to the heart at stress compared to rest. This would suggest that there is a blockage in one or more arteries of the heart.
Are there any risks associated with a nuclear stress test?
The risk is very small, maybe 1 in 1,000, of any complications.
Rare complications include:
- Allergic reaction.
- Low blood pressure.
- Sustained irregular heartbeats.
- Flushing sensation.
- Unrelieved chest pain or even a heart attack.
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What is a Left Heart Catheterization/Coronary Angiogram?
Catheters (a tiny tube) placed into the heart assess blood flow in the coronary arteries, which supply blood to the heart muscle.
This diagnostic test can also assess the function of the heart and its valves. Blockages in the coronary arteries are called coronary artery disease. An acute blockage causes a heart attack
The day of your test.
- Do not eat or drink the day of the test.
- You should have a family or friend drive you to and from the procedure.
The test can last anywhere from 1 hour to 4 hours depending on what is found and if any additional procedures are needed
After being placed on a special exam table in the catheterization laboratory, you will receive local numbing medicine before a catheter is inserted into a blood vessel in your wrist and/or groin.
A catheter is inserted into the blood vessel, then advanced through the blood vessels to the heart. Contrast dye is then injected into the coronary arteries.
The interventional cardiologist will take pictures of your heart as the camera moves around you. Additional procedures may be required, such as placing a stent, depending on what the doctor sees
Are there any risks associated with left heart catheterization?
This test is relatively safe.
Possible complications include:
- Minor bleeding at the site of the catheter, bruising.
- Temporary heart rhythm disturbances.
- Temporary changes in blood pressure.
- Perforation of the heart wall.
- Sudden blockage of a coronary artery.
- Additional bleeding.
- Stroke.
- Reaction to dye.
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What is a Right Heart Catheterization?
A catheter (a tiny tube) inserted into a blood vessel in the arm or neck or leg, then directed into your heart, assesses the pumping of your heart and measures the pressure in your heart and lungs.
The diagnostic test also measures the oxygen content in the different chambers of the heart.
A right heart catheterization can also diagnose or help manage:
- Heart failure.
- Congenital heart disease.
- Shock.
- Valve disease.
- Pulmonary hypertension.
The day of your test.
- Do not eat or drink the day of the test.
- Have a family or friend drive you to and from the procedure.
After being placed on a special exam table in the catheterization laboratory, you will receive local numbing medicine before a catheter is inserted into a blood vessel in your arm, neck or groin.
A catheter inserted into the blood vessel is advanced through the blood vessels to the heart. The pressures in the heart are measured in each chamber of the heart and at the level of the lungs.
Blood sampled in each chamber of the heart is checked for oxygen levels. The doctor might use X-ray images to guide the catheter to the correct area.
This test usually takes 30 minutes to 1 hour.
Are there any risks associated with a right heart catheterization?
This is a relatively safe test with these possible complications:
- Minor bleeding or bruising at the site of the catheter.
- If the neck is used, partial collapse of the lung.
- Abnormal heart rhythm disturbances.
- Perforation of the heart wall.
- Air embolism.
- Additional bleeding.
- Pulmonary artery rupture.
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