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Nuclear Cardiology
Nuclear Stress Testing   1

This procedure is used in the evaluation and management of patients with chest pain or shortness of breath who is suspected of having coronary disease or who have had previous coronary procedures such as angioplasty, stent placement or bypass surgery. We perform nuclear stress testing in our I.C.A.N.L. Accredited office on a daily basis using the services of a full time nuclear technologist and state of the art equipment. The test requires a 3-hour fast, followed by treadmill or drug stress testing and is completed with a heart scan. The test takes about 3 hours to complete due to the waiting time between scans.

Nuclear Pharmacological Stress Testing
This test provides information on the blood supply to the heart. It tells us if you have had a previous heart attack or problems with blood supply to the heart. This test requires no exercise. Medication (Adenoscan) will be given through an IV.  We perform nuclear pharmacological stress testing in our I.C.A.N.L. Accredited office on a daily basis using the services of a full time nuclear technologist and state of the art equipment. The test requires a 3-hour fast; this test will take approximately 3 1/2 hours. DO NOT USE CAFFEINE (No coffee, tea, pop or chocolate, including decaffeinated products), 24 HOURS PRIOR TO YOUR TEST.

Cardiovascular Testing

Cardiac Ultrasound or (Echo)  1
Echocardiography (also known as Doppler Echo) is a sound picture or sonogram of the heart and is used to evaluate patients for conditions that can produce chest pain, shortness of breath or palpitations. The gowned patent lies on the exam table with the left side down. A technician at our I.C.A.E.L. accredited laboratory positions the sound probe under the left breast or chest. Images are viewed in real time for preliminary diagnosis and recorded on videotape for later analysis. No preparation is required for a resting echocardiogram, which requires about 30 minutes to complete. When performed with a treadmill test, images are taken before and after exercise. The exercise or stress echo does require a 4 hour fast.

Carotid Ultrasound

In this procedure, the technician positions a sound probe over the carotid arteries on both sides of the neck. The carotid artery is the blood vessel, which carries blood to the brain. Thickening or narrowing of the artery due to cholesterol accumulation can be easily visualized. The test is used to evaluate patients with stroke like symptoms or to assess the risk for future stroke.

Arterial and Venous Duplex Scan
Arterial and venous duplex scans are painless tests using ultrasound waves to evaluate the arteries and/or veins of the legs or arms. Your family physician or cardiologist may ask you to have this test if he or she feels you are at high risk for blockages in these arteries or if you have been experiencing pain in your calves when you walk, which would make it difficult for you to walk any distance. This is a non-invasive test that is performed at our offices and takes approximately 45 minutes to perform. 

Stress Testing
A stress test, sometimes called a treadmill test or exercise test, helps your physician find out how well your heart handles work. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart. It also helps your physician know the kind and level of exercise appropriate for a patient.  The length of time you walk is based on your heart rate, EKG, blood pressure and ability to exercise. This test will take approximately one hour. A person taking the test Is hooked up to equipment to monitor the heart.  Walks slowly in place on a treadmill. Then the speed is increased for a faster pace and the treadmill is tilted to produce the effect of going up a small hill.  Can stop the test at any time if needed.  Afterwards will sit or lie down to have their heart and blood pressure checked.

Transesophageal Echocardiogram (TEE)
A transesophageal echocardiogram is a special type of echocardiogram (ultrasound of the heart).  This test uses a special echocardiography transducer (ultrasound camera) that is inserted through the mouth, through the back of the throat, and into the esophagus. It is very similar to the scope used for upper endoscopy by gastroenterologists. This test enables doctors to obtain images of the heart from inside the esophagus (the tube that goes from the mouth to the stomach). Since the esophagus lies close to the heart, the TEE allows very clear images of the heart structures and blood flow.  This test is performed in an hospital setting.

Arrhythmia Monitoring (Holter Monitoring)

Patients with evidence for irregular heart beating often wear a 24-hour solid-state recorder known as a Holter Monitor that is attached to the chest with electrodes and worn on a belt. After the device is returned the following day, the continuous EKG recordings it contains are downloaded to a computer and analyzed for patterns of irregular heartbeat. If the patient presses the event button at the time the symptoms occur, an explanation for the complaints may emerge. In some instances, when the irregular heart beat occurs less frequently, a "transient event recorder" is needed. We offer several types of these monitors. Some models do not require patient activation because the device can automatically send an abnormal recording to a central monitoring station.

Tilt Table Test
This is a simple test that helps the doctor determine a possible cause for fainting spells. It determines how your body responds to changes in position. During the test, you lie on a table that can be moved to nearly upright position while your symptoms, heart rate, and blood pressure are monitored.


Pacemaker Implantation

If your cardiologist diagnoses a problem with your heart’s electrical system, he may suggest a pacemaker. These small electronic devices keep track of your heartbeat and when called upon, will generate an electrical signal similar to the natural “pacemaker” of the heart. These signals help keep your heart at a regular rate, and can increase the rate when required, such as during exercise. Depending on your problem, you may get a pacemaker with one or two leads. The leads are positioned into the upper and/or lower chamber of the heart.
A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart.
Most pacemakers are demand pacemakers. They have a sensing device. It turns the signal off when the heartbeat is above a certain level. It turns the signal back on when the heartbeat is too slow.

Pacemaker Clinic
The Pacemaker Clinic offers follow-up services for pacemaker patients. Pacemaker recordings can be transmitted to the clinic by phone where they are reviewed by physicians to ensure proper pacemaker performance.  The clinic is staffed by medical professionals trained in cardiology and pacemaker care who are available to answer referring physician and patient questions.

The Pacemaker Clinic helps optimize pacemaker therapy by:

  • Providing patient support and education specific to pacemaker therapy
  • Identifying pacemaker malfunction early on
  • Optimizing the pacemaker settings to best meet patient needs while maximizing the life of the pacemaker battery; predicting pacemaker battery end-of-life to ensure elective and safe replacement.

Interventional Cardiology

Cardiac Catheterization
A catheter (a long, thin tube) is inserted into a large artery (usually from the groin) and advanced to the arteries of the heart. A dye is injected through the catheter into the arteries of the heart while a series of x-ray images are recorded. This allows visualization of the arteries and any blockages that may be present. This test can measure blood pressure within the heart and how much oxygen is in the blood. It's also used to get information about the pumping ability of the heart muscle. Catheters are also used to inject dye into the coronary arteries.

Coronary Balloon Angioplasty

When a blockage in any of the arteries of the heart is identified during a heart catheterization, many considerations are taken in regards to “mechanical fixes”. One of the options for treatment is a percutaneous balloon angioplasty (PTCA). A balloon is placed at the location of the blockage and inflated. This pushes the cholesterol buildup up against the wall and restores greater blood flow through the artery.  The balloon is then inflated, compressing the plaque and dilating (widening) the narrowed coronary artery so that blood can flow more easily.  This is often accompanied by inserting an expandable metal stent.  Stents are wire mesh tubes used to prop open arteries after the PTCA.


When a blood clot, plaque or scar tissue cause an artery to become narrow or completely blocked, blood circulation is limited and the organs and tissues supplied by that artery do not receive enough oxygen. Stenting is another option in the treatments for blockage(s) in the arteries of the heart. The stent is a metal mesh that is delivered to a blocked artery through a balloon (PTCA). The device is placed at the blockage, the balloon is inflated, which opens the stent. This pushes the cholesterol buildup against the wall of the artery and the stent reduces the chances that the blockage will come back.

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Helpful Links

American Heart Institute

American College of Cardiology

Pacemaker/Defribrilator Patient Information

Women's Health & Heart Disease

Diseases and Conditions Index

Smoking & Health Risks



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