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Diagnostic Tests

Blood Test
Substances in the blood can help determine if an individual is at risk for some heart diseases, have heart failure or are at an increased risk for developing plaque in your arteries. Blood tests include those to detect cholesterol and sugar levels, as well as certain proteins used to measure the inflammation in the blood. The American Heart Association recommends that everyone over the age of 20 should get a fasting lipid profile blood test every five years.

Cardiac Catheterization and Coronary Angiography
Cardiac Catheterization and Coronary Angiography
Cardiac catheterization is the insertion of a catheter into a chamber, vessel or coronary artery of the heart. A coronary angiogram is done to look at the arteries of the heart. A doctor inserts hollow tubes called catheters up into the arteries of the heart. A contrast dye is then injected through these hollow tubes and down the arteries of the heart, and moving x-ray images of the arteries are taken. These tests are done for both diagnostic and treatment purposes and, depending on their results, can lead immediately to angioplasty/stenting within the same procedure. Women are at a slightly greater risk for bleeding or other complications of cardiac catheterization when compared with men. Therefore, cardiac catheterization and coronary angiography on women are best handled by experts in treating women’s heart disease.
Cardiac MRI
A cardiac MRI is an imaging technology that uses magnetic waves to produce an image of the heart. A cardiac MRI creates very detailed images of the heart muscle and heart valves, and gives physicians a more accurate evaluation of the heart muscle function. The MRI can also give the doctor a good idea of the amount of damage the heart muscle may have suffered during a heart attack. There is no radiation with a cardiac MRI, however the test requires the patient’s cooperation and patience as it takes time to perform. The patient may be asked to lie still for up to 1 hour of time.

Coronary Artery Calcium Test (EBCT)
A coronary artery calcium test or EBCT (electron beam tomography) is a fast form of a computerized tomography (CT scan) that measures calcium deposits in the coronary arteries. Calcium build-ups can be an indicator of atherosclerosis, which is a build-up of fat and fibrous material in the arteries of the heart. A high calcium score is associated with an increased risk for a future heart attack.

CT Coronary Angiogram
A CT Coronary Angiogram produces detailed and accurate three-dimensional images of the coronary arteries, the coronary veins and the heart itself. This angiogram is done noninvasively, although it does require contrast dye, and it exposes the patient to radiation to a similar degree as cardiac catheterization.

Echocardiogram (Echo)
An echocardiogram, or sonogram of the heart, is a painless test performed by a specially trained technician. The echo machine uses sound waves to take pictures of the heart muscle and heart valves. The pictures provide the doctor with information about the size of the heart, the strength of the heart muscle and the blood flow through the valves of the heart.

Electrocardiogram (ECG or EKG)
An electrocardiogram is a simple, painless test that records the heart's electrical activity through small electrode patches attached to the skin of the chest, arms and legs. This test is usually done in a doctor’s office and takes about 30 seconds to perform. The EKG measures how fast the heart is beating, whether the rhythm of the heartbeat is steady or irregular, and the strength and timing of electrical signals as they pass through each part of the heart. An EKG recording can show signs of damage to the heart or evidence of arrhythmias, as well as the effects of medications or implantable devices.

Electrophysiology Testing
Electrophysiology tests are a series of controlled studies used to identify arrhythmias. While electrocardiograms (EKGs) are important tests of the heart’s electrical system, they record only the events that occur while the tests are running. Arrhythmias are unpredictable and intermittent, making it unlikely that an EKG will capture the underlying electrical pathway problem. Even tests that stretch over longer time lengths, such as Holter monitoring, may not capture an event.

During an electrophysiology (EP) study, a specially trained cardiac specialist may provoke arrhythmia events and collect data about the flow of electricity during actual events. As a result, EP studies can help locate the specific areas of heart tissue that lead to the abnormal electrical impulses that cause arrhythmias. This detailed electrical flow information provides valuable diagnostic and treatment information.

Once the damaged site or sites are confirmed, the specialist may administer different medications or electrical impulses to determine their ability to halt (stop) the arrhythmia and restore a normal heart rhythm. Based on this data, as well as information acquired before the study, the specialist may proceed immediately to place an implantable device or will perform cardiac ablation.

Stress Test
Stress tests are performed on patients with chest pain to try to determine if the pain is due to coronary artery disease, or narrowing of the arteries of the heart. There are different kinds of stress tests. Most of the time the patient will walk on a treadmill following a set protocol; this is called an exercise stress test. If a patient is unable to walk on the treadmill, a pharmacologic stress test is done. In these cases the patient receives a medication to simulate exercise.

The simplest form of stress test involves only EKG monitoring while the stress test is being performed. Women, more commonly than men, may have a “false positive” EKG reading during an EKG stress test. This means that the EKG looks abnormal, but the patient is really fine. The reason for this is not known. Therefore, in many cases, an imaging test is performed along with EKG monitoring. An echocardiogram or a nuclear imaging scan, or MRI scan may be done to provide images. Images for both types of tests are obtained before and after the stress test and then the images are compared for any changes. With nuclear stress tests, the patient is given a small amount of radioactive tracer and special cameras are used to obtain images of the heart. Women who are pregnant should not undergo a nuclear stress test.

To make an appointment with a Women’s Heart NY physician, please call
(877) WOMEN-00/(877) 966-3600.

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