Cardiac Imaging and Diagnostic Tests
You may undergo a number of cardiac diagnostic tests so your doctor can determine your specific heart condition. Many of these cardiac function tests are outpatient tests.
Some of the more common cardiac imaging and diagnostic tests include:
An EKG is a painless procedure that records the electrical activity of the heart. It is used to evaluate the cause of shortness of breath, lightheadedness, dizziness (syncope), chest pain (angina), palpitations and congenital heart problems. We place electrodes on your arms, legs and chest to record a series of heartbeats that will help determine your diagnosis.
Cardiovascular CT or MRI
Electrophysiology (EP) Study with 3D Mapping of the Heart
An EP study is a test to help diagnose the nature of a person's abnormal heart rhythm (heart arrhythmia). During an EP study, an specialized doctor, known as an electrophysiologist, inserts a thin tube called a catheter into a blood vessel that leads to your heart. The catheter sends electrical signals to the patient's heart and records its electrical activity. This process helps the electrophysiologist determine the cause of the arrhythmia to recommend appropriate treatment.
Exercise Stress Exam
Your physician may order an exercise stress exam to test your heart’s response to exercise and evaluate the cause of chest pain (angina), heart attack (myocardial infarction), coronary artery disease or shortness of breath. During the test, you will walk on a treadmill at various speeds and elevations to see if you experience any symptoms or heart rhythm changes.
Nuclear Exercise Stress Exam
A nuclear exercise stress exam is a more specific test. It evaluates your heart’s response to exercise, as well as the amount of blood flow to your heart muscle when you rest and when you exercise. It is commonly used to evaluate the cause of chest pain (angina), heart attack (myocardial infarction), coronary artery disease or shortness of breath.
- We place a small flexible catheter in an arm vein so that we can administer the special nuclear imaging material.
- The material enables us to image the blood flow through the arteries to your heart. We will scan you both before and after exercise on the treadmill.
- The treadmill portion takes approximately 20-30 minutes, and each scan takes about 30 minutes. The entire test lasts approximately three hours.
- A pharmacological (drug) nuclear stress test may be performed when a patient is unable to walk on a treadmill.
We use an event monitor to record your heart rhythm when you are experiencing symptoms, such as dizziness, palpitations, shortness of breath, fainting spells or chest pain. This allows us to discover what is causing the symptoms. An event monitor is similar to a Holter monitor. For both tests, you wear a very small, portable monitoring device over a period of time (anywhere from two to four weeks). When you have a cardiac event, you just push a button to record what is happening with the heart. The device sends the recorded data to your doctor for analysis. Event monitors are beneficial when rhythm changes might not be captured with a 24-hour Holter Monitor.
Tilt Table Test
A tilt table test assesses fainting spells or dizziness, often called syncope. During this test:
- You lie on a tilt table and wear a blood pressure cuff and a painless pulse oximeter.
- We place EKG leads on your chest.
- We monitor you while you lie flat for approximately 10-20 minutes.
- Then, we tilt the table upright and monitor you in this position for another 20-40 minutes.
- During the test, you inform the nurse of any symptoms, including nausea, dizziness, blurred vision, chest pain or a fainting feeling.
A Holter monitor is a device that continuously monitors your heart rhythm for an extended period. It is commonly used to evaluate the cause of shortness of breath, lightheadedness, dizziness (syncope), chest pain (angina), palpitations or congenital heart problems. It can detect irregular heartbeats as well as evaluate pacemaker performance and drug therapy effectiveness. While you wear the monitor, you keep a diary of your activities and symptoms.
This monitor often records the heart rhythm for 24 hours but can be kept in place for longer. The device, about the size of a small transistor radio, attaches either to shoulder straps or to a belt. It has multiple wires (called leads) that we tape to your chest. The doctor will inform you when and where the monitor will be removed
Drug Administered Nuclear Exam
If you cannot exercise on a treadmill due to physical limitations, you may undergo a nuclear exam. We will administer various medications that will simulate exercise so your physician can see how your heart responds.
An echocardiogram is a painless procedure that records the movement of blood through the chambers and valves of your heart. It is commonly used to evaluate valvular heart disease, chest pain (angina), heart attack (myocardial infarction) or coronary artery disease. It takes about 30 minutes. We place gel on your chest and use a small hand-held device to take pictures of your heart.
A stress echocardiogram has the added component of exercise. We monitor how your heart performs before, during and after exercise. This procedure can take up to two hours.
The echocardiography lab at Sentara RMH Medical Center is accredited by the Intersocietal Commission for the Accreditation for Echocardiography (IAC Echocardiography).
A transesophageal echocardiogram takes pictures of the heart from within the esophagus. It is commonly used to evaluate blood clots before cardioversion or valvular disease. Before the procedure, we numb your throat so that you can swallow a tube with a tiny camera at the tip. The tube travels down your esophagus. The camera takes pictures of the heart and blood vessels from angles that are otherwise impossible to view.
A transesophageal echocardiogram is uncomfortable but not painful. Generally, it takes less than 30 minutes. You will receive a sedative to help you relax during the exam.