Cardiac diagnostic testing
Unity's Heart & Vascular Center offers a complete range of diagnostic services to help physicians
evaluate a patient's heart function and determine a plan of care.
Tests include:
Cardiac 3T MRI (located at Mercy Hospital)
MRI (magnetic resonance imaging) uses radiofrequency waves and a strong magnetic field to obtain images of internal organs and tissues. Cardiac MRI gives the physician the ability to clearly see the function and structures of the heart such as the valves and blood vessels. It is also useful in determining the extent of heart damage caused by progressive types of heart disease or a heart attack. Cardiac MRI is being used to diagnose heart diseases earlier, determins treatment and in assessing recovery progress after treatment.
CT cardiac calcium score (located at Mercy Hospital)
Commonly called a “Heart Scan,” a Cardiac Calcium Score is a non-invasive way using x-ray technology with a CT scanner to determine the amount of calcified plaque in the arteries of the heart. Calcium build up is a sign of coronary artery disease (CAD). This can be present and identified even before symptoms are present. The goal of calcium scoring is to screen for coronary artery disease (CAD). Calcium scoring does not image or predict specific narrowing in the arteries of the heart. You do not need a referral for this exam.
CT coronary angiogram
This is a non-invasive way to look at the blood flow and specific arteries of the heart. Using x-ray technology from a CT scanner, high speed multiple slice pictures of the heart are taken with the help of intravenous contrast dye. This makes it possible to see the coronary arteries and the degree of plaque build up or narrowing in the arteries. The images are three dimensional and guide doctors as to whether further procedures such as coronary angioplasty, stent placement or coronary bypass surgery might help the patient.
Dobutamine stress echocardiogram
If you have a physical problem that prevents you from walking on a treadmill,
your physican may order a stress echocardiogram using a medication called dobutamine.
Dobutamine will cause your heart rate to slowly increase and your heart to pump
harder. This is similar to the way your heart responds to exercise. The dobutamine
will be given through an intravenous (IV) line. The medication will be started
at a slow dose. You will be monitored throughout the test. The effects of the
dobutamine wear off quickly after the test is done. The test takes 60 - 90 minutes.
Echocardiogram (Echo)
An echocardiogram (echo) is an ultrasound study of your heart muscle, heart
valves and pericardium (sac surrounding the heart) and some of the major blood
vessels connected to the heart. The test uses sound waves to see how well your
heart is working.
A wand-like instrument makes the sound waves. As the wand is moved over your
chest, pictures of the heart appear on a screen and are recorded.
You will be asked to lie in different positions on a bed or stretcher. The echo technician will place electrodes on your chest and may need to reach closely across your chest to get good echo pictures. The test takes 30-45 minutes.
Echocardiogram with bubble study
A bubble study can be used to add information to a regular echocardiogram or
to a transesophageal echocardiogram. The most common reason for doing a bubble
study is to look at the wall (septum) that divides the heart down the middle.
A saline (salt water) solution is injected into your vein and then followed
by the ultrasound image as it flows through your heart. This test will take about 30 minutes added to an echocardiogram. (See echocardiogram description for further information.)
Echocardiogram/Stress echocardiogram with a contrast agent
Use of a contrast agent can improve the quality of the pictures obtained during
an echo or a stress echo. This may help the physician to better interpret
or read your echo images. To give the contrast agent, a nurse will place a small intravenous (IV)
catheter in a vein that will be removed when the test is completed. A small amount of the contrast agent is slowly injected and flushed with saline.
One or more doses may be needed and you will be monitored after the test for approximately 30 minutes. (See Stress Testing and Echocardiogram for more information.)
EKG or ECG
An electrocardiogram (EKG or ECG) is a recording of the electrical activity of your heart.
Small, sticky patches are placed on your chest, arms and legs. These patches
are connected to a machine that records the electrical activity of your heart,
then prints this out on paper for a physician to interpret. The test usually
takes less than 15 minutes to complete.
Stress testing
An exercise stress test is an elctrocardiogram (EKG) taken and analyzed while you are walking on a treadmill. The nurse, physician or physician's assistant monitoring the test will ask the technician to increase the speed and elevation of the treadmill at certain intervals to make the heart work harder. They are looking for EKG changes brought on by exercise.
Your blood pressure is also checked periodically through the test to see how it also responds to exercise. You are allowed to rest afterward and are given drinks of water at the end of the test.
You will want to wear comfortable clothes and tennis shoes to exercise on the treadmill and be asked to be "NPO" or to eat or to drink nothing except water within two hours. Your physician will also ask that you not take certain medications, such as your blood presure or heart rate medications. Please check with your physician on these orders. This test takes about one hour to complete.
Exercise stress test with nuclear myocardial perfusion imaging
This is also known as a Cardiolite stress test. This test allows
your doctor to see if your heart muscle is getting the amount of blood that
it needs through your coronary arteries.
There are two parts to the test, a "stress" portion and a "rest"
portion. Images of your heart will be taken with each portion. A small amount
of a safe radioactive medicine, needed for the images, will be injected into
your arm for both portions of the test.
For the "stress" portion, you will walk on a treadmill until you reach
a heart rate based upon your age. The radioactive medicine will be injected
into your IV as you walk on the treadmill. After a short wait, you will be asked
to lie on the exam table while a camera takes images of your heart.
For the "rest" portion, you will receive an injection of the radioactive
medicine and have images taken.
Comparing the "stress" and "rest" images will help your
doctor evaluate any areas where blood flow may be decreased to your heart muscle.
The complete test may take one to two days to complete. You will know when your
appointment is scheduled if it will be one or two days.
If you are taking medicines, talk with your doctor about which ones you may
take before each portion of the test.
Holter monitoring
Your doctor may want to observe your heart rhythm during your normal, everyday activities. For this test you will wear a small, portable EKG machine on a belt or shoulder strap for 24 hours. You will be asked to keep a diary of your activities and any unusual feelings that you have such as a fast heart rate, shortness of breath, chest pressure or chest pain. You will be given instructions on not showering with the Holter in place and also when and where to return this monitoring device.
MUGA (Multiple Gated Acquisition) scan or radionuclide ventriculography
This test will help your doctor see how well your heart is pumping. A very low
dose of radioactive medicine is injected into your IV. Using a computer and
a sensitive radiation detector, the radiation within your heart is measured
and displayed on a video monitor.
Before and after the test, you may eat and drink as usual and take your medicines.
Nuclear myocardial perfusion imaging with adenosine or dobutamine
If you cannot walk on a treadmill or cannot walk long enough, your doctor may
order a stress test done with a special medicine. There are two portions to
this test:
- the "stress" portion when the special medicine is infused, and
- the "rest" portion.
During each portion, images using the radioactive medicine (Cardiolite)
and a camera will be obtained.
If you cannot walk on the treadmill or can walk for only a very short time,
your doctor may have your test done using a medicine (Adenosine)
that will increase the amount of blood supply to your heart.
If you cannot walk on the treadmill and also have lung disease, such as asthma
or emphysema, your doctor may have your test done with Dobutamine, a medicine
that will cause your heart rate to slowly increase and your heart to pump harder.
Each of these medicines is given through an intravenous (IV) line. The radioactive
imaging medicine will be injected after the infusion of these medicines. After
a short wait, you will lie on the exam table while a camera takes pictures of
your heart.
Comparing the "stress" and "rest" images will help your
doctor evaluate any areas where blood flow may be decreased to your heart muscle.
The complete test may take one to two days to complete. You will know when your
appointment is scheduled if it will be one or two days.
If you are taking medicines, talk with your doctor about which ones you may
take before each portion of the test.
Stress echocardiogram
A stress echocardiogram (echo) measures how well your heart responds to exercise.
It uses ultrasound with a regular stress test to record images of your heart
before and after exercise. The test takes 60 minutes.
Transesophageal echocardiogram (TEE)
A transesophageal echocardiogram (TEE) obtains images of your heart from a small
ultrasound probe (about the size of a normal piece of food) that is placed in
your esophagus or swallowing tube. The probe is at the end of a small flexible
tube you swallow. The TEE gives excellent pictures of the heart because the
heart lies in front of the esophagus.
Do not eat or drink anything for six hours before the test. It is important
that you ask your doctor for instructions about taking your medicines.
You will be given medicine to help numb the back of your throat. This will make
swallowing the tube easier.
You will also be given sedating medicine through an intravenous (IV) line that
will help you relax and decrease your gag reflex.
This test requires 1-1/2 to two hours to complete.
You will need a responsible adult who can drive you home and stay with you for
12 hours after the test.
Resources
- Helping Your Heart -- a Handbook for Patients and Families, 2nd Edition,
Allina Hospitals & Clinics
- Patient education brochures:
Ejection Fraction/Wall Motion Analysis (MUGA), The Cardiac Centers, Mercy
& Unity Hospitals, May 2002
Stress (Treadmill) Test and Stress Echocardiogram, The Cardiac Centers,
Mercy & Unity Hospitals, June 2002
Dobutamine Stress Test, The Cardiac Centers, Mercy & Unity Hospitals,
June 2002
Echocardiogram, The Cardiac Centers, Mercy & Unity Hospitals, June
2002
Myocardial Perfusion Imaging (Stress, Persatine, Adenosine or Dobutamine
Cardiolite), The Cardiac Centers, Mercy & Unity Hospitals, June 2002
- Stress Testing: Principles and Practice, Ellestad, Myrvin H., 5th
edition, Oxford University Press, 2003
- Primary Cardiology, Braunwald, Eugene; Lee L Goldman, 2nd Edition,
W.B. Saunders, 2003
For more information
To speak to someone in the cardiac, vascular or respiratory programs at Unity Hospital, please call 1-866-4HEART2.
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