• 2-D Echocardiogram

    What is a 2D-Echocardiogram?
    An echocardiogram is a test in which ultrasound is used to examine the heart. In addition to providing single-dimension images, known as M-mode echo that allows accurate measurement of the heart chambers, the echocardiogram also offers far more sophisticated and advanced imaging. This is known as two- dimensional (2-D) Echo and is capable of displaying a crosssectional "slice" of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right ventricle.

    No special preparation is necessary. Clothing from the upper body is removed and covered by a gown or sheet to keep you comfortable and maintain the privacy of females.

    Sticky patches or electrodes are attached to the chest and shoulders and connected to electrodes or wires. These help to record the electrocardiogram (EKG or ECG) during the echocardiography test. The EKG helps in the timing of various cardiac events (filling and emptying of chambers). A colorless gel is then applied to the chest and the echo transducer is placed on top of it. The echo technologist then makes recordings from different parts of the chest to obtain several views of the heart. You may be asked to move from your back and to the side. Instructions may also be given for you to breathe slowly or to hold your breath. This helps in obtaining higher quality pictures. The images are constantly viewed on the monitor. These images are reviewed by the physician prior to completion of the final report.
  • 24 Hour Holter Monitor

    Holter Monitor Instructions

    • Do NOT get monitor wet (No Shower or Tub Bath)
    • Please do NOT touch/rub on the electrodes (patches) or in the area where they are.
    • Please try not to swing or bump monitor.
    • Keep diary tracking your activities and symptoms.
    • If the electrodes (patches) come off, try to replace them in the original area.

    While you are being monitored by the Holter monitor, it is important to keep an accurate diary of your symptoms and activities. If you feel symptoms such as chest pain, shortness of breath, uneven heartbeats or dizziness, note in your diary the time of day they began and what you were doing. Your diary will be compared to the changes in your ECG recorded by the Holter monitor.

    Remember that your doctor needs a complete picture of your activities. If in doubt, write it down. Use This Diary to record all of your daily activities.
  • Arterial Doppler

    What is an Arterial Doppler?
    An arterial Doppler (ABI) is a quick, non-invasive way to assess your risk for peripheral artery disease, a condition in which the arteries in your legs or ankles are narrowed from plaque.

    Preparation
    No special instructions prior to having the test. You will be asked to remove your pants for the tests.

    Procedure
    Blood pressure cuffs will be placed on your arms, legs. An ultrasound probe and gel will be used to record your pulses and blood pressures. You should experience minimal discomfort during the test. Please allow a minimum of one hour for the test.
  • Carotid Doppler

    What is a Carotid Doppler?
    An Ultrasound scanner consists of a console containing a computer and electronics, and a transducer that is used to scan the body. The transducer is a small hand-held device about the size of a bar of soap, attached to the scanner by a cord. The ultrasound computer displays information on a nearby screen that looks much like a computer or television monitor. You will lie on your back on an examining table. The technologist spreads a warm gel on your neck and then presses the transducer against the skin to obtain images. When the Doppler ultrasound is used, you will hear noises periodically. Both sides of the neck (right and left carotid arteries) are evaluated.

    How long does it take?
    The exam takes about 30-45 minutes, depending on the needs of the patient.

    What does the exam show?
    A carotid Doppler study is a diagnostic study used to determine if there is any plaque or blockage of the carotid arteries (neck) the carotid arteries supply blood to the brain. Plaque, narrowing (stenosis), or blockage can be a cause for stroke. The vertebral arteries are also evaluated; however the vertebral arteries cannot always be seen in every patient.
  • Renal Artery Ultrasound

    What is a Renal Artery Ultrasound?
    A Renal Artery Ultrasound evaluates blood flow to the kidneys through the renal artery.

    Preparation
    • For morning appointments, do not eat food or drink liquids after midnight the night before your exam. Take medications as usual.
    • For noon or later appointments, do not eat food or drink liquids 6 hours prior to your exam.
    • Do not smoke or chew gum prior to your exam as they can increase stomach gas.
    • Allow a minimum of 45 minutes for the exam.

    General Ultrasound Exam Guidelines:
    Follow the specific preparation instructions listed above for your particular type of ultrasound exam. These may include dietary restrictions and instructions on drinking fluids. Take your medication as usual (unless your physician has given you other instructions).Wear comfortable, loose fitting clothing. For some exams, you may need to change into a hospital gown or Please notify the technologist if you are pregnant or could be pregnant.

    What to Expect During the Exam
    Most ultrasound exams are painless, fast and easy with no side effects. Allow between 45-90 minutes for the exam, depending on the area of the body being imaged. You will be positioned on a cushioned examination table. The technologist will apply a warm clear gel to the skin above the anatomic structure to be studied. The gel acts as a conductor, eliminating air bubbles between the transducer and your body. The transducer, a hand-held device which sends and receives ultrasound signals, is pressed against the skin and swept back and forth until the desired images are captured. There may be varying degrees of discomfort from pressure as the technologist guides the transducer over the body, especially if you are required to have a full bladder for the exam. You may also expect to be asked to take deep breaths and hold it several times.

    What to Expect After the Exam
    You may leave as soon as the exam is completed and resume normal activities. Your normal diet may be resumed. Your referring physician will receive a report detailing the findings of your exam. You should contact your doctor or schedule a follow up to discuss the results.
  • Venous Doppler

    What is a Venous Doppler Ultrasound?
    A Doppler ultrasound study is a test which uses sound waves to examine the structures inside the body and to evaluate blood flow at the same time. With this test problems with the veins can be detected. The sound waves are far above the range of human hearing. Radiation is not used in this test.

    How is the examination performed?
    You will be asked to lie on your back with your head elevated slightly. A gel will be spread on your arms or legs on the area to be examined. A hand-held instrument, called a transducer, is used in the test. It looks like a microphone, and sends and receives silent, high frequency sound waves. The person who does the test, the sonographer, will move the transducer down the length of the arm or leg. He/she will be listening, looking, and putting slight pressure on the vein. The arm or leg may need to be lightly squeezed at various times, to check for the flow of blood in the vein. The transducer sends sound waves that pass through the skin into the body. They are reflected back to the transducer by the internal organs. These sound waves contain information that is changed into a picture of the area being examined. A picture of the image is recorded and interpreted by the doctor. To test the blood flow, a second method is used. When the sound waves strike moving objects (like red blood cells) the pitch of the sound is changed. This process is similar to the change in the pitch of a train whistle as the train passes. The change in pitch can be displayed in several ways to evaluate blood flow within the body. An audible sound may be used, or the flow may be shown as a graphic or color display. There is no discomfort in this test. Please allow 1 hour for the study.
  • Exercise Stress Test

    Exercise Stress Test Preparation
    You may eat something light 2 hours before your test.

    NO Smoking the day of the test.

    Dress in appropriate attire for walking/jogging on a treadmill i.e. loose fitting clothes and proper shoes. Do NOT take the following heart medications 24hr. before test:
    • Beta blockers [for example: atenolol (Tenormin®), carvedilol (Coreg®), metoprolol (Lopressor®, Toprol®), Propranolol (Inderal®)]
    • Isosorbide dinitrate (for example: Dilatrate®, Isordil®, Sorbitrate®)
    • Isosorbide mononitrate (for example: Ismo®, Imdur®, Monoket®)
    • Nitroglycerin (for example: Minitran, Nitropatches, Nitrostat)
    • Since many over-the-counter medications contain caffeine (such as diet pills, No Doz®, Excedrin® and Anacin®), DO NOT take any over-the-counter medication that contains caffeine for 24 hours before the test. Ask your physician, pharmacist or nurse if you have questions about other medications that may contain caffeine. If you have any questions about your medications, ask your physician.

    NOTE: Do not discontinue any medication without first talking with your physician.
  • Nuclear Stress Test

    What is the purpose of Nuclear Stress Test?
    A Nuclear stress test is a diagnostic exam used to evaluate the supply of blood to your heart muscle. Your heart receives blood from the coronary arteries. If these arteries become partially blocked or narrowed, your heart will not receive the blood that it needs for proper function. This test may be useful in detecting the presence and significance of coronary artery disease.

    How should I prepare for my Exercise Nuclear stress test?
    Wear comfortable clothes and shoes (workout style)
    ♥ Hydrate the day before (Drink plenty of water)
    ♥ You may have a light breakfast 1-2 hours prior to the test.
    ♥ Diabetic patients Consult your doctor as to your insulin dosage on that day.
    ♥ No caffeine 12 hours before the test! This includes caffeinated and decaffeinated beverages, chocolate as well as medications containing caffeine. Having caffeine will result in cancellation of your test.
    ♥ Do not smoke on the day of your test! Smoking on the day of your test may alter your test results.
    ♥ Take your medications at your usual time, unless your physician has indicated otherwise. Please bring a list of your current medications, as you may be asked for it.
    ♥ Wear a short sleeve, button down shirt that contains no metal, or a loose-fitting T-shirt. Please do not wear an under-wire bra or necklace.
    ♥ Bring a book to read, as there are some waiting periods during the test.
    ♥ Please shower prior to your appointment to reduce the spread of bacteria to our equipment.
    ♥ Family members are allowed to accompany you to the test, but they are restricted to the waiting room.
    ♥ Your total test time will vary, please expect to be here a minimum of 4-6 hours.

    What will I experience during an Exercise Nuclear stress test?
    You will be asked to read and sign a consent form. This form provides information regarding the benefits and risks of a nuclear stress test. Female patients will also be asked to sign a breastfeeding and pregnancy waiver. If you have any questions regarding this information, please do not hesitate to ask. The nuclear medicine technologist will start an I.V. line in your arm. The I.V. will be used to inject the Cardiolite and nuclear medicine into your bloodstream. This will remain in your arm until the test is completed (approximately 4 hours). Once the I.V. is in your arm, the nuclear medicine technologist will give you an injection of Cardiolite. The Cardiolite will allow images to be taken of your heart. Your skin will be prepped for the electrodes that are placed on your chest. If you are allergic to latex, please inform the technician. These electrodes will be connected to a monitor so that your heart rate and rhythm can be watched closely throughout the test. You will be asked to lie still on an imaging chair for approximately 12 to 15 minutes with your arms over your head. Your first images (the resting set) are taken at this time. When your resting images are completed, you will begin the exercise portion of the test by walking on a treadmill. As you walk on the treadmill, it will increase in speed and incline. Your heart rate and blood pressure will rise. This is normal. Your heart rate and blood pressure will be monitored along with your ECG (Heart Rhythm). If you experience any unusual symptoms at any time, such as chest pain or lightheadedness, immediately inform the staff performing the test. To increase the effectiveness of the test, it is important to exercise as long as you are able. Any possible side effects are short-lived, and there are no lasting effects. We will continue to monitor you to ensure that your heart rate and blood pressure are within normal limits and any side effects have dissipated. You will then need to wait in the waiting room again. Please bring a book or magazine to read. You may drink water or juice at this time. The second images (the stress set) are obtained in the same way as the first. Two sets of images are taken to allow your physician to compare your heart during rest and stress. When your test is completed, you will be asked to schedule an office visit with your physician to discuss the test results. Please do not ask the testing staff for your test results, as they are not allowed to discuss them.

    Heart medications
    DO NOT take these heart medications for 24 hours before the test, unless your physician tells you otherwise, or if it is needed to treat chest discomfort:
    • Beta blockers [for example: atenolol (Tenormin®), carvedilol (Coreg®), metoprolol (Lopressor®, Toprol®), Propranolol (Inderal®)]
    • Isosorbide dinitrate (for example: Dilatrate®, Isordil®, Sorbitrate®)
    • Isosorbide mononitrate (for example: Ismo®, Imdur®, Monoket®)
    • Nitroglycerin (for example: Minitran, Nitropatches, Nitrostat)
    • Since many over-the-counter medications contain caffeine (such as diet pills, No Doz®, Excedrin® and Anacin®), DO NOT take any over-the-counter medication that contains caffeine for 24 hours before the test. Ask your physician, pharmacist or nurse if you have questions about other medications that may contain caffeine.
    • If you have any questions about your medications, ask your physician.
    • NOTE: Do not discontinue any medication without first talking with your physician. If you experience chest pain prior to your stress test please call 911 for transportation to the closest Emergency Room.

Additional In-Office Services

- Same Day / Next Day Cardiac Consultation / Surgery Clearance
- EKG
- Ambulatory BP Monitoring
- ICD (Implantable Cardiac Defibrillator) and Permanent Pacemaker Interrogation
- Lipid Profile Evaluation and Treatment
- Protime / INR Evaluation and Monitoring
- Stress Echocardiogram
- 30 Day Event Monitor

Hospital Services

- Hospital Consults and Follow-ups
- Cardiac Catheterization, Coronary Angioplasty and Stent placement
- Temporary and Permanent Pacemaker Implant
- Trans-Esophogeal Echocardiograms
- Peripheral Interventions
- Cardioversion
- Tilt-table Testing